Dallas Has a Real-Life Dr. Gregory House in Dr. Richard Buch

"I just laid in the bed and cried," Vest says. "I was begging them to amputate my hand."

A second surgeon cleaned out the wound and tried to repair the damage. After leaving the hospital, Vest was on intravenous antibiotics through a shunt to his aorta, twice a day for three months.

Because the pain persisted, Vest sought a third doctor, who diagnosed osteomyelitis, an infection of the bone.

The physician didn't understand why Buch used the rods. "Why didn't they just take that bone out of your hand?" the doctor asked. "You don't need that bone." He removed it and partially fused Vest's wrist. The pain was gone.

Like Linda Bajadali and Mary Mote, Vest suffered complications from surgery done by Buch that had to be repaired by other physicians.

All three say he became impatient or angry when they complained, that he was too busy or uninterested in their follow-up care, that he allowed nurses or a physician's assistant to handle tasks without proper supervision, and that he did not share important information with them, such as disclosing the drill bit left in Mote's hip.

Most upsetting: Buch blamed the severe complications on his patients, accusing Vest of removing his bandage, Bajadali of non-compliance with physical therapy and Mote of being a drug-seeker and troublemaker.

"Ladies and gentlemen, at the conclusion of this trial, it's my belief that none of you—none of you—will like my doctor at all." Defense attorney Bill Chamblee stood and addressed the panel of prospective jurors. "And the reason is: I don't like him either."

Next to him sat Buch. At the other table sat Vest and his lawyer.

Vest had been outraged to learn—thanks to information uncovered in another, separate malpractice suit filed against Buch—that his surgeon had a habit of consorting with hookers. In 2001, Vest sued for malpractice for his bone infection and deformed hand.

"I was just sick," Vest says. "Who knows what kind of diseases he could be exposed to? I didn't even sue for money. I just wanted this man out of the operating room."

Concerned that Vest's attorney might try to introduce evidence about his client's personal life and ongoing battles with hospital administrators and the Texas State Board of Medical Examiners (now the Texas Medical Board), Chamblee made a pre-emptory strike.

"You may hate him for his personal life," Chamblee said, "but I believe wholeheartedly that he did nothing wrong medically in this case."

The trial lasted two weeks. The jury had only one question to answer: Did Buch do something wrong during surgery by using the pins? Their answer: No. What came after the surgery didn't matter.

Doctors usually win, says Chamblee, who has defended malpractice lawsuits for 23 years. "In thousands of cases, more than 50 percent, the doctor did nothing wrong medically. All you have is a bad or less-than-favorable result, which is what is going to happen in medicine regardless."

Proving causation is the biggest obstacle in malpractice lawsuits, says plaintiff's attorney Amy Witherite, who filed a lawsuit against Buch on behalf of another patient. The impact of surgery, medications, pre-existing conditions, nursing care—all can affect the outcome. But making the connections is hard.

Chamblee has successfully defended Buch in malpractice trials twice and says the physician's medical skills have been overshadowed by his personality.

"He was involved in so many little personal battles and issues...," Chamblee says. "He's a good doctor but very poor in handling the politics of medicine. If they have a hearing at the hospital on privileges or on policies or procedures, he's not very good at being diplomatic. He just throws gas on the fire."

June 10, 1993, was unseasonably cool for trolling in the parking lot of the Deluxe Motel on Royal Lane near Harry Hines Boulevard, not far from St. Paul University Medical Center.

About 10:20 p.m., she got a nibble. A clean-cut man driving a Jeep Cherokee pulled up and looked her over.

"What's going on?" he asked.

"Not much," she said. "Whatcha looking for?"

"Blowjob," he said. "How about $40 for it?"

"That sounds good," she said. "I have a room. Let's go."

Moments after he entered room 112, the young woman turned on her customer and showed him a badge. A uniformed Dallas police officer put him under arrest and charged him with solicitation of prostitution.

The unhappy john was Buch. "The suspect was not placed in jail due to his occupation, a surgical doctor," the police report noted. "He had surgery scheduled the following morning at 7 a.m."

Buch had been living dangerously close to the edge for at least several years. Near midnight on September 21, 1989, Buch had propositioned another female undercover officer strutting down Harry Hines.