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Listener discretion is advised, this episode features discussions of poisoning and murder. We advise extreme caution for listeners under 13.


Chasing perfection can poison a life, but that doesn't stop people from pursuing it. The prestigious job, the fancy car, the perfect home, the supportive family, we all want them. But some people treat them as markers of success or boxes on a to do list. And when it doesn't work out after years of doing everything right. Failure can be a lot to reconcile. Dr. Deborah Greene discovered this the hard way. The physician spent decades in pursuit of the quintessential American dream, and her five year plan started off just how she'd hoped.


But when things started slipping. Deborah found herself willing to do anything to keep it all together. This is Medical Murders, a Spotify original from podcast, every year, thousands of medical students take the Hippocratic Oath. It boils down to do no harm. But a closer look reveals the phrase much more interesting. I must not play at God. However, some doctors break that oath. They choose to play God with their patients, deciding who lives and who dies each week on medical murders.


We'll investigate these doctors, nurses and medical professionals. We'll explore the specifics of how medical killers operate not just on their patients but within their own minds, examining the psychology and neurology behind heartless medical killers. I'm Alastair Murden and I'm joined by Dr. David Kipa, M.D.. Hi, everyone. I'm Dr. Kipper. And I'm so happy to be here with Alistar to provide some medical insight into the case of Deborah Green, a doctor with many specialties.


You can find episodes of medical murders and all other Spotify originals from podcast for free on Spotify or wherever you listen to podcasts to stream medical murders for free on Spotify. Just open the app and type medical murders in the search bar. This is our first episode on Deborah Green, an oncologist from Kansas City, Missouri, accused of poisoning her husband and murdering two of her children. This week, we'll explore Deborah's past, her qualifications as a doctor and her ruthless pursuit of perfection.


Next week, we'll dive into Deborah's heinous acts and her desperate attempts to get out of prison. All of this and more coming up. Stay with us.


In the summer of 1995, 44 year old Deborah Green looked at her visibly ill husband, Michael Ferar, lying in a hospital bed and seemingly felt nothing, the air in the room hung heavy with resentment.


He'd recently asked for a divorce, which sent Deborah into a downward spiral.


Now she felt sickness was exactly what he deserved. Mike's tending nurses and doctors conducted their routine checkups, seeking the source of Mike's illness. But no one suspected that Deborah, who stood at his bedside throughout it all, was the reason he was there in the weeks leading up to his health emergency. Deborah had poisoned him by grinding up castor beans and putting them in his food after several meals. Her husband experienced crippling abdominal pain. Deborah hoped he'd die. But when he didn't, Deborah didn't let up.


She was determined to make her husband's life a living hell, no matter how far she had to go to do it. In many ways, Deborah's drive towards her goals was the most dangerous thing about her, but it hadn't always been.


Deborah Green was born on February 28, 1951, to a quaint, unassuming family in Illinois. Her father drove a bakery truck and her mother stayed at home to look after Deborah and her older sister. Despite her modest background, Deborah showed flashes of genius almost immediately. According to her uncle, Deborah taught herself how to read at only two years old. She grabbed the newspaper every day and scanned its pages until the words started making sense from their nothing held the young girl back.


She thrived in elementary school, but often felt bored. Her teachers noticed that Deborah always appeared ahead of the curve, which may have been why she never seemed to care what they were talking about. For her, it was yesterday's news.


Still, Deborah continued to excel effortlessly in school, and by the time she got to high school, her caseload boasted a majority of Advanced Placement classes. But Deborah was anything but a one dimensional academic. She enjoyed a spot on the cheerleading team and was popular for her witty sense of humor. Her social life flourished starting her junior year. Deborah dated a varsity football player, Greg Short, and became the envy of many.


But Deborah didn't truly appreciate the joys of her adolescent life. Instead, she had her eyes on the future while her peers were plotting which parties to go to and who they wanted to kiss. Deborah pondered college, noting that her favorite subjects were math and science. She considered pursuing a career in engineering. There were certain trepidation she had to confront first. However, while the number of women in STEM roles had gradually increased in the 1960s, many still viewed it as unconventional.


After deliberation, Deborah decided she wouldn't let this stop her.


In 1969, she graduated co valedictorian and headed to the University of Illinois, where she majored in chemical engineering. Shortly after arriving there, she broke things off with her high school boyfriend, Greg, who stayed behind to attend a local community college. Deborah wasn't shy about why she walked away from the relationship. Greg just wasn't smart enough. Deborah didn't imagine she'd have time for guys who weren't on the same life track. She was one that was headed for greatness.


At just 18 years old, Deborah looked around her and for the first time there were people she considered to be equals academically.


Things were a bit more difficult now, but Deborah didn't struggle in the least. She may have received her first baby, but by all other metrics, she coasted through her first year at the university, despite the ease of it all. Deborah grappled with a tough decision after observing just how many engineering students there were. Deborah worried the job market might be oversaturated, so Deborah changed her major to chemistry with an emphasis in medicine. The switch felt effortless, and despite the grueling coursework, Deborah found time to start dating again.


It was during her undergraduate years that Deborah met an engineering student named Dewayne Green. He was smart, kind and handsome. The pair hit it off almost immediately. Their conversations were far more substantive than the ones Deborah had in high school with Greg. And unlike that previous relationship, Deborah saw potential in D'Wayne. He was a brilliant engineer, driven to succeed. He already had his eyes set on getting a Ph.D.. To Deborah, D'Wayne appeared like the right safe choice in a partner, the perfect person who could offer her the idealistic life she wanted.


The feeling was mutual and the pair grew closer before finally dating. They remained together over the next few months and eventually moved in together as her college experience came to a close. Deborah decided to attend medical school at the University of Kansas. It was no coincidence that her boyfriend, Dwayne, was on his way to an advanced degree as well, in line with her earlier academic achievements. Deborah completed her undergraduate degree and only three years, an impressive feat given her field of study and degree switch midway through.


Somehow she made it work, and after their graduation, she and Dwayne packed their bags for a huge next step that they would be taking together.


As far as Deborah was concerned, everything was falling perfectly into place in the fall of 1972, at only 21 years old, Deborah made her new home in Kansas City, where she began medical school. This was no small undertaking.


Getting a medical degree isn't for the faint of heart, and it can end up consuming your life. Medical school is pretty much a full time commitment, and there really isn't much time for a personal life outside of it. I remember our socialization was primarily restricted to our fellow classmates and mostly revolved around the classroom, work and study groups on a romantic front. Very few of us developed any serious dating relationships during our time at school. Medical school clearly represents immense stress and can be a threat to someone's well-being, especially during a time in life or socialization.


And fun feels so vital to overall happiness. Many students needed to take some time off from school in order to clear their heads. If someone entered medical school with an underlying mental health issue, their condition was very likely to worsen. On a personal level. I feel the sacrifices I made in medical school were necessary in gaining a command over the academic and clinical challenges I now face on a daily basis. However, any pressure like this clearly comes with a cost.


Despite these hurdles, Deborah seemed to be doing just fine in medical school.


Deborah didn't seem to mind that she was investing her years of youth, brilliance and beauty in exam rooms and study halls. She wasn't fazed by her first cadaver dissection and got along well with her classmates. They found working with her to be exceedingly pleasant. Outwardly, she conveyed the appearance that she had everything together and loved her life. Matters in her physical world were cut and dry. She'd made them scientifically based on which would yield the optimal result. But on the inside, Deborah felt unsure of her career choice.


She didn't mind the medical work, but she didn't love it. Unfortunately, she felt that she had already chosen a path and needed to stick with it. During clinical rotations, Deborah desperately searched for an area of medicine that felt right.


Young med students work in different areas of the hospital to get a feeling for what kind of medicine they want to practice. When a student initially in her school, they go in with an idea of what branch of medicine they want to pursue. However, this preference almost always shifts during their third year of med school. Future doctors are required to take standard rotational courses in hospital settings. And because of this new exposure to different medical specialties, it's during this time that career trajectories change.


These course rotations cover general medicine, general surgery, pediatrics, obstetrics, gynecology, radiology and psychiatry. In essence, this is the time during training that students get a hands on comprehensive overview of the many available medical careers they're able to choose from, with the advantage of having supervision and guiding mentorship going into my third year of medical school.


I firmly believe that I wanted to get into pediatrics because I loved working with kids and thought it would be fun and rewarding. I then briefly turn to obstetrics before jumping into psychiatry, but ultimately I fell in love with my training in internal medicine. It's definitely interesting how my initial interest morphed into something completely different, but this is what tends to happen in medical school. I feel that these third year rotations were incredibly helpful and necessary for me, and they really helped reveal a med students true strengths and weaknesses for practicing medicine.


After Deborah made it through her first several rotations, she found herself interested in the emergency room. She liked the fast influx of patients with various conditions, complications and circumstances, everything from gunshot wounds to mystery illnesses. Deborah expected the treatment routes would never become mundane because each day seemed different and exciting. Deborah revelled. Each time the nursing staff brought a critical patient to triage for assessment. Each was a new opportunity to employ critical thinking, and the assortments would teach her how to juggle her responsibilities.


Deborah took her next step forward in stride, as she always did. Her clinical instructors were impressed by her work, and Deborah felt at home in the E.R. with her career plan in place. It seemed like she had everything she wanted, but around that time she got another piece of the American dream, a wedding proposal from her boyfriend, Duane.


This was the final achievement that would launch her into the idyllic life she'd always hoped for. Without hesitation, Debra agreed to the engagement. Before graduating medical school, Deborah and Duane got married. They didn't have enough money for a large service, so very few people attended their wedding. But the couple didn't mind. They were simply happy to be checking off another box on their road to success. Deborah didn't know that. Just around the corner, her picture perfect plan was about to unravel.


Up next, Deborah's personal life takes a drastic turn. Hi, listeners.


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Now back to the story. In 1975, 23 year old Deborah Green, near the end of her last year of medical school and faced the grueling coursework that came with it, unfortunately, Deborah found herself a bit distracted by her personal life. Her marriage with Duane had started to crumble as both pursue doctorates, Deborah and Duane had drifted apart. Deborah spent countless hours studying for her exams and working different clinical rotations, and Duane studied tirelessly for his Ph.D., caught up in the chaos of their day to day lives.


The pair barely had any time to see each other and slowly lost their connection.


But instead of trying to save their marriage, they seemed resigned to move on from one another like she once had as a young child in school. Deborah had grown bored.


She couldn't shake the feeling that Duane was nothing more than a safe option. In the grand scheme of things, he didn't seem to be all that interesting. But rather than voice those thoughts, the moments, they began to haunt her. It seems Deborah let her feelings fester.


She pushed her failing marriage to the back of her mind while she completed her last few classes. Deborah graduated with her M.D. in 1975 at 24 after only three years of medical school, if life had a concrete fast track. One thing was certain. Deborah was on it and she wouldn't stop after she had two degrees in her pocket. Shortly after completing med school, Deborah started her first residency in the emergency room of Truman Medical Center in Kansas City, Missouri.


Residency programs are the first steps for new doctors in the working world. After four years of medical school, followed by a one year internship, med students enter their residency programs. The likes of these residencies vary depending on whether one chooses to pursue a residency in general medicine or surgery if one decides to enter a general medicine path. These programs typically last three years. The first year is spent training as a general practitioner during their second and third years. They can continue on their general medicine path or choose a subspecialty route that focuses on targeted medical interventions and specific disease treatments.


This subspecialty training includes areas like pulmonology, cardiology, gastroenterology, endocrinology, neurology and infectious disease treatment, to name a few. Surgical residencies, on the other hand, range from about three to six years, depending on the chosen field. Besides general surgery, some surgical subspecialties include neurosurgery or orthopedics, obstetrics, urologic and vascular surgery. Doctors are also able to take elective courses during their last year of residency, regardless of their chosen professional domain. And this allows them to gain even deeper insight and perspective into their wheelhouse.


These doctors are able to practice general medicine at this point, however, they aren't allowed to practice medical or surgical specialties until they complete their residencies. From my own experience during my residency, I augmented my training and income by moonlighting in emergency rooms where I had to make treatment decisions without the support of supervising professors or senior doctors. This was at times very scary because I was forced to make life and death decisions. But the silver lining from this experience was the confidence I gained in trusting my ability to care for patients on my own.


Although the failure and dropout rate among residencies and high, it's definitely a time where you have to step up your game for Deborah.


Failure wasn't an option. She excelled in the department and many viewed her as a shining young star. But Deborah soon learned she couldn't have it all.


As she progressed through her residency, she and Dwayne separated. Initially, fear flashed through Deborah's mind she'd worked hard, building the seemingly perfect life on paper.


Now others would see her failure for someone used to succeeding. The first couple of days of her split may have felt demoralizing, but rather than sinking into the shame she felt for falling back on something that had once been a vital part of her plan, she leaned into her newfound freedom. Just weeks after her separation, Deborah decided she was done playing it safe. Rigorous schooling had kept her on a strict schedule, pursuing options that only ever supported her career.


The sense of liberation, she felt, was likely a reaction to the years she had spent repressing her desire for spontaneity and fun.


Now she chose to make up for the portion of life that passed her by in school.


She bought a fast car, went to bars and took plenty of men home, though her career still dominated much of her time, she took on a work hard play hard mindset without a husband to worry about.


She didn't have to answer to anybody for who she was in her downtime. But after months of letting loose, Deborah was burnt out by her own indulgences. What started as a nourishing experience drained her, and about a year after her split from D'Wayne, Debra felt like something was missing. Perhaps she longed for the safety of an anchor that kept her close to shore. Fortunately for Deborah, the search for grounding didn't last long. By 1978, during the final year of her medical residency, she'd met a kindred spirit.


His name was Michael Farrar, and he was a med school student at the time with a vested interest in cardiology. Deborah appreciated the hard work that Mike put into his job as an intern in the emergency department and quickly grew to like him, though she was four years older than him, that didn't keep her from developing more serious feelings.


And though Mike found himself slightly embarrassed by Deborah's occasional outbursts of anger, he thought she was gorgeous, brilliant and strong willed. More than that, the two appreciated that. They shared similar professional aspirations. Meaningless hook ups had been a good break from the mundane life Deborah had built in her first marriage.


But she was ready to invest in something secure, and Mike made her feel comfortable. So in 1978, the pair began dating. But even though Dwayne had spent the better part of a semester getting to know Deborah, there was still much he didn't know about her. And by this point, Deborah had a pretty significant skeleton in her closet, her past marriage. She couldn't leave it unaddressed forever.


One day, Mike was spending time with Deborah at her house when a man came knocking at the door hoping to pick up a few of his things. Mike soon discovered it was Duane. Deborah's first husband. Mike was likely taken aback by the encounter, but Deborah assured him that Duane was firmly part of her past and she wanted to move on. This was enough reassurance for Mike. He accepted Deborah's explanation and went on in pursuit of a life with her in their beginnings.


They were delighted to find that they made a good power couple.


Deborah was on track to become an attending physician, and Mike was a promising young med student about to look for a residency program of his own. Mike figured Deborah might even be able to give him a helpful suggestion or two as he completed it. And Deborah was effectively moving on from her past. In December of 1978, Deborah was finally legally divorced from Duane. In the settlement, the judge awarded Duane Deborah's prized car. But Deborah didn't seem to mind all that much.


Her life moved on with Mike a year later, in early 1979.


The new couple was engaged to Deborah's delight. According to Mike's recollection, Deborah's demeanor in the relationship began to change. Around this time, he didn't know if it was pre wedding jitters or just the stress of it all. But Tepper was transforming before his eyes and not for the better.


Gone was the lively, humorous person Mike had fallen in love with, instead, Deborah became critical and mean she had frequent outbursts in public over minor inconveniences, like someone swooping in to take her parking space. These were akin to the sorts of reactions she'd shown when Mike was interning in the emergency department where he'd met Deborah. But seeing this side of her come out in her personal life was a whole new experience. Ultimately, Mike rationalized Deborah's behavior by attributing it to the stressful wedding planning.


So many logistics had to come together, and Deborah's perfectionist tendencies weren't conducive to overseeing so many things. Still, she managed to pull through and everything fell in line with ceremony details and reception bookings. Unfortunately, even then, when things were good, Deborah's eruptions didn't stop. On May 26, 1979, shortly after Mike graduated from medical school, the pair were married in front of their friends and family as Mike walked back down the aisle with his bride on his arm.


He couldn't shake the feeling that he'd made a terrible mistake. It was supposed to be the happiest day of his life, but he didn't experience any joy. Love didn't radiate from his new wife either. Instead, she seemed cold and calculated.


That night, after the reception, Mike noticed that Deborah appeared more interested in reading a book than spending her wedding night with him. To her, the marriage seemed to be a minor formality. In that moment, Mike feared the worst for their future. But he wouldn't return to those trepidations for some time. He was preoccupied. Shortly after their union, Mike landed an internal medicine residency, which meant he would need to move to Cincinnati, while Deborah wouldn't be working at the university hospital there with Mike, she found work at the Jewish hospital several miles away.


So with logistics squared away, they started a new chapter of their lives in Ohio.


But even though she'd found work, Deborah wasn't so jazzed by the shift.


Her work in the E.R. had lost its novelty.


Deborah realised that not everything about the emergency room was exciting, the majority of her patients ended up being those with easily treatable ailments. Many of them were people with colds, earaches and minor scrapes who by Deborah's assessment, should have gone to a general practitioner or stayed home. Deborah refused to accept the fact that she'd spent five long years of her life preparing to care for people whose conditions were so lackluster. Deborah felt demoralized while doctors sometimes appear to have everything together.


There are people, too, and can fall out of love with their job. But it's not something we commonly see their interests in their respective specialties is generally very strong, which is what drives him through schooling and their chosen residency path. However, there are those outlying cases where doctors expectations of a particular medical field don't line up with reality. The reasons for this are diverse and can have to do with unfulfilled lifestyle goals, newfound interests and subspecialty fields, and even the unanticipated mismatch between someone's personality and their chosen medical profession.


Despite all of this, it's not uncommon for emergency room doctors to grow resentful of their work. They can easily develop burnout, and this has a lot to do with their overloaded work schedules. On top of this, there's a growing trend for patients to come to the E.R. with relatively minor problems, issues that don't really qualify as emergencies. This is because primary care doctors are becoming more difficult to see due to insurance barriers, their limited work hours and a declining number of these practitioners.


Also, many people that work during regular business hours can only find time to seek treatment in emergency rooms, which offer 24/7 care. However, for lots of our doctors, this is a stress that waxes and wanes and many find their spark again. Still, some end up progressively resentful, lose inspiration and can continue.


As the years stretched on, Deborah didn't regain her passion for her yard work. Instead, she grew increasingly frustrated. Many of her patients aggravated her. She thought about all of the resources they were wasting by taking up her time. And apparently she didn't always regulate her resentment maturely, though she'd always considered herself a people person. Her strong willed nature clashed with others, and sometimes she took it upon herself to tell off patients. She also had no problem disputing the decisions of her colleagues several times in the emergency room.


Deborah gave an assessment her superior disagreed with Deborah hated being wrong and fought it. But usually in the end, Deborah was proven right while it was validating in the moment.


Over time, these disagreements fostered hostility between Deborah and her co-workers. In addition, Deborah allegedly developed a poor bedside manner, especially with patients she believed were wasting the hospital's time.


Understanding and empathizing with a patient are some of the most important parts of medicine. A doctor can be an excellent and skilled clinician, but if they don't relate well to their patients, their medical advice and messages may not translate well. Developing a good relationship with patients is critical in establishing trust, which is vital when it comes to their acceptance of appropriate treatment recommendations and an ongoing maintenance of their overall health in sensitivity to a patient's needs can result in a lack of compliance in terms of their willingness to take prescribed medications, following up with diagnostic exams, and may even lead to avoiding their doctors altogether.


Many practitioners realized early on in their training that they have a low tolerance for dealing with patients, and if they're smart, they'll go into specialties where communication and compassion are of background importance. Some specialties that don't require lots of face to face. Doctor patient interactions include surgery, radiology and pathology. This is not to say that these kinds of specialists lack empathy or kindness, but these traits aren't as essential in these domains outside of these historically less personable fields of medicine.


However, a poor bedside manner can lead to poor quality health care, and the outcomes of this can be devastating to someone's well-being.


Fortunately for Deborah and more importantly, her patients, she realized the E.R. wasn't a good fit.


She decided to pursue a career in health care that would allow her to feel more esteemed for her specialized knowledge to do that, she joined in the second year of Mike's three year internal medicine residency program.


Deborah had already completed one residency, and she did have ample medical experience in order for a doctor to transfer into a different residency program, though, they had to matriculate through that specific new program. This isn't a very common move for a doctor. And only about 15 percent receive specialty licensing and more than one area of medicine. The doctors that do this, however, are greatly sought after in special circumstances. A doctor may also switch specialties because of their incompetence or dislike for their chosen field, which seemed to be Deborah's motive.


Given the lack of care Devers showed her patients, her switching specialties was actually a responsible decision on her part, and it certainly benefited her fellow staff and patients in the E.R. who seem to be equally tired of her.


While this switch helped Deborah's professional life, it complicated her marriage like she'd experienced in her first marriage. Deborah found herself so focused on academics she didn't have time to dedicate to Mike in turn.


Mike felt unloved to him. Their marriage seemed more like a financially beneficial living arrangement than it did a harmonious relationship. But though their personal matters were frayed at times, they stuck it out through their medical program, hoping they could fix things once their residencies came to an end. Unfortunately, that never happened. Even though they both finished in 1981, they didn't have space in their lives to focus on repairing their marriage. Deborah accepted a fellowship in oncology and Mike entered one for cardiology.


These new fellowships were equally as taxing as their former program, but this time they couldn't afford to keep postponing their personal lives.


Shortly after they took up their fellowships, 30 year old Deborah started vomiting and experiencing extreme nausea at all hours of the day. That's when the couple received surprising news. Deborah was pregnant. Up next, Deborah's unplanned pregnancy further complicates her crumbling marriage. Now back to the story.


30 year old Deborah Green excelled at nearly everything in life, but the cracks in her perfect facade showed after years spent prioritizing her career, Deborah's marriage with her second husband, Mike Farrar, was on shaky ground. But when Deborah discovered she was pregnant, everything came to a crashing halt. Though the couple remained in their respective fellowships, their busy lives and career goals were impacted by their preparations for a child. Between that and their workloads, there wasn't time to map out an ideal future.


Instead, they were forced to find a way to make things work.


On January 20th, 1982, Deborah gave birth to a baby boy named Timothy, to their surprise, he brought a previously unknown joy to their lives. But just six weeks after she delivered him, Deborah returned to her fellowship at the hospital. Life became an even bigger balancing act than before. A work life balance can be very delicate for many doctors, their work requires complete concentration and home life can often fall to the wayside. People don't just get sick between the hours of 9:00 to 5:00.


And unless you're a specialist who's able to define your own hours like a radiologist or dermatologist, you may have to remain on call for patients after hours, on weekends and during holidays. I would say that female doctors have a greater struggle in striking this balance, given the added societal pressure women have when it comes to being viewed as the glue that holds the family together. On top of this. Doctors usually finish the bulk of their training and dive into practice at around age 30, which puts a biological strain on female practitioners if they wish to bear children.


Being pregnant while practicing medicine can also, understandably, be grueling at times.


There are, fortunately, always special circumstances and creative methods that can be worked out to make these situations more manageable.


Parental leave for doctors is typically eight weeks, but there are variations depending on the country, health care employer and the specific needs of a newborn and mother's health. Regardless, there are some doctors and managed to get this just right, while others seem to struggle and have a very difficult time.


For Deborah Omic, new parenthood was made harder by the fact that they were both training as doctors, they struggled to find the sweet spot with their routines. But rather than address the problems, the two drifted deeper into their own self avoidant tendencies. Deborah still had outbursts and yelled about annoyances at the hospital to her husband. Meanwhile, Mike receded further into his own work. Yet in the midst of the chaos and deepening marital fracture, they decided it was best for their child, Tim, to have a sibling nearly three years later.


The couple welcomed their daughter, Kate, while Deborah and Mike planned on having Kate. Their lives became even more hectic. They now were accountable for two young lives.


Adding to their stress, both Deborah and Mike prepared to take their board certifications in their respective fields as their fellowships came to a close. This would be the make or break moment in both of their careers. Without board certification, it could be much more difficult to work in their desired specialties. In 1985, Deborah was in the midst of what should have been a full blown crunch time.


However, according to Mike, Deborah spent most of her nights reading novels instead of studying, meanwhile, he worked arduously at his own studies, worried that when the time came, he would not be ready for the exam. Mike didn't necessarily approve of Deborah's cursory attitude toward the certification. Perhaps she thought she had it in the bag. But as it happened, Deborah did not. While her medical skills were nearly unmatched, Deborah failed the exam after receiving her results.


She erupted, blaming Mike for her failure. She yelled at Mike, saying that she was handcuffed by her duties as a mother. But Mike stood his ground, claiming he'd helped out with parenting in equal parts. He just used his limited downtime to study, as usual. Deborah wasn't willing to admit where she'd screwed up. It took days for things to calm down in the household as they tried to figure out their next move as a family. Mike still had a year left of his fellowship, but Deborah needed a new plan.


Perhaps she feared that not passing her boards was the final nail in the coffin for her career. But instead of crumbling in defeat, Deborah decided to join a private practice in hematology and oncology, though she wouldn't be listed as board certified. While Deborah was a licensed doctor, she couldn't become a certified oncologist without passing her boards, which some hospitals require before a physician can start practicing. There are approximately nine hundred thousand board certified physicians in the U.S., although passing the board exam isn't a necessity to practicing medicine.


Oftentimes, however, or certification is necessary in order to work in teaching hospitals or to practice within large HMO or PPO groups. All one really needs in order to practice medicine is state licensure. But many doctors wish to become certified due to the prestige that it implies. Board certification on a surface level creates a greater perception of competency among peers and patients. And this is because it demonstrates that a doctor has passed additional testing. In Deborah's case, however, she wanted to go into private practice, which doesn't require board certification, having more insight into her perfectionist streak, I would guess that her desire for certification was an issue of ego, not necessity.


Despite the fact that building her private practice was full of hurdles, her troubles weren't the result of her failing her boards.


Deborah languished, getting her business off the ground. She found at least some success, but her new staff was less than impressed. While no one argued with Deborah's medical knowledge, her bedside manner showed no signs of improvement. If anything, Deborah seemed more confrontational now that she had her own practice and the business appeared to suffer for it.


Nurses who worked with her at the time described her as cold and unfeeling. One even claims that, quote, She was the strangest doctor I've ever worked with in my life, likely as a result of such behavior. Her schedule of patients lightened, leaving the practice in a difficult financial spot. A hectic year later, Mike completed his cardiology fellowship and a medical group in Kansas City soon offered him a lucrative job, since Deborah's practice never truly found success. The decision to move was easy.


In 1986, the young family moved to Kansas City for Mike's new job, and Deborah joined a private practice there. Everything went smoothly for Mike, but for Deborah, things weren't so easy. Her behavior continued to cause problems.


She didn't get along with the other doctors and nurses at work, and her headstrong attitude rubbed clinicians and patients the wrong way. A year after joining, Deborah left the clinic to form her own private practice, and this time she would be the only doctor and by most assessments, her new venture thrived. But that all changed when Deborah discovered she was pregnant again. In 1988, the family welcomed their third child, Kelly, and once more, the family's delicate balance was thrown off kilter.


Over the next four years, Deborah and Mike desperately struggled to keep track of their chaotic lives. But eventually they knew something had to give.


In 1989, 38 year old Deborah gave up her practice. It made sense since Mike made more money, but Deborah held resentments that she'd been the one who'd had to sacrifice her career.


Deborah felt like Mike got to have everything the home, a family and a career. Meanwhile, she was constantly pivoting to keep everything afloat, despite the anger that welled up inside her. Deborah decided she wouldn't give up on work altogether. Instead, she put her knowledge of health care to the task of reviewing medical complaints submitted by Medicare beneficiaries. It was less engaging work, but it allowed her the flexible hours she needed to shuttle her kids to the growing list of activities.


Tim loved hockey, Kate had ballet, and Kelly was a precocious four year old who needed lots of attention.


But every effort Deborah made to help her family seemed to make her resent Mike more.


In response, Mike spent more and more time working, which only catapulted their marriage further into conflict.


From Mike's perspective, Debra's behavior was growing dangerous. He suspected that Deborah had developed a dependency on pain medications. He knew what she was capable of while sober, he'd seen her yell at minimum wage clerks and airline employees on plenty of vacations. He shudder to think about what she in an overly medicated state might do to her kids at home without him there to calm her down.


Additionally, Mike thought Deborah seemed to shock a lot of responsibilities as a homemaker. The house rarely seems clean, and Deborah didn't care. When Mike brought up the issue, her growing despondency was all the more reason for Mike to give up. So at the beginning of 1994, Mike did just that. He asked for a divorce. This sent Deborah into a tailspin, she reckoned with everything she'd sacrificed, she'd given her body, her time and her career for this family and their American dream.


And now Mike was discarding her as though all of it had been for nothing. Mike moved out shortly after and Deborah was quick to spread her anger toward her husband, to her children. She allegedly fed them horrible comments about their father in desperate attempts to get them on her side. She'd hoped they'd vouch for her when lawyers eventually got involved. It wasn't long before Mike noticed his children's growing hostility toward him. A few months after he left, Mike reconsidered the divorce and told Deborah he wanted to work through the problems that had arisen in their marriage.


After moving back in together, the couple promised to actively address their issues. They talked about starting fresh in a new home and decided to buy a luxurious house in the upscale Kansas City suburb of Prairie Village. For the first several months after the move, things improved. Mike tried spending less time at work, and Deborah appealed to Mike's pleas of being a better homemaker. But old habits die hard.


Debra sank into her usual routine. Her temper became short and her behavior grew erratic. Mike picked up extra shifts, as he had before. By the spring of 1995, Mike wanted to call it quits again. But this time Mike kept his discontent secret. The family had a trip planned for Peru and he didn't want to ruin it. So Mike decided to table the topic of divorce until they got back. The trip was planned through the kids school, so there'd be plenty of distractions and other people to spend their time with, including an attractive fellow parent who we'll call Elizabeth.


In Peru, Mike and Elizabeth met and they were immediately drawn to each other while Mike broke Deborah's trust. He didn't seem to care. He wanted to move on back home. Two weeks later, he finally told Deborah of his intentions.


According to Mike, she reacted with extremely volatile behavior, screaming a lot of profanity and hitting herself in order to keep things amicable with the children.


Mike said he'd stay in the house until everything was finalized, but Debra likely perceive this as Mike's tactic to keep her out of her children's ears. So he had a chance at custody. In her mind, he'd made himself the enemy. So a few weeks later, when Deborah drove to the other side of town to special order castor beans from a store, she didn't feel any guilt. She told the clerk this unusual request was for her daughter's science project.


In truth, her children didn't have any assignment. Deborah intended to poison her husband. While castor beans are innocuous enough to be purchased at specialty grocery stores, they contain high traces of the chemical ricin. If castor beans are chewed up and swallowed, the ricin within them can cause serious harm to the human body, including death. When someone ingests ricin, the substance invades your body cells and prevents cellular protein production without the ability to make this needed protein cells die.


This is ultimately harmful to the body's entire system and over time can cause death in the absence of meticulous intervention. If someone is poisoned by ricin, symptoms can include seizures, vomiting and bloody diarrhea. This causes a major loss of fluid, which then leads to severe dehydration and a dangerously low blood pressure. Eventually, organs will start to fail. Notably the liver, spleen and kidneys resulting in death. It usually takes anywhere from 36 to 72 hours after exposure for ricin to kill someone.


And this time frame is hastened or drawn out depending on the size of the dose. Unfortunately, there's no antidote for ricin poisoning, so the best treatment is tending to the immediate symptoms. This treatment includes administering intravenous fluids, using activated charcoal to flush and cleanse the gut and giving medications to reverse the drop in blood pressure. Seizure medication is also an important tool if cesium becomes part of the clinical picture, even though castor beans are relatively safe on their own in the hands of someone looking to do harm, they can be very deadly.


When she got home from the store, Deborah ground the castor beans up into a colorless, tasteless powder, then placed the dust into Mike's food and it wouldn't take long before they took effect. Shortly after Deborah started feeding Mike the ground up beans in his food, he began feeling ill.


He chalked up his abdominal pain to lingering issues with some of the food and water he'd ingested in Peru. But when the pain didn't subside, he grew worried that he was coping with a more serious condition. Things got so bad that when Mike went to the emergency room, doctors decided to admit him to the hospital, while doctors moved frantically to figure out what ailed Mike. Deborah stood by and watched, keeping a wry smile just hidden from view in her mind.


Everything was going perfectly to plan. Thanks for listening to medical matters and thanks again to Dr. Kipa for joining me today. Thank you, Alistar. For more information on Deborah Green. Among the many sources we used, we found the book Bitter Harvest by Ann Rule, extremely helpful to our research.


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Medical Matters is a Spotify original from podcast. It is executive produced by Max Cutler, Sound Design by Trent Williamson with production assistance by Ron Shapiro, Carly Madden, Kristen Acevedo, Jonathan Cohen, Alexandra Trick for Dotti and Bruce Kaktovik. This episode of Medical Murders was written by Robert Tyler Walker with Writing Assistants by Maggie Admi, Fact Checking by Bennett Logan and research by Chelsea Wood. Medical murder stars Dr. David Kepa and Alistair Murden.


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