by J. David McSwane, propublica.org, Co-published with Montana Free Press
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Hailed as a savior upon his arrival in Helena, Dr. Thomas C. Weiner became a favorite of patients and his hospital’s highest earner. As the myth surrounding the high-profile oncologist grew, so did the trail of patient harm and suspicious deaths.
Lisa Warwick found her husband gasping for air at the foot of the basement stairs and knew the miracle was over. It was Aug. 2, 2020, more than 11 years since Scot Warwick had been diagnosed with Stage 4 lung cancer. Most patients are dead in months, but her husband, who had just turned 51, had somehow destroyed the odds.
“Are we going in?” she asked.
“Yes,” he said. “We are going in.”
His body had endured six years of chemotherapy and an additional five of experimental therapies. According to his medical record, he had responded “singularly impressively.” Two months earlier he had been running 5 miles a day, but since the latest round of chemo he had rapidly declined.
Lisa Warwick guided her husband up the stairs, dragged him to the car and raced to St. Peter’s Hospital in downtown Helena, Montana.
The emergency room doctor cited shortness of breath, fever and chills. He flagged that Warwick’s respiratory crisis could be the result of the chemotherapy. It had been restarted weeks before on the order of the oncologist who diagnosed him, the only doctor he’d consistently seen for more than a decade.
The next morning, a doctor named Randy Sasich arrived for his shift at St. Peter’s. An independent nonprofit with just under 100 beds, the hospital is the only acute-care facility for about 100 miles in any direction and has touched the lives of virtually every area resident going back generations. Helena, the state capital, remains a small vestige of the Old West, with just 34,000 residents, so luring doctors has always been a challenge. This was especially true in April 2020, at the onset of COVID-19, when Sasich signed a short-term contract.
A 47-year-old lung specialist, with degrees from Georgetown and Santa Clara University and experience at hospitals in major cities, Sasich was a rare get. The de facto director of the hospital’s intensive care unit, Sasich met with the morning shift’s coordinating doctor. Standing in the ICU, the two ran through patients, their needs, the usual, until Warwick.
We have a 51-year-old patient with metastatic lung cancer, diagnosed 11 years ago, Sasich remembered the doctor saying.
“There’s no way,” Sasich interrupted.
Well, he’s been treated for 11 years, the doctor explained.
“You don’t live 11 years after a Stage 4 lung cancer diagnosis,” Sasich said. “That doesn’t make any sense.”
Between patients, Sasich reviewed Warwick’s chart. Something must have been misread along a medical game of telephone, he reasoned, or he’d missed some great advancement in cancer treatment. He found the 2009 report that prompted the cancer diagnosis. A smoker at the time, Warwick had seen an ear, nose and throat doctor about a tiny lump on his neck. The ENT had sent a sample of cells from Warwick’s neck to the lab. A few days later he wrote in the file that they were “most likely consistent” with cancer.
That is not a cancer diagnosis, Sasich thought.
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