Fluent Essays

The Runaway Doctor” presents an amoral surgeon who becomes a fugitive. Certainly, he caused harm as a doctor, but were others harmed by his disappearance? Develop an argument where you explore the consequences of someone abandoning their life. The Runaway Doctor Vanity Fair – January 2011 When luxury-loving Dr. Mark Weinberger vanished, in 2004, he left in his wake a wife saddled with more than $6 million in debts, a father headed for bankruptcy, and hundreds of patients who say he misdiagnosed them and performed completely unnecessary sinus surgeries. Now “TheNoseDoctor” of Merrillville, Indiana, is facing prison, along with more than 350 malpractice suits, after finally being captured while hiding out in a tent in the Italian Alps. The author investigates charges that a talented young physician became a greedy, mutilating monster. By Buzz Bissinger THE FUGITIVE UNKIND Mark Weinberger, then wanted by the F.B.I., skiing in the Italian Alps, November 8, 2009. The photo was taken by his girlfriend, Monica Specogna. His hair is longer than it was in his former life, the life he left behind like a snake shedding its skin. A yellow bandanna wraps around his forehead, and reflective dark glasses cover his eyes, giving him the look of a ski bum trying too hard to hide middle age. Married and divorced three times, he has found serenity in his latest relationship, with an Italian woman named Monica, who runs a small grocery store. It is she who has taken the picture of him after a day in the mountains of northwestern Italy, just outside the storybook ski resort of Courmayeur. There is a thin smile across Mark Weinberger’s face on this sunny day in 2009. The smile suggests contentment—a contentment distant from the driven, fanatical years he spent marketing http://www.vanityfair.com/contributors/buzz-bissinger himself as “TheNoseDoctor” in a small midwestern town, his local celebrity buoyed by a first- rate pedigree that includes the University of Pennsylvania, U.C.L.A. medical school, and a prestigious fellowship. There is something wry about that little smile in the mountains, something smug and self-congratulatory. Or maybe it is just that he looks so relaxed, at ease, not a care in the world. He has done it. He has left behind a trail unlike that of any previous doctor in the U.S., one in which he saddled a wife with more than $6 million in debts and pushed his own father into deep financial trouble; left behind mountains of public documents claiming that in the name of sheer greed he performed hundreds of sinus-related surgeries that not only were completely unnecessary but also made some patients’ conditions worse; left behind accusations that he scared patients into having surgery by showing them hideous but phony images of their supposed conditions; left behind alleged misdiagnoses in which he failed to detect throat cancer in a woman who subsequently died, and missed the tumor on the pituitary gland of an eight-year-old girl while giving her sinus surgery she never should have had, because her sinuses were not yet fully formed; left behind a criminal indictment in federal court on 22 counts of health-care fraud; left behind more than 350 malpractice suits that have been filed against him; left behind a court deposition in which an eminent medical expert called him a disgrace to his profession and the worst doctor he’d ever encountered. People can say all they want about him: that hundreds of patients in northwestern Indiana are walking around with worthless holes in their sinuses which he put there using an outdated surgical procedure, and that he has billed insurance companies for a myriad of operations that one medical expert says he could only have performed with “twelve hands” in the 25 minutes his notes indicate the surgeries took. “He mutilated people for money” is the way trial lawyer Barry Rooth will ultimately describe his practice in a court proceeding. But this is like talking about a dead man. Because as Christmas nears in 2009, nobody in the United States has a clue as to where he is. Stories about doctors causing harm by performing surgeries incorrectly, or trying to game the system by over-billing insurance companies, are hardly new. But none come close to the depredations of Mark Weinberger as pieced together through dozens of interviews and an examination of thousands of pages of court records. His is a saga so disturbing, cruel, and bizarre as to be almost surreal. Weinberger himself told his wife at a time when he was still practicing but under increasing scrutiny that he was the victim of a grand conspiracy brought on by other professionals envious of his phenomenal success; they in turn had friends who were trial lawyers, and so the long knives came out. When the first wave of legal actions were taken against him, in the summer of 2004, he painstakingly plotted to combat them. The plan was: he disappeared. For five years he was on the run. During that time he never contacted his wife, Michelle Kramer. He never got in touch with or sent word to members of his family. He seemed settled in Courmayeur, although he apparently did not work, paid for everything in cash, and was seen getting around often by bicycle. The relationship with his new girlfriend was blooming into an improbable love affair, and they talked of adopting children together, since she could not have any of her own. But he also spent stretches of time in a tent by himself on the Italian side of Mont Blanc, the tallest mountain in the Alps, apparently proving to himself that he was able to survive. This way of living represented a wholesale re-invention, given the excessive lifestyle that had been his addiction when he still practiced medicine and lived in Chicago—the only way of proving to himself his worth and success, some believe. He had lived high and mighty in his former life, reportedly making as much as $3 million a year. He owned a $2.4 million town-house condominium in Chicago; it was five stories high, with an elevator, and was across the street from a park where elegant widows walked elegant little dogs in the looming shadow of the John Hancock building. He had an 80-foot yacht called the Corti- Seas, worth roughly $4 million. He had an undeveloped property of 1.41 acres with a pink-sand beach on Harbour Island, in the Bahamas, worth $750,000. He could be charming and erudite, and, having been a philosophy major at Penn, was fond of quoting Schopenhauer. He could also be dismissive and rude and narcissistic; once, according to Michelle, he said he was unhappy in their marriage over the issue of her lack of eagerness for oral sex. He would yell at nurses in his office, telling them they were fat because they were eating pizza. He would take change from shopkeepers and throw it on the ground because he could not be bothered with it. Since he was cunning and smart, his disappearance was the result not of some impulsive moment of panic but rather of painstaking plotting to ensure that nobody he knew would ever discover him. He almost certainly felt the odds of being found after five years were nonexistent. He had rendered himself invisible, just as a book on the very subject which he had bought before he left, How to Be Invisible, had instructed. There were cracks, though, little mistakes he was starting to make in Courmayeur in the summer of 2009. He was getting casual in concealing himself. But these missteps amounted to nothing, because no one was actively looking for him anymore. His actions, if all the accounts are true, resembled those of a sociopath, a monster for whom the only needs that mattered were his own. The wave of malpractice allegations could hardly have been foreseen during the academic year 1995–96, when Mark Weinberger was a young and ambitious doctor with a fellowship at the University of Illinois at Chicago, studying under one of the most eminent rhinoplasty surgeons in the world. The fellowship was extremely competitive—only 2 of the roughly 100 who applied that year were accepted, and Weinberger’s references from the Division of Otolaryngology at the University of California San Diego Medical Center, where he had been a resident for five years, were impeccable. “We have searched over and over again for clues and there really weren’t any,” says Dr. Eugene Tardy, now retired, under whom Weinberger served the fellowship. “He was a bright, talented, compassionate, caring doctor,” adds Dr. Daniel Becker, who was the other fellow that year and is now clinical associate professor in the Department of Otorhinolaryngology at the University of Pennsylvania with a private practice in New Jersey. “I don’t know what happened after that time. That’s the big mystery.” “A Dollop of Schmaltzmanship” Mark Weinberger was one of three boys born to Fred and Fanny Weinberger. He was the middle child, with a birth date of May 22, 1963, and the family had a unique claim to fame: What do you think I am, chopped liver? They were. They were the kings and queens of chopped liver, thanks to a recipe created by Mark Weinberger’s grandmother Sylvia with what The New York Times called in her 1995 obituary “a sprinkling of matzoh meal, a pinch of salt and a dollop of schmaltzmanship.” That story began when she made chopped liver for a luncheonette she and her husband had opened in 1944 in the Bronx. When people liked the chopped liver, she put it in Bronx supermarkets, a sideline that ultimately transformed into a $2-million-a-year packaged-food business known as Mrs. Weinberg’s Food Products. (Her name was shortened because it would not fit on the original labels, according to the Times.) The company was dissolved in 1989, but the chopped liver still lingers, having earned mentions in exhibitions at the American Jewish Historical Society and at the National Museum of American Jewish History. Fred Weinberger worked as a physicist in Washington for the federal government, and, for a time, as an executive with the family business. He eventually settled his family in Mamaroneck, in Westchester County, New York, so the three sons—Jeff, Mark, and Neil—could attend the well-regarded Scarsdale High School, one town over. The move paid off, as all three then went on to Ivy League schools: Jeff, the oldest, to Columbia, Mark and Neil to Penn. According to Michelle Kramer, based on extensive conversations she had with Mark after they were married, all this achievement had not been without cost. Jeff carried the stigma of being hard to get along with and was argumentative with his parents, ultimately becoming estranged from the family; when his mother died of cancer, in May of 2002, he did not attend the funeral. Mark, for his part, had the sense that his mother always favored Neil, because she and he had similarly artistic personalities; she liked the fact that Neil went into the film business after graduation from Penn. Mark, according to Michelle, had tried to impress his mother with his academic accomplishments. He was a cum laude graduate of Penn, then thrived in medical school at U.C.L.A. with a grade-point average of 3.82 and a merit scholarship. But those stellar marks apparently didn’t count for much with Fanny Weinberger, to the extent that years later Mark wanted as few drawers as possible in the Chicago condominium he and Michelle redesigned because, he told his wife, “my mom would take any award I had and put it into a drawer because she didn’t want Neil to feel bad.” Later on, after Mark had become a successful doctor, Michelle would watch as he tried to impress his mother when they were out for dinner together. He regaled Fanny with stories of trips taken all over the world courtesy of NetJets (the private-jet service that is somewhat akin to a time-share), and she responded by saying, “You should donate your money to charity. You should do some good in your community.” Invariably, after an hour at dinner together, mother and son would be fighting. Mark had what could be categorized as classic middle-child syndrome, always wanting to please and to prove his success. And, at least in his father’s case, there was ample family pride and, at times, parental assistance. When Mark expanded his practice by building a state-of-the-art clinic, in 2002, Fred Weinberger lent him a million dollars for the purchase of a cat-scan machine. Fred was particularly proud that Mark was scientific-minded, as he himself was. But that loan would come back to haunt him after his son’s disappearance, in the fall of 2004. The next year Fred Weinberger filed for bankruptcy. When the federal court appointed a receiver to sort out Mark’s assets in his absence, Fred, then 76, requested repayment of the million-dollar loan—plus interest and expenses. The claim was rejected. In 1996, after completing his fellowship, Mark had begun practicing as an ear-nose-and-throat surgeon in Merrillville, Indiana, roughly 30 miles from Chicago. A tepid and dreary town of 30,000 at the time, Merrillville seemed an unlikely place for a doctor with such lofty credentials. But the air quality in the region was poor because of all the steel mills surrounding it. The concentration of airborne pollutants could often lead to sinus problems, which became Weinberger’s specialty. The blue-collar population in the area, largely unionized, also had something that is believed to have been essential to Weinberger’s plans for his practice: health insurance, of which he accepted any and all kinds. Michelle Kramer was Mark Weinberger’s third wife. Little information is available about his first marriage, which occurred around the time he was a resident, in San Diego. Weinberger himself seems to have swept it under the carpet to the degree that Michelle did not even know about the marriage until she was told about it during a television interview after Mark’s disappearance. On December 31, 1997, Weinberger, then 34, got married for the second time, to a woman named Gretchen Vandy, then 24; the couple separated after 14 months. According to a request for support Vandy filed in Cook County during their divorce, Weinberger was already making in excess of a million dollars a year and living a lavish lifestyle—multi-thousand-dollar shopping sprees, frequent vacations, and dinners in restaurants costing upwards of a thousand dollars. One night in early 2000, Weinberger was at a club called Glow in Chicago when he met Michelle Kramer, then 25. She was a student at the University of Chicago, taking a variety of graduate courses. She was also blonde and thin and striking, and both seemed instantly smitten with each other. She had always looked up to doctors—ever since she was 13, growing up on the southwest side of Chicago, when she had been hit by a car, leaving her in a body cast for roughly a year—and she found Mark Weinberger charming and smart and romantic. He in turn, as they fell in love, promised to treat Michelle as a “princess for the rest of your life.” They became engaged in the spring of 2001. Weinberger liked being over the top, doing things differently from the common herd, so the engagement wasn’t an engagement as much as it was a piece of performance art. The extravaganza took place at the Piazza Navona, in Rome, while the couple was there on vacation. Mark had a special affinity for Italy and would travel there often. On this occasion, he got to the Piazza before Michelle and hired singers to serenade her as she arrived. In a final flourish, with people gathered around to watch, he dropped to one knee and proposed with an enormous ring. But even at this infatuated stage of their relationship Michelle noticed signs that Weinberger had a difficult personality: the way he could be charming one moment and irrational and haughty with others the next, the way he could not deal with the slightest adversity. Shortly after the couple became engaged, Michelle’s father was diagnosed with advanced lung cancer. He was dying, and while Weinberger tried to be supportive, he almost seemed more upset that the illness might, as Michelle says, put an end to the “fun and games” the two of them had enjoyed up until then. “Now everything is going to change,” she remembers his telling her. “Do you realize how our life is going to change?” He even suggested they should not get married. He changed his mind, but later expressed puzzlement, almost irritation, when Michelle spent as much time as she could with her father while he was in the hospital. “Why does somebody want to be in a hospital room?” he asked petulantly. “It doesn’t help anything.” She was struck by the lack of empathy, particularly from a physician. Several years later, right before his disappearance, he told Michelle that he didn’t even enjoy being a doctor and disliked patients. The wedding was planned for May of 2002. Weinberger had envisioned a grand ceremony in Ravello, Italy, with both a rabbi and a Catholic priest flown in to fit their religious backgrounds. But the date was moved up to November 1, 2001, at the Chicago Botanic Garden, so that Michelle’s father could walk her down the aisle. At first Weinberger was adamantly against the shift. “You can’t let dying people change what the living are going to do,” he said to her, but once again he changed his mind and told Michelle he loved her. In the end, there would be three different wedding celebrations, the one in Ravello transformed into a blessing ceremony. Weinberger flew in roughly 15 guests from the United States and housed them in the Villa Cimbrone, a restored 12th-century residence that has included among its guests Winston Churchill, D. H. Lawrence, and Greta Garbo. It was again typical of the way Weinberger did things. The third reception, for 110 guests, was at the Field Museum, in Chicago. The couple purchased their condominium in November of 2002. Mark eventually had three drivers, and his car was always on call in front of the property. He kept a large staff at home, including a personal assistant, three women in maid’s uniforms to clean and do the laundry, a personal trainer, and a massage therapist who gave Mark and Michelle nightly massages. He was extremely particular about his needs. Every day, according to Michelle, one of the chauffeurs would drive him the hour or more it took to get to work in Merrillville, fighting traffic all the way, then return to the city to pick up sushi from a restaurant he liked called Japonais, and then drive back to Merrillville in time for Weinberger’s lunch. Mark also had particular sexual desires when it came to marriage. He had been obsessed with the fantasy of bedding cheerleaders ever since high school in Scarsdale, back when the real thing was clearly off limits because of his non-jock status, and Michelle would surprise him from time to time by wearing a cheerleading costume when he came home from work. On another occasion, during one of their trips to Italy, he turned to her over dinner and said he was not happy. When Michelle asked him why, he said he was disappointed with the level of enthusiasm that she put forth while performing oral sex on him. He said he had a DVD for her to look at to gain pointers. Shocked and humiliated, she left the restaurant. But what upset Michelle even more was Mark’s obliviousness to what was going on in her life at the time—studying for her Ph.D. at the Chicago School of Professional Psychology, still mourning her father. All he seemed to care about was receiving nightly oral sex from Michelle, and receiving it with gusto. 1–800-sinuses TheNoseDoctor! He shouted it on a billboard. TheNoseDoctor! He used it as the name for his Web site. TheNoseDoctor! He couldn’t use it as a number for patients to call—too many letters—so instead he came up with 1–800-sinuses. He was a marketing machine, opening his new facility (paid for in part by his father’s loan) at the end of 2002 in a grand ribbon-cutting ceremony featuring a huge sign outside that heralded the weinberger sinus clinic, mounted beneath an expensive sculpture of a face with a very large nose. The clinic’s interior had ample deposits of marble and stainless steel and cherrywood. Even the refrigerator in the nurses’ kitchen was a Sub-Zero. Artful travel books sat atop the tables in the waiting room, instead of creased magazines. There were bookends in the shapes of noses. The software in the computer system was such that even before a patient left the office a bill was already on its way to the insurance company. Walking into the clinic, says former patient William Boyer (who would eventually win a $300,000 malpractice verdict against Weinberger), was like walking into the Ritz-Carlton. Boyer believes the clinic’s décor was all part of Weinberger’s business model, to convince patients, particularly an unsophisticated heavy-equipment operator such as himself, that to have built such a lavish palace Weinberger must have been at the top of his field. Through 2001, TheNoseDoctor’s reputation appears to have been unblemished, with not a single malpractice suit filed against him. That would change, especially following the opening of the new clinic, which, at least in hindsight, seems almost to have been designed to facilitate risky medicine. It was a one-stop shop: because Weinberger had his own cat-scan machine he could read the results himself and avoid the oversight that would have come had he needed to send patients to a hospital for scans. And the fact that there were no other surgeons in the practice meant there were no peers on hand to raise suspicions, which may be why, according to court filings, at least 90 percent of the patients who came to see Weinberger were advised on their very first appointment that they needed some type of sinus-related surgery. Around this time, even some of Weinberger’s friends began to question his behavior. Jim Platis, a plastic surgeon, had been friends with Mark since the 1990s. Platis liked Weinberger’s sense of humor and his varied interests, which ranged from philosophy to classical music to old George Carlin routines. Platis also believed his friend to be a very good surgeon, respected by his peers. Along with his wife, Platis had attended the blessing ceremony in Ravello, in 2002. But afterward he began to notice a change in the way Weinberger was spending money, whether it was the 80-foot yacht that trolled the Mediterranean, or the multiple drivers, or the sushi lunches from Chicago. “The way he was going through money,” Platis says, “my wife and I both thought that he had another source of income [outside the practice]. The money was being spent almost carelessly.” Platis and his wife began to feel uncomfortable, and they eventually stopped socializing with the couple. Though Michelle herself was pursuing a doctorate in psychology, she felt in many ways like a kept woman, believing Mark’s priority was for her to wear skimpy outfits and have her nails and hair and makeup done. Newly wed, Mark had indeed treated her like a princess, just as he had promised; their marriage was all Michelle thought it would be, and more, and she adored him. But as her academic career advanced, Mark came to resent it, particularly as problems began to mount in his own work. Instead of supporting her, he made increasing demands, and her self- esteem ebbed. “I like it when you spend your day getting beautiful for me,” he told her. Although she weighed roughly 105 pounds, he gave her grief when, as a self-indulgence every Thanksgiving or Christmas, she went to Godiva and bought a box of truffles. He spread his fingers as if to measure her buttocks, and while there was a tone of frivolity to it, she could tell that he was serious in making sure she wasn’t gaining weight, since he had an obsession with the subject and said he hated fat women. (He himself worked out three times a day.) He had a saying that the size of an engagement ring should be in inverse proportion to the size of its recipient’s buttocks, and since Michelle’s engagement ring was large her buttocks should be small. “It’s almost like he wanted this transitory life and he wanted me to be a slutty girlfriend and not his wife,” she says. Mark did not allow her to have her own checkbook or see the bills. He gave her a thousand dollars a week in spending money, leaving it on the kitchen counter as if she were a prostitute. He did complain they were overspending, and Michelle, still in her 20s then, readily admits that she enjoyed the lavish trappings of wealth and extravagance, particularly the yacht, as probably any spouse would have. But when Mark worried about money, she claims, she told him to get rid of at least the NetJets account and the personal staff that took over the house each day. Instead, during one of their next jaunts in the Mediterranean, they docked at Marbella, where they went to Versace and Weinberger spent tens of thousands of dollars on the latest styles for both of them. Phyllis Barnes was 47 years old and employed helping recently laid-off steelworkers find new jobs when she went to see Weinberger in September of 2001. She had had a cough for several months, sometimes spitting up blood, and was now having problems breathing. She was losing weight, because it was hard for her to swallow. She had already been to a physician assistant and a doctor, who thought the problem might be asthma or allergies, but her symptoms persisted. A colleague suggested that she go see Dr. Weinberger, that maybe her problem was sinus- related. When she saw the ear-nose-and-throat surgeon, he diagnosed her problem as exactly that. She had surgery the following month, supposedly to remove excess polyps so that she could breathe more easily. The surgery did not work, and she continued to have enormous difficulty breathing. She went back to see Weinberger, and he told her to relax and give the surgery time to work. But her condition did not improve. She thought she might have pneumonia, and she saw Weinberger once more, but he said he did not treat pneumonia and told her to go to an emergency room. She saw several other doctors: one said she had a virus; another said it was bronchitis and prescribed antibiotics. But her breathing was not getting any better—to the point, she later said in a court deposition, that it felt “like somebody was hanging me by a rope.” On December 7, 2001, she went to yet another doctor, named Dennis Han. Like Weinberger, Han was an ear-nose-and-throat surgeon. He immediately saw how sick she was and, based on the sound of her breathing alone, made the correct diagnosis: she did not have sinus problems; she had throat cancer. According to legal documents, Weinberger had not even performed a throat exam on Barnes during her initial visit, but ordered a cat scan of her sinuses only. The reason, her lawyers suggested, is that Weinberger sometimes saw more than 100 patients a day, meaning, given his hours, that he spent an average of three minutes with each of them; he also took on as many as 120 new patients a month. His practice was likened in one document to an “assembly line.” As Peggy Hood, Barnes’s sister, later put it in a deposition, “I feel like he had just treated everybody the same and didn’t treat them as individuals You went in, you got a sinus operation, you left.” When Dr. Han had seen Barnes in December, three months after her first visit to Dr. Weinberger, the tumor inside her larynx was easily visible upon examination, filings assert. So too, in all likelihood, was the enlargement of the lymph nodes in her neck. She also had two firm masses on the left side of her neck which were consistent with cancer. But when Weinberger had last seen Barnes, only 18 days earlier, he made no notations of any of this. “With such obvious abnormality, Dr. Weinberger would almost have had to intentionally ignore this situation in order to have missed it as badly as he did,” her lawyer, Kenneth J. Allen, stated in a filing on behalf of Barnes. After Barnes died of cancer, in 2004, an Indiana medical-review panel consisting of three physicians would find Weinberger negligent in his treatment of her. “Cancer ultimately took her life, but that son of a bitch stole her dignity,” says Allen. Barnes filed suit against Weinberger on October 29, 2002, when she was still struggling to survive. But instead of deterring Weinberger’s procedures in any way, the suit seemed to have the opposite effect, particularly after the new clinic opened. In 2003 and 2004, according to court records, Indiana state records, and interviews with trial attorneys, he performed hundreds of sinus surgeries that were allegedly medically unnecessary. Weinberger’s ostensible goal was to relieve congestion by removing what he identified as obstructing …