The Cowboy | Dirty Laundry | S5-E4

Summary

Podcast Summary: Dr. Death – The Cowboy | "Dirty Laundry" (S5-E4)

Release Date: June 18, 2026
Host: Laura Beil
Podcast: Dr. Death (Audible Original)

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Episode Overview

In "Dirty Laundry," the fourth episode of Dr. Death Season 5, reporter Laura Beil delves into the unraveling of Dr. John Schneider—a charismatic but deeply troubling spinal surgeon operating in Wyoming and Montana. The episode traces the aftermath of a tragic surgical outcome involving a staff member’s husband, Russell Monaco, whose death sets in motion investigations, feuds, and lawsuits that expose the heart of a broken medical system and the lengths to which Schneider will go to protect his reputation. Schemes, coverups, and further patient harm are unearthed, as the show explores how institutions failed to stop a dangerous doctor.

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Key Discussion Points and Insights

1. The Tragedy of Russell Monaco (00:00-12:19)

• Introduction to the Monaco Family

  • Kathy Monaco, a seasoned medical administrator for Dr. Schneider, trusted him to operate on her husband, Russell, after a back injury.
  • “It's worth it in my book to have somebody you trust do the surgery for you versus somebody you don't know.” (Kathy Monaco, 01:21)

• Surgery and Pain Management Gone Wrong

  • Russell, after a spinal laminectomy, was sent home on a dangerous cocktail of opioids and sedatives—including fentanyl, oxycodone, Valium, and hydromorphone.
  • Nurse Julie Mossbacher describes Schneider’s notorious prescribing:
    “He was notorious for sending patients home with this cocktail. ... Here's your pharmaceutical bag. Take what you think you need.” (Julie Mossbacher, 06:14, 06:34)
  • Staff concerns were often dismissed:
    “He expected me to follow his orders blindly.” (Mossbacher, 07:34)
  • Internal complaints went unanswered; the hospital declined to comment for the podcast.
  • Russell Monaco died within 24 hours of discharge from an opioid overdose.

• Immediate Fallout

  • The Wyoming Board of Medicine takes the fatality seriously and suspends Schneider’s license:
    • “You don't unring that bell easily.” (Kevin Bonnenblust, Board Executive Director, 10:42)
    • “If you're not paying attention to what the black box warning is, that's a pretty hard argument that you failed to meet the standard of care.” (Bonnenblust on fentanyl, 11:21)

2. The Smear Campaign and Investigation (12:19-18:00)

• The Mystery "Rita" Letter

  • Dr. Jimmy Biles, a rival surgeon, investigates defamatory flyers (“the Rita letter”) mailed across the region.
  • Lawsuit revealed Indiana nurse Lisa funded the mailer, despite her implausible denial of involvement:
    • “[Her lawyer] said, ‘No nurse in Indiana decides one day to send out a flyer because she does not like the way a doctor is behaving in Wyoming. ... That story is not believable.’” (15:31)

• Evidence from the Laundry Room

  • A flash drive found in Schneider’s unwashed scrubs contained instructions to Lisa suggesting Schneider orchestrated the campaign.
  • Excerpts from Schneider’s letters included both inducements and intimidation:
    • “If you are able to take a bullet, you will be taken care of far in excess of any paycheck.” (16:40)
    • “As soon as they turn you, you will be treated like a prison bitch.” (16:40)
  • Schneider offered Lisa strategies for destroying evidence (“microwave treatment”) and downplayed his role in the smear, despite accumulating evidence.

3. Schneider’s Defiance and Return to Practice (18:00-25:05)

• Malpractice Insurance Maneuvers

  • Schneider settled Biles's lawsuit ($3 million) with funds intended for patient harm payouts, a diversion that jeopardized future victim compensation.

• Allowed to Resume Practice

  • After a brief remedial course and prescription restrictions, Schneider’s suspension was lifted. He quickly resumed operating, despite ongoing investigations.

• The Case of Alan Knope

  • Alan, a longtime patient, describes being overprescribed opioids and undergoing unnecessary, damaging surgeries:
    • “I honestly did believe that if he had told me that the moon was made out of cheese, I would have believed that he was telling me the truth.” (Alan Knope, 21:24)
    • “Not only did I wish I hadn't had it, I wish I would have died as a result... I was in too much pain.” (Knope, 21:39)
  • Dr. Michael Copeland, a former colleague, breaks the devastating truth:
    • “You never needed an operation. ... Your back is an absolute train wreck.” (Copeland, 22:41; Knope quoting, 22:55)
  • Hardware from the surgeries was found dangerously faulty.

4. Systemic Failures and Final Reckoning (25:05-End)

• Medical Board Dilemmas

  • Bonnenblust explains difficulties in maintaining suspensions without “imminent threat” evidence—resulting in delayed action and more victims:
    • “We cannot keep them suspended if ... there is [not] an imminent threat to public health and safety.” (Bonnenblust, 25:09)
  • Ultimately, after more than two years and multiple complaints, the board brings 33 counts against Schneider, with 29 upheld.

• Passing Blame and the Aftermath

  • Schneider blames his physician assistant, Harley Morell, who expresses regret and confirms feeling scapegoated.
  • The board finds Schneider’s testimony "not credible" and revokes his license, imposing a fine.
  • Schneider moves assets to shield them from malpractice claims and prepares to resume operating, this time with the VA hospital system.

• Preview of What’s Next

  • “He screwed with the wrong people.” (CJ Baker, 28:25)
  • “It looks like you finally crossed the line and this is your day of reckoning.” (Baker, 28:30)

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Notable Quotes & Memorable Moments

• “He was notorious for sending patients home with this cocktail. ... Here's your pharmaceutical bag. Take what you think you need.”
  —— Julie Mossbacher, 06:14, 06:34

• “If anything went down, he just blamed Harley. Harley did it, not me. Nope. He didn't talk to me. He did it all on his own.”
  —— Mossbacher, 07:11

• “We have a silver bullet here. I don’t know if it’s hurting people in surgery or overprescribing or just whatever, but if somebody is repeatedly doing that, something needs to happen.”
  —— Kevin Bonnenblust, 12:07

• “[Her lawyer] said... unless you are completely crazy, that dog don't hunt, the boat don't float. And that story is not believable.”
  —— Lisa’s lawyer, 15:31

• “Your back is an absolute train wreck, and there's no way to straighten out your back except through the most radical surgery we can do on a person.”
  —— Alan Knope recalls Dr. Copeland, 22:55

• “I mean, my gosh, you would have thought that the Wyoming Board of Medicine would have stopped him after they had gotten one, if not two, cases filed against him. If they were really being prudent about what they do.”
  —— Alan Knope, 24:47

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Major Timestamps

• 00:00–06:14 — Russell Monaco’s surgery, post-op drugs, deteriorating health
• 06:14–08:00 — Nurse concerns, pushback, allegations of bullying and scapegoating
• 10:07–11:38 — Medical board responds; details on fentanyl warnings
• 12:19–16:27 — The “Rita letter,” Biles’s lawsuit, investigation details emerge
• 16:27–18:00 — Digital evidence exposes Schneider’s role; legal fallout
• 18:00–21:39 — Schneider’s malpractice insurance, quick return to operating room
• 21:39–25:05 — Alan Knope’s story, unnecessary surgeries, outside medical review
• 25:05–28:25 — Board hearings, license revocation, asset transfers
• 28:25–End — Cliffhanger: Schneider’s new venture and the law closing in

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Conclusion

"Dirty Laundry" masterfully unpacks the layers of Dr. John Schneider’s misconduct, the pain left in his wake, and the failures of the medical system to prevent harm. The episode weaves together patient stories, institutional inertia, and personal vendettas, showing how easily a dangerous doctor can slip through the cracks—and how hard justice can be to achieve. The saga continues, with Schneider neither humbled nor finished, setting up a dramatic confrontation to come.

Transcript

[A]

Audible subscribers can binge all episodes of Dr. Death the Cowboy early and ad free. Join Audible today by downloading the Audible app or by subscribing on Apple Podcasts. Kathy Monaco had seen her share of bad backs. She'd worked in medical administration for nearly 25 years. For the last four, she'd worked for Dr. John Schneider, handling patient requests at his clinic. So when her husband, Russell, heard his back lifting a beer keg, Kathy knew he needed to see a doctor. According to court documents, she later said, he was in a lot of pain and I said, it's time to go. We need to get checked out because you can't miss work. Russell was 47 years old. He and Kathy lived with their two daughters, Mallory and Madison, and their husky, Timba. Russell worked as a machinist and and in his spare time, coached softball for one of his daughter's teams. He'd had trouble with his back before, and Russell wasn't sure about his local surgeon. So Kathy called in a favor. She sent her boss an email. It read, I know you're busy and I'm sorry to bother you again, but could you look at my husband's lumbar MRI? That was done yesterday. Dr. Schneider got back to her the same day. He told her that Russell had three ruptured discs and would need an operation pretty quickly. But if they wanted Schneider to do it, they would have to go all the way to the hospital where he did his surgeries in Cody, Wyoming. And that was out of their health care provider's network. She said later, it's worth it in my book to have somebody you trust do the surgery for you versus somebody you don't know. We knew if he needed surgery, we wanted Dr. Schneider to do it. Kathy was doing what any wife would do, putting her husband's care in the hands of the doctor she trusted most, the doctor she worked for. She had no way to know that they were walking headlong into a tragedy from which her family would never recover. And this time, the medical board would finally seek justice. From audible originals I'm laura beale, and this is Dr. Death the cowboy. This is episode four, Dirty Laundry.

[B]

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[A]

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[C]

He was notorious for sending patients home with this cocktail. He would send home volumes of prescription medications.

[A]

Julie Mossbacher, the self professed battleaxe of the nursing station, says she saw this kind of thing happen multiple times you

[C]

know, here's your pharmaceutical bag. Take what you think you need.

[A]

It wasn't just the quantity of drugs that Dr. Schneider was prescribing, but also the combination, which if taken together, could be dangerous. But when Schneider was challenged, he would crush you.

[C]

You know, he looks at you like he could shoot daggers at you. And we started empowering some of the other nurses to stand up to him, which to say, no, this isn't safe. This is not saf safe for the patient.

[A]

Julie says that if things went wrong, Dr. Schneider's physician assistant would take the fall.

[C]

If anything went down, he just blamed Harley. Harley did it, not me. Nope. He didn't talk to me. He did it all on his own.

[A]

Then one day, it was Julie's turn. Dr. Schneider wrote one of her patients a prescription for a combination of sedatives and painkillers. To her, the mix was dangerous.

[C]

I said, no, I am not going to do that. He was angry at me. He expected me to follow his orders blindly.

[A]

But Julie was convinced it was risky.

[C]

So when I discharged that particular patient, I did not give him that cocktail. I refused, just let my supervisors and immediates know that I did this and this is why I did it.

[A]

Julie says that she reported her concerns about Dr. Schneider up the chain of command. Then she waited for a response. None ever came. Nor did the hospital respond to our requests for comment. Dr. Schneider, meanwhile, told us via his lawyer that he doesn't even remember Julie. He says that his practice was always aligned with the highest standards of care. The Monaco's took Russell's prescriptions and made the long drive home, waiting for them. There was Russell's mom, who'd been looking after their two daughters. She later testified that he could barely walk or stay awake. He had trouble even getting from the doorway of their family room into a chair. That evening, Russell lay in his recliner in the living room as the family ate dinner before bed. His eldest daughter asked if she could get him anything. A new back, he told her. At 9.30pm, Russell's wife Kathy left him his painkillers. She offered to stay with him in the living room, but he told her to get some rest upstairs. Even so, she left a phone next to him and told him to call her if he needed anything at all. The next morning, Kathy checked on her husband. He was in the same position as the night before, she said. His glasses were sitting on the desk, his crutches sitting there. He hadn't moved an inch. Then she saw that he was blue. Russell Monaco died less than 24 hours after being discharged from Dr. Schneider's care. A few days later, news reached the Wyoming Board of Medicine. They already had complaints against Dr. Schneider, the ones from Dr. Naradsky. But this raised the stakes. A patient had died.

[D]

That's a big deal. As you would imagine, we take fatalities very, very seriously.

[A]

Kevin Bonnenblust is the board's executive director.

[D]

You've got a case where there's something egregious happens, something that, to use the court's term, shocks the conscience. Something needs to happen. The sooner the better.

[A]

The autopsy left no doubt Russell Monaco had died of a drug overdose. To the board, it seemed like Dr. Schneider was an imminent threat to the public, so they suspended his license to practice medicine in Wyoming.

[D]

You don't unring that bell easily. All of a sudden you're having to call patients saying, hey, you know, I'd do your surgery next week, but the Board of Medicine suspended my license.

[A]

For the first time, Schneider was barred from seeing patients. His career was hanging in the balance. With Schneider sidelined, they set about investigating just exactly what had gone wrong in Russell Monaco's treatment. They looked at the decision to prescribe Russell a fentanyl patch. Fentanyl carries a black box warning. It's the strongest safety alert the Food and Drug Administration can make.

[D]

The black box warning on that says do not give it for post operative pain. It's for long term cancer treatments, things like that. It is not for acute pain. So if you're not paying attention to what the black box warning is, that's a pretty hard argument that you failed to meet the standard of care.

[A]

The deeper they looked, the worse it got. They found that Schneider repeatedly prescribed fentanyl after surgery, despite the warnings against that use. Then there was the mix of other opioids and sedatives, plus the decision to send Russell home when his oxygen levels had been so low. To the Wyoming Board of Medicine, it seemed like they had overwhelming evidence of Dr. Schneider's wrongdoing.

[D]

We have a silver bullet here. I don't know if it's hurting people in surgery or over prescribing or just whatever, but if somebody is repeatedly doing that, something needs to happen.

[A]

Schneider's history was catching up with him, and not just through the Board of Medicine. Remember those mysterious letters that got sent out across the Bighorn Basin? Well, the man they targeted had been trying to find out who was behind them. And now he'd found some answers.

[C]

Hello.

[A]

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[E]

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[A]

CODY Dr. Jimmy Biles had been on a quest to figure out who was behind the mysterious letter from Rita, the one that had landed in 14,000 mailboxes filled with false allegations against him. We did reach out to Dr. Biles for this series, but he declined to take part. However, we know what happened because Dr. Biles eventually filed a lawsuit that named the supposed perpetrator. And that person came out of nowhere, a woman named Lisa who lived 1500 miles away in Indiana.

[B]

But the suit was also clear in saying that although she had paid for the flyer that they believed she was acting on behalf of someone else.

[A]

Journalist C.J. baker was tracking the story for the local newspaper. He couldn't understand what a woman in Indiana had to do with a feud in Wyoming, so he gave her a call.

[B]

I said, hey, maybe this is completely random that you were just named in this suit by this physician over here in Cody, and he's saying that you were responsible for this mailer. You know anything about it? Got anything you can tell me about

[E]

that kind of thing?

[B]

And she said, I don't have any idea what you guys are talking about.

[A]

Eventually, she admitted it to the court. She had sent the letters but she insisted she'd acted alone. Even Lisa's own lawyer struggled to believe her. In an email later revealed in court, Lisa's lawyer laid it out for her. He said, no nurse in Indiana decides one day to send out a flyer because she does not like the way a doctor is behaving in Wyoming. Unless you are completely crazy, that dog don't hunt, the boat don't float. And that story is not believable. Still, she stuck to this implausible alibi until the truth arrived in the form of a flash drive found in the pocket of a pair of unwashed scrubs in the laundry room at the hospital where Dr. Schneider worked. It contained pages and pages of letters addressed to Lisa.

[E]

Oh, man.

[B]

You know, I don't know how much further your jaw could drop or how many more times you can be surprised in the course of a case, but this is one that just seemed to get worse and worse.

[A]

Those letters weren't signed, but there was one person. They certainly appeared to have been written by Dr. Schneider. One document read, as we have discussed, if you are able to take a bullet, you will be taken care of far in excess of any paycheck. And another one said, they will obviously say many times through various ways that it is better for you to tell the truth about your co conspirator. Don't believe any of it. They will not befriend you or help you in any way, and as soon as they turn you, you will be treated like a prison bitch. Dr. Biles launched a new lawsuit against Schneider, accusing him of masterminding the smear campaign. Dr. Schneider replied that he would fight the case, but the evidence kept mounting. As the case entered discovery, Dr. Biles got a hold of more damning material. Emails showing that Dr. Schneider told Lisa she should have a, quote, 250K plus payoff for her future, as well as instructions for how she could avoid answering questions under oath. Dr. Schneider even offered to help her destroy evidence by giving her hard drives the, quote, microwave treatment. And yet Dr. Schneider continued to insist that he had done nothing wrong. To this day, he says he did not, quote, direct review or send the flyer to the community. But now Schneider was fighting on two fronts. The Wyoming Medical Board was questioning whether he was putting patients at risk, and the court filings around the Cody Mailings portrayed him as a man willing to intimidate and manipulate to get his way together. They painted a picture of a doctor who seemed dangerously out of control. Still, Schneider kept moving forward. He flew to Nashville and sat through a short course on prescribing medicines and agreed to restrictions on what he was allowed to prescribe. That was enough to get his suspension lifted while the Wyoming investigation continued. As soon as he got the news, Schneider began firing off tweets to his one single follower back in the operating room, stamping out disease. Communication failure from the physician assistant caused this death, not Dr. Error. These events are orchestrated by our competitor to undermine our vision. We will prevail and provide expert, cost effective care. Then he settled the case with Jimmy Biles at a cost of nearly $3 million, without admitting any wrongdoing. To pay it, he used his malpractice insurance. For years, Dr. Schneider had insured himself with his own money. He'd set up an insurance company backed by his personal millions. The money was supposed to be fenced off for patients, but instead, he used the funds to pay for the defamation settlement and legal bills, meaning there wouldn't be enough left to pay out any malpractice claims. And with his suspension lifted, he was back in the operating room, working on patients who had no clue about the kind of trouble he was in. 63 year old Alan Knope wasn't a new patient. He'd already been seeing Dr. Schneider for a while. Alan had first become aware of Schneider a few years earlier when he saw a billboard off the highway. He could hardly have missed it. The advertisement was enormous. A giant picture of a doctor in a white coat beaming down at him.

[E]

I mean, we're talking about something the size of my living room. He had this huge smile on his face. The impression that he gave me from the billboard was, you can trust me. And it said, does back surgeries. I thought, man, as bad as my back is hurting, I think I can go see this guy.

[A]

Schneider operated first on his neck, and that seemed to go well. Then Dr. Schneider operated on Alan's back. A spinal fusion. Over time, the pain got worse. By 2012, just months after getting his license back, Dr. Schneider was telling Alan that he needed a second operation on his back. Alan listened, his mind fogged by opioids.

[E]

I honestly did believe that if he had told me that the moon was made out of cheese, I would have believed that he was telling me the truth.

[A]

Alan agreed, and they scheduled the procedure.

[E]

I remember coming out of the back surgery and being in an excruciating amount of pain, where they then put me on even more pain medication. I should have never had that second back surgery. Not only did I wish I hadn't had it, I wish I would have died as a result of having had the surgery because I was in too much pain on an ongoing basis.

[A]

After nine months of excruciating pain, Alan finally decided he needed a second opinion. He hobbled into a new doctor's office alongside his wife. As he slowly sat down, the doctor began asking questions.

[B]

When did this all start? What's going on?

[A]

It was Dr. Michael Copeland, Dr. Schneider's former colleague. He'd already seen the scans.

[B]

Your first thought is Schneider now he

[A]

needed to break the news to Alan.

[B]

So my task then was to say you never needed an operation. You don't want to hit him over the head with that, but at the same time, it's the truth, so you can't really skirt around it.

[E]

He put it in terms of, I know you're not going to like what I have to tell you, but your back is an absolute train wreck, and there's no way to straighten out your back except through the most radical surgery that we can do on a of piece person. My wife and I were both kind of just in shock.

[B]

It was just a whole mess. To then have me say that, oh, and you never needed any of that, was just too much.

[A]

When Copeland operated, he says the hardware was unstable from the middle of Allen's back down to his pelvis. He found plastic spacers so loose they could be removed with his fingers. One had been hammered so deep between his vertebra that it was poking into Alan's abdominal cavity. Doctor Schneider says that Copeland's allegations stem from professional jealousy, and he denies that he was to blame for Allen's failed back fusion. Instead, the problem, as Schneider saw it, was the patient himself. In his blog, he described Allen as, quote, a drug addicted miscreant whose tobacco and alcohol ruined his spine. Allen says that his reliance on prescription painkillers was a result of the complications he'd suffered after Dr. Schneider's surgeries. It was only later that Allen discovered the truth.

[E]

If I had known that he had had his license suspended, I wouldn't have allowed him to do surgery on me.

[A]

He also didn't know that the Wyoming Board of Medicine was aware of multiple complaints about Dr. Schneider.

[E]

I mean, my gosh, you would have thought that the Wyoming Board of Medicine would have stopped him after they had gotten one, if not two, cases filed against him. If they were really being prudent about what they do.

[A]

We put that to Kevin Bonnenblust, the board's executive director.

[D]

We cannot keep them suspended if we cannot, with a straight face, say, there is an imminent threat to public health and safety. And so that's the hard part, because to this patient, yeah, he was an imminent threat. When it happens that we have multiple complaints and things like that, what our prosecutor will normally do is he's going to go with the best cases he's got. And so what is the ultimate objective? Doesn't mean that other complaining patients didn't matter. Doesn't mean that their cases weren't important at all. Not in the least.

[A]

The investigators finally brought their case against Dr. Schneider in 2014, more than two full years after Russell Monaco's death. They filed 33 counts against him for violating the Medical Practice act, all tied to Russell's case. Dr. Schneider contested the case against him. In his view, the problem lay with his physician assistant, Harley Morell. Dr. Schneider accused Harley of having gone rogue and acting without his knowledge or authority. We did reach out to Harley Morell. At first, he was open to an interview, but the next day, he changed his mind because reach rehashing everything was too upsetting. He says Kathy and Russell Monaco were like family, and it makes him shake to think about what happened. He told us that he feels deep remorse for Russell's death and wishes that he had done more to stand up to Dr. Schneider. He feels that Dr. Schneider threw him under the bus to try to protect himself. The Board of Medicine did not find Dr. Schneider's defense persuasive. They described Schneider's testimony as not credible or believable. The expert he chose to back him was also considered, quote, not credible or worthy of belief. In the end, of the 33 counts, 29 were upheld. The Board of Medicine issued its punishment. It fined Dr. Schneider and stripped him of his license to practice medicine in the state of Wyoming. Schneider was cornered. His business was gone, and more malpractice accusations were stacking up against him. He needed to plot his next move. So he shifted his remaining assets into trusts and businesses in his wife's and his children's names. There was the luxury ranch near Cody known as Whispering winds, a wild $1.9 million home in California, and other properties, too. He called it estate planning. Others would call it fraud. And even without his Wyoming medical license, Schneider wasn't done being a surgeon. As we've seen in past seasons of this show, it can be surprisingly easy for a doctor who's suspended in one state to reinvent himself in another. Dr. Schneider would set out to stake a claim on a new frontier, Hired to operate on military veterans through the VA hospital system. But this time, the law was on his trail.

[B]

He hates saying he screwed with the wrong people.

[A]

And you know what?

[B]

It looks like you finally crossed the line and this is your day of reckoning.

[A]

That's coming up next time on Dr. Death. Listen to Dr. Death the Cowboy on the Audible app or wherever you get your podcasts. Audible subscribers can binge all episodes of Dr. Death the Cowboy early and ad free right now. Join Audible in the Audible app or by subscribing on Apple Podcasts. This has been an Audible original. I'm your host, Laura Beale. Executive producers are Russell Finch and Marshall Louie. Our senior reporter is Zachary Stouffer. Tom Wright is our senior producer. Our associate producer is Mohammed Ahmed. Joe Wheeler is the senior story editor. Senior development producer is Rachel B. Doyle. Our production managers are Cherie Houston and Sarah Mathis. Our associate director of production is Latha Pandya. Fact checking by Jacqueline Coletti. Sound design and mixing are by Nicholas Alexander and Mark Pittam. Sound supervisor is Marcelino Villapando. Music supervision by Scott Velasquez for Frison Sync Production services provided by Novel Executive producer for novel is Max o'. Brien.

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