The Cowboy | Paper Trail | S5-E1

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“It's a chilly Wednesday, Indie Simmer. When Julie Mossbacker pulls up to the post office and”

meditesy Wyoming. We don't get home mailed delivery, so we all have to go to the post office. Metitesy, population 300 give or take, is an outpost on the Grable River in one of those wind-wipped Wyoming counties that has more cows than people. Just around the corner from the post office stands the Cowboy Bar, a saloon that served renegades and ranchers for more than 100 years.

But Cassidy once got arrested as he was leaving there and sent a jail for horse theft.

Today, you can still find men on barstools with their Cowboy Hats pulled low. Hurt next to tourists in sensible shoes on their way to Yellowstone. Julie Mossbacker has lived here for almost 15 years. She's a nurse at a hospital in Cody about a half hour up the road. On this chilly day, she's sifting through the usual stack of envelopes. Here's bills, bills, junk mail, another bill, a few Christmas cards, and then something odd falls out.

A small folded scrap of paper. Julie opens it up to find a photo of a man staring back at her. He's middle aged with a stunned expression of someone who's just been caught doing something he shouldn't. It's a police mugshot. Then then, above, and big bold letters, the word alert. Julie scans through the text. "My name is Rita and I broke my ankle this summer and this doctor did a terrible job. I looked up this doctor and found this recent arrest. He's already been

investigated for drunkenness when on call at the hospital and has a dozen lawsuits that he lost. How can they let someone like this practice?" Julie stares at the note. She knows this man. He's a surgeon at West Park Hospital,

the same hospital where she works. My first thought was whoever did this is full of shit.

She throws it in the trash and drives off. Convince that someone is playing some kind of childish

“game. But when she walks into the hospital's nursing station, it's the only thing folks are talking about.”

Everybody was like, "Did you get one? Did you get one?" We were all finding out how widespread this mailing was. It wasn't just Julie or the staff at the hospital. Thousands of people were getting the letter. 14,000 to be exact. All morning, in town scattered across the big horn basin from Powell to Lovell to Grable and Shell. And now, the hospital's phones won't stop ringing. The people of northwest Wyoming might be shocked to learn that a doctor's been accused of harming

patients drunkenly. But it's not the doctor in the photo that residents would need to worry about. It was another man, an outsider. Like so many stories from the Old West, had come to town looking for a fresh start. And he would leave families devastated, searching for answers, trying to comprehend what had gone wrong, and who he really was.

“I'm Leon Nefak. What happens when only fans becomes more than just a side hustle?”

Only fantasies in depth look at the world's newest profession and how the rules of human intimacy are being rewritten online. Listen wherever you get your podcasts, or binge all episodes of only fantasy, add free, only on audible. From audible originals, I'm Laura Beal, and this is the fifth season of Dr. Death, the cowboy. I probably spent too many hours as a kid watching reruns of TV Westerns. Gunsmoke,

alias Smith and Jones, Benanza. I decided I wanted to be a girl with a horse, and for a while I was, I wrote a spotted gray apple loosea named salty mama.

They were usually the good guys, but even the heroes had an edge, a kind of dangerous charm.

“The American frontier always had a mythical aura, but it was, and remains, a real place.”

Today, many of the folks in these old frontier towns are older, a lot of them have made a living with their hands and backs, and their bones they carry the pain that comes from a lifetime of hard work. For relief, they often have to drive long distances across vast open country to find a surgeon, to help them. This is the story of a doctor who fashioned himself as a cowboy. He rolled into Wyoming in his dress boots, ready to saddle up and be a hero.

But the legend he left behind was one of broken bodies, lawsuits, bankruptcy, and fraud. This is episode one, paper trail.

“Over an hour northeast of Matizzi, Kathy and Jerry U.N. lived on an old family ranch.”

The nearest town was shell, a town so small, doesn't even have a stoplight. He was gorgeous. He was a little piece of heaven, had a big death that faced the mountain. Jerry had grown up there, putting out hay every morning for the sheep on his parent's farm. And we could see ten miles in either direction and all the way to the mountain. He and Kathy met when they were children back in the 50s.

He was kind of a shy, farm kid. He did really have a whole lot of social skills. In high school, Jerry worked up the courage to ask Kathy out on a date.

“His best friend was dating my friend, and John, our friend, had to literally twist his arm behind”

his back and say, "Call her." And so I get from Jerry, you wouldn't want to go out, Friday with you.

Their first date was a trip to the movies. They saw the pink panther.

Three years later, they were married. Jerry flew helicopters in the Vietnam War and later worked as a carpenter. Kathy trained as a nurse and then a physician assistant, specializing in rural medicine. They had three children. By 2008, two years before Julie Mossbacker found the mysterious flyer in her mailbox, Kathy and Jerry were in their 60s. The high school sweetheart still lived busy and active lives.

One day, they were hiking in the mountains with some friends that set up camp, and it was Kathy's turn to cook. I was kneeling down in front of the fire, cooking, when it dawned on me that I'm not sure I can get up. The pain was excruciating. A sharp burn that radiated across her middle and lower back. I took so much aspirin on that trip that my ears were just ringing. She and Jerry decided they would head home early. By the time they reached the ranch,

it was clear this wasn't just a strain. Whatever it was, the pain wasn't going away. Over the coming months, Jerry could see just how badly his wife was suffering.

Kathy's always been a gardener. She loves to be outside, and we had some trees,

and Kathy liked to plant flowers, and he was becoming very painful for her to do that. So, Kathy asked her doctor for some advice. He told her there was a surgeon who had set up in the area. His name, Dr. John Henry Schneider. He had started a clinic called Northern Rockies Neurospine in 2005, specializing in spinal complaints. He had a signature look, cowboy boots, even in the operating room. For Kathy, he was a convenient choice. Most of the nearest alternatives were all the way across

the state line in Billings, Montana. I made an appointment there just based on the fact that he was a new man in the community, and it was kind of supportive on my part. Soon, Kathy was sitting in a dim examination room. A dark-haired man in his late 40s came in, wearing dress pants and an open neck shirt. He got straight into it. He said, "We'll now have to operate." He paced up and down,

big, and that might be all you need." Dr. Schneider told Kathy, she had degenerative disc disease,

“common for women with 60-something bones. The MRI confirmed that her spine had worn down in places,”

causing bones in her back to shift and press on the nerves, which led to pain and weakness. And so I'm thinking, "Well, if that's something that's that minor, let's do it because I I got to get some of the wildlife back. I want to do stuff still." On a mild September day, Kathy and Jerry set off from the ranch and their old white Lincoln to Cody's West Park Hospital. On the long drive, the couple held hands.

Kathy did her best to reassure Jerry, and it was all going to be okay. I told him,

"I will be back on my feet. Well enough for you to go. You know, you go camping.

You take the grandkids or whatever, and you go. It's no biggie." At the hospital, as the nurses tended to Kathy and the prep room, Jerry remembers Dr. Schneider

“walking into the room in his surgical scrubs. He said that he had all this additional hardware”

that was set aside, that he would use if he found to be necessary. In case we find something that we hadn't planned on, and we need these parts, there'll be there in the operating room. A question began to form in my mind. "Why do you have this extra stuff when you've already done the diagnosis?" It seemed a little odd, but I dismissed it. With that, Jerry kissed his wife goodbye. Kathy was wheeled into the operating room,

where Dr. Schneider was waiting. He was all gown and gloves, and he just said, "We don't know exactly what we're going to find, but I'm prepared for whatever." And he says, "I'll talk to you when you wake up." While Kathy lay unconscious, Dr. Schneider made an incision into the midline of her back.

“He carefully dissected the muscles to reveal Kathy's spine.”

With a soft tissue cleared, Dr. Schneider got to work, using a drill and other tools he removed parts of Kathy's spine and ligaments. He widened the nerve passageways, relieving the pressure. He then set about stabilizing Kathy's spine using the hardware he'd set aside. He implanted screws and a metal rod.

Finally, a deep drain was placed at the base of Kathy's spine to collect any excess spinal fluid in the

days ahead. When Kathy opened her eyes in the recovery room, Dr. Schneider was standing over her. He said that everything went well. It was a bit more extensive than he anticipated, but everything had been cared for. Everything was okay. They're going to take you up onto the floor and you'll be here a couple days.

Kathy does in a private room for a few hours. And then, at about 3 a.m., she suddenly woke up with a jolt. And I was ringing the bell. The pain and Kathy's back now consumed her entire body. When I said, "You guys, I don't know when I had meds last, but now it's the time."

I want them, please. Kathy says the nurse has left to go get her church, but they came back looking apologetic. They came in and said, "Cathy was sorry, but there's no pain medication written for you." And that's when I said, "We'll call him." Kathy waited and waited.

But she says the nurse's could not get a hold of Dr. Schneider. All she could do was lie there. It wasn't until the morning when Dr. Schneider surfaced with a prescription for pain meds. Later, he arrived with an update on Kathy's condition. He was happy with her progress and said she could be discharged at the following day.

When Jerry came to pick Kathy up, he was shown the drain that had been implanted at the base of Kathy's

[Music]

“Back at the ranch, Kathy rested in the rocking chair and looked out onto the mountain side.”

Each day, Jerry would help her into the shower and empty the drain.

He did his best to keep it clean and sterile. As instructed, Kathy expected the drainage to gradually stop, but as each day passed, the clear fluid kept flowing. After a couple of days back home and four days after the surgery, Kathy started to worry. As a physician assistant, she could tell that something wasn't right. I kept telling him you don't leave a drain in more than four days.

But Jerry kept reassuring her.

He said, "Just relax. It's okay. Just relax. Go sit in the rocking chair."

“I remember calling over to the hospital and telling Dr. Schneider's crew that I was still draining”

and that I thought it was time for those drains to be pulled and being tools that we don't have time today. Dr. Schneider is very busy and we're all really busy. I kept saying, "These are supposed to come out. These have to come out." And then I started really getting fuzzy headed. I knew I was losing periods of time. Kathy could feel herself slipping and yet it seemed like no one was listening to her. Jerry was no doctor and he was following the only instructions he

says he was given to keep clearing the drain until it stopped. But it didn't stop. I told him, "I'm getting sicker, honey. I'm getting the sicker." We have to do something. Kathy was becoming increasingly concerned about just what was coming out of the drain. The spinal fluid looked different. It was getting creamy by then. And that, that unnerved me. While Kathy panicked, Jerry determined to do his best, kept on clearing the drain.

And he kept dumping that out. He didn't have any medical training, really. A week went by, and the milky discharge just kept coming. Until one day, I woke up one morning and took my temperature and I was over 104. I said, "Let's go out and see Dusty. I don't care what we're doing. We got to do something." Dusty was their family doctor. Jerry helped Kathy into the car, and they drove over to see him. He said, "This isn't right. If this drain is still here.

“I remember him asking me, what did they tell you to do with this?" Jerry did his best to explain”

that he'd done everything he was told, but it was all no use. Jerry didn't know why Kathy's condition had deteriorated so badly. He was very concerned, and his orders that were, I was to take her immediately to the hospital in Cody. Jerry raced back home to get some clothes for Kathy. Yet no idea how long she might be in the hospital. We packed a bag for her and Kathy was convinced that that point that she was going to die. And we actually had to stop on the way out to door so

she could show me the dress that she would be buried in. Kathy and Jerry were preparing themselves for the worst. They headed for the hospital praying. She would make it out alive. Hello, I'm Matt Ford. And I'm Alice Levine. And we're the hosts of British scandal. Yes, we are an our new series. It starts with a loud, lovable woman from Burmese who becomes one of the most famous people in Britain. This is the story of Jade Goodie. The reality TV star who built a

fortune just by being herself. And then lost everything. In one of the most public racism scandals Britain has ever seen. It's a story of fame. And a change of the conversation around cervical cancer forever. Follow British scandal wherever you get your podcasts or listen early and add free on audible. I'm Leon Nefak. Best known as the co-creator of slow burn and fiasco. I, of course,

heard of only fans, but always with a distant and quiet skepticism, a silent judgment you might say.

Who is actually using this platform? I am. Hi, I'm only fans creator and comedian, Gracie Cainan. I work from home. Now I'm only fans. And thank you so much for not only fans. My journalistic curiosity got the best of me when I found out that my own sister had started it only fans account. I'm not a sister. Just a clarify. It turns out a lot of what I thought I knew about

What happens when connection comes with a price tag? Listen to only fantasy wherever you get your podcasts.

“Or binge all episodes of only fantasy add free right now only on audible.”

Start your audible subscription in the audible app or on Apple podcasts. Kathy and Jerry UN arrived at West Park Hospital. They've been dealing with complications since her surgery with Dr. Schneider. The hospital saw her right away. They told her it was a severe infection, a rare and life-threatening combination of meningitis and in cephalitis.

Soon she was back in the operating room with Dr. Schneider.

Schneider reopened the wound. He scraped and cleaned it with three liters of antibiotic. Kathy was sent to the ICU to recover, hooked up to an IV with a cocktail of still more antibiotics. For three days Jerry sat by his wife's side. He held her hand and spoke softly to her as she drifted in and out of consciousness. She was definitely not in her head. She wasn't in the right line because she imagined that there were flowers on the wall and she was reaching out to pick him.

I was scared. I just sat by her and held her hand and said it's going to be okay. Things you're going to be fine. We're going to get through this. I've been through a lot of things in my life. I spent a year in Vietnam as a meta-vac helicopter pilot and I saw people die every day and people wounded in the worst possible way and it was hard to have that experience.

“I think this is right up there with those things. As he sat by her bed, Jerry prayed that she”

would make it through. I had faith. You know, we're people of faith and personally able to put this in the Lord's hands and say okay. The kind of bacteria Kathy had kills up to one and four people who get it. With Jerry by her side, Kathy's immune system fought until she started to come around. But as she slowly regained her faculties, she started to notice that doctors and nurses who cared for her making curious comments. The hospitalist would come in and look at my back and he would say,

"Well, I think you're very lucky to be alive." And I said, "Yeah, I think so too. I'm, you know, this is a miracle." And he said, "I'm sorry that you had to go through any of this." And he looked at Jerry like this was on calls four. Before long, she was moved out of the ICU and into a regular hospital room. Then, Jerry and Kathy heard someone approaching a room. Dr. Schneider had come to check on his patient. He came just as far as the door and he stood at the door and he said, "Well, it looks like you're doing

fine." And I said, "I'm getting better." He said that he gets one or two infections a year and it was her misfortune to be one of them. From a chair in the corner of the room, Jerry eyed Dr. Schneider, whereily, a seat of doubt was in his mind. He was questioning not just the infection, but all that

“extra hardware Dr. Schneider had set aside and put into Kathy's back. What was it you saw?”

Are you found? After you started the operation, that you didn't find on your diagnostics. He wouldn't answer me. But he said, "De Kathy, I don't think your husband trusts me. I thought, "Well, hell no, I don't trust you. Look at what happened." For his part, Dr. Schneider recorded his perspective on Kathy's condition and dictated medical notes. And Dr. Schneider's view, Kathy's back surgery was "extremely effective." He says that until

she developed meningitis should have been doing extremely well. The surgery, as he saw, it was

successful. After seven days in the hospital, Kathy finally went home. The infection was under

"It would get better with time." He said, "Your surgery was pretty extensive, so you do have pain,

“but it will go away." But it never did. I never got to the point in my recovery,”

where I was out of pain, not for one single day, not for one hour. It destroyed our life as we knew it.

So, after two years of daily struggle, she finally decided to get a second opinion. She said she

went to a doctor in Billings, Montana. She showed him where Schneider had operated. He looked at my back and he was very shocked at how scarred up I was. It's a huge scar. And he said, "We need to get some pictures." Here, but he said, "This is pretty extensive." When he got the MRI and the X-rays, he had this almost be dazzled, look on his face and said, "Well, there's a lot of hardware in you, but some of it's not attached to anything."

Kathy sat rooted to her chair in shock. Dr. Schneider had insisted her pain was just an unavoidable

“hurdle on the long road to recovery. He said, "I think we need to take out all of that stuff that's”

floating around in your back."

Once her second operation was over, Kathy was relieved to discover that the pain should

been suffering had finally subsided. The surgeon sat her down to tell her what had found. He brought this bag of the titanium rods, all those screws, the crossbars, everything that had been put into my back. He said, "Your back has been cut to ribbons." He said, "Those screws, the screws that were floating around there, have just ripped up your nerves and those titanium rods have been poking you because they're loose."

I was angry, I was angry with it, did to my family and I realized that all of this time,

I was being patient waiting for the healing with all that stuff and it was causing me not to heal.

It was more than enough to make her furious. All that time should lost. We did hear from Dr. Schneider when we reached out to him about Kathy's case. While he wouldn't speak with us directly, his lawyer told us that the series appears to focus disproportionately on a handful of negative outcomes and patient complaints, while disregarding the thousands of successful cases and positive testimonials from colleagues and patients.

The series must acknowledge the inherent risks of neurosurgery and the fact that adverse outcomes do not in themselves constitute malpractice or unethical conduct. On a dry December day, back when Kathy had been recovering from her infection, Jerry was driving home in his truck when he checked the mailbox. "I shuffle through it and pull my gosh. What is this?"

A small piece of paper folded down the middle with a picture of a man's mugshot. My name is Rita and I broke my ankle this summer and this doctor did a terrible job. How can they let someone like this practice? Jerry jumped in the car and went straight home to show Kathy because he knew exactly who the doctor in the mugshot was and so did Kathy. It wasn't Dr. Schneider in the photograph,

but it would eventually reveal to Kathy and Jerry the links that Schneider could go to when someone questioned his decisions. "It really disturbed me on so many levels. What have you done?" That strange flyer was in mailboxes all over the county that morning. Words spread quickly about the possibility of a dangerous doctor in the area and soon someone at the

local newspaper was asking questions. "This wasn't a flyer that just went one person's suit.

“It's obviously newsworthy. We were getting quite a few people that are just like what is this?”

Is it real? Is it legitimate?" CJ Baker is a classic old school local reporter with wire-rimmed glasses and a stubble beard. He knew a story when he saw it. "We need to figure out

center of the controversy, the one in the mugshot. He was an orthopedic surgeon named Dr. Jimmy

“Biles. Dr. Biles was from Texas. He was tall and burly with swept-back sandy hair.”

Just like Dr. Schneider, he often wore cowboy boots. Texas, you know. And it seemed, Dr. Biles had recently, just that past October, been arrested for a DUI. That was right around the time that our sheriff's office had started putting booking photos online. And so I recognized it as a legitimate booking photo. And then, listed in a rest day of October 17, 2010. And then, list charges of actual physical

control, the blood alcohol level over 0.18. Lute act with resisting arrest, illegal possession, control substance, felony investigation. The more CJ looked over the information, the more he questioned it. The mugshot of Dr. Biles was really, yes. But the information underneath it and the laundry

“list of crimes seemed pretty implausible. For example, it listed is alleged blood alcohol level,”

which is not information that is ever put on the sheriff's office site. And then, there was the

charge itself. CJ had covered the courts for a couple of years and never heard of that charge.

He called up a prosecutor to double check. I had my mind, or is there no such thing as Lute act with a resisting arrest? That's not a thing under Wyoming law. No one could ever be charged with what's listed there. CJ couldn't help but wonder what else on the flyer was made up. Kathy, you and new Dr. Biles, very well. He worked at West Park Hospital. The same hospital, the Dr. Schneider. In fact, Kathy had known Dr. Biles for years. He shared an office together,

the same office that she was now driving to, and their families went back even further,

and even paid for her father-in-law's honeymoon. So when Kathy got the letter, she wanted to ask

him about it directly. People were saying, well, boy, if it comes out in the mail like that, there's truth behind this. So then people were starting to call the hospital and say, "Am I supposed to keep my appointment with him today?" Or, you know, are we supposed to be concerned? Is my care provider a drunk? When Kathy had been in the hospital with her infection, Dr. Biles had come to visit her. And he said, "I have been so concerned about you,

Kathy, he's sucked in. Here I've been checking on you." As Kathy and Dr. Biles had talked about her ordeal, she noticed an undertone to his gravelly draw. If you knew Dr. Biles, you would know as tones are very monotone when he's speaking,

“and you have to listen carefully, but I picked up an edge of anger in him, which very few people would see.”

I knew he was angry that I had been so sick. He started really saying this should not have happened to you. There was no doubt. He was angry. Live it. But now it was her old friend who was being accused of being a danger to patients. Kathy had to know was any of it true? Within minutes, Kathy pushed open the door of Dr. Jimmy Biles clinic. He looked up as Kathy put three copies of the flyer down in front of him. And I said, "Was this a joke?" I said if it is, it's not funny.

Dr. Biles read the note in silence. I just felt so guilty, maybe, for being the one that brought him the bad news. He stood up and shut the office door. He just could not go out and face his patients knowing that probably some of them had seen that that day. It was like he'd just went numb when he saw that. I mean, I wanted to hug him because I knew how this would be ripping him up. That story is not that man, not the man I know, not at all.

Later that evening, Dr. Biles called Kathy. The whole thing was still on his mind. He said, "But I just want to let you know from my mouth that this did not happen. This is not real. I don't know where it's coming from." Kathy didn't know who sent the letter, but whoever sent it, she felt like it wasn't just some kind of prank. CJ Baker had enough to go on for his story, which ran under the headline, Dr. disparaged.

In the very same addition, Dr. Biles and West Park Hospital bought an ad, declaring that the

“accusations in the flyer were "simply not true." But one mystery remained.”

Who was Rita, the patient whose name was on the flyer? CJ tried to track her down and came up empty. Until the day that Dr. Biles identified her in a lawsuit, she was a woman living more than 1,000 miles away in Indiana. But that wasn't the only detail that caught CJ's attention. Dr. Biles claimed that she hadn't acted alone. She had been working with someone else. A doctor, a doctor named John Schneider.

Once this complaint was filed, and the allegations made that this was another medical professional who had been behind this whole disparagement campaign. I guess whatever you want to call, what the flyer was, certainly escalated the newsworthiness. The allegation that Dr. Schneider had orchestrated the letter campaign hit the headlines. Schneider denied that he had anything to do with it. He launched a counter-suit.

Now, it would be up to the courts to decide. Sitting in her rocker, the one that overlooked the mountains, Kathy Yuen's brow furrowed as she digested the news.

“I was very puzzled about why would Dr. Schneider do that? What was the why of that?”

That drove him to go to such lengths. Who was Dr. Schneider really? Who was he? Really? Kathy wasn't the only one. Other patients and their families would ask the same questions. Schneider, of course, had his own response. He says he had a highly successful career, setting up medical practices in Montana and Wyoming and making what he called "significant contributions to the field of neurosurgery." And that success, he says it made him "a target for

professional and personal attacks." Years later, in a blog post, he would set down his own version of who he was. This is not his voice, but they are his words. I've lived the life of Icarus. As with every hero's journey, the Greek tradition ends in tragedy. I have lived well and laughed at the lawyer's beating drums and soliciting my accusers,

satisfied that they will never find peace. If their ancestors are in heaven or hell,

I will find them and torment them as they have tried but failed to torment me. John Schneider liked to write his own myth as a Greek hero. But the reality about what kind of men he truly was and how far he was willing to go was only beginning to surface. Coming up this season on Dr. Death. This inexcusable, what he did I consider inexcusable and I will never, ever forgive him.

He was just one of the best, very easily top 10 percent, very intense. Kind of like the

fifth grade teacher that scares the shit out of you. Members of the committee, Dr. Schneider never

should have been hired to trade our veterans. It's not a very long leap to think how far could

“this go? He's hurting people. How far is this guy willing to go to hurt us?”

Listen to Dr. Death, the cowboy, on the audible app, or wherever you get your podcasts. audible subscribers can binge all episodes of Dr. Death, the cowboy, early and ad-free right now. Join audible in the audible app, or by subscribing on Apple Podcasts. This has been an audible original. I'm your host Laura Beale. Executive producers are Russell Finch and Marshall Lui. Our senior reporter is Zach Restalfer. Tom Wright is our senior

Senior development producer is Rachel B. Doyle. Our production managers are Sherry Houston and Sarah

“Mathis. Our associate director of production is Lotha Pandya, back checking by Jacqueline Coletti.”

Sound design and mixing are by Nicholas Alexander and Mark Pittam. Sound supervisor is Marcellino

Velopondo. Music supervision by Scott Velosquez for Frison Sync.

“Production services provided by novel. Executive producer for novel is Max O'Brien.”

(siren wailing)