At one point in Secrets of the Killing State, Corinna Barrett Lain recounts how a lawyer for the Oklahoma Department of Corrections selected the execution drug midazolam by browsing Google. He clicked past the “wiki leaks, wiki leaks or whatever it is”, glanced at a few webpages, and decided, under intense political pressure and with no medical expertise, that it would do. It wouldn’t. Midazolam, a benzodiazepine rather than a barbiturate, is pharmacologically incapable of producing the deep unconsciousness required to prevent pain during execution. Oklahoma’s executioners found that out the hard way when Clayton Lockett woke up mid-procedure and tried to rise from the gurney, his body convulsing against the restraints as he died slowly from an agonising chemical cocktail. “This shit is fucking with my mind,” Lockett reportedly muttered, as the state of Oklahoma murdered him in what a federal court later called an “ineffective application of medical implements”.
Lain’s book is full of such scenes. They are narrated not with moral outrage, though that would be appropriate, but with the meticulous dispassion of a trial record. She is both lawyer and narrator here, marshaling evidence from autopsy reports, court transcripts, pharmacological studies, and interviews with executioners, prison officials, and medical experts. The result is less an argument than a demolition: a methodical, unrelenting exposure of what the American state is doing behind the curtain of “humane execution”.
The Theatre of Execution
Capital punishment in the United States is the crime scene. Lethal injection is the murder weapon. Lain’s central argument is devastating in its simplicity: the death penalty’s most popular method is not a medical procedure gone occasionally wrong, but a grotesque system working exactly as designed. When it goes “right”, it conceals pain. When it goes wrong, it reveals the truth.
This is not a polemical book, though it contains the material for a thousand polemics. Lain insists at the outset that Secrets of the Killing State is about how we kill, not whether we should. But as the evidence accumulates. Seventeen puncture wounds on Lockett’s body, prisoners drowning in their own pulmonary fluids, IVs set by untrained paramedics using the wrong tubing and expired drugs. The line between method and morality collapses. Lain invites us to draw our own conclusions, but she knows what those conclusions must be. “Lethal injection not working well,” she writes, “is how lethal injection works.”
As she remarks, in one of the book’s more damning lines, “We are essentially waterboarding people to death. We’re just doing it with drugs under a façade of peaceful slumber.” The medical theatre, in other words, is a lie told to soothe the executioner.
Inventing Death
The book is structured around a series of chapters that each excavate a different aspect of the lethal injection regime. We move from the gruesome autopsy of Clayton Lockett’s death to the pseudo-scientific origins of the three-drug protocol. Originally invented by Oklahoma’s medical examiner in 1977, who had no pharmacological training and simply dictated a combination that “sounded right”. This improvisation was then copied nationwide, not out of medical consensus but political expediency. The result, Lain shows, was a cascade of institutional mimicry: states assuming others had done their homework when none had.
As Lain makes clear, no other realm of state violence relies so heavily on such naked pseudoscience. No serious testing, no peer review, no clinical vetting. Just a poison cocktail and a prayer. Even veterinarians, she notes, follow a more rigorous and humane protocol when putting down animals.
The contrast with Europe is stark. Britain, which abolished capital punishment in 1965, did so not because it perfected humane execution, but because it recognised that the state had no legitimate claim to such a power. The United States, by contrast, has invested in the illusion that it can kill cleanly. What Didier Fassin calls ‘humanitarian reason’ deployed to inflict pain.
‘I Don’t Do Femorals’
Clayton Lockett’s execution is the book’s centrepiece, and Lain returns to it not for sensationalism, but because it reveals the entire rotten structure in a single event. The IV was set in the wrong place using the wrong length needle. The paramedic had no training in femoral access. The doctor had never tried it with such a short catheter. Once inserted, the vein leaked and the drugs seeped into Lockett’s tissue rather than his bloodstream. He convulsed. He spoke. He tried to get off the gurney. Blood spurted onto the doctor’s jacket. The executioners kept injecting. The doctor didn’t even know the names of the drugs.
And yet, as Lain shows, Oklahoma officials claimed afterwards that it had all gone according to plan. That Lockett died of a heart attack, that he was unconscious throughout, that nothing was particularly amiss. The state lied. The autopsies proved otherwise. But the performance of control. Like the alcohol swab before the needle—is what matters. The dramaturgy of death persists.
Out of Sight, Out of Mind
The book details how secrecy statutes now shroud nearly every aspect of lethal injection. States conceal the identity of their drug suppliers, the qualifications of their executioners, even the composition of their drug protocols. They argue national security, public safety, professional anonymity. In truth, they are hiding incompetence, fear of legal liability, and political cowardice.
Because the politics of the death penalty in America are not about deterrence or retribution. They are about optics. As David Garland and others have argued, support for the death penalty is largely symbolic, a cultural signal, a tool of social control. Lethal injection enables this symbolism by sanitising the reality. It lets the public imagine a painless sleep, not a panicked, prolonged asphyxiation. It keeps death off camera.
That most of the executed are poor, disproportionately Black, and tried by overworked public defenders in the South goes almost unmentioned in Lain’s text. But only because it is already the ground it stands on. The horror of lethal injection is not that it fails occasionally, but that it does precisely what the state requires: it kills the expendable quietly, and gives voters the illusion of order.
Cruelty as Bureaucracy
The Marxist in me reads Lain’s book not just as a legal indictment but as a revelation of the American state form. The carceral apparatus is an organ of repression built to contain surplus populations and discipline labour. It is revealed here in its most naked function: the power to decide who lives and who dies, and to do so with impunity. There is no due process in a cutdown. There is no rule of law in an execution chamber with suction tubing and faulty syringes. There is only the sovereign prerogative to kill, made banal through bureaucracy.
What makes Secrets of the Killing State so politically useful is that it locates the horror not in individual bad actors, but in the structure itself. The executioners aren’t monsters. They’re functionaries. Lockett’s warden was concerned about the blood. The paramedic was trying her best. The doctor wanted a new jacket. The system grinds on.
A System Working as Designed
Lain’s style is cool, almost clinical. That is her strength. Where a polemic might inflame, she freezes. She forces us to sit with the evidence. Witnesses. Transcripts. Autopsies. Every claim is footnoted, every fact documented. Her writing carries the precision of a legal brief, but also the rhythm of literary non-fiction. She allows the horror to unfold in the voices of those who were there. It is a chorus of incompetence singing a national requiem.
One might ask, why focus on method? Why not just denounce the death penalty outright? But in exposing the mechanics, Lain strips away the last veil of legitimacy. The state cannot claim to execute painlessly, nor can it pretend to do so lawfully, expertly, or efficiently. What remains is cruelty, cloaked in ritual, administered by amateurs. Even if one were to accept the moral premises of capital punishment, Lain shows, the system as it exists cannot be defended.
It should be said that this is not a book for the squeamish. The descriptions of botched executions. Veins missed, blood pooling, gasps and convulsions—are hard to read. But they are harder to ignore. That is Lain’s wager: if Americans knew what was being done in their name, they might not tolerate it. Whether that’s true is another question. But no one who reads this book can say they didn’t know.
Lethal injection, Lain writes, allows the death penalty to “hide the brutality that executions entail.” But in Secrets of the Killing State, the brutality is no longer hidden. It is exposed, slowly, painfully, with forensic care. And in that exposure, Lain makes the only argument that matters: the death penalty is not broken. It is working as designed. That is why it must be abolished.
If abolition means anything, it must begin with unmasking the violence hidden behind policy. But it must also continue past the gurney, to the courts, the prisons, the police. Lain has dragged one part of the killing state into the light. We must do the rest.
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