Doctoring the Truth
Welcome to Doctoring the Truth, a podcast where two dedicated audiologists dissect the world of healthcare gone rogue. Explore jaw-dropping stories of medical malfeasance, nefariousness, and shocking breaches of trust. The episodes provide deep dives that latch onto your curiosity and conscience. It's a podcast for truth-seekers craving true crime, clinical insights, and a dash of humor.
Doctoring the Truth
Ep 30-Oh Snap! Another Sociopathic Surgeon! (Part 1)
Anthony Pignataro exemplifies narcissistic personality disorder in medicine, using forged credentials and manipulation to practice despite repeatedly failing residencies and harming patients. His story reveals how narcissism and hubris in healthcare can lead to devastating consequences when warning signs are ignored, and systems fail to protect patients.
Join us next week for part two of this shocking case, where we'll reveal more of Anthony's victims, the investigations that followed, and the ultimate consequences of his actions.
Resources:
- DSM-IV and DSM-5 Criteria for Personality Disorders. American Psychiatric Association. (2012). [PDF]. American Psychiatric Association. Retrieved from http://www.nyu.edu/gsas/dept/philo/courses/materials/Narc.Pers.DSM.pdf
- Cunha, J. P. (2020, August 10). What Are the Nine Traits of a Narcissist? Retrieved from https://www.emedicinehealth.com/what_are_the_nine_traits_of_a_narcissist/article_em.htm
- Mayo Clinic Staff. (2017, November 18). Narcissistic personality disorder. Retrieved from https://www.mayoclinic.org/diseases-conditions/narcissistic-personality-disorder/symptoms-causes/syc-20366662
- “Last Dance, Last Chance” by Ann Rule
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Amanda.
Speaker 1:Jenna, that sounded very aggressive how the heck, are you Aggressive as? Heck, very excited to be here. How are you?
Speaker 2:Yay, I'm great, just loving the fall life. I know, the other day I went through Caribou on my way to work. They have a really convenient little hut. I tried to avoid it. But really convenient little hut. I try to avoid it, but damn, the hut was calling me. I drove through and I was like I'll take a caramel high rise, please. Thank you very much. And when I got it it was pumpkin spice and I wasn't hating it. I mean, I don't know if they did that to me on purpose. It was probably an accident, but it was a happy accident because I was like that's here, oh yeah.
Speaker 1:It's fall official. I have definitely already taken advantage of the fall flavors at good old Starbucks. Yum.
Speaker 2:Yummy. And, by the way, no shade to Starbucks, because Starbucks and I were born the same year in the same city, so I mean, that's where my heart lies, but Starbucks, you guys, you don't have a hut on my way to work.
Speaker 1:So there is a Starbucks by my office, which is dangerous because when I drop Ray off at daycare, I like order a mobile to go, and so it's ready by the time I get over there. The only thing is it's a very busy intersection so it gets hard to get out to get to the office.
Speaker 2:That's all right, because you've got your lot tied up Exactly. Fuck on while you're waiting for traffic.
Speaker 1:And you know what? I just have one of those really, really nice jobs now where there's no micromanaging person. So if I'm there at 802, if I'm there at 747, you know what? No one cares, because they're just like oh, you did your job today, thank you.
Speaker 2:I'm just like god, what's that like?
Speaker 1:I know that sounds like such a foreign land when people work in hospital life, because I used to be there, you guys. But I'm telling you, oh, there are some bright lights out in the world, wow yes, you're living the dream girl. I'm living vicariously and I'm so proud and so jealous at the same time so, yeah, I guess, other than being so excited about the fall drinks, I went and got my mom's this weekend, so my front porch is looking all nice so we're not just for our uk listeners.
Speaker 2:We're not talking about your, your parent, your, you know family. We're talking about plants. Yeah, the flowers. Oh yeah, cute me mom's, me mom's on the porch and I keep her there, water her from time to time.
Speaker 1:Yeah, my husband and I took our niece to the store to give my brother and sister-in-law a little reprieve from the four-year-old madness. So she ran errands with us and she was so excited to be at Sam's Club. Um, so she ran errands with us and she was so excited to be at sam's and she was like, well, adam walked her in like on his shoulders and she was like you know, like am I gonna get my head on the?
Speaker 1:door and then I could hear them yelling, like in the where the carts are, like outside where the moms are. I was like, oh my god. And then he brings her out in the cart and she's yelling sales club, sales, club, sales. And it was big it was. I think that was on saturday, so I mean it was busy and everyone loved it oh my gosh, that was fun.
Speaker 2:I mean, listen, most people aren't that happy. It's like a fun fight in there. We like the prices, but, lord, we don't like to have to go through the aisles. And you, my dear, I thought you were the person who ordered ahead of time to get them to chuck the shit in your car, so you didn't have to go in. You're like, oh, this would be a good outing. I am?
Speaker 1:I am Well see, we had like just errands that we had to do. And then I was like well, I should offer to take my niece, because it was my brother's birthday this weekend, and so I was like oh, a little quiet time.
Speaker 2:Um, yeah, steve, listen, appreciate, appreciate, um, and return the favor to Sunday. Okay, I'm just saying the name over the rainbow.
Speaker 1:Sam's.
Speaker 2:Club will be fun. Honestly, I love looking at it through a child's eyes because you know, as an adult going in there, you've got your list. You're like, okay, I'm prepared for battle, I'm going to go down this aisle, I'm going to go down that aisle, I'm going to try not to get sidetracked by all the samples, and you know the people that are fighting over the deals. And no, I don't need another sweatshirt in my life. No, I don't need another cell phone plan.
Speaker 1:But also it's only $8. You're like T-Mobile Shut up, I gotta go.
Speaker 2:I'm happy with my service. Bye. But you know what your niece is like woohoo, look, candy. You know you're like okay, yeah, we can buy yours with the candy. Yes, she likes it.
Speaker 1:It's the big store.
Speaker 2:Yes.
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Speaker 2:So, alleycats, we do have an episode that I tried. Unfortunately for everyone, I read a book and when I read a book, it's really hard to narrow it down and I'm learning. It's a learning curve, but there's so much I want to share about this case that it's a two-parter Two-parter, so we're going to do part one today, but once again, alleycats, I'm mixing it up because we're going to start with a chart note rather than starting with a case. It's a nine minute read, but it's worth it, because I want you to keep this learning in mind, because today's case epitomizes what we're about to talk, so welcome to our chart note. Chart note.
Speaker 1:Oh my gosh, we did the same thing, I felt the bubble so I had to stop. But I was like, oh, we're there, we nailed it.
Speaker 2:We nailed it, amanda. Welcome to the chart note segment, where we learn about what's happening in medicine and healthcare. All right. So today we're talking about narcissistic personality disorder. Welcome to the chart note segment where we learn about what's happening in medicine and health care, all right, so today we're talking about narcissistic personality disorder Disorder. I said it like I said it like I'm from the East Coast. It's the disorder according to the DSM-5 criteria, and we'll talk about some treatment options too. Options too.
Speaker 2:So a narcissistic personality disorder is one of several personality disorders that people can be diagnosed with, and it involves features like arrogance, lack of empathy and self-centeredness. You may have heard the word narcissistic more than once in your life, and perhaps it was used to describe an individual who seemed to want to be the center of attention frequently or was boastful at times. Narcissistic personality disorder can involve these types of traits. However, they tend to be much more severe and significantly negatively affect their ability to function correctly. So it's a little bit different than liking the limelight or the spotlight. So an individual with this personality disorder will typically have an extremely high or exaggerated sense of self-importance, a strong desire to be admired virtually at all times and struggle to have empathy for others. However, behind the grandiose feelings, empathy for others. However, behind the grandiose feelings, the sense of superiority and excessive confidence, is a fragile ego that can be easily damaged by criticism. Individuals can also become very envious if others receive praise and validation as a rebuttal. It's common for people with narcissistic personality disorder to try to belittle and put down others to inflate their own self-esteem. These individuals also tend to prioritize their own thoughts, feelings and needs above those of others and often disregard what others might say or feel. Because of these issues, people who have narcissistic personality disorder will struggle in many life areas, especially interpersonal relationships. So, according to the narcissistic personality disorder DSM-5 criteria, the essential features of a personality disorder are impairments in personality, self and interpersonal functioning and pathological personality traits. To diagnose a narcissistic personality disorder, the following criteria must be met Significant impairments in personality functioning, manifested by impairment in self-functioning or identity.
Speaker 2:Excessive reference to others for self-definition and self-esteem Regulation. Exaggerated self-appraisal may be inflated or deflated or vacillate between extremes. Emotional regulation mirrors fluctuation in self-esteem or self-direction. Goal setting is based on gaining approval from others, so personal standards are unreasonably high to see oneself as exceptional or too low based on a sense of entitlement, often unaware of their own motivation.
Speaker 2:Impairments in interpersonal functioning, either A or B. A empathy impaired ability to recognize or identify with the feelings and needs of others. Excessively attuned to the reactions of others, but only if perceived as relevant to themselves. Over or under estimation of their own effect on others. And or b intimacy Relationships are largely superficial and exist to serve self-esteem. Regulation Mutuality is constrained by little genuine interest in another's experiences and predominance of a need for personal gain. So pathological personality traits in the following domain are characterized by Antagonism, which means grandiosity.
Speaker 2:Feelings of entitlement, either overt or covert. Self-centeredness. Firmly holding to the belief that one is better than others. Condescending towards others. Attention-seeking, excessive attempts to attract and be the focus of attention of others. Admiration-seeking. The impairments in personality functioning and the individual's personality trait expression are relatively stable across time and consistent across situations. The impairments in personality functioning and the individual's personality trait expression are not better understood as normative for the individual's development stage or sociocultural environment. The impairments in personality functioning and the individual's personality trait expression are not solely due to the direct physiological effects, so like of drug abuse or medication or a general medical condition like a severe head trauma.
Speaker 2:So in addition to the criteria mentioned above, the DSM-5 narcissism guidelines also point out nine different features of narcissistic personality disorder that professionals should look for when diagnosing the condition. So number one inflated self-esteem or a grandiose sense of self-importance or superiority. Two craving admiration. Three exploitative relationships like manipulation. Four little to no empathy. Five identity is easily disturbed, like they can't handle criticism. Six lack of attachment and intimacy. Seven feelings of depression or emptiness when they're not validated. Eight a sense of entitlement. Nine may feel like others are envious of them or they may envy others. So an individual must possess at least five out of nine of these traits, many of which can begin to appear at a young age.
Speaker 2:Like most mental health conditions, the exact causes are unknown, but personality disorders are especially complex and various factors can influence their development. Environmental ones, especially a person's upbringing, can play a role in narcissistic personality disorder. For example, being excessively praised or overvalued by parents, peers or teachers can lead to an inflated self of self-importance and arrogance seen in the disorder. Self of self-importance and arrogance seen in the disorder. On the other hand, abuse, neglect and criticism can also be a contributor, and this might lead to the attention-seeking behaviors that are characteristics of narcissistic personality disorder, so like manipulation and lack of empathy for others. Certain behaviors can also be learned from those around them at a young age. Unfortunately, it can reinforce the personality disorder because it can result in the individual getting what they want. So genetics and neurobiology can also be important when it comes to the development of narcissistic personality disorder. Some characteristics can be inherited, and changes or differences in brain chemistry can contribute to the formation of the condition.
Speaker 2:A narcissistic personality disorder is one of the most difficult mental health conditions to treat, because many people with the disorder feel they don't have a problem, even though it causes them distress and impairs their ability to function. Therefore, most NPD people don't seek out help and the condition will continue to persist. If someone does try to find assistance, it's often due to coexisting issues usually seen alongside NPDs, like depression, anxiety, bipolar or substance use. Medication will often be prescribed to help manage the symptoms of these conditions, but there aren't any medications recommended to treat NPD itself of these conditions, but there aren't any medications recommended to treat NPD itself. Instead, psychotherapy is a primary treatment.
Speaker 2:With NPD, individuals have a distorted sense of themselves and their actions and motivations are often contradictory. While people may exhibit traits like grandiose or inflated sense of self-importance, a belief that they're special, and display other arrogant behaviors. That's often a coping mechanism for their insecurities. They're often used to try and mask their self-doubt. To try and satisfy this, they'll crave attention and validation from others, and if they don't receive it, they become hostile or vindictive. Therapy will attempt to replace the distorted thinking patterns and behaviors with more positive, realistic ones and teach individuals with NPD more productive and effective ways of coping, instead of resorting to attention-seeking and other damaging behaviors for relief. Therapists who work with people with NPD must be extra careful not to criticize the individual, since people with the condition are often resistant to treatment at first. Over time, trust and rapport must be built for progress to be made and eventually they can realize that they can make significant progress if they cooperate with the therapist and the advice that the therapist has to offer. So, in conclusion, despite the challenges that NPD creates, it can be addressed. With the right resources, people can learn how to cope, mend their relationships with others and have happy, healthy and successful lives. Now for our case, resources will be listed in our show notes, but the primary resource for this episode is a book by Ann Rule called Last Dance, last Chance. And so a lot of what we know about the intricacies of this case is from that book. Trigger warnings this episode will discuss emotional abuse, medical malpractice and murder. So be warned.
Speaker 2:Anthony Pignataro was born May 12, 1958, in the West Seneca neighborhood of Buffalo, new York. Anthony's father, ralph Pignataro, was a prominent surgeon in the Buffalo area and Anthony grew up in a wealthy neighborhood on a grand estate in West Seneca. He attended Nichols School, which was a prestigious private school. He had an older sister, antoinette, and younger brothers, ralph Jr and Stephen. They lived a life of privilege, having all their wants and desires fulfilled. They lived a life of privilege, having all their wants and desires fulfilled. Dr Ralph Pignataro wanted his family to have only the best and Anthony idolized his father. Dr Ralph was also beloved throughout Buffalo.
Speaker 2:Deborah Rago was born in Erie County, new York, on July 22, 1957. Her mother, caroline, was a housewife and her father, frank, supported the family with hard physical labor. She had an older brother and she was the little girl her parents had hoped for. Her family was close-knit and loving. They worked hard and they spent time together when they could. There weren't many luxuries to be had, but there was a lot of joy. Debbie started working at 16. She worked retail at a mall and later got a job as a pharmacy technician.
Speaker 2:In early July 1978, debbie met a tall, dark, handsome Anthony at a dance. They began dating and fell in love. Debbie was so enamored with his intelligence and charisma that she overlooked the fact that he often said the wrong thing to people, frequently embarrassing her with his loud and sometimes rude remarks that hurt other people's feelings. She excused his behavior because he seemed so oblivious that he'd said anything wrong. They continued dating and they became very serious. But Anthony said that he couldn't marry Debbie until he decided on a career. He wanted to go into medicine to please his father, but he felt he could be good at anything he set his mind to. Anthony said that while he didn't want to let his father down, he also didn't want to let himself down. He explained that he'd been blessed with special gifts and possessed intellectual capacities far beyond those of most men.
Speaker 1:Anyone feeling sick oh my God, I don't know if you guys heard my head rolling around.
Speaker 2:Dude, get over yourself, it gets worse Anyway. So he thought he should go into computers, because most people had no idea how vital computers would become, he told Debbie. But then again he was fascinated by the prospect of becoming Dr Anthony Pignataro. He liked the idea of eventually being able to work side by side with his father. Anthony took self-confidence to new heights. He was full of hubris, but Debbie chose to see his confidence as his strength rather than an overblown ego. In the end, anthony decided to apply to medical school, which pleased his father immensely, even though Anthony's older sister had gone into medicine. Neither of his brothers had, so I guess it didn't count because she was a woman and Dr Ralph always wanted to have his son to practice medicine with yeah, I mean right on?
Speaker 2:no really, guys. Come on. Debbie knew it would be a long haul before anthony finished medical school. She didn't mind. After all, she and anthony were both deeply in love with. Anthony.
Speaker 1:Do you see what I did there?
Speaker 2:I see what you did there.
Speaker 1:I hate it for her, but I like what you did there.
Speaker 2:She vowed to help him and support him as he made his way through medical school and his residency. To his absolute shock, anthony was not accepted at any medical school on the mainland of the United States. He just did not Let go loser. Anthony did not make the cut. Perhaps it had something to do with the fact that he did almost nothing to prepare for the MCAT, believing that his intelligence was obviously going to help him sail through the exam.
Speaker 1:Oh, of course I'm Anthony. I don't need to study for the MCAT.
Speaker 2:The only medical school that was willing to take him on was the unaccredited San Juan Bautista School of Medicine in Hathoray, puerto Rico. The tuition was almost as high as the tuition at Harvard at the time. No worries, daddy Ralph paid the bill to the tune of $24,000 a year, plus all of Tony's living expenses in Puerto Rico. Okay, I'm so happy to see that you have the equivalency to today's money, because I was like okay, other estimates that suggest it could be around 98,755 in 2025.
Speaker 1:Which I'm like. Obviously I didn't go to med school, but that seems like on par for what med school costs.
Speaker 2:No, yeah right. I don't know.
Speaker 1:If you know, please write in. Thank you. We love learning new things, thank you.
Speaker 2:And it's a lot of money. You and guess what? The classes were taught in spanish, in spanish, and he didn't speak spanish oh my god, what a poop I like.
Speaker 1:Should that not have been a qualification to be accepted? How did you fill out the application so?
Speaker 2:yeah, boy had to learn fairly quickly, but nobody actually can tell whether or not he graduated, because he left after two years and typically it's four years for an md. You know, we can draw our own conclusions there. But Debbie and Anthony were finally married on June 15, 1985, which was almost eight years after Debbie had her first dance with Anthony.
Speaker 1:Yay.
Speaker 2:Ralph. No Things were looking up for Anthony. His dad secured him a residency at St Agnes Hospital thanks Dan in Baltimore, maryland. The facility was a satellite hospital of Johns Hopkins, but the prestigious university's administration didn't entirely run its facilities. Of course, though, anthony went around telling everyone that he worked at Johns Hopkins. He definitely used the name to inflate his importance whenever he could drop it into conversation. He opted to transition from OB-GYN because quote female problems didn't interest him. End quote. I mean, why would you go? And that's all you're going to find there Just rocking in my chair back and forth? Why would you go into OB-GYN if you don't care about female problems? What an asshole dude he's like.
Speaker 1:I guess I'll see women in clinic, but not if they have a problem so the author of last, last dance, last chance?
Speaker 2:I mean, it's only women's problems, am I right? You can't, you can't have any other problems.
Speaker 1:Why do people go to the freaking doctor? You fuck, I'm just like any specialty. If they didn't have a fucking problem, they wouldn't be at the doctor. If you're an OB-GYN, do you know what it means to be a care provider? You fuckweasel. None of them have a problem.
Speaker 2:Anyway, dude, provider, you fuck weasel. None of them have a problem anyway, dude, did he not look up what it meant before he went into? Oh my god, anyway. Uh, no, well, thank god for women all over that he decided not to go into that, although, yeah, god anyway. So in the book last dance, last chance and rule surmised that it was because he was attracted to this field merely because he wanted the glory of being to be the person, or getting to be the person, that handed the parents their new baby. So that appealed to his ego and nothing else.
Speaker 1:He's like oh, look at me, I'm God. He's your baby. It's like no, I grew that Hand it over.
Speaker 2:Thanks, I think she was right on.
Speaker 1:Thank you for bringing it from one threshold to the other. I'm handed over. Thank you.
Speaker 2:At any rate, he ended up choosing general surgery, likely to follow in his dad's footsteps. So that meant that he was on call every third night and when he was home he was sleeping or studying. So Debbie longed for the time when he would have his own private practice and they could be a family. Debbie went to work in a plastic surgeon's office to earn money to help support her family and two years later, in April 1987, she gave birth to their son that they named Ralph after Anthony's father. But Anthony started to grow more and more distant Red flag, which hardly seemed possible since he wasn't home much. To begin with, he began criticizing Debbie's weight and appearance, pointing out that he would work out at Gold's Gym every day for hours. But what was she doing to stay fit? Meanwhile, he insisted on her cooking the things that he liked, regardless of whether she was trying to eat healthier to please him. Now feel free, Go ahead and rant. I just want to punch this guy so hard.
Speaker 1:I'm just like I'm at home raising baby Ralph, Keeping our household together. Oh, and I had to get work because you suck, so how about rub my feet? You fuck.
Speaker 2:Exactly.
Speaker 1:And my appearance. I'm sorry. I grew a human being.
Speaker 2:Yes, yes, really honestly, you should have been burned at the stake, but anyway, we're going gonna get less than that, but all right. So the phone calls. Phone calls started, a woman's voice and then a hang-up. And then someone left a cassette tape in the back of debbie's car.
Speaker 1:It was recorded for our young listeners a cassette tape no, seriously, cassette tape was.
Speaker 2:How do you explain a cassette tape, amanda?
Speaker 1:I know I'm, I know I'm like okay, so it has, because I'm like do we still call it film if it's just audio? I mean like, okay, young listeners, if you can remember back to what like a videotape was, it's a mini version of a videotape and it only has audio on it, but it was literal tape, like you had to rewind it and fast forward it and like you couldn't on it, but it was literal tape, like you had to rewind it and fast forward it and like you couldn't pull it out of the thing just like a vc or yeah, like a videotape oh god, whatever I mean, and when you rewind them, it went it did, and we used to make mixtapes for our friends which was pretty much like a spotify list oh my gosh.
Speaker 1:Yeah, you used to wait till the top nine at nine came on and you had to like hit it right at the right time, or you like missed your favorite song.
Speaker 2:You're like no, but there was commercial breaks, because you know what friends we didn't have spotify back then, that's actually a really new thing anyway, this cassette tape was in the back seat of debbie's car, so it was planted there, and it was a recording of Anthony flirting with another woman, so it was clear that he was having an affair. Heartbroken, debbie called her father for advice. Her father, an Italian immigrant, said Forgive, but only once, and so she did.
Speaker 1:Or I'll cut him, is what he should have said.
Speaker 2:There was a brief honeymoon period during which Anthony was doting and contrite until his contract at St Agnes wasn't renewed, which he needed in order to become a board-certified surgeon. So he was humiliated. The family moved back to Buffalo, where they lived with Anthony's parents for a while, before moving into a place of their own. Anthony took a job that he felt was way beneath his stature, working at a walk-in emergency center. On the contrary, he proved he wasn't even qualified enough for this job. He missed a crucial diagnosis of bacterial endocarditis, which is a severe inflammation in the lining of the heart and that can be deadly if it's not treated in time. Patients with this condition experience symptoms like chest pain, fever with chills, shortness of breath and possibly irregular heartbeats. Anthony failed to consider this illness as a possibility, and that turned out to be fatal for the patient. The patient died and Anthony was hit with a wrongful death lawsuit, which was eventually dropped. Anthony viewed this as a lucky break and that his own involvement was more of a sad coincidence, rather than taking any responsibility for it.
Speaker 1:And at this point I'm still like did you even graduate school?
Speaker 2:Because you were only there for two years so he somehow landed a residency at Georgetown University in DC, and when Debbie moved there with Ralph to join them a month later, he carried on verbal abusing her. He would say stuff like have you looked at yourself in the mirror lately? Do you think I want to be with someone who looks like that? I just want to punch this guy in the throat so badly right.
Speaker 2:All of a sudden, anthony decided he didn't want to be a general surgeon. After all, he was going to specialize in otolaryngology. To make this decision after spending over a decade of his life on education and training was virtually unheard of. He'd started his undergraduate degree in 1976 and medical school in 1983. And now, in 1987, all he had to show for all this was a half completed residency experience. He still did not have the same privileges as a board-certified doctor, and yet he was not deterred from chasing this new specialty, even though it required him to switch his focus yet again. Otolaryngology residencies are significantly longer, lasting a minimum of five years, compared to other specialties that may need only three or four years. Of course, tony's passion for his new focus was not about sinus problems or ear-related conditions, nor was it about helping to cure head and neck cancers. Nope, he was all about appearances. Elective plastic surgery was what really appealed to him and knowing what we've learned about him thus far, it makes perfect sense. Incidentally, there's no shade to people who've undergone or who are interested in plastic surgery. I just found it telling that he wasn't drawn to any of his passions for altruistic reasons, like helping people boost their self-esteem. He was merely in it for the money and the prestige.
Speaker 2:Unfortunately, his newfound interest didn't improve his attitude and he continued to be an asshole to everyone around him. Staff members and colleagues at Georgetown detested him, finding him conceited and self-serving. For example, on New Year's Eve 1988, when he was 30 years old, he was supposed to be covering the ER, but instead he walked out in the middle of his shift to get drunk at a nearby bar. He walked out in the middle of his shift to get drunk at a nearby bar. By some miracle he didn't get kicked out of the program, but he didn't even appreciate that fact. Instead he griped and moaned about everyone was out to get him. He was the victim. They're all idiots at Georgetown, blah, blah, blah. In the middle of his second year there he left to try a different program. This one was at Thomas Jefferson University Hospital in Philadelphia. Since he didn't finish at Georgetown, he was going to have to do another two to three years at this facility.
Speaker 2:Ever faithful, debbie continued to accept the changes and accommodate her husband's selfishness. In June 1990, they moved north. By that point Debbie had given birth to their daughter, lauren. Now Debbie was essentially a single parent to two little children, too far away from her family or in-laws to receive any help.
Speaker 2:Funnily enough, anthony didn't seem to be able to outrun his troubles. Shockingly, people at Thomas Jefferson didn't seem to like him any more than his colleagues at Georgetown. What are the odds? Anthony supposed that people were jealous of him. That's why they didn't seem to like him any more than his colleagues at Georgetown. What are the odds? Anthony supposed that people were jealous of him. That's why they didn't like him. After all, he came from prestigious programs like Johns Hopkins and Georgetown. Maybe that explains his scores.
Speaker 2:After his first year, doctors had to score residents on a scale of one to five. Typically, successful residents achieve a grade of at least a 4. Anthony scored between 1 and 2.5 across the board. I mean, would you want this guy up your sinuses? No thanks. One comment from his evaluation described him as a medical sociopath. From his evaluation described him as a medical sociopath. Another comment warned that Anthony shouldn't be rehired for his second year of residency, fearing that lives are truly at stake. It seemed that Anthony may have had as much of a problem with his skills as he did with his personality, so he was not invited back, and here he was failing out of his third residency in six years and also in regards to the comments and the scores.
Speaker 1:I feel like when people are scoring, grading rating, whatever their students, we try to give them the benefit of the doubt. Yeah, because it's like you like them as a person, yeah, give them the benefit of doubt and like you don't want to, unless it's truly like you should not hire this person, you're gonna be like graze over it. You know like no, they were fine, you know whatever, but for someone, because also it reflects on the program.
Speaker 2:You know, if you didn't adequately prepare someone, so I mean it's it's damning on either end. You don't want to be known for promoting somebody who's inadequate, but you also like, yeah, feel for the person.
Speaker 1:There's always some good quality you can latch on to and try and highlight so that you can put the best forward, and not necessarily but for someone to screw their odds for having a career, but they did not hesitate literally describe you in the notes as a medical sociopath and say that lives are truly at stake. I mean right how do red flags?
Speaker 2:be a fly-in. Bless them for being honest about it though, oh my gosh.
Speaker 1:Yes, absolutely.
Speaker 2:So board certification exams for an initial specialty need to be taken within seven years of completing medical school. So our Tony was out of time. He was ineligible to take any board exams administered by the American Board of Otolaryngology and it made it doubtful that he'd ever be hired anywhere. So Anthony balked. He told his wife that these programs were out to get him ever the victim. Yeah, they were out to pigeonhole him and he wasn't going to conform to their whims, whims, okay, is it whimsical to promote patient safety? I don't know. So he figured he'd had enough experience. He was ready for patients. So time to move back to West Seneca Now.
Speaker 2:Board certification is not required in order to practice medicine, but most hospitals require it to ensure that high quality staff are employed and also to reduce liability in the case of malpractice lawsuits coming up. So Anthony would definitely have a super hard time getting hired as an ENT without it. But that didn't stop him. He made a plan If he couldn't get privileges on his own merit, he would work for someone who could. He discovered an elderly physician on medical leave who was recovering from a coronary bypass and offered to help him several days a week to cover his practice. Because they worked together, he was granted hospital privileges to see their mutual patients. In 1992, the Wyoming County Community Hospital granted him access to its facility. He was employed as an assistant, but he would still be allowed to treat patients. Somehow he schemed his way into working at a second hospital as well, our Lady of Victory, where he would be allowed to run his own surgeries.
Speaker 2:But this con didn't last too long. In February 1993, he operated on a 71-year-old patient at Our Lady of Victory. The surgery was to extract a laryngeal tumor for biopsy. Since this was a surgery deep in the throat, the airway was of particular importance because complications would compromise airflow, like swelling or bleeding. Additionally, there's a risk of infection and also compromising a patient's vocal folds, as they're vulnerable in this type of surgery. But Anthony didn't secure the airway and swelling ensued. The patient died, I know he was then restricted from performing any surgeries after 1 pm and before 1 pm had to be accompanied by another surgeon to monitor him. Right, they must have considered this an accident. But seriously he was lucky because they should have canned his ass. His contract at the hospital was set to expire in september that year and, not surprisingly, it was not renewed.
Speaker 2:Anthony continued to assist at the first hospital, but he screwed up there as well. He operated on a 30 year old man's deviated septum in August of 1994 and nicked the outer layer of the brain so that CSF cerebrospinal fluid leaked into the patient's nasal passages. This placed the patient at risk of meningitis, severe nerve damage or brain abscess. These are risks that are inherent to this type of surgery, but instead of acknowledging them, he completed the procedure and said nothing to anyone. Luckily, the patient survived in spite of him, however, the news reached an ENT specialist at the hospital who questioned whether Anthony had the necessary credentials to perform the invasive procedure in the first place. So the next day the Wyoming County Community Hospital canceled his privileges Around.
Speaker 2:This time the elderly physician he was covering for returned to work and no longer needed Tony's assistance. So Tony applied to work in ENT and plastic surgery at two different facilities in New York. Neither place was interested because he couldn't prove that he'd been board certified in either specialty. So he didn't have a prayer. To circumvent this. He appealed to the American Board of Cosmetic Surgery and Facial Cosmetic Surgery, requesting certification. This was something that an experienced ENT doctor would have been able to achieve once they completed an additional one-year fellowship in cosmetic surgery, but that would mean he'd have to have an otolaryngology diploma. Since Anthony didn't have that diploma, he turned to the Thomas Jefferson University Hospital in Philadelphia for help.
Speaker 2:His last residency program, anthony thought that one of the chairpersons may have sabotaged him. To gain eligibility for the exams, he sued the residency program. He hoped to prove in court that he was qualified and had been misjudged by those overseeing his advancement. To make his case, he selected a physician that he thought would treat him favorably and asked this man to write a report on his behalf. So this doctor had to work as an investigator and interview various specialists who'd actually worked with Anthony during his program and then write a conclusion.
Speaker 2:The plan backfired, however. The statement that the investigating physician provided the courts with described Anthony as a lazy loser who did not respond to constructive feedback and would routinely show up late for rounds, constantly claim that he'd completed work he'd not done, lie about having seen intensive care unit patients that he didn't see, fabricate laboratory data, fabricate physical exam data, fabricate information about post-op patients that he'd actually not seen, and the list went on and on and on. So this didn't do anything to deter Anthony, but instead he said the report was unusable for his defense and he dropped the suit. So I mean any one of us would just want to just go take ourselves out to pasture and shoot ourselves. I mean that's just so awful. But it was never his fault, he was always the victim. His father was always the victim.
Speaker 2:So now it was the spring of 1995, and Anthony had to find a different way to prove his legitimacy as an ENT physician surgeon to the American Board of Cosmetic Surgery and Facial Cosmetic Surgery, because in his mind he was well-qualified. So he just didn't have that pesky residency diploma. So in his inimitable ballsy approach he faked one. His vague diploma said he completed an ENT residency at Thomas Jefferson University Hospital on October 31st 1991. Halloween, spooky and fitting.
Speaker 1:You're going to make one up from the place. You just called for help and you found out you couldn't get it.
Speaker 2:But even if he had completed the residency there, the date would have been too soon for him to have finished it. But whatever, the board didn't follow up. Apparently they permitted him to take the exam and in April 1995, he passed. This secured Anthony the accreditation that he needed to offer plastic surgery at his own private practice. I mean, on false pretenses.
Speaker 1:I'm shocked he passed.
Speaker 2:Yeah as well. Yeah, so Anthony set up his own practice with the help of his wife. Debbie handled his books and they purchased the basics for the office, including examining room, furniture and equipment, as well as malpractice insurance. Anthony planned to have an operating room in the basement of the building, but this would take longer. He wanted to reach a point where he was autonomous and would never again have to depend on anyone but himself. If he had his own operating room, it wouldn't matter that hospitals didn't accept him. Initially, anthony began seeing basic ENT patients with ENT problems. Except on Wednesdays, wednesdays were days reserved for what he called his quote current research endeavor, end quote. He was searching for that irresistible service that would bring people through the door and make him a lot of money. He wanted to invent something that would make him rich and famous.
Speaker 1:Like maybe do that on a Saturday, because actually you're not making any money at all on wednesdays. So like, bro, maybe after dinner like homework or saturday, sunday even, like it's not like you're hanging out with debbie anyway I don't know.
Speaker 2:It's pretty gruesome. He started by working on female cadavers and was implanting wires for what he called an implantable bra what does literally my favorite yeah, under the skin taking the bra off.
Speaker 1:Can I get a permanent one?
Speaker 2:no, thank you, and a wire, implanting these wires into these cadaver boobs and like trying to string them up and he knows nothing about what.
Speaker 1:Can you imagine?
Speaker 2:they're from me, I'll take your bra off, oh, and then permanently being poked, but oh man fuck no, especially one with a real.
Speaker 1:It was a real wire too.
Speaker 2:Oh my god, no, do God, absolutely not, no.
Speaker 1:Do not even own. Fuck that Weirdly Do they even sell those?
Speaker 2:anymore. Oh, the external ones, probably With a real wire.
Speaker 1:Internal. I mean are people buying? Hey guys, are people still buying? Okay, well, I will say the. I can tell you who's not selling those Handfulcom.
Speaker 2:Handful. They are not. Handfulcom Promo code stays suspicious. Anyway, weirdly, his implantable bra never got off the ground Joking. But his next invention gained him notoriety A snap-on toupee. Oh, okay. So Bras to hair anthony.
Speaker 2:Anthony and his dad had a genetic predisposition to male pattern baldness and anthony began to lose his hair in his mid-20s, which you know for somebody super vain this. You're so vain you probably worry about your hair falling out. Yeah, douchebag, douchebag In his 20s. So he learned about the various ways that titanium can be used in body implants and we know about that. In audiology we have titanium implants for bone conduction, hearing solutions and other things.
Speaker 2:But anyway, he wanted to apply this technology to attach a hairpiece to a person's heads semi-permanently. But how to get this off the ground? Who would volunteer their head for his research? He thought of Cy Sperling, the president of Hair Club for Men, the famous commercial where he says I'm not only the president, I'm a client. That was it for Anthony. He knew he had to do it on his own. His father took some convincing but eventually agreed to implant four titanium screws with an abutment that snapped into the opposite coupling adhered to a hairpiece. After three months of osseointegration the hairpiece went on and it worked. Suddenly, with media coverage, men would fly into Anthony's practice for hairpieces of their own. He was featured on various shows, including CBS Nightly News and the Maury Povich Show. In each show he demonstrated his hair implant device. Imagine it.
Speaker 1:Pop, pop, pop, pop. Voila, I'm not bald anymore, imagine it.
Speaker 2:I mean, I guess you don't have to worry about like a strong breeze coming through because that baby is snapped on andrew's book describes how anth Anthony felt so relaxed and casual during his hair transplant surgeries that he sometimes ordered pizza to eat during the procedure, and one patient recounted how they joined him by eating the pizza. The patient ate the pizza as well during the surgery. Money started rolling in and he was living the big life. He celebrated his success by driving a red Lamborghini and sending expensive gifts to a stripper whose breasts that he'd enlarged With his pop, pop, pop, pop, pop snap on wig. Anthony was on the rise to the successful plastic surgeon he'd always dreamed of being. However, he didn't stay on top for long because, unlike his hair, money and fame didn't compensate for a lack of experience and proper training.
Speaker 2:In August of 1997, 39-year-old Terry Lamotti headed into Anthony's office for a liposuction procedure. Shortly after arriving, she was given some pills and asked to sit in the lobby. She remembers feeling woozy and unfocused and being brought down to the basement operating room of Dr Pignataro's practice. Even in her medicated state, she became concerned because the basement didn't appear to be a proper facility and her gut told her that something was wrong. When she woke up at five that evening, remember, she went in in the morning. She woke up at five. She was fully dressed somehow, and her husband drove her home. She didn't feel right. She began hemorrhaging blood. Terry's husband called Pinotaro, who reassured him it was just blood-tinged fluid and it was perfectly normal, so there was no need to worry. Meanwhile, Terry discovered jagged wounds between staples that seemed to have been placed haphazardly across her abdomen. She was in terrible pain. Her family took her to the emergency room the next morning and it turned out that Terry's intestine had been cut during the surgery and she was septic and the staples were cutting off her blood supply to her abdomen.
Speaker 2:Typically, liposuction only requires a few small incisions for that fat-sucking cannula to enter, but she had 18 to 22 stitches all the way across her belly. The wounds were left half-opened and not sutured. If Terry hadn't gone to the hospital when she did, she would have likely died. But Anthony was furious. He snuck into her hospital room at 2.30 in the morning one day while she was in recovery Remember he had no privileges in this hospital. He started flipping through her chart and then screaming at her to go home, that she had no reason to be there. I mean, how scary for Terry. But Anthony was forcibly removed from the premises and banned from entering, but this wasn't to be the last victim of Anthony's, not even that summer. So next week we'll learn more about his victims and other heinous acts, investigations and outcomes.
Speaker 1:Oh my God, I am so looking forward to next week. We're just getting started. I am so just on the edge of my seat of this story already.
Speaker 2:Yeah, it is crazy, and there is a crazy twist that you won't see coming.
Speaker 1:God, I love a twist. I can't wait for next week. Thank you for bringing this. We also really needed this because my thing last week was so freaking depressing.
Speaker 2:Yeah.
Speaker 1:This is perfect, perfectly crazy Snap, snap snap, snap, snap. What a friend.
Speaker 2:Pop, pop, pop, pop pop. Just picture him like pulling his toupee off and then waving around victoriously.
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Speaker 2:Stay suspicious, and I will say thank you to our over two dozen listeners who took advantage of this code. Write in, tell us about your experiences with stand shoes, because everybody needs a comfortable stand so tell us about your happy feet thank you.
Speaker 2:yeah, when you visit stand shoescom and use our promo, it's a shout out to us as well as a discount for you. So thank you for that. Is it time for our medical mishappening? It's this time. Well, so this time we got an email the title of which says the mystery of the missing scalpel. Oh boy, it started. Yeah, it doesn't sound good. Dear amanda and jenna, I'm a big fan of your podcast and it makes me, alternatively, laugh, cry and cringe as I learn about important issues in health care. With your funny quote best friends chatting around the coffee table, quote style. Aw, thank you, we're a big fan of you, they write. I've been a surgical nurse for over 15 years. You name it, I've seen it, except for the day that made me question reality. It was a routine gallbladder removal, straightforward. Our surgeon was experienced, the patient was stable and the atmosphere was relaxed enough that someone actually said this will be a quick one. Oh man, rookie, mistake you never say that.
Speaker 2:No, knock on wood, knock on wood. It's like if you don't say break a leg, instead you say good luck when someone goes on stage, it's just bad luck, right? So anyway, that was me. The email goes on to say midway through the operation, during our final instrument count, we come up short One scalpel blade missing. Oh no, now, if you've ever been in an OR, losing an instrument is like losing a baby on a plane.
Speaker 1:Seriously.
Speaker 2:Every protocol slams into place. We count again, we check the floor, we check the patient's drapes, trash even the surgeon's pockets Nothing. The x-ray tech is called in because if a blade is inside the patient we need to know immediately. Everyone is dead, silent, staring at the monitor but nothing shows up Clean, clear, no blade. Then the anesthesiologist clears his throat and says Guys, we turn. He points to the ceiling vent. There, wedged in the grate, gleaming like Excalibur, is our missing scalpel. It has been flicked by accident during a handoff, hit the vent at the perfect angle and lodged there like some modern art installation. The room erupted half relief, half disbelief. The patient came through fine, never knowing they were nearly the star of a medical mystery. And myself, well, I now triple count instruments and check the ceiling. Thanks for reading this on the show. If you do, I'll freak out. Love Dee, I'll be freaking out. Dee, love Dee. Go ahead and freak out, freak out, go ahead, have a freak out, freak out, for sure. I obviously thought it was a vacation.
Speaker 1:How did they get on the ceiling I know, and then the ceiling? Was like wait what is there, oh my, somebody must have been very. It was obviously very sharp played and somebody was very quick to flick and then like then kind of didn't fall Flick.
Speaker 2:I don't know if it's that sharp Quick to flick. I know that's a bit crazy. Thanks, Dee.
Speaker 1:Thanks, dee. Well, I guess we already know what's coming up next week. Can't wait for part two of this Doogie McScoogie. So until then, don't miss a beat. Subscribe or follow Doctoring the Truth wherever you enjoy your podcasts, for stories that shock, intrigue and educate. Trust, after all, is a delicate thing. You can text us directly on our website at doctoringthetruthatbuzzsproutcom, email us your own story ideas, medical mishaps and comments at doctoringthetruth, at gmail. And be sure to follow us on Instagram at doctoringthetruthpodcast, and Facebook at doctoringthetruth. We're on TikTok at doctoringthetruth and at oddpod. That's E-D-A-U-D-P-O-D. Don't forget to download, rate and review so we can be sure to bring you more content next week. Until then, guys, stay safe and stay suspicious.
Speaker 2:Goodbye, goodbye, goodbye, goodbye what happened to my mouth.
