Transcript

437:

Old Boys Network
Transcript

Originally aired 06.03.2011

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Full audio: http://tal.fm/437

Prologue.

Ira Glass

When I sat down to interview this guy, Bill Tobin, he made this request that I don't think anybody's ever made with me in all the years that I've been recording interviews for the radio.

Bill Tobin

You can cut out the dead air time, right? I have a courtroom style and deposition style that, when you live and die by the words that come out of your mouth, I want to make sure I try to select the most appropriate phrase. So I have a tendency to be a-- my wife tells me, you're not in the courtroom. Your speech is too deliberate and too slow. But anyway, you can edit out.

Ira Glass

Yeah, we'll edit out the pauses, yeah. Your wife will love you. When we are done with this, she'll be like--

[LAUGHTER]

Bill Tobin

All right.

Ira Glass

All right.

Bill's a former FBI agent. And back in the early 1970s, he was investigating organized crime and police corruption in Chicago for the FBI. A cop told them how it worked at the time. This cop said that, when he was a rookie, just coming on the force--

Bill Tobin

He was taken by his TO around the city-- and TO being a training officer-- and he expressed surprise that they were hitting all of the bowling alleys in their district and other businesses that had liquor licenses. And he was kind of confused, with all the crime in the city, why they were stopping at bowling alleys.

But he said after they hit a number of them, he was handed a white envelope by his training officer, and he said, here's yours. And he said he opened it up and there was this wad of money inside. And he said a light went off, and he kind of said, well, thanks but no thanks. I don't want to participate in this. This is not my bag, but you don't have to worry about me. I'm not going to blow the whistle or dime anybody.

So he said, when the next duty roster came out, he found himself on vertical patrol in a place called Cabrini-Green, which at the time was a high-rise housing project that was so pervasive with crimes that, for example, I remember one incident several officers were on an elevator, and residents had stopped the elevator between floors, poured gasoline down the chute, and ignited the gasoline.

The place was so bad that they had to actually put an officer every second floor, and they called that vertical patrol. So he worked that for a number of weeks, but he said a number of weeks working vertical patrol and you just basically almost go crazy. So he says, at that point, you're willing to do almost anything. And he kind of, after that, began to accept those envelopes. And he said that was the only way he could get off vertical patrol.

Ira Glass

Do you have any sympathy for this guy's dilemma, with the choice he made?

Bill Tobin

Well, to my knowledge, at the time, I would have to say the officer basically only had two choices, either change jobs or agree to go on the take. I mean, realistically or pragmatically, those are the only two choices he had.

Ira Glass

And if you faced that choice, you feel like that'd be clear? What to do?

Bill Tobin

Absolutely, unequivocally. I mean, to me, police corruption is the height of dishonesty, as far as I'm concerned.

Ira Glass

That's what's so insidious about this kind of old boys' network, is that it pulls in bad people and good ones also. You kind of have to take part if you want to stick around. You're with them or against them. The cop who told him this story really believed that.

Bill Tobin

He said, you know, truth be told, the overwhelming majority of officers with whom I have interactions would do anything for you guys to be able to come in and clean house. We really don't want to be on the take, but the peer pressure is just so immense that he said you just have to go with the flow.

Ira Glass

Do you buy that?

Bill Tobin

Oh, absolutely. After one of the search warrants that we executed, during the search we recovered a list of payees, and we're showing 90%-plus of the names on the police force were on the list, who were recipients of biweekly or monthly payoffs.

Ira Glass

Well, today on our radio show, we have two stories. One is about people who do not want to go along with the old boy network. The other is about people who very obediently do go along with it. And I'm just going to, before we get these started. I'm just going to give you a moment here to guess which of these two groups of people, the ones who go along and the ones who don't go along, are now sitting judges in Chicago.

From WBEZ Chicago, it's This American Life, distributed by the sinister and all-encompassing old boys' network that is known everywhere on the seven seas and seven continents as Public Radio International. I'm Ira Glass. Stay with us.

Act One. Messing with the Bull.

Ira Glass

Act One, Messing With the Bull. A little over a year ago, in a small west Texas town called Kermit, two nurses were accused of something very strange. They were accused of harassing a doctor. The harassment, basically, was that they complained to the Texas Medical Board, saying that this doctor was performing odd procedures and putting patients in danger. The nurses were fired for this, and they were arrested, and they were facing 10 years in prison.

Their story made the national news. You may have heard of it. It seemed like a classic case of retribution against whistleblowers. And one reporter, Saul Elbein, looked into this. He realized that it was actually a group of powerful men in this small town who went to extreme and even ridiculous lengths to try to bring down these nurses. In particular, one nurse. Anne Mitchell. Here's the story.

Saul Elbein

Anne Mitchell's trial took place last February. It lasted four days, and was filled with so many ridiculous moments that, by the end, it seemed like anything could happen, though Anne's attorney, John Cook, was optimistic.

John Cook

I got a sense that, we've won. We had blown them out of the water so hard. I didn't need to tell the jury why we should win. I figured they already knew. And then they stayed out for an hour, and I was hoping for a really quick verdict. So it stretched on an hour. When you're waiting for a verdict, an hour is a long time.

Anne Mitchell

So we're waiting, we're waiting, we're waiting. And then suddenly they said, the jury's back.

Saul Elbein

This is Anne Mitchell.

Anne Mitchell

And Judge Rex got the papers, and he flipped the page over, and he said, not guilty. Mrs. Mitchell, you're free to go.

John Cook

Talking to the foreman after the trial, I said, how come it took you so long? He goes, oh, Mr. Cook, it didn't take that long. We got back there, and I said to them, does anybody think this lady did anything wrong? And everybody said, no. And he goes, well, they all worked pretty hard, so we better stay in here. We better stay in here and look like we're working, too. So we sat back there for an hour and we talked about our families. But we could have had that verdict in less than five minutes.

Saul Elbein

The absurd and disturbing events that led to this five-minute, hour-long verdict began in 2008, when Dr. Rolando Arafiles took a job at the one hospital in Kermit, Winkler County Memorial. It's tiny, just 19 beds, plus a rural health clinic for non-emergency outpatient care. And they couldn't hold on to doctors. It's hard to find anyone who wants to move there.

Kermit's a tiny, dusty oil town out in the west Texas plains, about 20 miles from the New Mexico border. It's the kind of town where tumbleweed really does roll down the main drag in the afternoons. One of the nearest towns is called Notrees. But Arafiles seemed happy to settle in Kermit. And when he first came to Winkler Memorial, former nurses and the current board president say everyone was charmed by him.

Woman 1

He's a super nice guy. He's very charismatic.

Woman 2

As a person, he was very friendly, easy to get along with. I mean, he was down to earth.

Woman 3

I'll tell you one thing, Dr. A. is not a bad doctor. He's a [? barstool, ?] a seamstress. You cut your head open, man, that guy can sew like crazy.

Saul Elbein

For decades before Arafiles came, the hospital had mostly relied on foreign doctors, under something called the J-1 Visa System. They would come fresh out of medical school in places like India or Vietnam. They'd serve for three years, and then they'd move on to a bigger city. Their care was mostly good, but they were clearly just biding their time till they could leave. The hospital could only keep two to three doctors on staff at a time.

But Dr. Arafiles had bought a house in town, and put down roots. He was a native of the Philippines, but he fit in well in Kermit. He and his wife joined the Lions Club. They sang in the choir at the Methodist church. It seemed like he was going to give this small town exactly the sort of small town doctor they'd always wanted. But pretty quickly, nurses started to get concerned.

Debby Eggers

I had to go through his charts every day I worked on his side.

Saul Elbein

This is Debby Eggers, a nurse who worked directly with Arafiles.

Debby Eggers

I really never saw him open up a chart to go through it, to see if there's labs that had been done, to see if medications need to be increased, decreased, discontinued.

Saul Elbein

Or if patients needed to be on medication at all. Debby says she caught one chart where he put a non-diabetic patient on insulin.

Debby Eggers

It was on a day that I was working on his side, and he had signed something that, I believe it was a pharmacy OK-ing some kind of diabetic medication. We had no documentation, no labs, or anything in our chart justifying that this patient was even diabetic. When I brought it to his attention, he told me, he said, I like it when you work on my side. He said, you're my eyes. I never look at anything. I just sign my name.

Saul Elbein

Arafiles would diagnose patients without running labs. Or if the nurses had run labs, he wouldn't look at those either. Maybe this is stating the obvious, but this is really unusual for a doctor. It's also potentially dangerous. But nurses say Arafiles had his own way of doing things. Like, for example, how he diagnosed thyroid conditions. Debby says he brought in this questionnaire. None of the medical professionals at the hospital had seen it before.

Debby Eggers

And there would be, like, tests to see, is your skin dry? Are you overweight? Is your hair dry? Do you get tired? Are you fatigued? Do you sleep a lot? Do you not sleep? And he would score it, and depending on your score, he would put you on thyroid medicine. I myself took the test. I mean, because we had to make copies, so of course I'm going to see what all the questions are. I'll take it myself. And yeah, I'd need medicine, because I've got all the symptoms. But my lab, it's normal.

Saul Elbein

Naomi Warren was another nurse who saw this happening. She ran the clinic at Winkler, and she says Arafiles was really proud of his method of diagnosing thyroid conditions. He told her, you just look for obesity, extra fat behind the arms. You don't need the labs.

Naomi Warren

That's not the standard. I've never read that anywhere. I told him I could not follow that type of care without some sort of a medical reference to support it. And so, he told me he would give me some references. He brought back two paperback books.

Saul Elbein

Paperback books?

Naomi Warren

Two paperback books that were obviously alternative medicine. Frankly, I could only stand to read, kind of look at one, because I just didn't believe any of it.

Saul Elbein

Naomi says it's not just that he was a big believer in alternative medicine. He had no consistency. He would take people who had conditions off their medications, and put people who had no need for medications on them.

Naomi Warren

Thyroid wasn't the only thing. He would take people many times off of their cholesterol medicine or blood pressure medicine and offer an herbal alternative.

Saul Elbein

This really shocked nurses at the hospital. Because not only was Arafiles pushing these herbal remedies on patients, he was also selling them. One of these herbal medicines was something called Zrii, a fruit juice advertised as being based on the ancient wisdom of the Ayurveda. Nurses never saw him sell at the hospital, but it was well known that at the same time Arafiles was working in the hospital, he was holding seminars at the Kermit Pizza Hut and the Methodist church, signing people up as Zrii distributors. You sell Zrii sort of the same way you sell Tupperware or Amway. The more people you sign up to sell for you, the more money you make.

Naomi Warren

He had samples that he gave in the clinic.

Saul Elbein

And then you'd contact him after work?

Naomi Warren

Yeah. He had fliers and email alerts, and would give the patient a number to call if they wanted to order it. That kind of thing.

Saul Elbein

What he was doing with Zrii and the other supplements he sold wasn't exactly illegal, but it was sketchy as hell. And a violation of the hospital's policies. The nurses complained about Arafiles to the chief of staff, Dr. Pham. At that time, he was the only other doctor there. He refused to talk about it, but nurses say he was just as concerned about things Arafiles was doing. He'd bring up issues at medical board and staff meetings. Naomi Warren says that once she even heard Pham chewing out Arafiles.

Naomi Warren

There was some yelling behind closed doors. I did hear it. And Dr. Pham at one point told me, we've agreed to disagree. He'll take care of his patients. I'll take care of mine.

Saul Elbein

A lot of nurses took their concerns about Arafiles to Anne Mitchell. She's the nurse from the beginning of our story who ended up on trial. Anne had spent 30 years as a nurse, 20 of them at Winkler, working her way up. She'd held pretty much every nursing position, from floor nurse to director of nursing. When Arafiles arrived, she was the hospital's compliance officer. And it was her job to ensure the new doctors met the hospital's criteria. Arafiles didn't.

Anne Mitchell

His license was restricted when he came. He could not supervise nurse practitioners.

Saul Elbein

In 2007, the Texas Medical Board investigated Arafiles when he was working at a hospital in Victoria, Texas. Basically, it sounds like he was doing the same things there that the nurses would later see in Kermit. The TMB put Arafiles on probation. Anne says, according to Winkler Memorial's bylaws, they never should have hired him.

Anne Mitchell

When I checked with the National Practitioner Data Bank, when he was first hired, that information came back. I took it to the board of control, because I wanted them to understand we were violating the medical staff bylaws and he was in violation of the contract that they signed to have him there.

Saul Elbein

Why was he hired with a restricted license anyway?

Anne Mitchell

I can't answer that. I can only speculate that-- I will tell you this. In far west Texas, we don't have an abundance of people trying to get out here. That's why we had J-1 Visa doctors. And you have to wonder why a man in his 50's is not established somewhere. You have to question why somebody at that age, at that time in their life, would want to come to a small town like Kermit, Texas.

Saul Elbein

The person who hired Dr. Arafiles at Winkler Memorial was also a newcomer. Stan Wiley was the hospital's new administrator. He'd worked in hospital administration before, but when he was hired at Winkler, he was selling mobile homes. And he came in promising the hospital's board that he would bring in more money. Nurses say that under him, unnecessary tests were run, and admission standards were relaxed. When nurses took their complaints about Arafiles to Wiley, they say he seemed unconcerned. Here's Anne and Naomi.

Anne Mitchell

We were consistently bringing problems to Mr. Wiley.

Naomi Warren

The thing about Mr. Wiley is, you could tell him something. And he'd look you right in the eye and he'd say, good point, good point. But he never committed to fixing it.

Vickilyn Galle

Every time we discussed it, he bought a house here. That was the response I got. He bought a house here.

Saul Elbein

This is Vickilyn Galle, another nurse whose job it was to review care.

Vickilyn Galle

My issue was not where he had real estate. My issue was patient care. And that really didn't seem to be, in my opinion, a high priority for them.

Saul Elbein

So you would come with your patient care concerns and Wiley would say, he bought a house?

Vickilyn Galle

Yes. I had that response several times.

Saul Elbein

Now, all this stuff, not looking at charts, prescribing herbal medicines. They were egregious. But not as shocking as what came next. Anne and Vicki started getting reports that Arafiles was performing surgeries, and that was odd for two reasons. One, Winkler Memorial didn't do surgeries. They hadn't had a surgeon on staff in decades, and any non-emergency surgeries were supposed to be sent to the hospital in Odessa, 40 miles away. The other problem, Dr. Arafiles wasn't a surgeon. He was a family practice doctor.

One surgery he performed was on a 73-year-old diabetic who came in with a gash on his hand. Arafiles cut a strip out of the man's abdomen, and performed a skin graft himself, right there in the emergency room. Debby Eggers was at the clinic when the man came in for a follow-up.

Debby Eggers

When I first saw it, the hand looked good, good blood supply, didn't look like it was infected. The next time I saw it, it was black, hard like charcoal, and I couldn't see any blood supply or anything. I just thought the site did not take.

Saul Elbein

Did Arafiles ever follow up with this guy? Did he see that the guy's graft had turned black?

Debby Eggers

Yes. After we unwrap it and stuff, he goes in there and he assessed the site. The patient actually told me that Dr. Arafiles called this his masterpiece. He thought it was OK and it was taking and there was no problems.

Saul Elbein

I just want to make sure I've got this right. This guy has a giant black patch on the back of his hand, and Arafiles looks at it, and what does he say?

Debby Eggers

That it looked good and come back in two weeks.

Saul Elbein

Debbie told Naomi Warren and the hospital's chief of staff what she'd seen. They referred the patient to a hand surgeon in Odessa. Another patient came in with a compound fracture on his thumb. Arafiles wanted to protect the thumb after he stabilized it, so he cut off a piece of rubber from the packaging of a suture kit and he sewed it on to the patient's thumb.

Now, normally it isn't nurses or even hospital administrators who are supposed to oversee doctors. It's other doctors. Since Winkler County only had two or three doctors at a time, their performance was reviewed by outside, statewide medical boards. One of these boards was a peer review service for rural hospitals provided by Texas A&M University.

Part of Vicki Galle's job was to send records to this peer review system. Sometimes they were files that were flagged for questionable care. Sometimes they were just random files. It was standard practice for rural hospitals across the state, and the way it had worked at Winkler for years. Until one day, when Stan Wiley, the hospital administrator, called Vicki into his office.

Vickilyn Galle

I came in and sat down. I don't know if I was in his office over a minute. He was sitting there doing numbers, as he usually is. And he would use a ruler because he had lost one eye. And he looked up at me and said, don't send out any more records. I'll let you know when you can resume. And that was it. He said, that's it, you can go.

Saul Elbein

What was your reaction?

Vickilyn Galle

I was very upset. I went back to my office, talked to Anne about it when she came. And it just seemed to me to further show that they were trying to keep everything in house. In my opinion, we were going to deliver substandard care and just cover it up.

Saul Elbein

Anne, Vicki, and Naomi had become the main stopgap against what they saw as Arafiles' substandard care. All of them kept trying to bring up their concerns at medical staff meetings and board meetings, but they were ignored. Meetings scheduled to discuss Arafiles' care kept getting cancelled. This is when some nurses at the hospital decided they'd had enough.

In February 2009, Naomi Warren quit. At her final board meeting, Naomi tried to give a speech to explain why she was leaving. She said that it was a doctor's responsibility to submit his care to outside review, that if the board wanted a quality hospital, they must insist on quality patient care. That otherwise, Kermit's shiny new hospital would be a useless building.

Naomi Warren

During my talk, the board chairman was walking around the room, adjusting lights, causing such a distraction. That I thought I was going to-- I asked him once if I should start over. It was clear to me he wasn't interested in what I had to say. And he really didn't want anybody else to hear it either, I guess.

Saul Elbein

The chief of staff and at least two other nurses left the hospital around the same time. With Naomi gone, Anne and Vicki felt they had only one option, reporting Dr. Arafiles to the Texas Medical Board. It was a big deal, sort of the last straw. Anne says she and Naomi and Vicki had long conversations about what to do.

Anne Mitchell

Finally, I told her, I said, we have to do something because I don't know what else is going on that we don't know about.

Saul Elbein

Anne and Vicki sat down and wrote their letter together. Anne was at the keyboard, typing it on her computer. Naomi wrote a letter also. She signed hers. Anne and Vicki left theirs anonymous. They put both letters together in one envelope. Anne told Naomi she'd mail the package from Odessa. She didn't want to take the risk of mailing it from Kermit. Here's Anne.

Anne Mitchell

I knew that if Mr. Wiley found out that we had sent that letter in that he would do everything he could to fire us from our positions.

Naomi Warren

And I said, Anne, don't be ridiculous, they can't find out. This is confidential. It's protected. They're never going to find out that we did it. And I was a little bit put out with her, because I thought, why are you being so cautious? Why are you being so upset? When, in fact, I should have realized, I'm leaving. I don't have to face the scrutiny of Winkler County and the officials there. She had a much better pulse on the type of people we were dealing with.

Ira Glass

Coming up, how a confidential letter ends up in the hands of exactly the people that it is supposed to be kept confidential from, and what kinds of things can happen as a result of that. Saul Elbein's story continues, from Chicago Public Radio and Public Radio International, when our program continues.

It's This American Life. I'm Ira Glass. If you're just tuning in, our show today is about old boys' networks. And we're in the middle of Act One, a story about some nurses who sent a letter off to the Texas Medical Board about what they saw as one doctor's questionable practices, and then they found themselves tangling with all kinds of powerful people in their town. When we left off, Anne Mitchell and two other nurses had just sent off their letters to the TMB. Here's reporter Saul Elbein.

Saul Elbein

Six weeks later, Anne Mitchell started to hear strange rumors that the Winkler County sheriff, Robert Roberts, was doing an investigation. Word was that he was trying to find out who had complained about Dr. Arafiles.

Anne Mitchell

There was one person in the hospital that notified a friend of mine, who called me and said, Roberts is going to arrest somebody over this. Do you know who did it? Well, of course, I'm not going to say anything. I said, are you kidding me? No, Anne, he's looking to arrest somebody. I said, I can't believe that.

Then I had another person who works in the hospital, she called me and she said that, if someone wasn't arrested for this, that Dr. Arafiles and Mr. Beckham were going to be very upset.

Saul Elbein

Bill Beckham was the hospital's board president.

Anne Mitchell

I knew that I had the right to do that. I had the right to question poor care. I had the right to report anything that I thought was inappropriate. And I really felt that we had nursing laws in place that protected me. And then I began to hear that, no, he's going to arrest whoever sent that letter in for harassment.

And I thought, OK, what do I do now? We need to find someone just in case. Just in case this happens. And so I called John Cook.

John Cook

And when she called, I think the first thing she said is, I'm not crazy.

Saul Elbein

This is John Cook, Anne Mitchell's attorney during the trial. Both he and Anne say that the initial conversation was a little awkward.

Anne Mitchell

Our conversation consisted largely of, Anne, tell me what you did wrong. I would reiterate everything and he would say, yes, but tell me what you did wrong.

John Cook

Quite honestly, I didn't believe what she was telling me. So I asked her if I could call her back, and I called a judge out in Kermit by the name of Bonnie Leck, who was the county court judge. And I said, hey, Bonnie, this lady called me. And immediately she said, she's not crazy, John. And I said, really? Are they that stupid? And her response was, they are going to do something.

Anne Mitchell

I was sure in my mind that once Sheriff Roberts started investigating and looked at what a nurse could and could not do and what was appropriate, that he would realize there's nothing in this letter that was inappropriate. There was nothing in there that said he's a rotten guy, I don't like him. There was nothing personal at all. It was all about how he practiced medicine.

Saul Elbein

Winkler County sheriff, Robert Roberts, is a big man with a big voice. He's pretty much what comes to mind when you hear the words, "West Texas Sheriff." And if you're wondering, like Anne was, why the county sheriff would launch a criminal investigation into a formal complaint to a medical board, there's this to consider. Roberts was good friends with Arafiles. The sheriff and the doctor played golf together. Roberts and his wife sold the herbal supplement, Zrii, for the Doctor. And Roberts says that Arafiles had saved his life when he had a heart attack in 2008.

So when the Texas Medical Board sent Arafiles a letter telling him they had received a complaint about him and he was under investigation, he went to Sheriff Roberts and said he was being harassed. Roberts turned around and started his own investigation. But Roberts was missing his main piece of evidence, the actual letter the nurses had sent to the TMB. All he had was the notice that the TMB sent to Arafiles, saying they were looking into certain patient case numbers.

So Roberts took these case numbers and interviewed the corresponding patients. Taking this step was illegal. It was a breach of patient confidentiality. Because of pending criminal cases, Dr. Arafiles, Sheriff Roberts, Stan Wiley, and others are under a gag order and couldn't comment for this story.

It's unclear how Roberts got the patients' contact information in the first place. In any event, none of the patients said they'd filed a complaint. So Roberts knew it must have come from inside Winkler Memorial. So next, he got a list of 21 people who would have had access to the patient records. Both Vickilyn and Anne were on there.

Anne Mitchell

What happened then was the Sheriff came to the hospital and interviewed both of us, Vickilyn and I.

Vickilyn Galle

And he had the bylaws in my face, saying you can't do any outside reporting. I told him, a nurse can't be arrested for reporting their concerns to the Texas Medical Board. Obviously, he didn't believe me when I said that.

Anne Mitchell

And he kept asking me about policies and procedures and how my job worked and different things. And then he asked me, he said, now, Annie, I'm going to read this to you, and I don't want you to be scared. And I said, OK. And he Mirandized me. And I just looked at him, I said, OK. He said, now, I'm going to ask you a question. And I said, I'm not answering any of your questions, Robert. I'm working out here in a hostile environment. I'm going to call my attorney. And I left.

Saul Elbein

At this point, Roberts still hadn't seen the letter he was investigating. So he had to get a copy. Roberts wrote a letter asking the TMB for the complaint against Arafiles, and they sent it to him.

Leigh Hopper

By law, the board is required to turn over information. It's just that simple.

Saul Elbein

This is Leigh Hopper. She's a spokesperson for the Texas Medical Board. The sheriff contacted the medical board and asked us for information relating to the investigation of Dr. Arafiles. And I think there was a cover letter that said that the identity of the complainants has to be treated as confidential, and it's protected by law and only used in connection with the criminal investigation of the doctor. And that it is not to be used for anything else.

Saul Elbein

You guys sent the letter with the assumption that it was being used in an investigation of Arafiles?

Leigh Hopper

Right, because anything else would have been illegal.

Saul Elbein

So Roberts has Anne and Vicki's letter. Now, remember, Anne and Vicki's letter was anonymous, but they didn't work too hard to conceal their identities. In explaining why the letter is anonymous, the last paragraph of the letter states that, quote, "Due to the economic climate, the fact that I am over 50, female, and have been employed by this facility since the 1980s, I am hesitant to place a signature on this information."

There were only two employees who matched that description, Anne and Vickilyn. But Roberts still didn't have any solid evidence to connect them to the complaint. For that, he needed a search warrant. That, and the cooperation of another powerful man in Kermit, Scott Tidwell.

Beau Berman

Scott Tidwell is the Winkler County attorney.

Saul Elbein

This is Beau Berman. He covered the story for local CBS affiliate, KOSA-TV, in Odessa.

Beau Berman

Because the actual district attorney was ill, Scott Tidwell took over the prosecuting duties. And some may argue that there's a conflict of interest there, because he was also the personal attorney for Dr. Arafiles and Sheriff Robert Roberts.

Saul Elbein

Not only was Tidwell Arafiles' and Robert's attorney, he was also the hospital's attorney, which meant that he was often in board meetings when the nurses were bringing up their concerns about Arafiles. And he was in on the decisions to ignore Anne and Vicki's concerns. Beau Berman says that when all this came out in the courtroom, people lost it.

Beau Berman

There was just this chatter that overtook the courtroom, this almost laughter when people found that out. Because it just seemed so ridiculous that this county attorney had such a close relationship-- and actually had clients-- that were so closely involved to this case. It was like a farce, honestly. This whole deal was almost like a satire. At times, you couldn't believe this was happening.

And so, Scott Tidwell talks about how he golfs with the sheriff, how he's also the sheriff's personal attorney, but then denied that there was any sort of conflict of interest or that he was just prosecuting this case because he liked the sheriff. Or because he knew him. Or anything like that. And Scott Tidwell doesn't have the best name in Odessa. He was involved in a prior incident in Odessa. But you can research that on your own, probably.

Saul Elbein

I did research it. What Beau is referring to is something that takes this case to a whole new level of seediness. In 2004, Scott Tidwell had been charged in a scandal involving a massage parlor called The Healing Touch. The Healing Touch was the subject of a year-long prostitution investigation that resulted in 61 arrests. According to press accounts, Tidwell was a client, and he threw parties with prostitutes for some of his firm's clients.

He was charged with prostitution and promoting prostitution. He pled guilty to the prostitution charge, and the other charges were dismissed. Tidwell left Odessa shortly after and moved to Kermit, where he ran for county attorney. Sheriff Roberts campaigned for him.

In any case, with Tidwell's help, Sheriff Roberts got a warrant to seize Anne and Vicki's computers. Anne had a part-time gig in Kermit's Homeland Security office, and there, in the My Documents folder of Anne's Homeland Security computer, Roberts found what he was looking for. Anne and Vickilyn's letter to the TMB. Two weeks later, Stan Wiley fired Anne and Vicki. 10 days after that, they were both indicted.

But looking at the facts of the case, it's pretty obvious that the only nurse they were after was Anne Mitchell. Roberts didn't know that Vicki had collaborated on the letter until she told him. And even though Naomi had signed her letter, he never investigated her. He never even talked to her about it. Everyone in town says that Naomi was so beloved that there was no way they'd go after her. But why Anne? I asked Naomi about it.

Naomi Warren

Anne, quite frankly, is a Yankee.

Saul Elbein

Anne had come from upstate New York, but she moved to Texas over 20 years ago. She married an oil roughneck. She speaks with more than a hint of a Texas accent. But Naomi says there was something about Anne that stood out.

Naomi Warren

When you come to an area like west Texas, there's a certain culture here. You don't roll in and say what you think, especially to a lot of men. So I think that she was unintentionally pushy, but that that's her way. She says what she thinks. She doesn't play the southern belle.

Saul Elbein

Which Vicki does?

Naomi Warren

Yes, and I to a certain extent, because we're old southern gals. That's the way it is. So I don't think she went over really well with the good ol' boys.

Saul Elbein

From the beginning, it was clear that Scott Tidwell's case against Anne and Vicki was weak. The charge was misuse of official information. Essentially, the accusation was that the nurses harassed Arafiles simply by sending their letter to the Texas Medical Board. It was a felony charge. Anne and Vicki were facing a possible $10,000 fine and 10 years in prison. But in July, a month after they were indicted, Tidwell made their lawyer, John Cook, an offer.

John Cook

They wrote us a letter, and told us that if they would not contest their firing, if they would release Winkler County and the hospital from any type of civil liability, that they would dismiss the criminal case. And what that really is saying is, if you all would just go away, we'll leave you alone.

Saul Elbein

Anne and Vicki didn't take the offer.

John Cook

I believe that they got to the point where they thought the only way that they could get out of this thing was to convict Anne Mitchell. They saw that as a way that, yes, this is not going well. But if we get a conviction, it'll be OK.

After jury selection, I had a private talk with Mr. Tidwell. And I told him, I said, Scotty, you need to dismiss this. You need to dismiss this now. You have no idea what is coming down the pike. And Scott's response was, well, I've taken it this far and I don't see anything else to do but just let the jury decide it.

Saul Elbein

At least, let the jury decide Anne's case. A week before the trial began, to everyone's surprise, the prosecution dropped all charges against Vickilyn Galle. They gave no reason. Anne's case, based on the exact same evidence, moved forward.

I could pick a lot of things to demonstrate how ridiculous the trial was. There's this exchange about the skin graft that turned black. Anne's attorney had a sketch Arafiles had made. He asked Arafiles, and you cut off a portion of his abdomen, didn't you?

No, sir.

Well, do you recognize that drawing, Doctor?

Yes, sir.

Who made that drawing?

Me, sir.

What is the bottom part of that drawing supposed to represent?

Skin, sir.

And where did that skin come from, sir?

From his abdomen, sir.

Did it fall off?

No, sir.

Did you cut it off?

Yes, sir.

At several times throughout the trial, the judge had to warn spectators to curb their laughter. TV reporter Beau Berman says he couldn't really believe what he was hearing.

Beau Berman

In the early stages of this, my thought process was, wow, it appears as though these guys are going to get away with this. That was my personal feeling, when I take off my reporter hat. Even when I leave it on. But as it went on, I started to think, when it got to the trial, the more you started to think about it, you start to realize, how well did these conspirators, you might call them, really think this through? Because all of their evidence or all of their reasoning for doing everything they did is ultimately going to come out on the stand. And that's under oath. That's official, that's on the record. And there's a transcript of it.

Saul Elbein

And in fact, Arafiles admits, on the stand, to the questionable medical practices that Anne and Vicki wrote to the TMB about. Sheriff Roberts admits that he approached patients in his investigation, which the TMB says is illegal. He admits he used the nurse's complaint to the TMB to investigate them, which the TMB says is illegal. Prosecutor Tidwell admits that he's also the personal attorney of the sheriff and the doctor and the hospital. Again, TV reporter, Beau Berman.

Beau Berman

There were times where I really wanted to just kind of say to my audience, can you even believe this is happening?

Saul Elbein

Reading the transcript, it's shocking just how open the men who tried to take down Anne and Vicki are about what they did. It's as if they never truly expected the case to go to trial, like they expected Anne and Vicki to give in and go away. Anne, of course, won the case, after either five minutes or one hour of jury deliberation, depending on how you count it.

Anne Mitchell

Of course I was relieved, naturally. I mean, who wouldn't be relieved after 10 months worrying about where you're going to be? And then it was like, OK, they still have this problem at the hospital.

Saul Elbein

Namely, that Arafiles was still a doctor there. In fact, he was still working at Winkler Memorial until April 15 of this year, more than a year after Anne's trial. He's still licensed by the State of Texas. I didn't understand how this was possible. And when I called Winkler Memorial, they suggested I talk to the new board president, Stefanie Haley.

Saul Elbein

I think the really obvious question here is, why wasn't Dr. A. fired after he was under investigation by the medical board for all this stuff, and after the trial?

Stefanie Haley

Well, now, there's 10,000 stories on that. And I think a lot of it is, we just had one big huge suit with the nurses. And I think that the county and the hospital really was afraid, maybe, just he would do a frivolous lawsuit. That Dr. A. would against the hospital. And already our image was terribly tarnished. And I think they decided just to-- I know we did the last few months-- just grit your teeth and let his contract end.

Saul Elbein

Weren't you guys worried that he was going to hurt someone in that time that you were waiting and gritting your teeth?

Stefanie Haley

That's one of the reasons why we took him off the ER. He couldn't do procedures. And then, finally, we even tried to keep him out of the ER unless we had to have him just for lack of doctors. But when he was in there, he had to have another doctor. If he gave a prescription, if he was going to perform anything, the other doctor had to approve of it. I know it's kind of complicated. It is a complicated thing, and something that we're glad we're over with.

Saul Elbein

The Texas Medical Board finished its investigation of Arafiles in February. He's been fined $5,000 for retaliating against the nurses, and he has a year to answer their questions about his old cases if he's going to have restrictions removed from his medical license. Another doctor monitors everything he does, and he has to pay for that, which will cost him tens of thousands of dollars.

As for Anne and Vicki, they say their nursing careers are over, that they'd have to start at the bottom again at a new hospital, leave their lives in west Texas, and they're not going to do that. They've become advocates for patients' rights, and they spend their time speaking to nursing associations in Texas and around the country. They filed a civil suit against Winkler County that settled for $750,000. Anne and Vicki had to split that, and that's before attorney's fees and taxes.

In December, a special prosecutor from the Texas Attorney General's office indicted Arafiles for felony retaliation, and, in a karmic twist, misuse of official information, the same charge leveled at Anne and Vicki. Three weeks later, Sheriff Roberts, the county attorney, Scott Tidwell, and hospital administrator, Stan Wiley, were indicted, too, for misuse of official information, retaliation, and official oppression. On June 6, Sheriff Roberts will be the first to go to trial.

Winkler Memorial still faces a lot of the same problems it did before. It's still a small hospital in a small town that not many people want to move to. The same is true in east Texas. Arafiles just took a job there at a hospital in a town called Grand Saline. It's even smaller than Kermit. He's one of three doctors on staff there. Grand Saline, like Kermit, needs doctors.

Ira Glass

Saul Elbein is a reporter in Austin, Texas. He reported a version of this story for The Texas Observer.

[MUSIC - "MEDICINE SHOW" BY BIG AUDIO DYNAMITE]

Act Two. Donkey See, Donkey Do.

Ira Glass

Act Two, Donkey See, Donkey Do. Well, now we turn from people defying the old boys' network in their town to people bowing before it. The people in this case, lawyers who want to be judges in the city of Chicago. Chicago is going through some changes lately. They have a new mayor who's not named Richard Daley, which hasn't happened very often during the last 50 years.

But some things haven't changed. And every two years, much of the Chicago political machine-- that's the Democratic machine, the only one that actually counts in Chicago-- meets in a hotel across the street from City Hall. It's the 50 Ward committeemen, the 30 Township committeemen. These are the sergeants who boss around the foot soldiers of the Democratic machine. These are party officials.

And if you want to become a judge, you go before them and try to get your name put onto the official Democratic Party ticket on the ballot, which helps. Chicago's a city that elects its judges, and there are always so many judges up for election-- dozens of names on the ballot-- too many to know who they are. This is one area where lots of people will just vote for whoever the party recommends. So, candidates come up before the Democratic Party machine, in what used to be literally a smoke-filled room. When indoor smoking was allowed in Chicago.

Abdon Pallasch

This is largely a ceremonial pageant, because they've already made up their mind and cut their deal of who's going to get the blessing. But they go ahead with the show and let people get up and speak their piece.

Ira Glass

That's Abdon Pallasch. The political reporter is probably the leading chronicler of this living remnant of the old Chicago machine. He's covered it since 1996, in recent years for the Chicago Sun-Times. He says it's not entirely a show. Often, there are decisions to make. They have to choose among several politically connected candidates for a few slots. And the main quality that they're looking for?

Abdon Pallasch

Loyalty. There's an old saying in both Daley administrations, old man, Richard J. Daley and the son, Richard M. Daley. What do you call 99% loyalty? Disloyalty.

Ira Glass

And so, when Abdon wrote about the 2003 meeting to choose which judges were going to go onto the Democratic ticket, he noted that nearly all of the 25 judge wannabes began their presentations with the same first sentence.

Abdon Pallasch

I am a lifelong Democrat. Because that's what it's about. These aren't law school deans making this choice. These are Democratic Ward committeemen. It is their job to turn out the votes for the Democrats on Election Day.

Ira Glass

One of the things in this 2003 account that I thought was really charming-- so they all stand up and say, I'm a lifelong Democrat. And then there's a candidate named Anna Helen Demacopoulos?

Abdon Pallasch

Yes.

Ira Glass

Can I ask you to read your account of what happens when she stands up?

Abdon Pallasch

Anna Helen Demacopoulos tells committeemen she really means lifelong. Demacopoulos, when you translate that, literally, in ancient Greek, it means son of a Democrat. So I guess you can say, ladies and gentlemen, that I was born a Democrat, she says. It was a nice try, didn't work. She didn't get slated, didn't have enough political clout.

Ira Glass

So what's expected of them? And what mistakes have you seen people in that setting?

Abdon Pallasch

A lot of lawyers who want to become a judge and who haven't done their homework, they don't know this is how the game is played. And they think this is just like going before a bar group. They'll come in and they'll talk for 10 minutes about their resume, here I worked at this law firm, I worked at that law firm. Maybe they'll actually pass out 25-page resumes, and the committeemen will kind of roll their eyes. I graduated magna cum laude from my law school. I spent a summer abroad in Costa Rica.

And the committeemen's eyes will glaze over, because that actually counts against you. Spending time outside Chicago. The best thing you'll say is, I never left Chicago. I went to grade school at St. Mary's and I've never left-- and I went to law school at DePaul. And I've been here. Every Monday night I go to my Ward office for my alderman and I give free legal advice to his constituents. That's what they want to hear.

Ira Glass

And so, when they don't hear that, when a guy actually gives his credentials, what happens?

Abdon Pallasch

They smile and say, thank you very much. Next. And you can pretty much spot the ones where it's been decided. This person's going to get the slating for the judgeship. Because they get up, they speak very briefly. They say, I've got good ratings from the bar groups. My alderman is Alderman Burke, and I would welcome your support. Thank you very much. And maybe one or two committeemen will get up and speak on their behalf, and they'll say, thank you very much. Next.

Ira Glass

You describe a wannabe candidate, Denise Staniec, who's the former head of the Women's Bar in Illinois, get up before the committeemen. And usually if you're going to be successful, somebody's going to stand up and speak for you. Can I just ask you to read from your account of what happens to her?

Abdon Pallasch

Sure. None of the committeemen stand to speak on her behalf, not even those she calls to by name. Some are still shaking their heads over her impertinence a few weeks ago at a slating session held for the 8th Judicial Subcircuit. That meeting was chaired by retiring 42nd Ward Committeeman, George Dunne, who appeared to nod off during her talk, until Staniec stopped midspeech, grabbed the 90-year-old Dunne by the arm, shook him awake and shouted, Mr. Dunne, please don't leave me now.

Ira Glass

Now, when you're there in one of these meetings, you see a lawyer named James C. Murray stand up. And you write, quote, "Burke all but says that a seat on the bench has been saved for Murray for 40 years." Can I ask you to just tell the story of why?

Abdon Pallasch

So, Ed Burke, the alderman who runs the judicial slating session, just looking at his face is often a good gauge of who's going to be slated. And Burke, as Murray gets up there, Burke says, if there's ever a book entitled Chicago Profiles in Courage, this man's father would go on the top of that list. James Murray, the elder, was an alderman under Richard J. Daley. And when Richard J. Daley needed someone to sponsor the Open Housing Ordinance back in the '60s, he picked Murray. And Murray knew this was going to be his political death sentence.

Ira Glass

And this ordinance, was it a pro-civil rights or an anti-civil rights ordinance?

Abdon Pallasch

Oh, this is pro. This was an integration. This was stopping realtors from being able to play games to keep people out of certain neighborhoods.

Ira Glass

And he was basically in a ward where the white population wouldn't want that?

Abdon Pallasch

Yes. But he sponsored the ordinance anyway, and it passed, and he was voted out of office. And so, 40 years later, Burke's line is, this seat's been reserved for Murray for 40 years.

Ira Glass

You know, what's surprising isn't that this happens, that committeemen are choosing judges based on connections and politics, but that everyone is so open about it. You know what I mean? Like, there's no code of silence. There's no secret language. There's no pretending that something else is happening.

Abdon Pallasch

And when you bring up the argument some of the bar groups bring up about, shouldn't we have merit selection, appointed judges? They say, well, look at the states that have that. It's the governors that appoint judges. Would Governor Blagojevich or Governor Ryan appoint better judges than the ones we're picking?

Ira Glass

I should say, Blagojevich, of course, is currently on trial for selling a Senate seat. Ryan is serving six and a half years on corruption charges.

Abdon Pallasch

Yes. And there's the appointive systems. If it's law groups, are they going to pick corporate lawyers who live in the wealthy suburbs and can't sympathize with the rights of the common man? We want judges who will sit on the bench and when they see a working guy come in there, be able to identify them and be fair to them. So that's the committeemen arguing for keeping the current status quo system of the committeemen helping pick judges. But the voters make the ultimate choice.

Ira Glass

Yeah, but it isn't that these guys are showing such loyalty to the working man. These guys are showing loyalty to Democratic Party machinery, which is them.

Abdon Pallasch

That's exactly right. But part of the problem is now there's national business groups that have targeted Illinois, and Cook County, in specific, as a terrible place to try cases. Because, they say, the Democratic Party so dominates the choosing of judges here that verdicts are lopsided against businesses. And they've had some numbers to back that up.

Ira Glass

Over his years covering this, Abdon has seen a change. Various constituency groups-- minorities, women-- have demanded judgeships. And they have gotten slated by the Democratic Party. Abdon says that the committeemen point to the diversity on the Chicago bench as one of the advantages of slating judges this way. And since Abdon started writing about the meeting, and committeemen started seeing how it came off in the newspaper, they have made some adjustments.

Abdon Pallasch

I've watched it progress from fairly raw politicking to a little more polished and trying to give the appearance of, we really care about these candidates' credentials. And we want lawyers who actually have good ratings from the bar associations and will actually perform well on the bench. They're more conscious of how this looks in the public arena. And so, they just know to be a little bit more discreet in talking about how loyal a party member, how many doorbells this person has rung, how many garbage cans they've delivered.

Ira Glass

Not that that stops them, he says, from still doing things like Abdon saw them do in 2009, putting in the well-connected Pamela Hill Veal onto the ticket for appellate judge despite a bad bar association rating. And despite being scolded by the very appeals court she was trying to get onto. The one way that the Chicago Party Judicial candidates lack diversity, he says, is that there's still nobody on it without clout.

You can become a judge in Chicago without going through this process. You can simply put your name on the ballot and run against the official Democratic Party candidate. And people do win this way, especially women and people with Irish names. It's such a truism that Irish names win Chicago judicial elections that candidates will actually add a Fitzgerald to their name, which sadly works.

James G. Smith lost a judicial election, and then changed his name to James Fitzgerald Smith and won. And the political machine will use this fact to manipulate the ballot, which brings us to another rule to get on the Democratic slate in Chicago. If the party doesn't choose you for the ballot, of course they don't want you running against them. With one exception.

Abdon Pallasch

Here's some rules of the game. You're not supposed to run if you're not slated. Unless they ask you to run as a pretend candidate to siphon votes. If you're a woman with an Irish name, and they say, OK, now, I want you to get in this race, but don't do anything, don't campaign. You're just there to siphon the opposition so that our guy wins.

Now, this last session that I went to in '09, it was very funny. Because one of the women got up there and apparently she hadn't been well enough briefed that you're not supposed to publicly discuss what they call ballot management. And so, this was a former state's attorney by the name of Barbara Bailey. So she gets up and she's saying that, my father was a judge for over 20 years and he was helpful in getting union backing for the Party. And the committeemen would say, yeah, that's true. And then she says, I think I'd be able to get union backing for all the candidates. I think I can help. But then she kind of commits the faux pas of saying, I did run five years ago for judge. I did run in a race. I was told not to raise money and not to do any campaigning. I didn't. And you're not supposed to publicly talk about that, but she did. She didn't-- [LAUGHTER] Ms. Bailey did not get slated.

Ira Glass

So she did not get slated again.

Abdon Pallasch

No, she did not get slated again. She was told, OK, be a little bit more discreet next time.

Ira Glass

You know, you think of an old boys' network as being sort of shadowy and sinister, but there's something-- like, reading your accounts-- there's something sort of goofy about this. You know what I mean? Like, seeing it up close.

Abdon Pallasch

Yes, goofy and quaint. It's sort of a vestige that's still there. An important point to make is, there are some very good judges in Cook County. If you're a good lawyer and you want to be a judge, you realize that this is the game you've got to play and you learn how to play it. And you can do it without completely compromising your morals or ethics.

And there are some judges who have done that, and who have come through the system. The system actually, miraculously, does produce some good judges. But a lot of them will say privately how annoying they find it, having to go through this process of having to kiss the rings of all the committeemen in order to get elected to the bench.

Ira Glass

Abdon Pallasch, political reporter for the Chicago Sun-Times. We called 12 judges and former judicial candidates for comment. 11 did not return our calls. One told us he was very grateful to his committeemen. If not for the committeemen, he said, he never would have been able to become a judge.

[MUSIC - "GOOD OLD BOYS" BY JOHN HARTFORD]

Credits.

Ira Glass

Our program was produced today by Sarah Koenig, with Alex Blumberg, Ben Calhoun, Jane Feltes, Jonathan Menjivar, Lisa Pollak, Robyn Semien, Alissa Shipp, and Nancy Updike. Our senior producer is Julie Snyder. Production help from Eric Mennel. Music help from Jessica Hopper. Seth Lind is our production manager. Emily Condon's our office manager. Jen Berman's filling in as our west coast producer.

[ACKNOWLEDGEMENTS]

Our website, thisamericanlife.org. This American Life is distributed Public Radio International. WBEZ management oversight for our show by our boss, Mr. Torey Malatia. He's been catching up with his old DVDs of Project Runway. He loves Andre.

Woman 3

He's a [? barstool, ?] a seamstress. You cut your head open, man, that guy can sew like crazy.

Ira Glass

I'm Ira Glass, back next week with more stories of This American Life.

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