On the surface, the central subject of J. David McSwane’s “Eat What You Kill” is a familiar type in American journalism — the bad doctor. But “Eat What You Kill” is about much more than that: a battle between an outsider and a hometown hero; a step-by-step look into how a hospital scrutinizes one of its own; a disturbing examination into how one doctor in a small hospital accumulated influence and wealth and, for years, intimidated his colleagues; an investigation into how hospital administrators looked away until they couldn’t, and when they finally did take action, hid their own complicity from the community; and how that community found itself torn apart, split between those who believe the doctor was brilliant and unfairly fired and those who had observed or experienced firsthand what they believed was malpractice or worse. That’s a lot. But “Eat What You Kill” is never weighed down by the complex strands that run through it. Rather, it is a magisterial and riveting account of how a doctor exerted his power over a hospital and a town for years.
Arriving in Helena, Montana, in 1996 as the hospital’s permanent oncologist, Thomas C. Weiner was greeted as a savior and revered by his patients. Inside the hospital, though, he was feared by many of his colleagues. He was its biggest revenue generator and relatively quickly its biggest earner. (His compensation exceeded $2 million the year he was fired.) He had helped push two CEOs out after they questioned his pay. What administrators seem to have never questioned was the quality of his care until a travelling pulmonologist arrived at the outset of COVID-19 and raised questions about Weiner’s treatment of a lung cancer patient.
Fifteen months later, McSwane traveled to Helena to report on the effects of COVID-19 on a small-town hospital. But when he interviewed the staff of St. Peter’s, they told him the real story was about the oncologist many inside the hospital suspected of hurting his patients. No journalist, it turned out, had investigated why Weiner had been fired and what hospital administrators knew and how long they had known it. From that conversation, McSwane spent months interviewing dozens of doctors, nurses, administrators, former patients of Weiner’s, family members of those he treated — and Weiner himself. Crucially, he examined thousands of pages of depositions, medical files, text messages and work emails — documents both Weiner and the hospital wanted kept out of public view — as well as Medicare data. Distilling all this, McSwane has written a searing portrait not just of a doctor but a health care system that doesn’t know how to police itself.
