Blind Eye: The Terrifying Story of a Doctor Who Got Away With Murder (4 page)

Because it was founded in part to improve medical services in southern Illinois, SIU accepted only Illinois residents and looked for a commitment to family practice in small-town or rural Illinois. After a committee evaluated all the information candidates submitted, SIU (like other medical schools) placed them into one of three categories: “Reject,” “Accept,” or “Accept When Place Available.”

Muriel proudly reported to family members that Michael had been accepted at several medical schools. Given his excellent academic record and test-taking ability, Swango would have been a strong candidate. His work in a hospital as an orderly would also have worked in his favor. And SIU would have been especially interested in someone like Swango, who was from Quincy, part of the area the medical school was meant to serve.

Yet his classmates speculated that Swango had been admitted from the waiting list, because he moved into the dorms late, along with students who, like Rosenthal, had been admitted at the last minute. They surmised that Michael hadn’t performed well in the admissions interview and wondered what he had answered when asked why had wanted to become a doctor. Among his classmates,
the decision to become a doctor formed a large part of their getting-acquainted conversations. Swango never participated in these conversations; he seemed blank when the topic surfaced. Swango never expressed any interest in patients.

Still, apart from the cadaver incident, nearly everyone conceded that Swango seemed hardworking and disciplined. Some classmates were astounded to learn that he was working as a paramedic for America Ambulance in Springfield while a first-year student. Not only was outside employment during the first year frowned upon (Rosenthal had to get permission from the dean to teach a Sunday school class in Carbondale), but Swango was commuting to a city one hundred miles away. And his violation of the antimoonlighting policy was particularly brazen, for the Springfield hospitals the ambulances served were affiliated with SIU and staffed with many SIU residents and professors. These staffers soon realized what Swango was doing, but no one on the faculty complained. He passed all 476 tests, however unorthodox his methods, and all of his courses, including anatomy. One member of the class had to repeat the first year, and one person flunked out, but when the rest of the class moved on to the second year in Springfield, Swango was among them.

T
HE
central Illinois city of Springfield, with a population just over 100,000, seems a metropolis compared with Carbondale. It boasts the state capitol building and is steeped in the lore of its most famous resident, Abraham Lincoln, whose restored home is a major tourist attraction. The city is attractive to SIU because its two hospitals, St. John’s and Memorial, are much larger than any in Carbondale, and it is there that SIU medical students gain their first clinical experience. Beginning with the second year, the medical school’s curriculum turns away from basic science and anatomy to disease-oriented courses, including pharmacology, radiology, and pathology. Pathology, which includes toxicology, the study of poisons, seemed particularly to fascinate Swango. It was taught by a popular professor, Dr. John Murphy, who was favorably impressed by him.

During their third year of SIU’s medical school, students undergo a series of rotations, including pediatrics, obstetrics and gynecology,
internal medicine, and surgery. In the surgery rotation, students were assigned in pairs to give oral presentations. Rosenthal and Swango were partners, and at Rosenthal’s suggestion, they chose to discuss the repair of certain defects through open-heart surgery. A relative of Rosenthal’s was a heart surgeon and volunteered some original papers the students could use. But Rosenthal ended up having very little contact with his partner. This may have been because Swango was still working for the ambulance corps and frequently was either unavailable or fidgeting because he was going to be late for ambulance duty. But it was also because Rosenthal didn’t like being around Swango. He was jumpy, nervous, and seemed unable to relax. He wore a beeper and would rush off whenever the ambulance service called. The pair ended up giving their presentation in two discrete sections, which might as well have been separate reports. Swango had assembled several slides and gave a creditable, if unmemorable, performance.

But given that the topic was heart surgery, his subsequent performance in class was baffling. Swango’s class assembled at the start of each day for what’s called morning conference; one day Dr. Roland Folce, the chairman of surgery, led a discussion of X rays. He put a chest X ray on a screen and pointed to a shadowy area in the middle of the image. He looked around at the class, then focused on Swango. “Mike, tell us what’s in this picture,” he said. Swango was silent. Finally he said, “I don’t know.” There were some titters from other students. “That’s the heart, Mike,” Folce said, sarcastically emphasizing the word “heart.” It was almost as big a debacle as the cadaver incident, for any medical student this close to getting his degree should have been able to recognize the heart on an X ray. It was so obvious that his classmates concluded that Swango must simply have panicked and frozen.

Yet the episode was one of many that led some of his classmates to conclude that Swango was taking a surprisingly cavalier approach not only to medical school, but to the well-being of his patients. One of the first clinical assignments medical students receive is to take histories and perform physicals—“H & P’s”—on hospital patients. Students interview patients, record their medical histories, undertake routine physical examinations, and post the results on the patients’ charts. Depending on the patient, the procedure
can take anywhere from a half-hour to ninety minutes. His classmates observed that Swango was completing his entire rounds in less than an hour, sometimes spending what seemed like as little as five minutes with a patient. Yet he filed complete H & P’s. In at least one instance, another student charged that Swango had plagiarized or fabricated his entire write-up. The claim triggered renewed talk and concern about Swango among his classmates; Rosenthal and several others even wondered whether Swango should be reported to the Student Progress Committee, a group of twelve faculty and two students that heard complaints of student misconduct. But no one did so.

Within their third-year rotations, students can choose areas of specialization. There was a standing joke at SIU that the dumb and the lazy chose anesthesia; the smart and the lazy went into radiology; the dumb hard workers chose pediatrics; and the smart hard workers went into neurosurgery. Thus, it came as a surprise to many when Swango concentrated his courses in neurosurgery, especially considering the cadaver incident. Neurosurgery, involving delicate operations on the brain and other parts of the nervous system, is one of medicine’s most demanding (and highly paid) specialties. It is emotionally taxing, because patients needing neurosurgery are often in dire straits, and because deaths and catastrophic incidents on the operating table are probably more common than in any other area of practice. Still, competition for internships and residencies is intense. But Swango was no more forthcoming to his classmates about his choice of a specialty than he had been about why he had chosen medicine as a career.

Swango’s decision came as a particular shock to his classmate Sweeney, who had been so dismayed by the cadaver incident and thought Swango was ill-equipped to practice medicine at all, much less neurosurgery. Furthermore, neurosurgery happened to be Sweeney’s area of concentration as well, so he and Swango would share patients and work closely together.

The two were jointly assigned to a resident, Mark Zawodniak, who would oversee their work and act as a mentor. Though that meant Sweeney and Swango had to see each other virtually every day, they avoided each other as much as possible. Though most students sharing a neurosurgery specialty would observe each other’s
surgeries, Sweeney stayed away from Swango’s—he was horrified by the prospect of what he might see—and Swango never showed up at Sweeney’s, either.

Zawodniak, though he was genial and friendly, also developed an aversion to Swango. When Swango was out of earshot after one particularly frustrating encounter, Zawodniak turned to Sweeney and lamented, “What did I fucking do to deserve him?”

But finally, in the person of a faculty neurosurgeon, Dr. Lyle Wacaser, Swango seemed to find a kindred spirit. Wacaser raved about Swango. He would brook no criticism of Swango’s alleged haste, sloppy habits, or indifference to patient care. The two seemed all but inseparable, Swango eagerly accompanying the neurosurgeon on his rounds and into his surgeries. Indeed, Swango had persuaded the nursing staff to beep him on his ambulance pager whenever they learned that one of Wacaser’s patients was about to be admitted. That way Swango was usually on the scene even before Wacaser, and sometimes before the patients themselves. This naturally froze Sweeney out of numerous opportunities for clinical experience, and it hardly endeared Swango to fellow students. (The first-come, first-served system for assigning medical students to patients was subsequently changed.) But naturally, Swango’s eagerness made a favorable impression on Wacaser, who found him remarkably pleasant and industrious. He thought Swango’s patient write-ups were close to perfect.

Wacaser was one of several Springfield doctors in private practice who also served as clinical instructors. He was popular among students and highly respected in his field, and the fact that he championed Swango went a long way to ease student concerns about Swango’s competence. He was also eccentric. Wacaser drove around town in a truck that had emblazoned on it in bold letters, “Lyle Wacaser, M.D., Neurosurgery and Light Hauling.” Recently divorced and in his early fifties, Wacaser would often invite students for post-surgery beers at his spacious office in a house across the street from the hospital, where he displayed the brain of a former patient in a jar of formaldehyde on the fireplace mantel. He also threw numerous parties. His office phone could be connected to the hospital’s public address system; Wacaser would get on the system and announce, “Fluid and electrolyte rounds in progress.” The signal sent medical
students flocking to the parties, which were often rowdy affairs where they could blow off steam. But Swango didn’t drink alcohol and, despite his close relationship to Wacaser, never attended the parties. Indeed, after Swango’s surgery rotation ended, Wacaser hardly ever saw him, and later realized that he knew nothing about Swango’s background or personal life, even who his parents were or whether they were alive.

During their third year at SIU medical school, students have significantly more contact with patients and are responsible for hundreds of H & P’s in the course of the year. Swango’s classmate Rosenthal noticed that Swango seemed unusually interested in, even preoccupied with, the sickest patients. The hospital maintained a large blackboard on which were written patient names and treatment remarks. When a patient Swango had seen died, he scrawled “DIED” in large capital letters across the person’s name. Rosenthal and other students found this distasteful, almost as though Swango were celebrating the demise and wanted to call attention to it. When Effie Walls, a kindly patient whom Rosenthal had met, and whom Swango had been treating for an injury, died suddenly after a visit from Swango, he scrawled “DIED” over her name as well. Rosenthal went up to Swango and asked him why he did such a thing. “Don’t you feel bad that she died?”

Swango gave Rosenthal a blank look. “No,” he replied. “That’s just what happens.”

It happened often with Swango. A standing joke among the students was that if they wanted to get rid of a patient, they should assign Swango to do an H & P.

One day Zawodniak mused to Sweeney that unusually often, it seemed, when he assigned Swango to do an H & P, the patient would suddenly “code,” meaning suffer a life-threatening emergency. “Do you think it was just coincidence?” But even as Zawodniak spoke, he dismissed the thought, and the two laughed it off. Swango was correct, after all, that death is a regular occurrence in a hospital.

Zawodniak, Sweeney, and many of their classmates were developing a black sense of humor under the twin pressures of medical school and hospital life. After about five deaths in patients who seemed to be recovering satisfactorily, all of them soon after an
H & P by Swango, Zawodniak coined a nickname for his seemingly disaster-prone protégé: Double-O Swango.

Other medical students thought the nickname was hilarious, and soon it was in widespread use. “Double-O Swango” meant License to Kill.

CHAPTER
TWO

D
URING
S
WANGO’S
last year of medical school, in January 1982, his mother called him and his brothers, Richard, Bob, and John, with the news that their father was dying and that they should return home to Quincy as soon as possible. Michael drove from Springfield. Richard, Virgil’s stepson, made the trip from Florida, where he was working as a certified public accountant, and Bob flew back from Eugene, Oregon, where he was an orderly at a nursing home. John, the youngest, stayed at his Air Force base in Italy. But Muriel’s call to her sons had come too late. Virgil died on January 29 at Quincy’s Blessing Hospital before the family had converged.

Colonel Swango was given a twenty-one-gun salute and was buried with full military honors in a brief graveside service attended by a handful of family members and friends. At his request, there had been no visitation or memorial service at the funeral home, either. Michael was the center of attention—clean-cut, neatly dressed in blazer and tie, easily the most handsome of the colonel’s sons. Along with his girlfriend, an attractive brunette, he was at his mother’s side through the ceremony. None of the sons spoke. Muriel sat rigidly, saying nothing and showing no emotion at her husband’s death. But she seemed to glow with pride afterward as relatives congratulated Michael on his progress in medical school, his work as a paramedic, and his seemingly bright future as a doctor.