When Mary Efurd woke from her surgery, she couldn't stand.
Crippling pain shot through the 74-year-old's body.
It shouldn't be like this. The surgery to fuse two of her vertebrae, performed in 2012 at the Dallas Medical Center, wasn't a difficult one. Her surgeon, Christopher Duntsch, had 17 years of training and experience under his belt.
Still, something was clearly wrong.
Days later, she underwent surgery again, this time under the scalpel of Robert Henderson. What he found shocked him.
Spinal fusion hardware was left in her soft tissue. One of her nerve roots - the segment where a nerve attaches to the central nervous system - had been severed. Another nerve root had a screw in it. He found multiple screw holes, meanwhile, on an area of Efurd's spine where they had no business being.
How had Duntsch messed up this badly?
Efurd didn't know the surgeon's background.
Duntsch, as described to Dallas magazine by his colleagues, was a confident man, perhaps too confident. He'd make statements like "Everybody's doing it wrong. I'm the only clean minimally invasive guy in the whole state," according to fellow surgeon Mark Hoyle.
Hoyle quickly learned this wasn't true during the first and only surgery he conducted with Duntsch that became so botched, the incision so pooled with blood, it looked like Duntsch was "fishing in a pond at night, saying he was working by feel, not sight."
That was a November 2011 surgery on Lee Passmore, which left him a partially broken man. As Matt Goodman wrote in D Magazine:
Lee Passmore can't feel his feet. His right leg is as stiff as his pressed blue jeans, and when he walks, he appears to use his hips to heave it forward. He also vibrates - his chest shakes, his right hand jitters.
Hoyle canceled the remaining operations the two had planned together and refused to work with Duntsch ever again.
Now, no one will.
On Tuesday, after just four hours of deliberation, a Dallas County jury convicted Duntsch of aggravated assault for deliberately maiming Efurd. According to the Dallas Morning News, he faces life in prison.
Efurd, for one, felt justified by the verdict.
"I think it's going to be like a floodgate that's going to really open, crying. I'll do some crying. And I'll reflect back on how difficult those first months were afterwards. I had so much anger, because my life changed so much. I was very independent and I had to become dependent on others for transportation, for my meals, for a lot of things," she told reporters at the court.
But she's far from the only one who considers Duntsch's conviction a deserved retribution.
Police originally accused Duntsch of causing the death of two patients and crippling four others between July 2012 and June 2013. In July 2015, he was arrested on five aggravated assault charges, but prosecutors eventually chose to focus solely on Efurd.
But there may have been many more. As Goodman wrote in the Dallas magazine article that gave Duntsch the chilling nickname Dr. Death:
There was Kellie Martin, who died from massive blood loss after a surgery at Baylor Plano. There was Floella Brown, whose sliced vertebral artery triggered the stroke that killed her at Dallas Medical Center. There was Duntsch's childhood friend, Jerry Summers, who woke up from a procedure unable to move his arms and legs. There was a dissection of one patient's esophagus, and screws that an indictment labelled "far too long" that caused significant blood loss in another patient. One surgeon described these as "never events." They shouldn't ever happen in someone's entire career. And yet they occurred in Duntsch's operating rooms over a period of just two years.
Somehow, though, many of these were passed off as accidents, random mistakes. His medical license wouldn't be suspended until 2013. Lawsuits besieged him; almost everyone quickly settled after signing nondisclosure agreements. Bizarre as that might be, it's only half as strange as the conviction that ended up sticking.
"I cannot recall a physician being indicted for aggravated assault for acts committed during surgery," Toby Shook, a Dallas defence attorney who spent 23 years working as a Dallas County prosecutor, told Dallas. "And not just Dallas County - I don't recall hearing about it anywhere."
What Duntsch's motive might have been is anyone's guess. Ex-girlfriends and former friends relayed to Goodman stories of abuse and a social life (which often allegedly blurred into his work life) loaded with bottles of vodka, mounds of cocaine and sheets of LSD.
He reportedly behaved erratically. In a particularly long, rambling email he sent to one of his employees, which was published by the Dallas Morning News, the doctor sounded delusional.
In one excerpt, he compared himself to both God and Satan:
Anyone close to me thinks that I likely am something between god, Einstein and the antichrist. Because how can I do anything I want and cross every discipline boundary like its a playground and never ever lose. But unfortunately, despite the fact I am winning it is not happening fast enough.
In another, he announced plans to become a murderer:
You, my child, are the only one between me and the other side. I am ready to leave the love and kindness and goodness and patience that I mix with everything else that I am and become a cold blooded killer.
Whatever his motive, his alleged victims may have finally found peace. In a taped interview with the Dallas Morning News, 45-year-old Philip Mayfield, who awoke from a surgery paralysed, said, "I am very well pleased that he will remain in jail and that justice will eventually be served for the crimes he committed."