Will we recall Elizabeth Wettlaufer's name the way we do Karla Homolka's?: Robyn Urback

Charles Cullen should be the most famous serial killer of all time.

He was more prolific than Charles Manson, Ted Bundy and John Wayne Gacy. He pleaded guilty to murdering 29 people and admitted to killing up to 40 throughout his 16-year career, though the total number of people he's suspected of killing has been estimated by investigators to be more than 300.

His victims had the misfortune of being hospitalized in one of several medical centres in New Jersey and Pennsylvania where Cullen worked as a nurse from the early 1980s until his arrest in 2003. These patients would crash and code unexpectedly — typically during Cullen's shift — with unusual and unprescribed levels of insulin or epinephrine or digoxin later found in their bodies.

Cullen hopped from one medical centre to the next, which partially explains why he was able to carry out his killing spree for nearly two decades before being apprehended. The other advantage Cullen had was his victims were old and sick. Well, most of them were.

Helen Dean, 91 — one of Cullen's many suspected but unproven victims — was recovering well after breast cancer surgery when she was released following one final, odd injection from a male nurse from another ward. Dean went home, experienced sudden heart failure and died. There were many more like her, though most died in hospital.

But despite his record, ask a room full of people to list off the worst serial killers In North America, and Cullen's name likely won't make the list. In fact, it's likely that few would recognize his name at all.

How long will we remember Wettlaufer?

In Canada, the name Elizabeth Wettlaufer is — for now — familiar to most as that of the Ontario nurse who has confessed to killing eight elderly people in long-term care homes and seriously harming six others.

Wettlaufer pleaded guilty to 14 charges, including eight counts of first-degree murder, in Ontario Superior Court Thursday. Her 2 ½-hour confession to police from October 2016 was played in the Woodstock, Ont., courtroom as families of the victims listened.

In it, Wettlaufer admited to injecting her victims with lethal levels of insulin — the same method often used by Cullen — and also made clear that her actions weren't ones of mercy for the sick and elderly. They were intended to satisfy her own sadistic urges.

Wettlaufer explained repeatedly that she felt a "red surge" that compelled her to kill her patients. She said she felt guilty, she tried to stop, but she couldn't. She also said that after a kill, she was often overtaken by a strange "laughing feeling."

• Here's what ex-nurse Elizabeth Wettlaufer confessed about killing 8 patients 
• Elizabeth Wettlaufer pleads guilty in nursing-home deaths
• Ex-nurse Elizabeth Wettlaufer felt 'red surge' before killing elderly patients

​Wettlaufer's confession makes her one of the worst killers in Canada's history. Whether her name will come to be as notorious as that of Robert Pickton, Russell Williams, Paul Bernardo or Karla Homolka, is unclear. 

Homolka's name popped back up in the news recently after it was discovered that she was involved in school activities and interacted with students at her children's elementary school in Montreal — a perplexing role, to put it extremely lightly, for someone who served 12 years for manslaughter in connection with the deaths of two Ontario schoolgirls, Kristen French and Leslie Mahaffy.

Homolka really needs no further description. Say her name or that of her ex-husband, Bernardo, who was convicted of the murders of French and Mahaffy, or the words "Scarborough rapist," and most Canadians of a certain age can effortlessly retrieve the horrific story.

Wettlaufer's death count is higher — by one measure of a killer, that makes her worse — yet it seems doubtful that in 25 years' time we'll recall her story the way we still do Homolka and Bernardo's.

Part of the reason could be the way the public learned about their respective crimes. The Scarborough rapist case was an ongoing, frightening saga. Girls were vanishing — then turning up dead — and no one knew why. The public followed not just the crimes but the investigations, the arrests, the trials and the convictions. For many, the horrific details have been singed into their minds.

Wettlaufer's story, on the other hand, became public after the fact. There was no terrifying public search for the person who was killing sick and elderly patients across southwestern Ontario. Had there been, Canada surely would've been rapt with the saga of the serial killer in scrubs, perhaps more so than we have been with Wettlaufer's confession and arrest.

Murdering the elderly

But there's also a distinction in terms of the victims of these crimes. Homolka and Bernardo killed teenage girls. Manson killed rich and famous people and their friends. Bundy's victims were college students, teenagers and young women.

Wettlaufer's victims — like most of Cullen's victims — weren't in the prime of their lives. They were old and ailing and required professional care. Some had dementia or were confined to wheelchairs. Wettlaufer poked them with an insulin pen and sent them to their graves.

A murder is a murder no matter the victim, of course. But some murders tend to resonate more than others in the public consciousness.

Perhaps Wettlaufer's name will join the ranks of the top-of-mind Canadian offenders, like Pickton or Williams or Homolka or Bernardo. But if the relative obscurity of the name Charles Cullen is any indication, that's not likely.

This column is part of CBC's Opinion section. For more information about this section, please read this editor's blog and our FAQ.