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A listener note, this story contains adult content and language, oh, today I'm not. Well, still not.

[00:00:11]

Well, Dr. Christopher Dench perform surgery on 38 patients, 33 suffered serious injury. He still has numbness in his hand and his arm. He drops deaf all the time and that still happens to this day.

[00:00:27]

20 still live with some form of physical pain or paralysis. I have done everything I can. I stretch. I stay as active as possible. I try to eat right. I try to take vitamins. I do everything I can to minimize the progression of the disease of what's going on. Only three had no complications. It was just really hard seeing him where he wasn't able to move or to to get around or to function as he normally would. And two died.

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I tried to speak with many of those who survived, some of them did not want to be interviewed, they said they were working to move on or that they'd said all they have to say about. Those that did talk to me had one thing in common. Their lives will never be the same. It is very difficult for me to walk from one end to my house and up to the bedroom, to the kitchen, and I can stand up maybe two hours and on a good day from the time they get up to the time they go to bed, they live with the consequences of putting their trust in Christopher Dunt.

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But for some of them, the hardest thing to comprehend isn't what happened. I know I have the pain. I know that it affects my family. But my thing is how. The the system that's supposed to be in place allow this to happen, especially for the fact so many people. That's been my driving question, too, which leads to another if or when other doctor does come along, will there be anything in place to stop them? Here's the thing about home security companies most trap you with high prices, tricky contracts and lousy customer support.

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This is Episode six closure. Christopher Dench was booked into the Dallas County jail on July 21st, 2015, charged with injury to an elderly person and aggravated assault.

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Hello. Gosh, I've never tried so hard to hold, are you? Three days later, on July 24th, he called his father. Oh, I'm down.

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You called the phone. I'm downstairs with Mom. OK, I got mine back over and over. Oh, I'm sorry. Because I left.

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But the judge has set his bond at six hundred thousand dollars, 100000 dollars more than the starting point for capital murder. Don't plan to ask the judge to reduce the amount so he could get out before his trial.

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I'm on pins and needles right now just waiting to hear about the mine was so short and sweet talking to, you know what? I'm missing my my son's and write books. I need to use that money to help the.

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He's talking about Wendy Young, the mother of his two kids, of course, that she couldn't work and doesn't have. And she was pretty far up north and she doesn't have the ability to put up. Jackson did take her of boys and get down here tomorrow morning and Monday morning, OK? And that's really, really important to me that I know right now. I'm going I'm like literally staring at the ceiling, you know, and it's keeping my mind in one place right now.

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Is your heart OK? OK, I really appreciate that very much.

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Even before Christopher Dunn ended up in jail, his patients and their families had been searching for justice. Many of them had sought relief in the civil system. But despite what had happened to them, despite it being so clearly the fault of their surgeon, most of his victims had had trouble even finding lawyers.

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I could not find an attorney to save my life that would take the case. Come to find out, state of Texas, there are caps on malpractice. It it is not worth that attorney's time and energy to take on malpractice cases in the state of Texas. It's so hard to do. And a lot of lawyers won't even pursue it because you have to prove malice. You have to prove that this guy woke up and intended to go hurt you. There's no way we can win this case.

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It was there was like, no, we can't win this case. That was very Maalouf, Jeff Gladwell and Philip Mayfield, the malpractice lawyer Chavannes Way, ended up taking 14 of the cases herself, including Mayfield and Gladwell. Victims came to her after seeing her in the news. Doctors did, too. There were really highly regarded physicians in the community reaching across the aisle to lawyers like me saying, please help us. We can't get this guy stopped.

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Can you help us? So I just felt like after 30 years or so in the arena, if I didn't step up to help, they may not have gotten the help that they needed. You see, the Texas Medical Board is the main defender of patient safety in the state of Texas. There should be something else, say, the ability to sue a doctor who's done wrong. But that's been severely restricted, thanks in no small part to some changes in Texas law prior to passing significant reforms in 2003.

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Texas is facing a bona fide crisis.

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That's former Texas Governor Rick Perry.

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Employers and doctors were easy targets for plaintiffs, filing one frivolous lawsuit after another, playing the odds and hoping for a jackpot jury. The net result was a skittish business community and skyrocketing insurance rates for doctors.

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Those significant reforms Perry is talking about included a two hundred and fifty thousand dollar cap on damages known as pain and suffering from then on, no matter how bad the damage was. That was the maximum anyone could receive for anything other than economic loss or medical bills. At the time, state lawmakers pointed out that these reforms would lead physicians to flock to Texas safe from the fear of nuisance lawsuits. They said health care costs would fall and insurance premiums would become more affordable because there would no longer be a need to practice defensive medicine.

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Today, more than 30 states have similar laws. To find out if we, the citizens of Texas, have reaped the promised benefits, I asked Charles Silva of the University of Texas at Austin, a law professor who has studied the effects of these reforms. As we talked, he pulled up a graph showing the number of doctors in Texas per 100000 people. The figure you're looking at has a vertical red line at two thousand and three. That's when tort reform was enacted.

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If a new cap on damages worked, if doctors had flocked to Texas after the reforms, that line should have shot up after 2003. It doesn't. Health insurance costs haven't gone down either in Texas, about one in six Texans have absolutely no insurance. Currently, that's the highest rate of uninsured in the country. What has gone down? Insurance premiums. For doctors. That was the only intended effect of the statute, in my opinion, and that is exactly what happened.

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If you free people from liability insurers make money because they don't have to pay out on claims and insurance rates fall because in the future, claims cost less. Today, even as the state's population has risen, the number of annual settlements has dropped the year legal changes were enacted, Texas had around thirteen hundred malpractice payouts reported to the National Practitioner Databank in 2017.

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Only about 600 malpractice cases made it across the finish line because the damage caps are on pain and suffering, but not economic loss or medical costs. Those with the least earning power are the most vulnerable in our state babies, children, people in nursing homes, parents who stay home with the kids, and people like Barry Margelov, who can't prove that even a debilitating injury makes it impossible to work more. Tarloff finally found a lawyer, Mike Lyons, to represent him.

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Lyons says those caps mean that attorneys just won't take certain kinds of cases.

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And what I see day to day is people calling me saying they killed my child, they killed my child in the E.R. and now what do we do? Well, what you do is you pray that you get pregnant again and have another baby because no lawyer is going to take that case. That child didn't have a job, has no economic loss. Your physical pain and suffering is capped at two hundred fifty thousand very more.

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Gallup had asked several lawyers to take his case and each time he was told no. So when he met Mike Lyons, he didn't have much hope.

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I remember going in and talking to him, telling me that our chances of any type of recovery was slim, but he would take the case and we were extremely grateful. The financial aspect of it, I understood they're probably not going to be any money there and there was very little but to get this guy off the streets and nobody else got hurt again was important.

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The public needed to know that there was a monster out there. You know, frankly, the reason that this resulted the way that it did is because of some very, very courageous doctors that stepped in and did something. Had that not happened, he may still be Pratts. On August 2nd, 2015, with his bond hearing coming up, Christopher Dunned called his father again from jail. He says if he can just get out of jail before trial, then I'm going to talk to my attorneys again tomorrow about what options are to get out of here and work on this with the outside, because I just thinking about how much is at stake and what's going on and can tell you no matter what has happened here, there's a lot of very important things going on that I know from in here that could be all, you know, like I don't know something from outside of here.

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He's concerned that he won't be able to defend himself legally from inside jail, even use my computer. I can get the documents have talked in life, you know, in a through a glass window the whole time up to my house. That to me, that's almost insanity. You know, that's like asking me to make sure you lose a case and despite everything, don't hasn't given up on one day returning to surgery.

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That's another thing about me is that, you know, when me one of the reasons why I'm able to survive all this is is and was about me, I guess I guess my main point that really is because I've been able to at least have been able to work on it myself and have a very strong role in everything. And I hear I think I can do nothing but sit and stare at the wall. I did, you know, the way other people are handling on my own my entire life.

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And my teachers don't tell his father how supportive Wendy Young has been and really coming through for me and being on my side and, you know, to me everything I get and how much it means to him to see his sons.

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Yeah, I got to see my guy today. Oh, great. But even those visits are bittersweet. I know, I know, I know for all the talk about beating his case and getting his license back just feels isolated and alone.

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I'm very sorry, but, you know, I am kind of this gentle and, you know, they're all I got to do it. All right. You know you know, we have got to look for everybody. But you've got to family, like you said, my favorite.

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At the bond hearing, prosecutors presented Dench's last bank statement, his former accountant had loaned him more than 13000 dollars. He blew through it all in a month, including several cash withdrawals, a 626 dollar shopping trip to Wal-Mart and three charges in one day to a local pub that totaled 123 dollars.

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His attorneys asked for the bond amount to be lowered, they argued he didn't pose a risk to the public.

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The prosecution played those recorded calls he'd made from jail, and they ask his father if he was trying to get his license back. He responded, I guess that's probably true. Dunn didn't make bond. By this time, Dench's story and his face were everywhere. A few months before Dench's trial, D magazine, the city's monthly glossy, published a cover story. The title was Dr. Death. The nickname Stuck. Changing up your hair color can change your whole day, week, month even.

[00:16:37]

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Hi, I'm Stephen Johnson, the host of Wonderings American Innovations, where we tell the stories behind the inventions that have shaped our modern world. Do you recognize that sound behind me? It's the sound of the technology that makes the dog days of summer bearable. But at the turn of the 20th century, Americans were suspicious of the idea of artificially cool air.

[00:18:02]

On our newest series, Keeping Cool, we're tracking how and why America came to change its mind. And we're telling you the story of how AC then changed American culture from its pastimes to its politics. Listen to keeping cool on American Innovations on Apple podcast Spotify or the Wonder App. Join Thundery Plus in the wandering app to listen ad free. Christopher Dench's trial began on February 2nd, 2017. He seemed to be pretty confident about what he was at jail, that he didn't do anything wrong.

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He had a team of court appointed defense attorneys, among them Richard Franklin.

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I always thought when I looked at him, even when he was in his jail clothes, he exuded a confidence. And I could certainly understand why patients would trust him. Mary Efford surgery was the one on trial. Remember, she was a senior citizen. Michel Schuckert in the prosecution team had decided to build their case around elder abuse. If they got a conviction, don't could be facing life in prison. But prosecutors talked about his other cases, too.

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If they could show that Mary Efford, far from being Dench's first botched surgery, was part of a larger pattern from the start of the trial, all the way through the closing arguments, they painted a portrait of a surgeon who should have known that he needed to stop operating.

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Really, it comes down to the sheer number of patients that he was hurting in a very short amount of time. The massive damage that he was doing to them was beyond what any normal doctor would encounter in their entire careers. And he did this in a matter of two years.

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He certainly knowingly did these actions. He knew that he was hurting patient after patient. He had been told by other doctors, by the medical board, by hospitals, kid kicking him out that there were problems and he just kept going. He didn't care. He wasn't going to stop.

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So by the time he took Mary effort into the operating room, even if he didn't intend to hurt her, he had to know that he would marry. Efford, who now has to use a wheelchair, took the stand to recount her own experience. Other patients testified to his defense attorneys, didn't think that was fair and objected every time prosecutors talked about a case that wasn't Mary Efford. Here's the lead defense attorney, Robby McClung. So we argued it's going to be too much outside evidence.

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It's going to overwhelm the jury and it's going to be overly emotional. Over eight days of testimony, each patient who took the stand told his or her own story in excruciating detail. The widower's of Kelly Martin and Florella Brown both testified struggling through their grief. Some patients were telling their stories publicly for the first time. You had people in Walker.

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She had people on crutches. You had people that can barely move. You had people that had lost loved ones. You you had all sorts of things that had gone wrong.

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At one point in the trial, Jaclyn, Troy's husband, was testifying.

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She's the one who had her vocal cords cut during an operation at Legacy Surgery Center and was brought to the ICU by ambulance suffering from a severe infection.

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He was describing for the jury, her state in the hospital in the pain that she was in and they thought she was dying. I mean, she was dying there in the hospital from infections and the injuries that Dr. Dunshee had caused her. And he starts crying on the stand. And then we look over at the jury and for the jury, members were also crying with him. We realized that they didn't know that she had lived, that she had survived because of the way it was being presented.

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And so when she walked into the courtroom after her husband to testify, the jury was relieved you could see it on their faces.

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The defense team saw it, too. Here's Robbie McClung.

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Before you even get to marry for, you can see that it's just it's going downhill and so did Dunwich. And you can see it in him because his shoulders are slumping more and more and more. To make a judgment, the jury had to learn about neurosurgery. And they had a good teacher, Dr. Martin Lasar. He walked the jurors through everything that was done wrong.

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They're fascinated by Dr. Lazaar, who would step down from the stand and explain to them in very easy terms with these anatomical models exactly what was going on. And the jury would lean in and they were catching everything that Dr. Henderson and doctors are saying, oh, my God, he was excellent.

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It was devastating testimony.

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And it was during Dr. Lazard's testimony that Dench's defense attorneys noticed a change come over their client. They told me they thought it was the first time he realized that he really was a horrible surgeon. It wasn't the mountains of evidence that they'd already heard. It was Lazaar.

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I think that that he thought he was still it pretty good, really and truly in his own blood until he actually heard from those experts up there.

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On the sixth day of testimony, Schuckert called the star witness for the prosecution.

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One of the most dramatic parts was when we called Dr. Dutches ex-girlfriend, Kimberly Morgan, to testify.

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She's a major in the Air Force and at the time of the trial was deployed overseas. She testified via Skype. She told the jury how kind and caring that could be with his patients, but that his demeanor could change and become more angry and confrontational. She had some difficulty talking about Jerry Summers and Kelly Martin. Have you tried not to think about these cases? The D.A. asks. Yes, ma'am. Morgan answers. Tried to put them out of your mind as much as you could.

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Yes, ma'am. They were traumatic. Finally, she was asked to read parts of the Occam's Razor email, the one dunderhead center where he called himself a cold blooded killer. Dench's attorney, Robby McClung, remembers the impact across the courtroom. You know, that was like an ex-girlfriend, really, you know, putting the knife in his back and that just really that really hurt her, Chris, a lot because it was taking words out of context.

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It was he believed he was doing some venting and an email to someone he thought was a friend from the prosecution side, SHUGER, to saw the effect on the jury.

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The reading of the email was very dramatic and the jury was wide eyed. They could not believe who he was and the things that he was saying in this email.

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The defense called a single witness, a neurosurgeon from a highly regarded medical school in Dallas. He was not there to defend Dench's surgical skill, but to help the jury understand, as the attorneys put it, a culture that surrounds the surgical community. In other words, he was put on the stand to make the case that Dunn shouldn't be held solely responsible. He said, I think in order for this to happen, it would require a complete system failure.

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On February 14th, 2017, following eight days of testimony, the jurors left to consider their verdict as the jurors deliberated, the patients, witnesses, the lawyers, all were left to wonder, why did Christopher Dench do what he did? His defense attorneys thought he didn't realize he was a bad surgeon until a fellow neurosurgeon testified to all his errors. During the trial, his father claimed it was pride and his deep seated impulse to keep working harder in the face of difficulty.

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Michelle Sugar chalks it up to greed, ego, substance abuse.

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All of these things were combining together where he just thought he was this huge, unstoppable force. He had a God complex. He thought he could do anything. He wanted to be anyone, and he wasn't going to let anyone stand in his way or stop him. Nothing was his fault. Others, though, have described him as a madman with a scalpel, a sociopath, a psychopath, if it was immoral, did he know it was immoral? The sociopath or secondary psychopath is somebody who knows the difference.

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Jim Fallon is a neuroscientist at the University of California at Irvine who studied sociopaths and serial killers for decades. I know what they're doing is wrong, and that's different than a psychopath who really doesn't think what they're doing is quite wrong. Very essential difference.

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I went to Fallon for his opinion on Dirnt, but before we started, he wanted to make one thing really clear. It's really a huge caveat.

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Fallon has never met or examined Christopher Dench, but he was willing to talk about Dench's public behavior. So here's somebody who's really compromised in a judgement's compromise to begin with from the people who grew up with them. He is very narcissistic, but very focused. So he looks like he's got traits of narcissism and narcissistic personality disorder. He also has traits of psychopathy, but he also has traits that are not consistent with that. But he's got a perfect storm of where he was from, lack of sophistication, heavy constant drug alcohol abuse, and then getting so far into something and not being able to pull back and being narcissistic enough to say, I can't admit that I can't do this.

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Dr. Henderson and Dr. Kirby, two of the doctors who did the most to stop Dench, came to their own conclusions.

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Christopher Dorner was a sociopath. He was not wired like the rest of us or wired together. He's he's a criminal. But do you think he knew he was a bad surgeon? He thought he was doing his best. I don't think he thought he was a bad surgeon. Gives he he would have stopped operating. He kept operating. And after all these bad results in these patients and I think he thinks he's a great surgeon still.

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Well, I probably would have always given him the benefit of the doubt that he was just poorly or inadequately trained and that his ego was just way too big because of his intelligence.

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But in the end, Henderson would be swayed by one damning piece of evidence, and if I hadn't have seen the chain of emails that he created, one where he refers to himself as a cold blooded killer. Well, I believe he is a cold blooded killer.

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The jury thought so, too. It took them only four hours to agree on a verdict. And later, an hour to decide on punishment. The doctor convicted of intentionally botching a woman's surgery will spend the rest of his life in prison.

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This is Christopher Duch was convicted of injury to an elderly person and sentenced to life in prison. He's believed to be the first doctor in the country, tried in court for the way he practiced medicine. At the courthouse, patients and their families felt a cathartic release of joy and sorrow. Kelly Martin's daughter cried outside the courtroom.

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I'm just so grateful from the bottom of my heart this will not bring my mother back. But it is some sense of justice for all of the families, for all of the victims.

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And Michelle Shugart spoke at a press conference organized by the DA's office. I think the big thing for us was that the patients just kept going on and on. I mean, if they had just been the first couple of patients, like we said in court, you know, those are probably just malpractice cases. But the fact that he continued to go on hurting patients after patients, that's what really turned this into a criminal case. We did this for the victims because of what they've suffered and wanted everybody to know that this will not be tolerated.

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And another assistant D.A., Stephanie Martin. What is most important about this case is that this is unprecedented and no one has ever prosecuted a doctor for surgeries gone wrong. And we did it in Dallas County because no one has ever done the things that Christopher Dunn did. The medical community system has a problem, but we were able to solve it in the criminal courthouse. Not everyone subscribes to the idea that the legal system should be the ones to decide where to draw the line between medical malpractice and assault.

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There's been some pushback in the medical community that that our behavior in the operating room is now can be criminalized and we can be thrown in jail for trying to save people's lives. That's Dr. Kirby. God is laughing that there's never been anyone like Christopher. Dr.. Last spring, I went to see Mary Efford. She now lives in a senior center north of town. Her difficulty walking and moving has taken her independence. We sat and talked and made plans for me to return a few days later for an interview.

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But the next day I got an email from her that said I have tried really hard for the past year to put the trial behind me. I'm still not where I would like to be health wise, and I have had to accept this. Talking about this again would only cause more pain. It was necessary last February to do what was required to bring justice for all who were injured, but that is done now. Good luck in your endeavors. I'm Lindsey Graham, the host of Wonderings Show American Scandal, we bring to life some of the biggest controversies in U.S. history presidential lies, environmental disasters, corporate fraud.

[00:32:45]

In our new series, we look at a monopoly that defined modern America. John D. Rockefeller was a titan of oil. He built an empire with bribes, ruthless acquisitions and even espionage. Yet he wasn't invincible. Rockefeller would face off against a woman named Ida Tarbell who fought to expose Rockefeller through the power of journalism. Find out how. Subscribe to American scandal on Apple podcast Spotify. Or listen ad free in the laundry app.

[00:33:10]

Before we get back to the story, I want to let you know that there have been some new developments in the case of Christopher Dench will be posting extra episodes to keep listeners updated on this and potentially other cases to make sure you don't miss out on any update. Please take a moment to subscribe to Dr Death. Wherever you're listening right now, you'll find a link in the episode notes. Or if you're using an iPhone, you can say Siri. Subscribe to the Dr Death podcast.

[00:33:37]

Thank you. Christopher Dunn was an outlier, but if you look at his actions as a sort of stress test on the system, then it failed miserably after the trial.

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Attorneys on both sides say they will never think about the health care system the same way again. During the trial, one of his own defense lawyers, Richard Franklin, was shocked to hear his own doctor's name come up as someone who had referred patients to Dr. Dunt.

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And what did you think when you heard that this was your own little weirded out? Because you I used to think that they only recommended people that they really knew and that they really felt were qualified to do the surgery and that there had been a lot of favorable results. But as we find out in this case, no, that's not the case at all. And she didn't know anything about him that she was told, OK, this is our number one neurosurgeon.

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You need to send all your patients to this guy. And that's exactly what she did. And what we don't know that as patients we do now, if she had recommended you have, I would have gone to it.

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Michelle Sugan, the problems in the system that allowed this to happen with him are still there. Some of the hospitals have fixed some internal stuff by the hospital. I know has made a few changes in Dallas Medical Center. Certainly has.

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Dallas Medical Center has a new administration. University general has closed entirely. I can't say what internal changes Baylor Plano has made since they refused to talk to me. The hospitals who got burned by it, they learned their lesson and they're far more cautious. I think overall, the system still is built in such a way that any doctor could slip through. Why did Dr. Dent keep going? It's a question I've been asking myself for months, and the truth is I still can't answer it.

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He was certainly blinded to his mistakes by his own hubris, but it was more than that. I wanted to walk away thinking that the case of Christopher Dunn was such an anomaly that nothing like this could ever happen anywhere else again, that the safety net had been tightened, that the next dangerous surgeon wouldn't slip through the cracks in a system that's supposed to protect us.

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I didn't find the reassurance I was looking for, but it turns out there is there is really very little we could do within the medical community that I could ascertain to do other than make the complaint repeatedly, make the complaints and have multiple physicians make the complaints, but only after subsequent injuries to additional patients had occurred, which which I think is. Extraordinarily disturbing, do you think anything has changed as a result of this case that would keep this from happening again?

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No one. I've heard it said that when planes crash, it's not because one big thing went wrong, it's because a whole lot of small things went wrong at the same time. That's why planes don't crash very often at all. But sometimes. Sometimes they do. Still, we fly, we board the plane with little worry about getting home. We should feel at least that secure. When we step into a hospital. Ultimately, there's no winners.

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Well, I didn't find reassurance, I did find one thing I wasn't expecting Grace. Here's Barrymore of. I mean, you have a guy that went to medical school that trained that there were sacrifices made by his family and he's serving a life sentence. There are people that are dead. There are people that are injured. There are people there's no winners in this deal. It's sad all the way around. I mean, I do have empathy for the doctor's family.

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I have empathy for him. Even though he ruined a substantial part of my life. My life is so different, I still have empathy for him. That seems like kind of a remarkable thing to say. People think I'm nuts. I think that I have to for my own soul, I need to forgive. I do not have the luxury of harboring resentments, so I have to let it go. There are three families in Dallas who live with what Christopher Dunn did and what others didn't do, but there were those people who didn't just stand by the doctors and lawyers, the reporters and nurses, the hospital staff and the patients themselves.

[00:39:29]

All of them don't want what happened in Dallas to happen anywhere else ever again. Christopher Dunn is currently incarcerated in Huntsville about an hour outside of Houston, in April, he turned forty seven. He's appealing the verdict and his appellate attorney isn't approving interviews, if he wins the appeal, he'll get a new trial. But if that happens, Michele Schweigert said she's prepared to try him again. And on the five other cases of aggravated assault, whatever it takes to keep him in prison.

[00:40:04]

For the rest of his life. Well, you did not take away gays in Islam. Well, it don't take no vacation. My goal is no net, no mercy in this land. From wondering, this is the final episode of our six part series on Doctor Death, an investigative miniseries about the system that failed to protect 33 patients in Dallas. Next week, I'll be back with a bonus episode, including some updates about what's happened since this podcast was first released.

[00:41:01]

If you'd like to help us spread the word, please give us a five star review and tell your friends to subscribe for available on Apple podcast, Spotify, NPR, one and every major listing app as well as one Rickon. If you know of a story like Dr. Death or Dirty Jon that needs to be investigated. Please write to us at tips. At one dotcom. Christopher Dunta was not stopped by one person, but a coalition of people who spoke up.

[00:41:29]

I'd like to thank all of the patients, doctors, researchers, reporters and others. Even some you didn't hear for sharing their stories and their expertise. If you're listening on a smartphone, tap or swipe over the cover art of this podcast, you'll find the episode notes, including some details you may have missed. You'll also find some offers from our sponsors. Please support our show by supporting them. And thank you.

[00:41:59]

Dr Death was written, reported and hosted by me, Laura Beil, sound design by Jeff Schmidt, fact checking Milota Punya story consultant is Jonathan Hirsche, associate producer is Pallavi Akamatsu, executive produced by George Lavender Marshmallowy and Hernan Lopez for wondering.