Free Blind Eye: The Terrifying Story of a Doctor Who Got Away With Murder by James B. Stewart

a career in health care. She loved working in the Ohio State Hospitals, even though as a “casual” or supplemental nurse, working two to four shifts a week whenever she was needed, she ranked fairly low. Swango didn’t seem the least bit interested in his resemblance to her cousin, but Ritchie was accustomed to indifference on the part of doctors. At the Ohio State Hospitals, which maintained a rigid hierarchy among doctors, nurses, and other staff, nurses didn’t speak to attending physicians unless specifically questioned by them. The physicians gave their instructions to residents and interns, who in turn passed them on to the nursing staff. Any questions or statements by the nurses were supposed to be directed either to the interns and residents for transmittal to attending physicians, or to their nurse supervisors. 2
    With over 50,000 students at the time Swango arrived, Ohio State is virtually a city unto itself; it even has its own police force and governance. The Ohio State University Medical Center is located just a few blocks from “the oval,” the grassy center of the sprawling campus. After the Ohio State Buckeye football team, the medical center is the crown jewel of the giant state university. It has 1,123 beds and 4,278 employees, and university officials describe it as the second-largest teaching hospital program in the country (after the University of Iowa’s). The hospitals sometimes vie for supremacy in Ohio with the prestigious Cleveland Clinic, the highly regarded Case Western Reserve University, also in Cleveland, and the University of Cincinnati. But its size and political clout—the university trustees are appointed by the governor, and the hospitals’ board is a Who’s Who of prominent Ohio business and civic leaders—usually ensure Ohio State’s preeminence. Graduates of the medical school dominate Ohio’s medical establishment and institutions.
    So Swango joined an elite group of medical school graduatesfor his first assignment as a surgical intern, which was in the emergency room. Given such competition, it didn’t take long for some of his shortcomings to surface. Each doctor in charge of a surgical rotation evaluates the interns at the conclusion of the rotation, and Dr. Ronald Ferguson, the doctor in charge of transplant surgery, who oversaw Swango’s work from mid-October until mid-November, told Dr. Hunt that he was going to fail Swango, and that he didn’t believe he was competent to practice medicine.
    While the details of Swango’s performance have been shrouded in secrecy by Ohio State (the school has said only that nothing of a criminal nature was contained in Swango’s evaluations), Ferguson complained specifically about Swango’s brusque and indifferent manner with patients, his cursory H & P’s—charges that echo the criticisms of his performance at SIU—and a general sense that Swango lacked the temperament and dedication necessary to be a doctor. Swango also alarmed at least one other of his supervising physicians with remarks suggesting a fascination with the Nazis and the Holocaust. (This fascination was noted in his student record.)
    Some of the residents, who spent more time with Swango than the attending physicians did, also complained to doctors on the faculty that Swango was “weird.” While making rounds, residents often give interns tasks and then critique their performance. Whenever they criticized Swango—as they often did, because of his incompetence—Swango would immediately drop to the floor and begin a strenuous set of push-ups. He could do hundreds of them. It was almost as if he were still in the Marines, and this was his self-imposed punishment. Of course, the residents thought his reaction not only peculiar but highly inappropriate for a doctor making rounds. Despite their admonitions, he persisted.
    At the time Swango was hired, no one from Ohio State called anyone at SIU. Indeed, no one appears even to have noticed that he should have