Dr. Michael Swango is one of the prolific medical serial killers in history. He murdered a number of our nations heroes in Veterans hospitals.  On August 16, HLN (CNN Headline News) aired the show Very Scary People - Dr Death, detailing the investigation and conviction of this doctor based largely upon my book Behind The Murder Curtain.  It will continue to air on HLN throughout the week.

The story is nothing short of terrifying and almost unbelievable, about a member of the medical profession murdering patients since his time in medical school.  

Ask me anything!

Photo Verification: https://imgur.com/K3R1n8s

EDIT: Thank you for all the very interesting questions. It was a great AMA. I will try and return tomorrow to continue this great discussion.

EDIT 2: I'm back to answer more of your questions.

EDIT 3: Thanks again everyone, the AMA is now over. If you have any other questions or feel the need to contact me, I can be reached at behindthemurdercurtain.com

Comments: 2408 • Responses: 75  • Date: 

MansfromDaVinci4419 karma

Do other medical professionals generally support you for weeding out murderers who abuse their profession or grief you for bringing their profession into disrepute?

bts18115736 karma

Great question. It has been a mixed bag. Some are grateful and others unhappy that I have exposed the dark side of their profession. I continually preach that the overwhelming majority of health care professionals are honest, hardworking, dedicated individuals who perform miracles every day.

dlatty3504 karma

The doctors you've investigated, were their associates suspicious of them or were they oblivious to the fact that this was going on?

bts18114612 karma

There are always one or two associates who become suspicious but the majority of coworkers don't want to believe that one off their own is intentionally murdering patients

ftrotter2108 karma

How do you tell the difference between someone who is malicious vs someone who is just totally incompetent? What are the most telling data points that signal to you "this doctor is not normal"?

Are there any personality traits that you see show up in the medical professionals you catch?

-ft

bts18113680 karma

That a lot of really good questions. There are 26 red flags identified in my book but the short answer is the repeated administration of drugs to patients that were not prescribed these drugs. For instance epinephrine or insulin to a patient that had no medical necessity for these drugs.

Many of these killers suffer from Munchausen Syndrome by Proxy. They intentionally harm a patient to show the staff how well they respond to a medical emergency code

debacular1938 karma

What motivated you to start this work? Thanks for doing this AMA.

bts18112304 karma

The Swango case was thrusted upon me quite unexpectedly. After success with that, I began receiving unsolicited call for assistance

soup4muhBeb751 karma

How was it thrusted upon you? Did you have a personal connection? Did you have a specific motivation that began this project &journey?

bts18111227 karma

I got a call from the Chief of Psychiatry at the Northport VA that changed my life

soup4muhBeb531 karma

Why did they call you in particular? Did you have experience in actual investigation beyond watching a lot of Colombo, like you mentioned elsewhere?

bts18111535 karma

I served as the special agent in charge of the US Department of veteran affairs office of inspector general for the northeast. I was responsible for all major criminal investigations involving the VA from West Virginia to Maine. I have been an investigator since 1975

guitarnoir301 karma

I have been an investigator since 1975

Did Doctor Jeffrey MacDonald (Captain, US Army) kill his family?

bts1811313 karma

Couldn't say one way or the next

reeram835 karma

In your opinion, what are some of the most crazy stories of medical serial killers? (I'm sure all of them are crazy, but which ones are extra-crazy?)

bts18111575 karma

They are similar in some respects and unique in others. I think the nurse in Italy who took a selfie with her and the patient she had just murdered is pretty crazy

MagicSuperderp771 karma

How many medical serial killers exist, approximately? I hope this is really rare, because when you need a doctor you really need one. :-/

bts18111178 karma

It is impossible to give an accurate number. Historically about 150 have been identified

Janezo453 karma

Does that number include nurses or just physicians?

bts1811611 karma

both

macromaniacal247 karma

I'm assuming the number does not include the monsters from Nazi era-Germany?

bts1811542 karma

I know that Dr, Mengele is included in that group

meeseek_and_destroy72 karma

150 in how many years?

bts1811120 karma

since these instances have been recorded

GildedSnow752 karma

What’s the most interesting way someone was caught?

bts1811965 karma

The autopsies, toxicology, and the science of forensics is always very interesting to read and study

Vrael_Valorum505 karma

Did most serial killers have a target victim? What about general practitioners, did they pick a certain type of victim?

bts1811689 karma

Very sick patients in the intensive care units are usually the victims, but anyone could be a potential target

xhupsahoy246 karma

Do you think that they think they are 'culling the herd', or are they juust easy targets?

bts1811642 karma

easy targets usually, sometimes they are angry at the patient for being annoying

alltheplants05466 karma

Do you think there were more serial killers in the 70s and 80s or do you think there are just as many around today? I think about things like DNA technology, cell phones, cameras, and wonder how much easier it is to get caught today vs. back then.

bts1811716 karma

None of those traditional forensic techniques will usually apply to medical serial killers who conduct their crimes in sterile healthcare settings

br1t_b0i459 karma

What was the most disturbing case you've come across?

bts1811714 karma

They are all very disturbing. The case of Dr. Kornak in Albany was very disturbing because he was lying to veterans putting them into research projects he knew they were medically ineligible to be in

laughlines207 karma

I live like five minutes from the Albany VA and never heard about this! Crazy!

bts1811268 karma

you can google him or read the story in my book

bts1811609 karma

They were all very disturbing. For some reason I was most disturbed about Swango poisoning his fiancé

IronicDuke339 karma

Have you looked into the investigation of Dr Harold Shipman, anything to learn that would pick his like up sooner?

bts1811618 karma

I met with detectives in England about this case and others online. there were many red flags missed on that case as well like him always denying the need for autopsies and the horrendous death rate of his patients

KuriousKhemicals36 karma

When would autopsies normally be done that the guy was unwilling to do? I would have assumed in most cases if a patient dies in hospital, it would be clearly identified what killed them and thus an autopsy wouldn't normally be done unless the doctor hadn't come to a confident diagnosis before they died. I thought autopsies were usually for people who died unexpectedly at home.

bts1811117 karma

The cause of death is usually myocardial infarction or some heart related ailment. Don't confuse a hospital autopsy with a forensic autopsy

dlembs684329 karma

How did you get into this line of work?

bts1811750 karma

Initially watching too many Columbo crime shows and saying I can do that. Never looked back

lolexchange113 karma

I was going to recommend watching Dexter... but maybe not after reading this!

bts1811220 karma

I enjoyed that show very much

penny_eater314 karma

Have you been asked to look into the case of Dr. William Husel at Mt. Carmel Hospital in Columbus Ohio?

bts1811306 karma

No, I just know what I have read in the media

whatalongusername285 karma

What are your views on assisted suicide and euthanasia? (no, I am not stating that Dr. Michael Swango did that!)

bts1811534 karma

I am a supported if done legally and ethically

6119285 karma

Do you feel that credentialing departments in hospitals are catching more of these Dr.’s from practicing?

bts1811447 karma

Yes! One of the great things to come from the Swango case is the improvement in medical credentialing. I am guardedly optimistic that he would not be allowed to practice today, even after changing his name and lying about his background

Jasbach282 karma

Is it easy for you to come home and just realx after a long day of work?

bts1811603 karma

its sleeping sometimes that's a problem

BarnabyWoods44 karma

I'm wondering if one of the things that keeps you awake is agonizing over killers who you haven't quite been able to nail. For all the ones you've caught, there must be a few who've eluded your grasp.

bts1811107 karma

My book details the case of Richard Williams, indicted but never convicted. Suspected of killing about 60 veterans at the Harry S Truman medical center in Columbus Missouri

bing603273 karma

Do you have any medical experience yourself? If not, how did you prepare yourself for recognising the killers?

bts1811560 karma

I had the great fortune of being tutored by Dr. Michael Baden, the world renowned forensic pathologist who worked on all my cases

oldmandude231 karma

I once had to get stitches removed from my finger. I went to a clinic and the nurse who did it refused to give me even a topical anesthetic. She pulled two out to my excruciating pain before I had to leave. As I screamed in pain between stitches, she comforted me in a way that made it seem as though she enjoyed it. I went to another doctor who gave me anesthesia and I felt nothing as he removed the last few stitches. That experience haunted me in a way no other exchange with a medical professional ever has. Do you think there are varying degrees of predation and sadism in the medical community? How likely are professionals with relatively harmless (causing no long term physical harm) sadistic habits to go on to killing?

bts1811163 karma

Interesting question, I'm not sure I'm qualified to answer that

Scoundrelic227 karma

Hello,

Of the 26 red flags listed in your book, which were the most surprising to conceptualize or link?

How were these medical professionals as students? Their class ranking? Where they trouble makers before becoming professionals?

bts1811529 karma

The fact that staff will refer to one of their workers as the angel of death and they still remain working without any administrative action taken against them until the media or law enforcement is involved

drazool81 karma

Can you please elaborate on this? What do you mean that they were referred to as angels of death?do you mean that one of their colleagues had identified that they were doing this? Or did they mean this in a positive sense? I just don't understand what the linkage is.

bts1811301 karma

I mean that the talk amongst the staff is that this person is killing people and gets the nickname of angel of death but remains on duty. In the Richard williams case a patient heard that, rant out of the hospital and was returned only to die unexpectedly the next night after getting a visit from Williams

LexMelkan208 karma

Are there any common themes to their motivations? I'd imagine much of it has to do with feeling powerful but surely there are a lot of factors.

bts1811322 karma

Again, I have found that Munchausen Syndrome by Proxy surfaces in many, but not all of these cases

100LittleButterflies121 karma

Have any of them seemed to be trying to provide a painless death to terminal patients?

bts1811224 karma

I only had one physician who claimed that but the family and the investigators weren't buying his argument

SaberX91171 karma

My girlfriend talks about how there are cases where someone who is not dead but critically injured and is an organ donor will have their organs harvested by surgeons since they're in need and not many people would ask questions thinking their death was from the injury. Is this a thing that happens have you come across this? It's a scary thought.

bts1811229 karma

I have heard about this mostly in Asian countries

Never_Peel_a_Lemon158 karma

Do you still go to the Doctor? How does someone in your line of work who’s “seen behind the curtain” not succumb to paranoia and such? What do you do?

bts1811342 karma

Of course I still go to doctors and hospitals. You can read about bad lawyers and accountants but when you need their services you have to take a leap of faith. Again the odds of being a victim of theses people are extremely small

Ed2500142 karma

Is there anything in medical education that you believe could be changed to prevent some of these people from moving forward in their training?

bts1811269 karma

Swango was known by his fellow medical students as "double O Swango, licensed to kill". So I would say yes!

amooseme131 karma

How common do you think doctors are abusing their position? Why do you think they are killing patients?

bts1811249 karma

Again, the overwhelming majority are terrific, honest caregivers. Some have issues from their youth, some have substance abuse issues, and others are just pure evil.

Kaio_35 karma

The ones you say who are pure evil, in their interrogations what details about their childhoods came up that were indicative of their development into monsters?

bts1811108 karma

I recall speaking with the father of Nurse Kristen Gilbert who was convicted of killing patients at the VA hospital in Massachusetts. He was all about discipline and criticism of his daughter. Pretty telling interview

tx4468130 karma

I didn't see this asked already but how did they become aware of the doctor's acts? Like did someone analyze the doctors trend levels and just notice that this person has an higher level of deaths or something?

bts1811343 karma

It usually starts when a coworker notices that every time a particular nurse for physician is on duty the death rate goes up, he takes a week off and the death rate goes down

somekindofmiracle121 karma

My husband and I just watched this last night.

Why do you think someone like Dr. Swango chose to kill the way he did? As a doctor, he must have known that they would certainly test for all kinds of chemicals and harmful substances he used to kill people and/or make them sick. Do you think he wanted to get caught and this was easiest way for him to get that satisfaction?

bts1811189 karma

They would not test for the chemicals he used routinely that is why he was not caught early on.

JiN88reddit106 karma

Do doctors take offense that you are accusing them of murder, negligence, or lack of knowledge in medicine?

You know, the 'I did all I can! How dare you say I screw up! You dare question my methods?' cards.

bts1811160 karma

Of course, but we do not accuse without a substantial amount of evidence

r3dditor106 karma

What was the most difficult to prove case and why?

bts1811222 karma

The case of Richard Williams, indicted but never convicted in Missouri. The toxicology proved too unreliable for the prosecutor to continue the case

Chives_Bilini86 karma

How many medical professionals don't go to jail for this kind of thing? Has anyone somehow talked their way out of murder and just lost their accreditations?

bts1811121 karma

Yes, there have been cases in both the US and Europe where just such a thing has happened

shrimpscampi82 karma

Can 'big data' catch many of these? How useful is looking for outliers in patient outcomes/morbidities across physicians?

bts1811119 karma

It can certainly help. We use big data to catch hospital drug diverters all the time

OptimusSublime80 karma

At the risk of sounding like one of your subjects (I'm an engineer, not a medical professional fyi), how easy is it to be in the medical field and carry out these acts without getting caught?

bts1811128 karma

No one wants to believe that a person who has taken an oath to save lives actually is intentionally taking lives. These people often demonstrate to their coworkers how well they react to codes and have saved some lives so people can't seem to believe that at the same time they are murdering some patients

Thebluefairie72 karma

Do you find that each one focuses on a specific illness or issue ? Or have there been any that will only kill if there are specific issues ? Do they think they are being merciful or are they enjoying it?

bts1811146 karma

It has nothing to do with the patient, it only has to do with the thrill they receive from committing these acts

Lybychick63 karma

With long-term care facilities essentially locked down for several months now in the US due to covid, which limits the ability of family to make face to face contact with residents to verify their current health situation, and the statistical likelihood of negative outcomes for dementia patients who contract covid, is it probable that there are medical serial killers at work in long-term care now who will be undetectable so long as they don't get greedy or sloppy?

There are some dementia care units who are experiencing 30% mortality rates for residents due to covid ... isn't this an opportune time to literally hide the bodies?

We've already seen cases of 'bug chasers' in the health care field who knowingly contract covid, use medications to hide their symptoms, and continue to work in the health care field without properly using PPE in order to spread the virus. They've been seen so far as negligent and ignorant rather than malicious and criminal.

With state inspections limited due to the virus, are there particular red flags that would indicate intentional malicious medical practices rather than neglect due to overwork and limited staffing?

bts181149 karma

Wow, you are spot on in all your evaluations. 26 red flags are in my book in great detail

democracyhammock52 karma

I've always thought it would be good to evaluate the relationship between provider specific mortality rate and provider-specific average patient CAN score. This would allow the identification of practitioners who have a mortality risk beyond that of their patients disease profile. Is this something that is currently in place?

bts181141 karma

If it is, it is very limited. Can't really say with certainty

FrankyZola47 karma

I know we essentially have to take a leap of faith when we get medical treatment from someone, but are there any red flags we should look out for when seeing a doctor?

bts181184 karma

Do the best internet searches you can for malpractice and patient ratings before your first visit

youjerkfaceyou37 karma

I would imagine that there are enough people involved in patient care with enough medical knowledge that anything out of the ordinary should be noticed, especially similarities over time. What are the systemic problems that allow such prolific killings to happen?

bts1811101 karma

Management, when confronted with these allegations is satisfied to have the target move on to another hospital rather than conduct a thorough inquiry that can harm the reputation of this facility

Deathpacitoes37 karma

Do any of the ‘serial killers’ plead innocent? If so, do you believe any of the recorded people are innocent and just performed poorly due to incompetence?

bts181167 karma

Yes. Read about nurse Kristen Gilbert who was on trial for 6 months in Massachusetts for murder veterans. She was found guilty after trial

ShortWoman35 karma

A lot of people are asking you questions specifically about doctors. Have you also looked at nurse serial killers like Charles Cullen?

bts181150 karma

Yes, a great case study of a nurse who traveled from hospital to hospital, always under suspicion but never referred to laws enforcement until the end of his killing spree

jump_scout29 karma

Do you know if any hospitals that have had a killer doctor on staff have have resisted your investigation, and if so could you give an example of such an obstruction?

bts181151 karma

Many hospital stories of management resisting an investigation all over the world. Read about the nurse williams case or the recent case of a nurse in Germany who murdered of 100 of his charges

subjecttoinsanity28 karma

What's a potential early red flag that a patient could spot? As patients in that environment I would imagine it's natural that most people just trust what their doctor is prescribing or doing, even if it may seem wrong/dangerous. After all, they're the experts not us. I know there is a history of medical practitioners in many fields using that fact to abuse and take advantage of their patients. Are there any consistent telltale signs in the actions/behaviours of these individuals that a layman could pick up on? And in your experience even if a patient were to pass on their concerns, how receptive are staff to complaints of that nature? I could see it being something that might not be taken seriously and just brushed off unless there was serious evidence.

bts181149 karma

In the case of Swango, there were patients who survived his attempts and reported it to management. Their concerns were deemed to be examples of hospital delerium which is a patient imagining things happening that re not real. Staff does not want to believe one of their own is killing patients

FarAway8527 karma

Have you found that people enter the profession with the intention of committing murder on vulnerable people? Or have they been tempted having experienced the 'power' as a doctor and they literally want to play with someone's life?

bts181138 karma

This question is often asked of me. I feel that most killers do not enter the profession with the intent of killing but events in their personal lives and/or on the job change them. That's my opinion

PussyStapler26 karma

I'm curious if you were involved in the case of Anthony Garcia, a doctor who murdered his division chief and the family of his program director because they failed/fired him as a resident for unprofessional behavior.

Giving a trainee a failing grade usually has repercussions for the educator. They often have to spend extra time writing letters justifying the failure, or they have to spend an extra year working with an incompetent resident, or they get subpoena'd in a lawsuit. There is no incentive to self-police, and then these problem doctors are unleashed to the public. Anthony Garcia is an extreme case, but I do think about the possibility of retaliation when considering failing a resident or student.

Why do you think physicians don't self-police?

bts181138 karma

I think things are improving in the self policing arena because the public is demanding it. Dr. Dennis Charney the Dean of Mount Sinai Medical School was shot by a researcher he fired for submitting fraudulent research. Luckily the dean survived and is back at work.

lodge2823 karma

What did you make of Harold Shipman when the news of his murders surfaced through the media?

bts181132 karma

Incredible. He is the first doctor to be successfully criminally prosecuted for murdering his patients in the history of England....which in of itself shows you how hard it is to make these cases

Kattfiskmoo22 karma

I'm guessing you have heard about Dr. Macchiarini. Do think it's possible that he has munchausen by proxy? Or something similar? Or do you you think that he is just very very reckless?

bts181135 karma

You are referring to his research fraud. Very similar to Dr. Kornak in Albany. Don't know that much about his case but I will read up on it today

BananaEatingScum22 karma

You mentioned that Swango's coworkers gave him nicknames that indicated that they had suspicions or knowledge of what was going on, do you think that in cases like this coworkers should be seen as complicit either by the law or by whoever can take away medical credentials?

bts181134 karma

The managers who are informed of these incidents and take no action are complicit as well as coworkers or say nothing. In Germany they are looking to prosecute some of the managers who were informed of these alleged killing and did nothing

qbeanz21 karma

I read a book about Charles Cullen, and the thing that struck me the most was how easily he got hired just because the hospitals were in dire need of nurses. Have you found this to be the case frequently? Where hospitals know something is not right but turn a blind eye simply because they need to hire?

bts181129 karma

Not true any more, for the most part....however, we are in the middle of a pandemic and there are nurses and physicians in great need for this front line fight....I had a case of a nurse who came up to NYC to help out but are real mission was to steal drugs to feed her habit

wewdepiew19 karma

Are medical criminal thrillers accurate or realistic?(if you read them) and if so which one is the most realistic?

bts181129 karma

It varies from show to show. The Very Scary People episode, Dr Death is very accurate

xynix_ie18 karma

Based on your experience what is the likelihood that Jack The Ripper was a doctor?

bts181144 karma

I took the Ripper tour in London. I always thought it could be a member of the Royal Family...but remember back then barbers did surgery as well

MakihikiMalahini-who16 karma

Have you ever encountered one with good intentions? I.E thinking that they are actually helping by saving patients from imminent pain, like angel of mercy.

I imagine there were many that have done this one way or another, but I wonder whether if there's a serial one.

bts181121 karma

I have encountered healthcare professionals who have acted like this on occasion, yes, but I don't classify them the same way

EmEm7514 karma

Hi I’m currently finishing my bachelors in psychology. Majority of my family are law enforcement and government agents, those areas never interested me. The human behavior aspect as well as their actions under pressure are simply amazing. My question is for the serial killers in the medical field do they have a “God Complex” in the sense of not bringing the victim back from death but in a sense of the victim for whatever reason they deem as they don’t deserve to live?

bts181119 karma

medical serial killer Donald Harvey said that after he kill the first 19 patients and no one questioned him he thought he was ordained by GOD to do these killings...no so illogical if you kill 19 patients and no one bats an eye...

30minute_un12 karma

Is there any hope for a data-driven approach to catching these people in the future? Would record centralization help at all with this?

bts181118 karma

I'm all for using data to track folks. We have made great strides in this area identifying individuals diverting hospital pharmaceuticals

fuckenshreddit12 karma

What group is in charge of keeping tabs on the professional competence and due care of medical professionals and why do you think ethics is so easily abused in this profession?

bts181120 karma

The States have agencies and medical boards to watch out for bad performers. The ability to pull someone's license to practice is a great tool. But it is not so easy to use. I had a case of a pharmacist who confessed to stealing 200,000 dozes of oxycodone and the pharmacy board refused to even suspend his license until he pled guilty

Wiggy_00007 karma

Have you heard about what the uk is doing to the elderly in state funded care homes? Would this qualify in your opinion as medical murder?

bts18119 karma

Sorry, not familiar but will look into it, thanks for telling me about this

smoochiebear11 karma

Are you the only guy who does this?

bts18111 karma

Not too many of us who do this exclusively

freelanceredditor1 karma

Have you ever wrongly convicted anyone? Or been part of such a case?

bts18112 karma

Thank goodness no. These cases take years to develop and consist of teams of people gathering a lot of evidence