It will probably remain a mystery why anyone at Franklin Square Hospital Center would yank straight the arms of an 81-year-old woman two years ago, ripping her biceps from the bone and breaking the elbows that had been locked in a bent position. That movement, according to medical reports, caused the woman to hemorrhage and die.

But a lack of motive, Assistant State's Attorney James O. Gentry Jr. said in Baltimore County Circuit Court yesterday, should not keep a jury from finding nurse Ethel B. Barlow guilty of manslaughter.

"The evidence will show you this was intentional, but I can't tell you why," Gentry said as he concluded his opening statements. "Don't get caught up in the why."

Barlow, who now lives in Tennessee, has maintained her innocence. Yesterday, defense attorney Richard Karceski told jurors that nothing about his client's actions at the Baltimore County hospital, or in her 24-year history as a nurse, connects her to a crime.

"The crime charged of Ethel Barlow simply makes no sense," he said.

Barlow, 52, was arrested last year in what police and prosecutors have said is one of the most bizarre homicides in Baltimore County history.

Ruth F. Bowen, who had Parkinson's disease, went to Franklin Square Hospital on Oct. 30, 2000, with a swallowing disorder.

She also had a condition that caused her arms to be permanently crossed.

On Nov. 2 that year, the elderly women's family visited, Gentry said. Her daughter-in-law left the room about 5:40 p.m., giving the sleeping woman a kiss before she left. Barlow, a temporary licensed practical nurse then employed by the Baltimore County hospital, walked in at the same time, Gentry said.

The people visiting the woman who shared the hospital room with Bowen heard Barlow talking to the elderly woman on the other side of the curtain, Gentry said. Then, he said, they heard Bowen start moaning.

When one of the visitors walked across the room, he said, she noticed that Bowen's arms were straight, oozing blood.

About 6:30 p.m., Gentry said, Barlow told another nurse to give the elderly woman morphine.

Four days later, Bowen died.

The medical examiner found that the woman's elbows were broken, and that she had died from a "bilateral upper extremity injury."

"There was so much force used to straighten these arms, not only were the elbows broken, the biceps were ripped from the bone," Gentry said. "The woman was dying, the woman had Parkinson's disease. Maybe -- who knows -- maybe it was her time. But not this way. Not this way."

Karceski said that Barlow had suffered a stroke in March 2000 -- her second -- that left her upper body weak. He said that if she had wished harm to Bowen there would have been easier ways to do it, noting that the nurses station near the hospital room contained narcotics.

He also noted that several people had walked by Bowen's hospital room, and repeated a number of times that nobody had seen Barlow hurt the elderly woman.

"Remember," he said, looking at the jurors. "It's 'beyond a reasonable doubt.'"

Franklin Square Hospital Center settled a lawsuit brought by Bowen's family for an undisclosed amount of money.