Blind Eye: The Terrifying Story of a Doctor Who Got Away With Murder (8 page)

Louise found the explanation hard to believe, but Muriel said firmly that if Michael said so, then that was what had happened.

They waited, but Michael never showed up for dinner.

CHAPTER
THREE

A
FTER HIS BRUSH
with expulsion, Swango was a model medical student. He dutifully repeated the OB/GYN rotation, attending all the required surgeries and oral examinations, and he acquitted himself satisfactorily in his other supervised assignments.

Dean Richard Moy had taken an additional step that he believed might put others on notice that SIU had experienced problems with Swango’s performance. Every graduating medical student receives a “dean’s letter,” which reviews his or her strengths and weaknesses and is used in applications for internships, residencies, and other employment. Though another administrator usually drafted such letters, Dean Moy took a personal interest in Swango’s. It was carefully written to call attention to the fact that he had not graduated with his class, that he had failed a rotation and been required to repeat it, and that there had been concern about his professional behavior. Given the school’s anxiety about possible legal liability, this was as far as Moy felt the letter could go. He was confident that, at the least, it would cause a teaching hospital to call SIU for more explanation before admitting Swango for further training.

Yet on Match Day, March 16, 1983, Dr. William Hunt, director of the department of neurosurgery at Ohio State University in Columbus, offered Swango a residency in neurosurgery after the successful completion of a year’s internship in general surgery to begin on July 1. That year, Ohio State, one of the most prestigious residency programs in the country, had received about sixty applicants for its neurosurgery residence program and had invited twelve for personal interviews, Swango among them. He was the only student
finally offered a position. Swango’s success seemed even more astounding than his offer from the University of Iowa had been the year before.

Michael Swango was graduated from SIU on April 12, 1983. Though there was no ceremony, he received his diploma in the mail, and Muriel spread the good news of his graduation and acceptance at Ohio State to family members. These developments lent credence to Michael’s explanation that a computer glitch had postponed his graduation. No one questioned why it would have taken nearly a year to correct such an error. Nor did Michael mention to anyone in Quincy, let alone at Ohio State, that shortly after his graduation from SIU he was fired by America Ambulance.

Already on probation there because of his violent outbursts, Swango had responded to an emergency call in Rochester, Illinois, a small town close to Springfield. The patient, gasping for air and in acute pain, was suffering a heart attack. Swango’s instructions were to administer any emergency treatment called for and then transport him in the ambulance to the nearest hospital. Instead, he made the patient walk to his own car and told the family to drive him to the hospital themselves. The patient survived, but the family called America Ambulance to complain about Swango. No one could explain his cavalier behavior. It was both medically unsound and a clear violation of the ambulance corps’ rules. Swango offered no adequate explanation and was fired.

But Michael was no doubt indifferent to his dismissal now that he had graduated from SIU. He returned to Quincy and was promptly hired as a paramedic by the Adams County Ambulance Corps. He worked there for just three months, since he had to be in Columbus, Ohio, by July 1 to begin his internship.

A
NNE
Ritchie first met the new blond intern on the ninth floor of Rhodes Hall, one of the largest buildings in the Ohio State medical complex. She did a double-take. She thought he was handsome, with an athletic build and angular face, a very all-American look. But what struck her most was that he looked remarkably like her cousin’s husband in Minnesota. The similarity was so pronounced that she checked the I.D. tag on his surgical jacket to see if there
might be some family relation. That was why she remembered his name: Michael Swango.

Attractive, popular, and vivacious, Ritchie was the daughter of a physician, and had always wanted a career in health care. She loved working in the Ohio State Hospitals, even though as a “casual” or supplemental nurse, working two to four shifts a week whenever she was needed, she ranked fairly low. Swango didn’t seem the least bit interested in his resemblance to her cousin, but Ritchie was accustomed to indifference on the part of doctors. At the Ohio State Hospitals, which maintained a rigid hierarchy among doctors, nurses, and other staff, nurses didn’t speak to attending physicians unless specifically questioned by them. The physicians gave their instructions to residents and interns, who in turn passed them on to the nursing staff. Any questions or statements by the nurses were supposed to be directed either to the interns and residents for transmittal to attending physicians, or to their nurse supervisors.
²

With over 50,000 students at the time Swango arrived, Ohio State is virtually a city unto itself; it even has its own police force and governance. The Ohio State University Medical Center is located just a few blocks from “the oval,” the grassy center of the sprawling campus. After the Ohio State Buckeye football team, the medical center is the crown jewel of the giant state university. It has 1,123 beds and 4,278 employees, and university officials describe it as the second-largest teaching hospital program in the country (after the University of Iowa’s). The hospitals sometimes vie for supremacy in Ohio with the prestigious Cleveland Clinic, the highly regarded Case Western Reserve University, also in Cleveland, and the University of Cincinnati. But its size and political clout—the university trustees are appointed by the governor, and the hospitals’ board is a Who’s Who of prominent Ohio business and civic leaders—usually ensure Ohio State’s preeminence. Graduates of the medical school dominate Ohio’s medical establishment and institutions.

So Swango joined an elite group of medical school graduates
for his first assignment as a surgical intern, which was in the emergency room. Given such competition, it didn’t take long for some of his shortcomings to surface. Each doctor in charge of a surgical rotation evaluates the interns at the conclusion of the rotation, and Dr. Ronald Ferguson, the doctor in charge of transplant surgery, who oversaw Swango’s work from mid-October until mid-November, told Dr. Hunt that he was going to fail Swango, and that he didn’t believe he was competent to practice medicine.

While the details of Swango’s performance have been shrouded in secrecy by Ohio State (the school has said only that nothing of a criminal nature was contained in Swango’s evaluations), Ferguson complained specifically about Swango’s brusque and indifferent manner with patients, his cursory H & P’s—charges that echo the criticisms of his performance at SIU—and a general sense that Swango lacked the temperament and dedication necessary to be a doctor. Swango also alarmed at least one other of his supervising physicians with remarks suggesting a fascination with the Nazis and the Holocaust. (This fascination was noted in his student record.)

Some of the residents, who spent more time with Swango than the attending physicians did, also complained to doctors on the faculty that Swango was “weird.” While making rounds, residents often give interns tasks and then critique their performance. Whenever they criticized Swango—as they often did, because of his incompetence—Swango would immediately drop to the floor and begin a strenuous set of push-ups. He could do hundreds of them. It was almost as if he were still in the Marines, and this was his self-imposed punishment. Of course, the residents thought his reaction not only peculiar but highly inappropriate for a doctor making rounds. Despite their admonitions, he persisted.

At the time Swango was hired, no one from Ohio State called anyone at SIU. Indeed, no one appears even to have noticed that he should have graduated from SIU a year earlier than he did. But now, troubled by the negative report from Ferguson and other comments about Swango’s odd behavior, Dr. Hunt got on the phone to SIU’s Howard Barrows, the associate dean for medical education. Barrows was in charge of student recommendations, including the dean’s letters signed by Moy, and had helped draft Swango’s. With an edge of
annoyance, Hunt asked about Swango. “What kind of guy did you send us?”

Barrows said that Hunt should have seen plenty of warning flags in Swango’s dean’s letter. “Well,” Hunt retorted, “I don’t read dean’s letters.”

Barrows asked him if he’d kept the dean’s letter in Swango’s file, and Hunt said he’d check. Soon after, Hunt called back: he’d found the letter.

“Oh, my God,” Hunt said. “You’re right. You did tell me.”

Still, no consideration seems to have been given to terminating Swango’s internship. On January 14, 1984, Hunt met with Swango and warned him that he had received a failing evaluation from Dr. Ferguson that might threaten his residency. He reminded Swango that the offer of a residency in neurosurgery was contingent on successful completion of the one-year internship. Swango took the news calmly; he seemed suitably concerned and sincere in his desire to improve. He was sufficiently charming and contrite that Hunt helped him plot strategies for overcoming the negative review and continuing with his residency. Hunt recommended that Swango appeal Ferguson’s evaluation to the Residency Review Committee, made up of doctors from the surgery department. Swango took him up on the suggestion, and the committee met later that month to reevaluate him.

R
ITCHIE
and Swango didn’t have much contact after their initial meeting, when she had examined his name tag, though she did talk fairly often to his new girlfriend: a fellow nurse named Rita Dumas, who also often worked in Rhodes Hall. The relationship surprised many on the nursing staff, because Dumas hardly seemed a catch for a promising and handsome young intern. She was reasonably attractive, but her personality had caused some of the other nurses to keep their distance. Divorced a few years before, with three young children, she was always complaining about something. She worked the night shift, returning home at seven in the morning, just as the children were awakening. She said she was never able to get enough sleep, which might have accounted for her often surly mood.

But she seemed transformed by the romance with Swango. Though she still kept mostly to herself, she acquired a new glow of
confidence, and her attitude toward life seemed to improve. A few of the other nurses noted the changes with a touch of envy. Dumas had been going through a difficult period. Swango had been tender and supportive. He was wonderful with her children, and they loved it when he performed feats of juggling for them. She later said, “I do not think that I would have survived had Swango not been there for me.”

On February 6, Anne Ritchie reported to Rhodes Hall for the morning shift, and was assigned to a neurosurgery patient in Room 968, named Ruth Barrick. Barrick was a pleasant, elderly woman who had been admitted to the hospital on January 17. She had fallen and hit her head at home ten days earlier and suffered a cerebral hematoma. Though her condition was serious, it had never been considered life-threatening until she suffered respiratory arrest and nearly died on January 31—just after Swango’s appeal of his negative evaluation was rejected.

No one told Ritchie what had happened. But on January 31, another nurse, Deborah Kennedy, had given Barrick her breakfast and assessed her condition. The patient seemed to be doing well. She was sitting up in bed, talking, and responding to directions. At about 9:45
A.M
., Dr. Swango had come into Barrick’s room and told Kennedy, “I’m going to check on her.” Kennedy thought this was peculiar, since doctors rounded at 6:30
A.M
. and rarely returned unless there was a specific problem. In such cases, it was the attending physician, not an intern by himself, who would call on the patient. But Kennedy gave the matter little thought. She left Swango alone in the room with Barrick.

About twenty minutes later, Kennedy returned to check on Barrick. Swango was gone. Barrick was now reclining and seemed to be asleep, but when she drew close to the bedside, Kennedy was alarmed. Barrick was barely breathing. Her skin was taking on a bluish cast, a sign of imminent death from respiratory failure. Kennedy immediately called a code over the intercom, and doctors came rushing to the room. Swango was the first to respond, but others too began working to resuscitate her. After forty-five minutes Barrick’s vital signs seemed to stabilize and she was transferred to intensive care. There she recovered without any evident lingering effects, and returned to her room.

At about eight
A.M
. on February 6, Ritchie gave Barrick a bath. The patient was alert, talking, cheerful, and seemed to be recovering. But Ritchie noticed that the central venous pressure (CVP) was low in the central line, an intravenous tube supplying medication to the major blood vessels. She called to ask that a doctor check the line, and then left the room to check other patients. A few minutes later, she saw Swango enter Barrick’s room, remembered him as the new doctor who looked like her cousin, and felt relieved that an M.D. had responded to her call. Ritchie might have given the matter no further thought, but some time passed and she didn’t see Swango emerge, which made her think that there might be a problem with the central line. This wasn’t unusual, because the central line, connected as it is to the major blood vessels, often requires some delicate work if a blockage occurs, and there is a particular risk of air getting into the tube, which can be fatal. So Ritchie went back into Barrick’s room to see if Swango needed help.

Swango had drawn the curtains entirely around Barrick’s bed, which meant that neither Barrick’s roommate nor anyone passing the room’s open door could see what was happening. Ritchie found this odd. She stuck her head through the curtains. Swango was hovering over Barrick’s chest area and seemed startled. “Do you need any help?” she asked cheerfully. “No,” Swango replied. Ritchie left.