Listener discretion is advised, this episode features discussions of animal cruelty, murder, medical malpractice, mental health conditions and sexual assault that may be upsetting. We advise extreme caution for listeners under 13.

Power is a dangerous and elusive thing to acquire it. Many have intentionally devised false reputations or feigned necessary credentials, and unfortunately, those who lie their way to the top may subject others to suffering without ever facing consequences of all authorities one might answer to in modern society. Perhaps the most grim is a murderer who obtains office as an elected official.

Very few have traversed this path, perhaps because most killers pay for their crimes quite publicly. But in the case of Dr Marcel Petto, madness, medicine and command combined for a cocktail of untrammeled corruption and death. Often killers lurk in the shadows but not talk to Marcel Petto.

It's likely he held elected office while he committed many a murder and in doing so became one of the most prolific serial killers in the history of France. 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 it 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 Alistair Madden and I'm joined by Dr. David Kipper, M.D..

Hi, everyone. I'm Dr. Kiffer.

And here to offer Alster some medical insight into our first installment of the case of Dr. Marcel Patillo, who fast tracked his way to a medical license and in doing so, seem to miss the part of the Hippocratic Oath that directs doctors to do no harm.

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 Marcel Petitto, a French doctor who killed dozens of people during his medical career beginning in the 1920s and extending through the Second World War. Today, we'll cover Patio's troublesome early life, the controversies he sparked as a doctor and politician in small town France and the mysterious deaths of several of his patients.

Next time, we'll learn how Dr. Pazzo took advantage of Nazi occupied Paris to kill dozens in his own secret murder chamber. All this and more coming up. Stay with us. This episode is brought to you by Blue Apron, nourish your body, unwind and learn new skills with blue apron, you'll experience all the benefits home cooking can bring with perfectly portioned ingredients and exciting recipes delivered right to your door. See what's on this week's menu and get eighty dollars off across your first four deliveries when you visit blue apron dotcoms, Spotify.

That's Blue Apron Dotcom slash Spotify. This episode is brought to you by Land Rover, don't follow the crowd, blaze your own trail in the twenty twenty one Range Rover sport with its iconic, muscular silhouette, six exhilarating power trains and the control of terrain response to with dynamic program. It's a performance SUV like no other. Contact your local Land Rover retailer today to schedule a test drive Land Rover above and beyond.

This episode is brought to you by Uber Eats. Tonight I'll be eating local specifically pizza with tomato, spinach, broccoli, green peppers, no black olives, extra mushrooms from my favorite neighborhood spot. No matter what you're craving, Uber Eats has a great selection of your favorite local restaurants. Eat local with Uber eats tonight.

By January of 1922, a stranger had moved into the village of Ville Nerve, Cerrejón in France, about 70 miles southeast of Paris. This man rented a small cottage in the town and introduced himself to the locals as Dr. Marcel Patio. At 25 years old, Patio was far younger than the village's two elderly physicians, a detail he used to lure in new patients since he'd gone through his medical studies. More recently, he claimed he was more up to date on medical knowledge and treatments.

Dr. Petto was an immediate hit with the villagers, they appreciated his friendly bedside manner and willingness to see patients whenever they wanted. He also seemed able to diagnose their maladies far faster than the other doctors in town. Soon, Patio was the most popular doctor of the three. But what the villagers didn't know was that their new doctor had a violent past. Had they known his strange and bizarre history, they likely would not have trusted him with their health or with anything else for that matter.

Marcel Pazzo was born on January 17th, 1897, in Osaka, France. One thing was evident to the young boy that would follow him into adulthood. His personality swung between mischief and brilliance in school.

Patio's teachers were instantly impressed by his intelligence, which puts him far beyond his classmates.

By the time he was five years old, he was already reading at the level of a 10 year old. But as remarkable as his academic achievements were, his behavioral issues were even more out of the ordinary.

In 1988, when Pettier was just 11 years old, he passed around pornographic photos during class and sexually propositioned a male classmate. He also showed a worrying violent streak. His parents often caught him killing insects and torturing small birds to death while his teachers found him brandishing his father's revolver at school more than once.

In another incident, Patio roped a friend into a knife, throwing performance during recess, hurling knives into the doorframe around his classmate.

Shockingly, Pacho never hit anyone. His throws were extremely accurate. His parents didn't know what to do with their gifted yet extremely troubled child. Doctors failed to offer beneficial solutions, and Patio's behavior only grew more problematic as he became a teenager. As a teenager, Petto once interrupted a history class by pulling out his father's pistol and firing a shot into the ceiling.

With this, the school teachers finally had enough and expelled Petito. That meant Petto had more time on his hands to pursue other interests like theft when he was 17 years old, Petto was arrested for stealing mail from a post-box, possibly in an attempt to find blackmail material. The local police charged him with theft and destroying public property. When Patio went to court for these charges, they recommended psychological evaluation. On March 26, 1914, a psychiatrist concluded that patio was an abnormal youth suffering from personal and hereditary problems, which limit to a large degree his responsibility for his acts.

The judge on his case promptly declared Petto mentally unfit to stand trial. Patio's spent the remainder of his teenage years struggling to find any kind of stability, academic, emotional or otherwise, it seemed, however, that every effort to start somewhere new was thwarted by patio. He was expelled from at least two other schools in and around France as his petty thievery became something of an addiction. Kleptomania or addiction to petty theft is a type of behavioral disorder that can greatly disrupt someone's life.

It's characterized by issues with emotional regulation and difficulties with impulse control. Kleptomaniacs have trouble resisting temptation. And unlike common thieves, they don't steal out of necessity. Instead, they steal because they can't ignore the desire to steal. We really don't know the true reasons Patio's started pocketing his father's weapons or why he stole mail from the post-box. But it's clear that he had other underlying issues besides a propensity to take things that weren't his. This actually helps support the diagnosis.

Kleptomania often has other personality disorders associated with it, which ties into Patio's sexually inappropriate and often violent misconduct in school. Ultimately, it's not fully understood what causes kleptomania, but it's thought to be the result of imbalances in two neurotransmitter systems dopamine and serotonin, dopamine, the key neurotransmitter that governs the reward circuitry and serotonin, which has been linked to obsessive thinking and behaviors. Petito likely experienced a rush of dopamine every time he stole something, giving him immense pleasure.

And over time, this behavior became habit. The disorder may also be linked to irregularities in the brain's opioid system, which influences our ability to regulate impulse and cravings. Marcel Patio's certainly had other psychological issues, but it's clear that he lusted after the rush of taking things it didn't belong to him, but the consequences of his small crimes were growing untenable.

Naturally, Patio's widowed father was enormously affected by his petty theft and school expulsions.

Determined to turn his son toward a better life, he sent him to a special school in Paris, where he finally managed to graduate in 1915, six months later.

Like most of the other young men in France, 18 year old patio enlisted in the French army and was sent to the frontlines of World War One. Unsurprisingly, the brutal violence of trench warfare did not help stabilize Patio's erratic behavior or kleptomania. In spring 1917, he was hospitalized with an injured foot and lung issues caused by poisonous gases while taking rest in a health clinic. 20 year old patio was caught trying to steal blankets. This got him in hot water as punishment.

He was sent to a military prison in Orleans, France, where his mental state continued to deteriorate after being moved to the military psychiatric unit. A doctor examined Petto and diagnosed the troubled soldier with depression, melancholia, fatigue and emotional disturbance.

As a result, the doctor determined that Petto was not legally responsible for his thievery. When evaluating a patient with psychological issues, it's often very difficult to determine exactly how their mental disturbances might inform certain decisions for a doctor to establish if someone's condition supersedes their criminal responsibility. There are a number of things he or she needs to consider. One conclusion they need to make is whether or not the perpetrator knew the difference between right and wrong or understood the consequences of their actions when the crime was committed.

One measure in piecing this together involves deciding if the person was in a manic, psychotic or severely depressed state, all of which inhibit clear and rational cognition.

This is most effectively teased out by examining as much of someone's psychological history as possible and by looking closely at the days or weeks leading up to their criminal activity. It's also necessary to probe for any chronic mental health conditions like schizophrenia, which can cause paranoia, delusional thinking and visual or auditory hallucinations that can actually direct someone into inappropriate and criminal behaviors. This can also be uncovered by exploring a history of mental health problems that may have genetic or inherited patterns like psychosis or bipolar disorders.

Doctors will also want to look at any medications the subject may be taking or any they've recently stopped and if drug abuse might be a factor.

In addition, it's important to know if they're otherwise productive members of society and if the relevant crime represents a one off situation or a behavioral pattern. Given the symptoms, Marcel's doctor noted surrounding his crime, it's evident that the man was suffering with severe mental illness that would have likely inhibited his reasoning.

So Pettier rejoined his infantry regiment in June 1918.

At 21 years old, he never saw serious consequences for his thefts in the military, but he never managed to fully return to the front lines of the war either. Shortly after Pacho returned to the military, he suffered a nervous breakdown that caused him to purposefully shoot himself in the foot with his pistol. In September of that year, he was assigned to a new regiment, only to complain of debilitating headaches that returned him to the hospital. He spent the next couple of years in and out of different mental institutions, where he reported episodes of amnesia, sleepwalking and suicidal thoughts.

Compounding his other issues, Petto also suffered from regular epileptic seizures that left bite scars on his tongue.

By July 1919, the French army had enough.

They discharged Marcel Petto, granted him a disability pension and recommended that he be committed to a psychiatric institution. Petto refused this prescription after spending years in the hospital system. It seems that he had grown to hate everything about it. He was tired of being at the mercy of the various authorities who had tried to control him all his life. He'd watched his whole life as parents, teachers and commanders gave him orders. Now he wanted to be the one giving orders and get a taste of the power that had been wielded over him.

And there was one profession Marcel Petito felt drawn to that could earn him such dominion.

He decided to become a doctor. Coming up, Marcel Petko embarks on a new career in medicine, you discover their practices, seek their advice, and let yourself become more vulnerable than ever before. They have the ability to heal what the doctors can't, or so they say.

Hi, listeners. It's Vanessa from the podcast series Cults.

Be sure to check out our four part special on Myracle Healer's airing right now. Meet figures from around the world who claimed powers and pushed remedies. But Harbord, more sinister intentions. You don't want to miss it. And if you're looking for more episodes on the most radical and deadly groups in history, tune into cults every Tuesday from Jim Jones and the Peoples Temple to Charles Manson and the Manson family. To Keith Ranieri and Nexium, you'll uncover the unscrupulous methods used to turn bright eyed recruits into diehard believers.

Follow the Spotify original from podcast Cults Free on Spotify or wherever you get your podcasts.

When you have a migraine, you can become extra sensitive to light or sound, which can mean having to press pause when you're halfway through your favorite podcast or TV show, The Worst with neurotic Audette remeasurement, 75 milligrams. You can get migraine relief in as little as 60 Minutes. So you don't have to wait until tomorrow. Near the end of that cliffhanger, NorTech Oddity, a prescription medication for the acute, not preventive treatment of migraines in adults, is the only quick dissolve treatment for migraine attacks that can get many people back to normal activities.

And last up to 48 hours in just one dose. Don't take if allergic to Martek oddity, the most common side effect was nausea. For more information, including important safety information, patient information and prescribing information, visit NorTech dotcom bets. And you are. Com. Talk to your doctor about NorTech oddity today.

Now back to the story. After spending his youth in and out of mental institutions, special schools and gruesome battlefields, 21 year old Marcel Petto finally found something that he could stick with medicine. In 1991, after his discharge from the French military, Petto chose to ignore the Army's recommendation that he commits himself to a psychiatric hospital.

Instead, he enrolled in the medical school at the University of Paris, taking advantage of an accelerated program designed for military veterans surprising his family, Petto stayed out of trouble through his three years of study and graduated in December 1921 with a degree in medicine.

The validity of this degree was later questioned as Petto had only taken eight months to complete his accademia, followed by two years spent in an internship at a local mental hospital. His final thesis was only 26 pages long. For reference, schools have begun to develop three to four years of academic curriculum for doctors. At the time, the coursework for many in this field would have been far more rigorous that it was for patio.

Today, it takes upwards of 10 years for a medical student to become a licensed doctor. The timeline of this pursuit has definitely lengthened over the years due to scientific advancements. But an eight month education, followed by a two year internship, strikes me as completely inadequate, even for the early nineteen hundreds. Currently, entrance into medical school requires a four year degree from an accredited university and passing the exam. Then, once students are accepted, there's a four year general medicine education that involves science driven courses in subjects like physiology, anatomy and biochemistry, in addition to clinical rotations in health care settings.

After this, aspiring doctors go through a year long internship, followed by a residency program that lasts anywhere from three to eight years. Even for the standards of this early to mid 20th century, there's no way that this expedited training Petchey rush through could have produced a competent doctor.

There's just too much nuance involved, even in the most rudimentary understanding of medical care.

It's very hard to imagine that Pacho is actually prepared enough to practice medicine on his own.

Nevertheless, with his medical degree and license in hand, Petto moved to Villeneuve surgeon, a history steeped village with a population just over 4000. For Petto, it was the perfect place to start a private practice. Patio aggressively advertised his services trying to poach patients from the two older doctors in the village. It worked within a few years, he was a respected member of the community with a robust roster of loyal patients. Podio had somehow turned his life around.

He'd found a stable life and career. But the behavioral issues and emotional instability that defined his early life had not simply vanished. Even with a well-paying job, PTO kept up his klepto maniacal ways, he swiped people's belongings when he visited houses and even stole from his own brother's pockets when his family came to visit him. His petty theft was an open secret in the village, but Patio's popularity made it easy for people to look the other way. After all, they wanted to trust their doctor, but he was scamming every last one of them.

He'd made a habit of signing up each of his patients for public assistance without their knowledge. This allowed him to pocket government money while still accepting full payment from his clients, doubling his earnings. It was dirty work, and yet Petto carried on, unbothered by his own lack of moral character. But within a few years, Dr. Patio's actions began to concern the other doctors in the village. They thought his brash self promotion was improper for a doctor and worried that he was taking advantage of his patients.

And pharmacists complained. When Petto began regularly prescribing dangerous doses of powerful narcotics, Petto fought back, arguing that the drug companies watered down their drugs and that pharmacists had no right to question him. Petitto is wrong, of course, that a pharmacist can't question a doctor or refuse to fill a prescription. In truth, Allaster pharmacists play a big role in guiding a patient's treatment, and they're a crucial part of the treatment team. In reality, they have a better understanding of medications and doctors.

But physicians have to guide pharmacists because of their holistic understanding of a specific patient that references their overall condition. A pharmacist naturally has a right to refuse a doctor's prescription, and this could happen for a number of reasons. One example may be that of a pharmacist who recognizes a potentially harmful mixture of medications that a doctor has overlooked.

They also may feel that a doctor is over prescribing drugs. It may be dangerous like opiates. The appropriate solution to these scenarios is a consultation between the pharmacist and doctor so they can combine their efforts for the best possible patient outcomes. Alternatively, if a doctor strongly believes that a pharmacist is wrong, they can always find another one who shares their convictions. There's really no need for conflict between the two professions. And Patio's bad relationship with pharmacists is another example of how unfit he was to be a doctor.

In at least one instance, a pharmacist refused to fill a prescription for a child that far exceeded the safe dosage and could have killed an adult. The pharmacist claimed that Dr. Petto asked him why it wouldn't be better for the child to die since all he did was annoy his mother.

But for all his extreme treatment methods and questionable moneymaking schemes, Petto didn't face any notable recourse. He lived with a certain carelessness about the way his actions affected others. Unfortunately, this flaw impacted his love life to. In 1924, 27 year old Marcel Petto sparked the fancy of 24 year old Lewisite Delvaux, a housekeeper who worked with one of his patients after meeting her for dinner in town. Petto was immediately attracted to her. Soon, the two entered into a very public affair.

They moved in together after several months. It didn't take long for things to turn rotten. In early 1926, rumors spread that Delvaux was pregnant and seeking an abortion, possibly because Petto had cheated on her.

Then, in May of 1926, Louisette Delvaux suddenly disappeared. Petto claimed that she'd stormed off after a vicious argument, but she'd left all of her possessions in the village and failed to say goodbye to any of her friends.

Shortly after her disappearance, Pettier was seen placing a large basket into the trunk of his car.

A few days later, police in a town a little over 100 miles away fished a suspicious basket out of the river. The basket contained the body of a woman in her 20s. She'd been decapitated, dismembered and disemboweled. But the news of the bodies discovery didn't seem to make it to Villeneuve surgeon, where the town's police concluded their own research search for Louis Zet and suspected that she'd likely run away, just as Petto told them.

The town's gullibility, one patio freedom from his wrongs. Immediately after the police investigation finished, Patio's sat smug with a new understanding of his influence in the public sphere in this town. He could be more than a highly regarded doctor. So in summer of nineteen twenty six, twenty nine year old Petto announced his candidacy for mayor of New Cerrejón.

There was little he needed to do for his campaign as his natural charisma and good reputation had already won people's trust. In July of 1926, Patio was voted mayor in a landslide victory. Now empowered with elected office patios, criminality and erratic behaviors were about to grow far more brazen.

Mayor Patio allegedly took city funds directly out of the town clerk's desk and stole the bass drum of a local band he disliked.

Won City Hall employee witness patio, throw himself from a moving train after realizing it wasn't going to stop. And his preferred station. But many residents of Villeneuve, so young, loved their mayor eccentricities and all, despite the small scale theft and corruption rampant in his office patio, managed to push through public works projects in the village, including a sewage system and a new schoolhouse. These won him even more support, with his career and reputation at their prime patio set his sights on finding a new woman, perhaps one that didn't remind him of Lewisite.

It didn't take him long. Petto married Georgette Lable, a woman from a local wealthy family, in 1927. A year later, Georgette's gave birth to a son who they named Garratt. Within a decade, Petto had gone from nearly being committed in a mental institution by the French military to being a member of the professional elite. And yet still in line with Patio's klepto maniacal condition, even a burgeoning new life was not enough to satisfy him.

In January 1930, a local court sentenced patio to three months imprisonment for attempted fraud as a result of the conviction, Petto was placed on suspension from mayoral duties.

Patio vowed that he was innocent and appealed the suspension.

But the court battles that followed were interrupted by a brutal crime in the village.

On the night of March 11th, 1930, the owner of a local dairy co-operative named Armand Dubov arrived back at his house to find it engulfed in flames.

When Dubov ran into the house, he found something even more horrifying. His wife, Henriette, had been beaten to death. Her body was left on the kitchen floor as an inferno raged around her. While the fire department fought the blaze, Dr. Marcel Petto and his wife drove by the scene to the disgust of the village's patio, didn't stop to help or show his condolences to Armand Bov. Instead, he and his wife continue driving and went to enjoy a night out at the cinema before and after the movie.

Other theatregoers noticed that patio seemed especially anxious and tense. Investigators determined that whomever committed the crime must have known the DuBose personally, the killer clearly timed his attack for when the husband was out of the house. The suspect also would have had to know the day of the month that the DuBose distributed their payments for the milk they collected from local dairy farms. Since the attack had occurred the night before, that was to happen and the home was flush with cash.

Given this and the fact that the house safe displayed signs of an attempted break in, the motive seemed to be theft. When the police announced this information to the public, the villagers whispered about the fact that the killer must have been a local and rushed to implicate someone using the clues provided. But there was only one man in town who had a history of thievery and a personal relationship with the Dubbo's mayor, Marcel Patio. The investigation that followed sparked wild rumors, gossip and accusations, endless pages of the local newspapers reported on the case.

Speculation increased when the police revealed that they'd recovered unidentified fingerprints from the crime scene. They collected fingerprints from every potential suspect in town trying to find a match. Every suspect except for Marcel Petito, that is. He initially refused to hand over his prints and the investigators couldn't find a match. One of the main contributors to the media circus was Patio himself, who anonymously published lurid details of the murder. His tales from that night was so specific that even investigators were impressed and concerned.

Somehow, Adio successfully kept his authorship secret. However, there was one piece of evidence that spelled serious trouble the testimony of bistro owner Leon Fresco, who'd begun telling people that he'd seen patio near the farm on the night of the murder fiasco also spread rumors that Unresearched above had been cheating on her husband with Dr Patio. When Patio caught wind of Fiasco's statements.

He wasn't too pleased, but it helped that the man was one of his own patients, even someone Petito considered a friend.

So Petto invited Visco out for a drink, and when Visco complained of painful rheumatism, Podio happily offered him a treatment.

That evening, patio led fish go back across town to his office, promising to inject him with an innovative new arthritis medicine from Paris. Three hours later, the Owen fiasco was dead. An investigation ensued according to Frisco's death certificates. He died as a result of an aneurysm or heart attack, potentially the side effect of a hypodermic injection which caused death seems like foul play based on the ambiguities listed in the official cause of death.

A heart attack happens when a heart artery closes up or gets obstructed by a cholesterol clot. This stops the flow of oxygenated blood into the underlying heart muscle or ventricle and causes the heart to stop beating. This is known as cardiac arrest. And death can occur here without any treatment because the rest of our body relies on the heart to pump blood throughout our system. Without a beating heart, none of our organs can survive. An aneurysm, on the other hand, is when a blood vessels wall thins out and breaks open.

Blood vessels, especially arteries, are under constant pressure due to the force of ventricle exerts to pump blood and nourish all the organs and tissues throughout the body. Over time, these aneurysms become thinner and more vulnerable to breaking and eventually a compromised vessel wall can burst. This causes internal bleeding. And if the ruptured vessel is a big artery like the aorta, death can occur very quickly. Going back to Fiscals Death, it's more likely that he died of a heart attack than an aneurysm, possibly induced by whatever Petito it injected him with causing his blood vessels to constrict in his heart.

This would have prevented oxygenated blood from reaching his heart muscle, which could have caused cardiac arrest and death. It's also possible that Shishko died from something else entirely. We can't really be sure the explanation offered on the death certificate is definitely suspicious. Interestingly, the medical examiner who determined the cause of death and signed the death certificate was none other than medical extraordinaire Marcel Petto without a fingerprint match, testimony from Fiasco or any hard evidence linking Patio or anyone else to the murder.

The investigation petered out.

NATO evaded police questioning, and in April, his suspension from the office of mayor was overturned and he returned to his position.

But the media continue to investigate and report on Patio's corruption as mayor.

By late August 1931, 34 year old Petto finally resigned from his post as mayor.

In the years that followed, Pettier remained in the shadow of what he may or may not have done so less than two years later. In early 1933, Marcel Patio decided to leave Villeneuve surgeon for good. His next destination, Paris, he brought his family hopes of a fresh start as a doctor and his old habits. Coming up, Marcel Patio's starts his medical practice in Paris, finding more opportunities and more victims. This episode is brought to you by Sheikh Hydros, Skin Comfort Raiser's, whether you shave daily, rock a beard or sport a style in between Sheik hydration, comfort razors, deliver a shave that protects your skin without compromising on closeness.

And if you're the type of guy who shaves once or twice a week, there's a new shark. Hide your razor for you. The stubble eraser. It comfortably shaves up to seven days of stubble with a deep stubble comb that lifts and aligns longer hair to prevent tugging and pulling. Plus the stubble. A razor has three layers of comfort coating and skin grafts on every blade for extra protection. Twenty, twenty one just got a whole lot smoother. Get your razor today and comfortably shave up to seven days of stubble at Shick Dotcom.

That's ICOM.

This episode is brought to you by Land Rover, don't follow the crowd, blaze your own trail in the 20 21 Range Rover sport with its iconic muscular design and six available power trains, including a high performance, 518 horsepower V8 Range Rover sport turns even an ordinary morning commute into an exhilarating driving experience and to deliver optimal control terrain response to with dynamic program tunes, the suspension for greater stability and is ready for whatever road conditions come your way to experience the Range Rover sport for yourself.

Contact your local Land Rover retailer today to schedule a test drive Land Rover above and beyond. Now back to the story in early 1933, 36 year old Marcel Petto left the small French village he'd been living in for the past decade, driven out by allegations of corruption, theft and murder. Looking for a fresh start. He moved his family to Paris. He set up his office in a busy area of the city and went back to his old advertising tactics, leaving leaflets and flyers announcing his practice in every mailbox in the neighborhood.

Patios advertisements bragged, exaggerated and outright lied about his experience and qualifications. They claimed he could cure every illness under the sun, including cancer and diabetes. Petto even conveniently forgot an accent in the word Antoun, using the typo to emphasize that he completed an internship at a prominent hospital.

The truth was he'd also been interned at a hospital as a patient, just like before. It didn't take long for PTO to build up a list of satisfied and loyal patients who appreciated his friendliness and passion for medicine.

In time, however, dark rumors began swirling around Patio's practice. Some accused him of distributing narcotics to his patients in order to enable their existing drug addiction. Others allege that Dr. Petto was involved in something even more scandalous abortions. But if he was providing this illicit service, it went unnoticed by police and Petto managed to keep his practice afloat. Then in 1934, a 30 year old woman named Remon Owens went to Dr Patio to have a dental abscess drained.

Dr Pezzullo administered anesthesia and Owens slipped into unconsciousness as he performed the operation. She never regained consciousness and died a few hours later. Owens family requested an autopsy which revealed large amounts of morphine in Ray Manon's system.

Anesthesia can be really dangerous if used incorrectly, and if the wrong dosage or the anesthetics conflict with someone's underlying medical conditions, it works by blocking nerve responses in the body and brain and render someone unconscious, ultimately keeping them from feeling pain during surgery.

Death from anesthesia usually happens from a massive drop in blood, oxygen resulting from a dramatic compromise.

And respiration has depleted oxygen supply and turn stops the body's organs from functioning prior to giving a patient anesthesia. They get a pre anesthetic cocktail to help sedate their central nervous system and render them comfortable and less anxious. This mixture usually contains benzodiazepines, antihistamines and sometimes a painkiller. In this way, it wouldn't be unheard of to include morphine in this regimen as it's an opiate. However, it definitely wouldn't be given at a high dose. This is because opiates have the potential to slow breathing even more, which would dangerously potentiate the effects of the anesthesia.

But again, it would only be a small amount of the drug which conflicts with the findings enhances autopsy.

This is definitely fishy. Coupled with everything else we know about Petito. Foul play seems likely here. And Ray Monotones family agreed that it could be foul play after the autopsy, Raymond's mother accused Dr. Patio of killing her daughter. But yet again, the police didn't take the case seriously. They trusted that the good doctor was telling the truth. Freed from any liability, Patio decided to try his hand at government again in 1935. He applied for and was granted the title of state medical officer for the 9th arrondissement of Paris.

It was a relatively low level bureaucratic position, but offered Petto more authority. And it didn't take patio long before he abused the position for his own gain. At least once, he was suspected of stealing money from the homes of the recently deceased after signing the death certificate. Then, in the spring of 1936, 39 year old patio was stopped by a store employee who caught him shoplifting. A book patio responded by attacking the worker, threatening to kill him and fleeing down the Parisian side streets.

The police swiftly identified Petto as the assailant and called his office only to be told that patio was out of town. Needless to say, the police were surprised when they showed up at Patio's office and found the doctor there.

Petto claimed that at the time of the alleged theft, he'd simply been distracted as he was thinking about an invention to cure chronic constipation. He hadn't even realized the book was under his arm. The authorities found Patio's behavior concerning and recommended sending him to a mental hospital, but a defiant Petto refused to go voluntarily, so they forcibly interned him almost two decades after getting out of the mental health system.

Petto, to his horror, was back inside. He desperately fought against his hospitalization at every opportunity, trying to prove he was mentally healthy to the skeptical authorities who had put him there after seven months in the hospital patio got another chance to get out when a panel of psychiatrists was sent to examine him and determine whether he was healthy enough to be discharged.

PTO did not make a good impression on the psychiatrists. In their report. They detailed how he was a morally unscrupulous, emotionally unstable liar. But they also wrote that he wasn't legally ill enough to remain forcibly hospitalized. They had no choice but to authorize his release. The courts released patio, but offered him a stern warning. If he caused any further trouble, the police would revive the shoplifting and assault charges that began the entire episode.

In February 1937, Petto returned home, determined to keep his head down and stay out of trouble as he returned to his medical practice. Of course, Petto couldn't completely stop his addiction to thievery. Over the next two years, he still committed tax fraud by underreporting his earnings. But for the most part, Marcel Patio managed to stabilize his life. Meanwhile, the world around him was exploding.

On September 3rd, 1939, France declared war on Nazi Germany as Europe plunged into another great war. By June of the following year, France had fallen to the German army and Paris came under Nazi occupation in that chaos. Dr. Marcel Patio's saw an opportunity to fully indulge in his love of theft and his urge to kill. There were thousands of people trying to flee the city to escape Nazi persecution or forced conscription into the German army. These desperate Parisians made perfect targets for Marcel Petito.

They were willing to pay handsomely to escape France and would leave behind almost all of their possessions if they disappeared. No one would ask any questions.

With that in mind, Dr. Pazzo bought another house in Paris in May of 1941 and began renovating it to be the site of his new office. He told the construction workers that it would be a clinic and mental institution.

Mental health clinics are somewhat easier to procure than hospitals, as they don't require surgical rooms or complicated instruments, still, creating a dedicated space for those coping with psychosis is no simple task. The key here is establishing an environment that's safe for both the patients and staff. One measure in ensuring this would be the removal of accessible, sharp objects, which could include anything from coathangers to metal silverware. You wouldn't want doorknobs or high position structures like ceiling pipes in patient bedrooms either, as these can be used to commit suicide by hanging.

There could also be a need for windows that can't be reached or broken through to avoid escapes and broken glass being used as weapons due to the possibility of patients lashing out. There's a need for restraint devices like handcuffs and straightjackets. For example, medications need to be kept and securely locked in isolated cages or encasements. Additionally, the layout of a facility should be aesthetically pleasing enough so as not to further agitate a patient's mental instability. Attractive landscaping that provides outdoor areas for patients to visit would help mitigate patients from feeling confined.

There should also be recreational rooms with safe entertainment to help lower stress levels. Given the time in history that Petito is operating, it's likely that he would be qualified to create a center like this, despite his substandard medical degree. Doctors in the early 1940s had much more latitude in terms of their professional capabilities or legal liabilities. This is because medicine back then wasn't as highly specialized in comparison to modern times, and malpractice cases were rare.

Today, mental health clinicians require extensive training as psychiatry is as nuanced as any other medical science. It requires a highly specific level of education and expertise.

Given Marcel Patio's experiences in mental institutions growing up, it's likely he deemed himself clear on mental health procedures, practices and tools, but realistically, he would have needed more schooling to appropriately treat psychotic patients conveniently for patio. He didn't plan on performing those treatments. Petto had no intention of helping anyone inside the walls of his new office. It wouldn't be a place of healing. It would be a place of death. Next time on medical murders, Dr. Marcel Patio joins the French Resistance and opens his new office in Paris, luring victims to his custom built murder chamber when the truth of his activities are revealed, patio faces pursued by both the Paris police and the Gestapo.

Thanks for listening to medical murders and thanks again to Dr. Kipa for joining me today. Thank you, Alastair.

For more information on cell patio. Among the many sources we used, we found the unspeakable crimes of Dr. Petit by Thomas Mader. And Death in the City of Light by David King. Extremely helpful to our research. You can find all episodes of medical murders and all of the Spotify originals from podcast for free on Spotify, not only just Spotify already have all of your favorite music, but now Spotify is making it easy for you to enjoy all of your favorite Spotify originals from podcasts like medical murders for free from your phone, desktop or small speaker to stream medical matters on Spotify.

Just open the app and type medical murders in the search bar. We'll see you next time. Medical Murders 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, the daughter, and Bruce Kaktovik. This episode of Medical Matters was written by Ryan Lee with writing assistants by Maggie Admire and Lauren Dalil, fact checking by Bennett Logan and research by Chelsea Wood.

Medical Murders stars Dr. David Kipa and Alistair Murden.