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

The elderly Russell had undergone a total right hip replacement by Buch in October 1995. Russell's attorney would later allege in court documents that: "During the surgery, Dr. Buch used the wrong size rasp/broach which became lodged in Mr. Russell's femur. Once Dr. Buch recognized his error, he tried to impact [hammer] it out without success...Dr. Buch next tried using an extractor with the help of three assistants. Dr. Buch then proceeded to remove the prosthesis by making a stress relief cut in the femur, but the prosthesis was still too tightly engaged. Finally, Dr. Buch resorted to cutting open Mr. Russell's femur the entire length of the prosthesis in order to disengage it. Since Dr. Buch split the femur open, he had to place wires around the femur to close the split. The graft used to repair the femur was inadequate."

The picture is of a frustrated surgeon, who would later blame a scrub nurse for giving him the wrong size rasp. Russell had to undergo additional surgeries. Another doctor made note that the prosthesis was protruding out of the shaft of the femur. Russell's hip continued to come out of its socket until a "lock" was placed on it, limiting his range of motion.

Buch's expert witness said the femur fractured because of Russell's "poor judgment" and "lack of compliance in not protecting his femur"—meaning the overweight man had fallen or moved around too much.

Russell's claim was settled by an insurance carrier for the hospital, Buch and a nurse, but not before an attorney for Russell discovered Buch's arrests.

Ordered to attend counseling for sex offenders by the Dallas Probation Office, Buch had pleaded no contest and received deferred adjudication on each of the three charges. The records were expunged.

The records were leaked to KXAS-Channel 5. Irresistible story, doctor trolling for blowjobs in the red light district, knowing he had to get up early the next morning and scrub in for a complex surgery.

Humiliated, Buch accused the plaintiff's attorney of besmirching his reputation to force a large settlement.

Then Sandy Rose, a hooker found by a private investigator, gave a statement saying that a customer who looked like Buch had "dated" her regularly since 1996, paying $150 for sex in her car. He'd identified himself as a doctor, but Rose didn't believe him. On February 3, 1998, she signed a statement saying their last "date" had occurred about three weeks earlier.

A woman identifying herself as Trina Smith signed a similar statement, saying "the doctor" had given her money for sex in late 1997. Always $150, always between midnight and 4 a.m.

Stephani Moore charged him $200 for sex and an extra $100 "for me to get naked in the car." He told her he was a doctor and showed her his card.

The news of Buch's arrests sent rumors flying around St. Paul, still run by Catholic nuns. (St. Paul is now UT Southwestern Medical Center at Dallas.) Mostly they puzzled over why a physician making nearly $1 million a year would be soliciting streetwalkers. "Maybe it was the excitement of getting away with it," says the nurse. "That's Buch."

Russell's attorney requested that Buch undergo a psychiatric exam, saying that he was an "impaired physician who does not have the requisite emotional, mental or psychological faculties to be a health care provider."

Rycke Marshall, a forensic psychotherapist, reviewed depositions in the case and testified in a hearing that in her opinion Buch had "poor judgment and engages in impulsive and self-defeating behavior"; that he "had a propensity to blame others for his mistakes"; and that to "solicit prostitutes the evening before surgery shows problems with proper decision making, impairing his ability to make good decisions in surgery."

Judge Ann Ashby agreed that "good cause exists for a compulsory mental examination" and ordered that Buch undergo "at least" a four-hour interview and extensive psychological testing. Her order was overturned on appeal after Buch argued it violated his right to privacy.

The negative publicity from the prostitution arrests gave those who disliked Buch incentive to document his infractions.