The Cowboy | Shoot from the Hip | S5-E2

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While the people of Wyoming's big horn bass and were scratching their heads over that strange flyer, whispers were spreading even farther. In hospital corridors and conferences, one name kept coming up. I would hear from other friends, I might see someone at the meeting and say, "Oh, you don't you hear about John?"

I'd be like, "No, I hear something about John." At the time, Dr. Larry Chin was a neurosurgery professor, thousands of miles away in New York, but he knew the name John Schneider instantly, that done their medical training together.

“He could still remember the first time they met.”

I was walking over to an intern's dorm, and I remember seeing a guy, and he was very heavily muscled, short guy, huge biceps and pecks, wearing a tiny white sleeveless tank top t-shirt that barely concealed his massive muscles. But it wasn't just his pecks that made John stand out. He clearly had done really well in medical school, and he was talented, he was smart.

He'd let it be known that he was headed for the Air Force after training. Top Gun, I remember, came out when we were residents, and, you know, what neurosurgery doesn't fantasize themselves as a fighter pilot, top gun type, it just fits the stereotype.

Even years later, Larry Chin never quite forgot the impression that John Schneider

made. "Oh, this guy is really something." So when Larry heard the gossip that his old colleague was being accused of orchestrating a bizarre male campaign, Larry couldn't help but be curious. They would tell me some crazy story, and then, you know, I'd look it up and there was.

Larry could hardly believe it, how could the gifted young doctor he remembered, the one

“with all that promise, how could he have become the man that people were now describing?”

This is a guy that, I knew, was a good doctor, smart guy, could, should have contributed a lot to people's lives, great education, great training, it's a tragedy. I'm Leon Nefak, what happens when only fans becomes more than just a side hustle? Only fantasy is an 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 Dr. Death, Season 5, the Cowboy. This is Episode 2, shoot from the hip. John Schneider didn't grow up out on the wide plains of Wyoming, in fact he was raised in the suburbs outside of Los Angeles.

“Born in 1961, he went to school in Ventura County, the high school yearbook lists him”

in the school band, he played trombone. Once he got to LA County, his colleagues at the hospital quickly noticed traits that would influence his career in the years to come. Things that, depending on the context, could make him brilliant, or troubling. For the young doctors in training, county must have been a wake-up call.

The facilities are shithole. Mike Levy was a year above John. They don't clean the walls, they just paint the walls. So if you're taking a chest to about get blood all over the wall, some of these, they're painting the next day.

Somebody was always painting, but the volume is beyond comprehension.

In the early '90s, LA was in the middle of one of the worst homicide epidemics in the city's history. You save a lot of lives. I personally used to probably take a bullet out of somebody's head every other night. Bang members brought their wounded to county, and sometimes they thanked their doctors in

unusual ways. I was given a blue hat and told I would be safe in a crypts neighborhood, not that I would

And amid all the chaos, Schneider thrived.

“This was his home turf, he loved it clearly and, you know, like a ductal water.”

He stood out among the medical staff on the wards. He was this kind of cocky neurosurgery resident who were cowboy boots and, you know, tight scrubs that showed off his muscles and knew a lot. And more than looks, he was good with his patience. He had so many patients that didn't speak the English and he knew Spanish.

He could talk to a patient and understand that they were talking fast and he could respond and knew all the slang and, you know, whatever, like he was slick. The workload was relentless. Doctors found that in practice, county was the only facility that took uninsured patients in the area.

Which shift meant 40 to 50 patients and emergencies on top of that. During those long hours, Mike Levy had the opportunity to observe John, a close. You spend more time with those people than your wife, your kids, anybody, you live with them. And he was left with no doubt where John Schneider ranked.

He was just one of the best, I mean, very easily top 10 percent. He told him to do something you get to done. He doesn't ask how, where when he just gets it done. To Mike Schneider had the personality that allowed him to deal with tough situations. He's very intense, very intense, kind of like the fifth grade teacher that scares the shit

out of you, you know, just looks right through you, always very serious.

And his laugh was serious. That intensity didn't switch off when he left the hospital. A couple of years into his residency, John announced that he was getting married to his fiancé Michelle, a neonatal nurse.

“They had a dance at their wedding and I think he prepared for that dance for two years.”

Dancing didn't seem to come naturally to Schneider. He prepared for it just like surgery. He was putting in extra time, I think, then his wife even knew about because he wanted to impress her that he had put the effort in. Mike was there for the big day, a ballroom near Universal Studios, balloons scattered across

the floor, tables along the edges, the guests gathered to watch the happy couple. I vividly remember just wanting to see what's he able to pull it off, being a good surgeon being stern doesn't make you a good dancer, I think we wanted to get a sense if he could do it or not. He watched his John and Michelle stepped out for their walls.

They think that's what amazed me. Having been to weddings where people learn how to dance and they kind of pull something off for about 30 seconds, but no, it really looked elegant. They really looked good. But as the dance went on, Mike noticed something about his friend.

This was absolute stiff posture, no facial expressions, serious, it's almost like they're in a competition.

That was John, always intense, always driven, even while dancing.

But sometimes that intensity could turn into something more worrying. On occasion, residents like John would need to leave County to see a patient at University Hospital. It wasn't far about a 10 minute walk through East LA across the stretch of open ground, called Hazard Park.

He was walking to go see a consults at the University Hospital and was held up at gunpoint. Hazard Park was said to be the place where local gang members would initiate new recruits. And I don't think he had anything on him, because he was in his scrubs and he was going to see a consult, probably didn't even have a wallet. On somehow managed to get away unharmed and get back to the hospital.

But what struck Mike was what came next. But I remember he was really upset and he would discuss with us that he really wanted to chase after the guy, or resist. Mike tried to persuade him that that would not be a good idea. If somebody's pointing a gun at you, do what they tell you, doing pray for good luck.

But I remember he was really upset about that.

“I think we all would be, but people respond differently.”

I'd be like, "I just got mugged and I would have run the other way." The incident stayed with Mike. When John was crossed, he couldn't let it go. I think that was the pride component. Just to let something like that motivate him and something so unimportant in the absolute

But there's good and bad to that personality.

“And a clinical setting that works great.”

Larry Chin saw the same streak in John that absolute self-belief. And Larry's opinion, it tied in with the cowboy persona. You'd say shooting from the hip, right? So like he'd make a quick decision and probably more often than not, if it were 50-50, operate not operate.

He would operate. You know, like, I'm going to take him to surgery, I'm going to save his life. And maybe you might say, "Oh, you know, you're shooting from the hip because you're not really contemplating or thinking or roominating.

He was certain and right or wrong.

I'm doing it and if I'm wrong, I'm probably not going to admit I'm wrong." In 1994, Dr. Schneider completed his residency and headed to Texas.

“The Air Force had helped pay for his tuition, so Schneider served at Wilford Hall, a military”

hospital in San Antonio. While he was there, he would become the subject of a story in the National Media. One evening, a man named Joe Corcoran was on the highway, driving into San Antonio. All of a sudden, somebody was waving people down and pointing to a car that had gone off the road to the right.

He stopped his truck and ran over. A man was standing by the driver's side door, holding a t-shirt to the head of a woman.

He lifted the shirt as Joe got closer.

What I saw was her brain and I couldn't figure out where her skull went to. Joe had seen head injuries before. He happened to be a nurse, but nothing like this. It was a substantial injury going from her.

“I saw it back to the left side of her head to behind her ear.”

I'm going, how could this possibly happen and I looked towards the interior of the windshield and it was just a capping hole in the windshield. And there in the back seat was a rock, the size of a melon. It had fallen off the back of a passing construction vehicle and crashed through her windshield. And she looked at me and she said, "Yeah, my head really hurts."

I thought, "Oh my gosh, she's actually talking to me." She was wearing a blue air force uniform with a name tag still attached, Captain Margaret Herring. Just stay where you are and it helps on the way. You've been hurt.

I noticed she was getting gray on me. I thought this lady's not going to make it. Within minutes, a helicopter was rushing Margaret to Wilford Hall. Meanwhile, a page went out to the surgeon on call. He was John Schneider.

He sped through Reshauer traffic and arrived in just over 10 minutes. Schneider later described what happened next. As he looked at the scans, he saw jagged pieces of skull have been driven deep into her temporal lobe and a blood clot was pressing against her brainstem. Her heart was slowing.

She was minutes from death. There was no time to scrub in or even make a surgical entry into Margaret's brain. He went in through the injury itself. Up inside, he located the blood clot and suctioned it out. Margaret's vitals began to stabilize and only then could he scrub in and begin what he

called the most difficult part of the operation. Painstakingly, Schneider plucked out pieces of gravel and more than 50 fragments of bone and spent the next six hours re-constructing her skull. Then came the waiting to learn how much of the damage to her brain was permanent. Weeks later, John Schneider had a visitor.

I walked in and I said, "Good afternoon, Dr. Schneider." Margaret had recovered beyond all expectations. And he goes, "And your damn lucky to be alive and I'm like, "And it's nice to see you too." I mean, that was his nature. He was very direct, but he was just that way, you know, and I like that about him.

That summer, Margaret returned to work at the base. I went on in my career, I had 24 happy years in the air force, continued on and did other things, traveled the world, and I did it because of what he did. Her story was picked up by readers digest, at the time, build as the world's most widely

The article described her extraordinary recovery and cast Dr. Schneider as one of the heroic

figures who made it happen.

“Schneider kept a hold of that article for many years.”

It ends with his words to Margaret. Something terrible happened to you that day, he tells her, "But something miraculous happened too." By the time Schneider's service ended, he could have gone anywhere. His old friends Mike and Larry went on to have glittering careers at major hospitals in

universities in California and New York. But Dr. Schneider wasn't going to set up shop in a coastal state. He was heading to Montana. You know, a fitness persona, it kind of made sense that he would go practice by himself in Montana and ride horses, fair back or riding a motorcycle at 120 miles an hour, and there's a solo

cowboy neurosurgeon, you know, you could see that. For the first time, Schneider wasn't working inside the structure of the military or medical training. In Montana, he'd be blazing his own trail in private practice and getting rich. I'm Leon Nefoc, best known as the co-creator of Slowburn and Fiasco.

I had 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. My journal is to curiosity, got the best of me when I found out that my own sister had

started an only fan's account. I'm not a sister, just to clarify. It turns out, a lot of what I thought I knew about only fans was wrong. I felt like I wasted 3.5 years for something that wasn't real.

“What happens when connection comes with a price tag?”

Listen to only fan to see wherever you get your podcasts. Or binge all episodes of only fan to see ad-free right now, only on audible. Start your audible subscription in the audible app or on Apple podcasts. Hello, I'm Matt Ford. And I'm Alice Levine.

And we're the host of British scandal. Yes, we are, and our new series 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. It was 2003, six years after Dr. Schneider had arrived in Billings, Montana. The folks at the clinic were Schneider now worked, were throwing a welcome party for a new recruit. Everyone in the practice came and kind of had our own room at a little restaurant there.

Dr. Michael Copeland was the practice's latest hire. It had been living in Kansas City, Missouri when he realized it was time for a change. I was alone covering two hospitals, essentially 24/7, which was just not sustainable. So my wife and I realized we're probably going to have to leave here because this isn't going to change anytime soon, so she said, "How about mountains?"

So when he got a call about a job in Montana, Dr. Copeland listened. He considered it against his other options. It was definitely the worst financial offer.

I'm not financially very savvy, never have been so.

But the promise of living in a city with a view of seven mountain ranges was too good to pass up. So that night at the welcome dinner, Dr. Copeland and his wife Joanne were eager to meet the colleagues that'd be sharing their new life with. Across the table, set a handsome muscular man in his forties with dark hair combed neatly

to the side. He introduced himself as John Schneider. Very charming. Very engaging. You won't be doing much of the talking, but what he's saying is very interesting and so it's

guy."

What do you do, Joanne asked, "I'm a neurosurgeon," he told her.

But I really look at myself more as an entrepreneur. Later that night driving home, Dr. Copeland and his wife talked about his new colleagues. Joanne mentioned Schneider's comment about being an entrepreneur. We said, "Oh, well good, it'd be nice to have someone around who knows something about that kind of stuff and doesn't make stupid mistakes."

In the years to come, he'd look back on that night in a very different way.

“Yeah, that was more important than we realized.”

After the welcome dinner, Dr. Copeland got to work. His practice often dealt in orthopedic surgery. The population of billing skews older, so that means a lot of bad backs. And as a new guy, it was Dr. Copeland's job to deal with the patients who'd had a complication after surgery.

I got the stuff that the other guys didn't really want to do. Day and day out, Dr. Copeland was in the unglamorous business of wound infections. So you had to wash it out and you're dealing with post, which is no one's favorite. And those people are usually pretty unhappy because they're getting worse not better. And then there were the cerebrospinal fluid or CSF lakes.

If the spinal sac gets a tiny little hole in it, spinal fluid will drain out of that.

“It'll keep leaking until it gets infected and a spinal fluid leak that gets infected”

is meningitis, they can die from that. After three months of scraping out wounds and repairing leaks, Dr. Copeland decided to check and make sure he was doing a good job. I'm thinking, I haven't kept track of what I'm doing. You want to be a good performer for him, so that made me review what cases I had done

just to know, like what's my pace? As he studied the record, Dr. Copeland counted 76 cases in three months, pretty good. But as he went through the files, one detail jumped out of him. That's when I saw, ooh, there's a lot of CSF repairs, there's a lot of wound washouts. And then I counted those up and I'm thinking, well, 40, some of my 76 cases are Schneider

applications, gosh, that's a high number, that's a really high number, because if I get a CSF leak in a year, that's unusual and I had done a bunch of them in three months. Dr. Copeland kept going over it in his head. Dr. Schneider wasn't just a founding partner of the practice. He was one of its biggest sources of income, handling cases across Montana and Wyoming, too.

And he wasn't shy about it.

Copeland remembers he once told him he was making more than $2 million a year.

Dr. Copeland meanwhile was very much the junior colleague. Even so, when he saw Dr. Schneider's physician assistant one day in the hallway, he pulled her aside. I said, I don't know how many cases he's doing, but there's a lot of CSF leaks and a lot

“of wound infections, and she said, yeah, I don't, I think percentage wise it's actually low.”

He's just so prolific. So I thought, okay, okay, just thought it was just a number's game. He's got hundreds, and you don't know that this is an outlier, and it's someone you practice with and you have implicit trust. I've been there for like three months, and all this stuff is coming in, and I feel very

unqualified in making any judgment. I'm still figuring out where to park my car.

Dr. Copeland says he's always been cautious.

He takes time to consider every option to make sure it's the right thing for his patients. It's what I lay awake at night worrying about, and I think that's good. I mean, I think it's good that it's troubling, I think you're supposed to struggle. So the idea of pointing a finger at a colleague when he didn't have all the information, and nobody else seemed to think there was a problem, but did feel right.

I was really giving him the benefit of every dad, saying an out loud now sounds really bad, because I'm an older, more experienced human now, and I would have reacted sooner than I did. Instead, Copeland told himself to keep his head down, and for a while, that's what he did.

He came down the hall and grabbed me and said, "Hey, I'm just so busy these next couple of weeks,

“and I got this guy who needs to enter a cervical fusion, would you mind seeing it?"”

I said, "Sure, I'll see him right now." The patient was suffering from arthritis and is spine. Dr. Schneider wanted to operate, but as soon as Dr. Copeland examined the man, he started to wonder whether surgery right away was a good idea. He was a pack of a smoker, and the failure rate in the heavy smokers for a fusion is significant,

and so my practice at the time is, "We need to do smoking cessation," so I said, "Come see me in six weeks, and we'll get this done." Shortly after that, Dr. Schneider asked Dr. Copeland about the patient. How did the surgery go?

And I said, "Well, I'm just getting him to quit smoking first, and then we'll do that in six weeks or so."

“He says Dr. Schneider didn't really react, so Dr. Copeland got on with his day.”

But then he began to notice a shift in their relationship. He stopped talking to me after that. At first I'd bacon, and I imagined in this, and then after a few weeks, he realized he hasn't said a single word to me, not since I didn't operate on that guy that he said needed an operation. Dr. Copeland wouldn't have long to dwell on it.

Around this time, Dr. Schneider announced that he was leaving the practice, had taken a position at the University of Utah.

For Dr. Copeland, it seemed like the problem had taken care of itself,

but that relief didn't last. Soon Schneider's former patients began to show up in Copeland's clinic. And as he reviewed their case notes, he started to see a troubling pattern. Some of Schneider's patients had undergone a procedure called a spinal fusion, using rods and screws to stabilize the spine.

But in case after case, Dr. Copeland says he was finding serious problems with the way the hardware was put in. Now, if you haven't taken the extra time to really prepare that joint, which is time-consuming, it doesn't matter how long you have the hardware in, it won't fuse, and if it doesn't fuse in that period of time, and you're getting in and out of bed and on and off the chair, that hardware will loosen, because it's in bone, it's not in steel.

And so, as it loosens it, it hurts, it hurts. Dr. Copeland took a look back at Dr. Schneider's notes to see what he was telling his patients. When particular phrase kept coming up, he would say, "Oh, you're just having myalphasial pain." And myalphasial pain just means, "You have pain, it's not a diagnosis, it's a description of your pain,

but people think, "Oh, it's myalphasial pain, so I guess I'm okay then." To Copeland, their real cause was clear. The hardware had come loose. So he would just say, "No, you're fine, it's just myalphasial pain. Next, here's some percussive." And at the same time, it seemed to Copeland that Schneider had been working non-stop. So, he would schedule several what I would consider long cases in a day back to back,

and he doesn't get to get out till they're all done, so he's working super fast. In Copeland's mind, that schedule explained what he was seeing. I think he got sloppy. And in some cases, Copeland would wonder why Schneider had put the patients through surgery at all. One patient arrived in Dr. Copeland's office after Dr. Schneider had performed a laminectomy on her,

removing part of the bone in the spine. But even after surgery, the pain was no better. She was pretty upset about that, so I looked at her pre-op studies. Dr. Copeland was expecting to find a narrowing of the spinal canal, called stenosis that would explain the need for such an invasive surgery, so he pulled up her MRI. And it was pristine.

He saw no evidence of narrowing in any of the woman's scans.

“So, she didn't need an operation at all. Like, that was shocking. Like, what?”

You're cutting open her back and unrupping it. Who would do that? That's a human.

come from her back at all. He was all just in her leg.

“And, quite looking at her images, you would know if you're a junior resident,”

you would know that that's not a lumbar problem. But he didn't big operation on her anyway. We asked Dr. Schneider about all of this. He told us via his lawyer that Dr. Copeland's version of events are motivated by a personal grudge because he refused to make Copeland a partner in his practice. He says he received complaints about Copeland's bedside manner, attitude, and unwillingness to take on certain challenging neurosurgical cases. Schneider says that when they work together,

he found Copeland to be spiteful toward him, and that Copeland's accusations appear to be vague and petty because no patient ever brought to light the described accusations against Dr. Schneider.

“The White Dr. Schneider sees it, the Montana medical scene was characterized by intense competition”

among surgeons. Dr. Schneider believes that his success triggered significant backlash from what he describes as entrenched hospital interests and competing surgeons. This, he says, is the real story of his career. To need dealing, would disagree. I have not gotten over it, and I know I should forgive as a good Christian, but I can't.

Schneider operated on Schneider's husband during this period, and he would never recover.

[Music] Months before Dr. Copeland arrived in Billings, 47-year-old Tom Dealing had been playing ice hockey when he slipped, landing hard on his tailbone. Dr. Schneider had performed what should have been a routine operation, a micro-diskectomy, trimming the disk in bone to relieve the pressure on Tom's nerves. But within weeks of the surgery, Tom's wife, Janine, could see that he was still

in agony. It got to the point where he could not stand up. He could not walk. He had to crawl to the bathroom. Janine would watch Tom as he called Dr. Schneider's office. Dr. Schneider told him the pain was myofascial. And they would say, "Oh, that's just part of backstory." And, you know, it hurts. It's going to hurt for a long time, but it'll get better. Just be patient. And I mean, they said that every time, Tom would call.

But it didn't get better. To need remembers Tom coming back from one appointment, looking shaken. Schneider had told him that there was nothing wrong. He just needed to suck it up. Before the surgery, Tom loved to go hiking in the mountains. But now his daughters could barely recognize their father. It was hard on all of us. And the girls were really upset to see their big, you know, strong dad laying on the floor and unable to move. They sure weren't used to that.

And it was awful. Eventually, Janine had enough. So I called. And I said, "This is ridiculous." I got so angry. I said, "No, this is not normal. This is horrifying." And I said, "He needs

an MRI." And he needs to be seen immediately. Dr. Schneider's office finally agreed.

When the scan was over, Tom tried to get up and couldn't. As he pushed himself up, he fell from the table. A technician helped him dress, then they went home and waited.

“They didn't know it then, but the MRI had found something important. A serious infection. The image”

showed it clearly. A massive abscess in Tom's back. But when Tom went to visit Dr. Schneider, that's not what he told him. "Fnighter told Tom, you did re-herniated, we'll need to do another micro-disc activity, it shouldn't be a big deal." And Tom said, "Okay, just please. I can't stand this pain anymore." Within a week, Tom was back on the operating table.

Afterward Schneider came out to talk to Janine. He was like, "I can't believe it. This is so

never seen anything like it. It's infected. There is infection inside his spine."

“Dr. Schneider told Janine that he scraped out the infection, but it wasn't gone.”

Five weeks later, Tom was back for another operation. Then, one afternoon, while he was sitting in his recliner, the wound split open, pus oozed out. That was it for Janine. So, she says she reached out to other doctors at the practice. Even now, she's still remembers Dr. Copeland. He was much more approachable and caring and sympathetic than Schneider was. So, I asked him, "Could he work on Tom alone without Schneider there to clear out that

infection because Schneider wasn't able to clear it?" By this time, the infection had spread deep into Tom's abdomen. A radical surgery was needed.

“It took the head of the practice. Along with Dr. Copeland and two other surgeons,”

more than six hours to repair the damage. They cleared as much bacteria as they could. But they had to remove a large chunk of his spine.

After the operation, Tom was never the same. Unable to move without pain, his weight

ballooned to around 300 pounds. His dad was a palt, the time weighed that much, and said that is so unlike him. I said, "Well, he couldn't do anything bad. He could eat, but he couldn't do anything active." But Tom wasn't giving up. He got a hold of his medical records and sent them to a lawyer. Tom had a case, and there were other changes too. Tom and Janine's daughter had moved back home

“after having a baby. Tom was now a grandpa. It was like the baby gave him something to”

want to live for. You know, there's this little boy he always wanted to son and I'm sure he had images of throwing a baseball around in a football with this grandson and Tom wanted his crib in the living room, so he had full access to the baby. And could pick him up whenever he wanted and change his diapers.

Janine began to imagine a more hopeful future. On October 21st, 2006, three years after his first

surgery, Tom and Janine's younger daughter walked downstairs to find Tom lying on the recliner as usual. But when she looked closer, she realized something was wrong. He was white, you know, his face was white. His head was to the side and it looked like he fell asleep. It was sleeping except for the color of his skin. Janine called 911. The operator tried to talk her through CPR.

So he's not a recliner. We cannot. I have the only my daughter here with me. She's sobbing and asking her to push the recliner down so we can get him flat. And I couldn't do CPR and we couldn't. In the days that followed, she tried to make sense of her loss. He was improving. He shouldn't have died.

So I told them I'd want to not have she. She had to wait until she got the results from the medical examiner's office to find the answers she'd been looking for. They found them so many blood clots in his legs, from inactivity. The medical examiner found that some of those clots had lodged into Tom's lungs. The infection in his spine wasn't listed as a cause of death, but to need beliefs that's where

everything began. And for that, she blames Dr. Snyder. As far as I'm concerned, he killed him. He is responsible for Tom's death. Tom could not move. He spent three years not being able to do anything. All that inactivity is what caused his legs to develop blood clots. When we asked Dr. Snyder about Tom, he denied being responsible for the infection or his death. His lawyer told us that Dr. Snyder

decades of practice. The portrayal of Dr. Snyder as a surgeon who killed a patient is not only

“unsupported by impartial medical review, but also ignores the complexity and inherent risks”

of neurosurgical practice. Dr. Snyder has consistently denied any negligence. Three months after Tom's death, in January 2007, an independent panel meant to review the case, to decide if Janine's lawsuit was justified. They were not asked to make a call on whether Snyder was responsible for Tom's death or the cause of the infection, only to decide whether Snyder had fallen below the acceptance standard of care in his treatment of Tom. The result was unanimous.

He had. The panel also found by a majority that Tom had been harmed by Dr. Snyder.

One panelist noted that Dr. Snyder came across as arrogant.

After months of back and forth, Dr. Snyder offered to settle the lawsuit without admitting any wrongdoing. He offered Janine the maximum amount allowed under Montana law, which was $250,000. As part of the deal, Janine would have to agree to confidentiality. She would need to keep quiet about Tom, at least for now. On the advice of her lawyer, Janine took the money. It was the closest thing to justice the system could offer. The anger we all felt towards Snyder

for what we saw as him having done, the negligence that caused Tom's suffering, so much suffering. We are so angry, and I'm still angry. I mean, I have not gotten over it, and I know I should forgive as a big Christian, but I can't. I don't think I ever will. Dr. Michael Copeland, meanwhile, was settling into life without Dr. Snyder, who had left Billings for a position at the University of Utah. Copeland was relieved that his old colleague

was now long gone, and then one day a patient came into the ER with a postoperative complication,

“a spinal fluid leak. Who in Billings did you see Copeland asked?”

And they said, "No, I had my surgery in Cody." Cody was across the state border in Wyoming, nearly a two-hour drive away. And I said, "No, there's no one's doing operations there." Yeah, Dr. Snyder is doing operations. Yeah, yeah, yeah. Dr. Snyder was supposed to be in Utah. Nobody said anything about him coming to practice in Wyoming,

but Dr. Copeland soon found out what was happening. He was going to Cody on weekends and having a clinic. Before long, Copeland wasn't just dealing with Schneider's former patients, he was getting new ones. And he wasn't the only one. Billings' other hospital got in touch. The neurosurgeons there were colon and screaming at us because they were getting Schneider complications

in their ER, and they were mad at us, and we don't have anything to do with that. Copeland says that, together, the doctors alerted the University of Utah about Schneider's clinic in Wyoming. Not long after, Dr. Snyder left Utah. According to him, it was on good terms. His former supervisor wouldn't comment on the circumstances,

“but told us he does not remember anyone from Montana reaching out.”

In total, Schneider worked in Utah for about a year. Then he set up in Cody permanently.

And you're just looking at the future like, "Oh, gosh, am I never going to be away

from taking care of Schneider complications?" To Dr. Copeland, the patients were suffering unnecessarily, and it didn't seem like anything would stop it. He'd never gotten in trouble for anything. A bunch of bad things had happened, and he scurtered everything. There had been no real consequence.

It all brought him back to something that Schneider had once said, back at the welcome dinner. I really look up myself more as an entrepreneur. Now, it didn't seem like a throwaway comment.

And you're charging $2,000 per screw. You put in 30 of them. That's a pretty big bill.

Dr. Copeland came to the opinion that Dr. Schneider didn't care if he hurt patients unnecessarily.

“I don't think they are people to him. I think these are opportunities to operate,”

and if you're operating, you maximize the financial return from that. How could you treat another human like that, knowing they're going to fail and then dismiss them? That is complete disregard for your fellow human and profiting from that.

Years later, Schneider's old colleague from LA County, Larry Chin,

would learn about the accusations that had filled up over Schneider's career. At the time, Larry had struggled to make sense of how the promising young surgeon he once knew

“had ended up this way. It's a tragedy for all the patients, a tragedy for him, for his family.”

You can't imagine the pain that the patients went through. I can only imagine how much torment that, you know, for him as well.

Even now, he still has a hard time wrapping his head around it.

This is not the person that I knew or saw. You're trying to figure out how this happened, which I could tell you. But perhaps there were hints of what was to come and what Larry saw in his younger days. That shoot from the hip confidence, that unshakable belief that he was right.

“This person who was a little bit larger than life and confident and cocky, yeah, I mean, I”

definitely see that element. And there was a lot more that John Schneider's old colleagues didn't know about him, especially about what happened next after he moved to Cody and what happened when another doctor tried to stop him from operating. After your podcasts, I will probably start carrying a gun. I wouldn't be surprised if Schneider decided to come pay me a visit. That's next time on Dr. Death.

Listen to Dr. Death, the cowboy on the audible app, or wherever you get your podcasts. Autobl 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. [Music] This has been an audible original. I'm your host Laura Beal. Executive producers are

Russell Finch and Marshall Looney. Our senior reporter is Zachary Stalfer. Tom Wright is our senior producer. Our associate producer is Muhammad Ahmed. Joe Wheeler is the senior story editor. Senior development producer is Rachel B. Doyle. Our production managers are Cherie Huston and Sarah Mathis. Our associate director of production is Latha Pandya, back checking by Jacqueline Coletti. Sound design and mixing are

by Nicholas Alexander and Mark Pittam. Sound supervisor is Marcelino Villopondo, music supervision by Scott Filoskis for free-sonsync. Production services provided by novel. Executive producer for novel is Max O'Brien.