The state of Alabama took three hours to execute Joe Nathan James by lethal injection in 2022—the longest execution in American history. James’ autopsy showed numerous puncture wounds nowhere near the anatomical vicinity of a vein, with a jagged “cutdown” where unqualified personnel cut him open in a desperate attempt to find one. A media representative who witnessed the autopsy said, “His body was a war crime.”

Later, a state spokesperson declared the execution a success, announcing “nothing out of the ordinary had happened.”

In 2014, Clayton Lockett woke up in the middle of his 45-minute-long execution in Oklahoma and tried to climb down off the gurney—the bizarre culmination of years of flailing ineptitude by the state that included a Department of Corrections lawyer, Mike Oakley, admitting to browsing WikiLeaks to find which drugs to use.

These stories and many more are meticulously documented by University of Richmond Law Professor Dr. Corinna Barrett Lain in her new book, “Secrets of the Killing State: The Untold Story of Lethal Injection” (New York University Press, 2025). Her encyclopedic research, which spans over seven years, strongly debunks the frequently held belief that lethal injection is merely a “pinch and a nod to forever sleep” carried out by trained medical professionals in a death chamber masquerading as a surgical arena, with the killing process then deemed “neat and tidy” by the government.

In an April 23 presentation at the University of Richmond’s Ukrop Auditorium, Lain explained the three secrets of this practice. First, there is no science to the procedure. Lethal injection got its start in 1977 in Oklahoma, just after the U.S. Supreme Court ruled in Gregg v. Georgia that after a four-year hiatus, states could resume executions under a set of stricter protocols. Realizing that their electric chair was dilapidated and publicly perceived as barbaric, state officials—noting that pets were routinely safely put down by veterinarians—began looking into death by drugs. Since no medical professional would touch this idea, they turned to the state medical examiner, Dr. Jay Chapman, who had experience only in dead bodies, “not … in getting them that way.”

In a single afternoon, Chapman came up with a three-drug combination that became standard nationwide for over 30 years. “I didn’t do any research,” Lain quotes Chapman as admitting at the time. “I just knew from having been placed under anesthesia myself, what was needed.”

Second, the drugs are torturous. States find them with Google searches, buy them at wildly inflated prices from overseas sellers, unlicensed middlemen, and secret, sometimes non-compliant compounding pharmacies, then have prison guards mix and inject them in amounts no one ever prescribed or even studied in a research setting. Lain notes a 2020 study of 200 autopsies that found 84% showed the unintended consequence of acute pulmonary edema; prisoners drowned in their own fluid. In fact, she related that when given a choice between lethal injection and the electric chair, prisoners more and more choose the chair, explaining that yes, there is smoke, it stinks, and there is risk of bursting into flames, but at least it’s quick.

Third, Lain explained that states use inept executioners, who present to witnesses sanctioned killing disguised as medically adept, white-coated, alcohol-swabbed theater. Behind the curtains, however, inmates are still fully conscious and not anesthetized as inexperienced prison staff desperately jab and shove thick catheters into their arms, legs, necks, and groins in a desperate attempt to find a vein—any vein—pulling out and re-sticking them in various directions as needed. Finally, they conclude this performance with the same unqualified personnel pushing the deadly cocktails through syringes. One California execution team member explained under oath after seven executions, “Training? We don’t have training, really.”

“The white coat enjoys a credibility not associated with the black hood,” Lain writes.

In a 2016 interview, Virginia’s former executioner-turned-abolitionist, Jerry Givens, noted that Virginia’s switch to lethal injection in 1995 was unnerving, since he had zero medical training and was told simply to perform the procedure by “feel.” “With the electric chair, it’s a button you push once and then the machine runs by itself,” he recalled. But with the new procedure, he said, “I had this syringe in my hand, and [I was] pushing the chemicals into that man’s arm … I could actually see the chemical going down the line and into the arm and see the effects of it.”

While Dr. Lain is an academic, “Secrets of the Killing State” is more a work of journalism. “Would the American people authorize states to slowly suffocate prisoners to death, or burn them alive, or waterboard them as they die?” she posits. “Because that is exactly what states are doing with lethal injection.”

Whether you believe in the death penalty or not, this book is a must-read.

Disclosure: Author and Style contributor Dale M. Brumfield is the former field director for Virginians Against the Death Penalty (VADP).