While showering on Christmas Eve eight years ago, Cheryl Abels discovered a knot below her stomach. Her 44-year-old body, which had been sliced open three times to usher children into this world, was on intimate terms with pain. But this unidentified lump frightened her.
Her doctor told her it was a hernia. So a few days into the new year, she found herself being examined by Dr. Walter Ruf, the only surgeon in her health plan whose office she knew how to find.
Ruf was a bit of an eccentric: a man old enough to be her father who told dirty jokes and wanted to hold her hand. But he seemed kind enough.
Ruf described hernia surgery as a simple matter — a small incision, a one-day hospital visit. But on the day of the operation, as she was waking from the anesthesia, the doctor saw her flinch and gag violently on the tube in her mouth. Her stitches ripped; the hernia returned. Ruf told her she'd need more surgery to repair it.
Over the next two years, Abels would undergo five operations and witness her health plummet. She developed ulcers, vomited blood, and could keep only the blandest food down. There were infections in her surgical wounds, drainage bags for her stomach, and piles of medications.
Finally, in late 2002 — days after the last surgery to repair another hernia — Abels' husband and kids watched as she slowly seemed to lose her mind. She couldn't stand without falling. She babbled incoherently and soiled herself. Ruf suggested that perhaps she had taken too many pain pills. But her husband, Jim, was unconvinced. He rushed his wife to Akron City Hospital.
By the time she arrived, Cheryl Abels was so sick she couldn't even talk. Yet Ruf treated her as if she had a simple urinary tract infection.
Luckily, her kids were babysitting for their neighbor, Dr. Kathleen Vereb, who happened to be doing her residency — an apprenticeship for new doctors — at Akron City. The next day, Vereb swung by Abels' hospital room to check on her neighbor. That's when she flipped out: Abels had sepsis, a severe infection that invades the bloodstream and attacks the whole body.
Ruf was kicked off the case, and Vereb brought in a team of doctors. The source of Abels' problem: Layer upon layer of surgical mesh used to heal her internal wounds had become infected. Now there was a ball of pus and mesh "the size of a watermelon" festering inside of her, Vereb says.
This wasn't the first time Walter Ruf was accused of negligence.
Ruf became a physician in 1964, a lifetime ago in the world of medicine. Doctors were still seen as gods, and slips of the scalpel weren't destined to be hashed out in court.
He won patients over with his soothing bedside manner, an answer to every question, a sympathetic ear for their troubles. He gave out his personal phone number and actually answered when they called. "He made you feel as though you could trust him," says Vereb.
His chosen field, general surgery, may seem a bit archaic in today's era of super-specialties. Ruf treated most illnesses found in the middle of the body — in colons, gallbladders, and thyroids, along with breast cancer and vasectomies.
It was a profitable endeavor, and he earned a reputation as a rainmaker for hospitals. As one nurse would later testify, Ruf and a few other doctors were considered "the golden boys . . . the money-making general surgeons of Akron General [hospital]."
Yet Ruf was also generating an impressive roster of complaints. Over three decades, he'd had at least 19 malpractice and negligence suits filed against him in Summit County. While many were dropped before they made it to court — and Ruf won a few — those that remained featured similar gripes. Patients alleged that after seeing Dr. Ruf, their health grew worse.
In 1974, he was accused of damaging a nerve in Rosalene Partenheimer's leg while trying to repair her hernia. In 1992, he injected Bernice Orlando's legs with a chemical solution to get rid of varicose veins. Her legs began to hurt and blister, her ankle swelled, and she eventually developed ulcers in her legs.
A year later, another patient, Catherine Hamilton, ended up in the emergency room after Ruf removed her gallbladder. She accused Ruf of injuring her common bile duct — a tube connecting the liver, gallbladder, and pancreas to the small intestine — during surgery, so that bile started leaking.
Then there was Althea Harrison. Ruf removed her gallbladder in 1994, but she ended up back in the hospital after the surgery. She later accused Ruf of accidentally blocking part of a duct that forced bile to leak into her abdomen.
Ruf vigorously disputed any negligence in all these cases, but the women were paid undisclosed settlements before the cases went to trial.
Then, in 2000, Deborah Dillon alleged that while Ruf was removing a tumor above her elbow, he damaged a nerve in her arm. Ruf contested the charges, but a jury ultimately awarded her $25,000.
By this time, insurers had begun refusing to provide him with malpractice coverage. When the Abelses sued in 2003, Ruf claimed he didn't have enough insurance to cover damages if he lost the case.
Yet this string of payouts didn't seem to tarnish his standing in Akron's medical community. Many at Akron General thought Ruf was a good surgeon and a "competent, caring physician," says Dr. William Gardner, the former VP of medical staff services at the hospital.
Besides, hospitals aren't keen on barring their doors against rainmakers. It would take a different kind of problem — one that threatened their own bottom lines — before they'd begin to take a closer look at Dr. Walter Ruf.
By the early '80s, other complaints about Ruf's behavior began to surface at Akron General, and they had nothing to do with fixing gallbladders.
According to documents and depositions from Summit County court files, Dr. Ruf referred to young nurses as "wenches" and "cunts," and would "come up behind you and grab your breast," one nurse testified.
The nurse recalls being warned about him in her orientation. But in the feudal world of surgical units, it was a situation she was forced to tolerate. "He did it so routinely to so many people," she testified, "we all knew what was going on — the other doctors in the room, the residents, anybody."
Holly, a nurse who doesn't want her last name used, was a newlywed when she came to General in the early '80s, naive about the disparate power of doctors and staff. So she was surprised when Ruf whispered in her ear, telling her that he could "do things to [my] clitoris that [my] husband didn't know how to do," she said in an affidavit.
One of his favorite games, she testified, was to grope her while a patient was being put to sleep on the operating table. It was the nurse's job to comfort patients, to stay beside them at the head of the table in case anything went wrong. Ruf would stand behind her, "His hand would come up underneath my scrub, and he would grab my breast and/or shove his erection in my back," she testified.
She couldn't yell or scream, "because you didn't want to upset the patient."
At Christmas parties, she added, "It was always offensive. I mean, it was kind of the joke that when you got to the Christmas party, girls, guard your breasts because the breast exams are going to start. You're in party dresses, gowns, or whatever, and some of them would have lower necklines, and he literally would reach into their gowns and fondle nurses' breasts and whisper things into our ears." One year, he followed Holly out to her car, offering his keys, wallet, and paycheck "if I would fuck him," she testified.
When she refused, he pushed her down into the snow, she claimed.
In the beginning, Holly would complain to her supervisors, crying and begging not to be put in a room with Ruf. She wrote formal complaints about Ruf at least 10 times, she testified. But the years passed, and nothing changed. She gave up. She didn't want to sue and get branded a troublemaker among Akron's small circle of doctors.
So she and other nurses found their own ways to avoid Ruf. Holly started working with a different surgeon, who offered to "protect me from the slime," she testified.
Another nurse, who did not want her name published, seems to have borne the worst of Ruf, according to her deposition. When she started working at the hospital in the late '80s, she was getting cortisone injections in her hips. She complained to co-workers about the hard, painful lumps that formed where she received the shots. Ruf offered to remove them.
A few days after the procedure, she returned to his office to have the stitches taken out. Ruf told her to lie down on the table and take her scrubs off. He started to remove the hip stitches, then suddenly stuck his fingers inside her, the nurse says in her deposition.
She pushed him back and ran away. Crying and shaking, she found an older nurse who offered to help clean her up. The woman patted her on the arm, offering a common wisdom about Dr. Ruf, the younger nurse said in her deposition: "Don't worry, honey . . . He does it to all the young, pretty girls. Just stay away from him."
But Ruf wasn't quick to take a hint. Once, he forced the nurse into a bathroom, pushed her against the wall, and "humped me, grabbed my breasts, tried to French kiss me, and wouldn't let me go," she said in the deposition.
When she finally broke free, the nurse emerged, mortified, to see Ruf's fiancée standing outside the bathroom. Ruf, who had a stain on the front of his pants, was unconcerned. "Was it good for you too, baby?" he asked, according to her testimony.
In a letter to Scene from his son, lawyer Mark Ruf, the doctor says he never harassed the women: "Dr. Ruf denied all of the allegations in those cases and still denies the allegations. He feels he should have tried those cases to clear himself of the false allegations against him. The cases were resolved on the basis of Dr. Ruf not having to hear the allegations again."
By the early '90s, the mounting complaints had come to the attention of Akron General executives.
In a 1991 memo obtained from Summit County court files, Vice President Gardner wrote to Dr. Dan Guyton, then the chairman of surgery, about sexual harassment allegations made against Ruf by a drug rep and "other women working in the [ambulatory care center]." Gardner didn't describe the allegations, but he made the hospital's stance clear:
"He [Ruf] should be given the opportunity to tell his side of the story, but it must be made clear that behavior of this nature is unacceptable and the hospital will not defend him if sexual harassment charges are filed." He even suggested offering Ruf psychological counseling.
But the memo implies that Gardner was mostly interested in keeping the matter quiet. "I would stress to Dr. Ruf that this can be kept totally within the confines of the Department of Surgery as long as these actions are not repeated," he wrote.
Yet the following year, according to court files, Guyton wrote to Gardner about more allegations, such as grabbing a woman's crotch. When one staffer mentioned she was having blood pressure problems, Ruf invited her into an exam room, then suggested she remove her blouse and bra. If someone asked to use his fax machine, his usual reply was "Yes, for the price of a blowjob."
Maureen Van Duser, Akron General's VP for human resources, interviewed the women, documenting the complaints in unvarnished detail.
"These employees indicate that they are very frightened; they are afraid to be alone on the floor with Dr. Ruf and are afraid if they take any action that he will come after them in some fashion," she wrote in 1992. "They are very intimidated and extremely upset and indicate that his behavior has been this way a number of years. They do not understand why physicians or the Medical Center tolerate it."
Soon afterward, memos obtained from court files show that Van Duser and Guyton met with Executive Vice President Alan Bleyer, and talked about appointing a special committee to investigate Ruf.
But again, Akron General seemed more interested in keeping matters quiet than proactively protecting employees. Though executives had plenty of complaints to go on, the women refused to go public, fearing Ruf would retaliate. Instead of pressing ahead, the hospital let the investigation die.
"Unless somebody brings formal charges, then it's a 'he said, she said,' type of thing," says Gardner from North Carolina, where he now teaches. "If you took charges against him without evidence, he could come back and sue you."
No action was taken by the hospital for eight more years — until one nurse finally stepped forward.
In 1998, Donna Matako was a nursing student at the University of Akron. She didn't know about allegations against Ruf. She was just working at the hospital for a required surgical rotation. But she had the misfortune of being young and attractive.
On her last day, Matako claims in court documents, she and another nurse were putting equipment on a cart while Ruf was washing his hands for surgery. Suddenly he turned and gazed, smiling, at Matako's chest, commenting, "Boy, if only I wasn't scrubbed . . ."
"Well, you are, so you can't," Matako shot back.
"The hell I can't," he replied, and grabbed one of her breasts — so hard that it left bruises.
Shocked and embarrassed, Matako told Ruf she'd kick his ass if he ever did that again.
She subsequently sued Ruf and Akron General for physical assault and a slew of other complaints, asking for at least $25,000 in damages. (Ruf denied all the allegations, and Matako could not be reached for comment.)
After four years in court, the parties reached an undisclosed agreement before the lawsuit went to trial.
But Matako's suit emboldened Holly and another nurse to come forward with their own suit. Though Ruf denied their allegations, they too won private settlements. (Both women declined to comment for this article.)
By 2000, Akron General could no longer quell the allegations building up against Ruf. According to court files, a memo written by Daniel Cunningham, vice president of legal services, to Ruf lawyer Stephen Pruneski indicates both parties agreed that the doctor would resign.
'There will be no further incidents of alleged sexual misconduct by Dr. Ruf at Akron General," the agreement stated. It also required Ruf to see a doctor who specialized "in the area of sexual misconduct" and follow any treatment prescribed.
But Ruf's career was far from over.
At various points over three decades, Ruf had surgery privileges at nearly all the major hospitals near Akron — City, Barberton Citizens, St. Thomas, and Akron Children's. Slowly, he surrendered most of them.
In court depositions, he said he left Barberton because one of his patients nearly died from anesthesia. He resigned from Children's because he wasn't doing enough work there to justify the fee to stay on staff. He claimed to have resigned from Akron General because he had a fight with the hospital's president over the need to remodel the floor where he worked.
Whatever the reasons, his choices seemed to have dwindled to one: Akron City Hospital. He'd trained as a resident there in the '60s and had continued to see some patients, though most of his business was at General. After resigning from General, he moved to City.
It seemed an odd move in a town where so many doctors and nurses work at multiple hospitals and the allegations against Ruf were well-known. "Dr. Ruf's reputation was not hidden at General," Gardner says today. "That town's not that big."
Yet City Hospital's executives as well as its owner, Summa Health System, accepted him with open arms.
The rank and file were another matter. Surgical students weren't allowed to work with him, because their supervisors didn't trust him, Dr. Kathleen Vereb said in a deposition. She testified in a deposition that one boss, Dr. Bradley Martin, told her that Ruf had been put on probation several times, but "They couldn't find enough evidence and reinstated him." (Martin did not respond to interview requests.)
After Cheryl Abels' disastrous experience, another surgeon, Dr. Elizabeth Bender, vented her frustrations about Ruf. In a deposition, Vereb recalls Bender saying, "I don't know what he was like years ago, but as long as I've been here, I've known him to be incompetent."
Bender did not respond to interview requests. A call to Summa President Thomas Strauss was referred to spokesman Mike Bernstein, who also refused comment.
But in the end, Ruf's tenure at City Hospital appears to have ended in much the same way it did at General.
In the winter of 2003, nurse Jennifer DeBow complained that Ruf had patted her on the butt, according to a deposition of her supervisor, Judith Bishop. Unlike the women who feared Ruf in his younger days, DeBow wasn't about to let it slide. She took her complaint all the way to the top.
Bishop didn't know what became of the investigation, but six months later Ruf was gone.
Today, Ruf is still licensed to practice medicine in Ohio. But according to his son, lawyer Mark, the doctor is now retired. And he vigorously denies the allegations of sexual harassment.
The Abels' lawsuit — alleging malpractice by Ruf and claiming Summa shouldn't have allowed him in its hospital — is slated for trial later this month.
In court documents, Ruf's lawyers argue that Cheryl Abels was obese and therefore more prone to hernias and subsequent complications. They deny Ruf made any mistakes in treating her.
In his deposition, he testified that after she ended up in the ER and he treated her for a urinary tract infection, he thought "she was getting better. She was on a regular diet, eating regular food. She was without a temperature."
And though a CAT scan suggested she might have a ball of infected pus — called an abscess — in her stomach, he wasn't certain of this until he'd already been kicked off the case. "She showed no signs of sepsis. She showed no signs of abscess," he testified.
But when contacted by Scene, Ruf wasn't eager to elaborate: "I'm not interested in talking to you," he said before hanging up.
A few minutes later, son Mark called back to launch his father's defense. "A lot of false things have been said about him," Mark Ruf began. But he was vague on the details.
He wouldn't talk about the accusations lodged by Donna Matako and the other nurses, saying only that "nothing was proven" and that their depositions had been sealed from public view. "I'm gonna potentially sue you and Scene magazine," he threatened. "You're treading on thin legal ice."
He said Ruf's resignation from Akron General was a "confidential matter" that he wouldn't discuss. As for Vereb's allegations of medical errors, he wouldn't talk about those either. "The court has ruled that she is not competent to render expert testimony."
Six years after her last surgery with Ruf, Cheryl Abels remains a motherly woman with a firm set to her mouth, but she's still living in constant pain. The lines under her eyes etch a track record of worry. She can't lift anything heavy — not even a grocery bag. Walking is the only exercise she's allowed to do.
Husband Jim can't hide the anger in his voice when he talks about Ruf. He doesn't understand why the doctor was allowed to cut his wife open so many times.
"Why aren't there checks?" he asks. "This guy had a history."
But no matter how it turns out, Cheryl Abels has already won her greatest victory: She's no longer under the care of Dr. Walter Ruf.
Writes Mark Ruf: "Dr. Ruf is retired and wants to spend his retirement without being harassed."