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

She brings back an armful of large envelopes, pulls out an X-ray of her artificial hip, holds it up to the light and traces the bones, the socket, a screw. "See, there's the drill bit," she says.

After the surgery, Mote went into rehab but remained in "excruciating" pain. Her leg started swelling. On a return appointment, Buch came in the room, threw down her X-rays and said her femur was fractured.

"He acts like he can't believe it," Mote says. "I thought this was his first look at the X-rays. He told me to go ahead and do my exercises."

But her foot and leg swelled even bigger, and the pain remained. Mote called and insisted on another appointment.

Buch was angry, she says.

He insisted there was nothing wrong with her foot and leg. She was just a drug seeker, a troublemaker, Mote claims he told her.

"He was in my face, making awful faces and shaking his finger," Mote says. "I was scared. He's the most disgusting man I have ever met in my life."

Pain like a needle in her hip continued to bother her. Another doctor finally diagnosed her with cellulitis, a dangerous cell infection that carried a risk of blood clots, and immediately put her in the hospital. After the infection was controlled, Mote had home health care for almost a year.

The second doctor ordered X-rays and explained that Buch had broken her femur while inserting a hip replacement that was too large.

She filed a lawsuit claiming Buch had used excessive force and failed to use screws of the proper length during the surgery, then broke off a drill bit in her hip and left it there without telling her.

But Mote dropped the lawsuit in December 2003 after her lawyer told her there was little chance she would prevail at trial. Because her husband's Alzheimer's disease became worse, she decided not to pursue her case. The drill bit is still there. Mote's doctor decided it was safer to leave it rather than risk another surgery.

"[Buch] sent my personal doctor a can of treats," Mote says. "I think he's a crazy man."

His left hand hurt so much that he couldn't use it, Ronnie Vest told the man in the white lab coat. "What do you think, doc?" he asked, after the man examined it carefully and scribbled in the medical file. The man just smiled.

"Dr. Buch will be with you in a moment," the man said and left.

Buch arrived and introduced himself.

"There's only one thing we can do about that," Buch said. "Take it out."

Abruptly, he left.

"He spent less than an entire minute talking to me," Vest says.

A weather-beaten insurance investigator who has lived in the tiny town of Celina, north of Dallas, all of his 63 years, Vest had been referred to Buch in 1998 by another orthopedic surgeon who specialized in hands and diagnosed the problem as a cyst on the bone.

"Buch is amazing," the physician said. "I've seen him operate. He's been written up in all the medical magazines."

In what was supposed to be day surgery at Medical City, Buch performed an open curettage of the lesion on the bone and ran two sharp rods through the bones of Vest's hand, terminating in plastic balls that stuck out of his skin.

After sitting in the waiting room for five hours, Linda Vest began wandering the clinic trying to find her husband. He was in the room where he'd started the morning, screaming because Buch had ordered no additional pain medication.

"The nurses had called Buch twice, and he hadn't come," Linda says. "They called him three more times." Buch arrived at midnight, apologized and ordered painkillers.

"He said, 'I never go out and talk to the people. The nurses do that.'"

Vest returned 30 days later to have the rods removed. "The waiting room was so crowded there were four or five of us sitting on the floor," Vest says. "Three of us had 1 o'clock appointments."

Accompanied by an assistant and two interns who had come from Japan to witness his surgery techniques, Buch pulled out one rod as Vest moaned in pain.

Saying his assistant would take care of the other rod, Buch left the room. "He's never in with you over a minute," Vest says. "It's like running cattle through a sale barn."

The assistant pulled off the plastic ball, leaving no way to grasp the rod. He had to resort to pliers.

Vest sits in the breakfast room of his country home, reliving the anguish with tears in his eyes. His hand started swelling. Worried about infection because the assistant didn't seem to be taking sanitary precautions, he called Buch's office asking for antibiotics.