The care of Raymond LaVallee-Davidson offered a few clues. In the summer of 2001, Arndt operated on his back at New England Baptist Hospital. LaVallee-Davidson says Arndt told him the surgery would take about eight hours. It took eighteen, and even after that, Arndt told him he had been unable to finish the job. Because

LaVallee-Davidson suffered serious complications, it wasn't until December that follow-up surgery was scheduled at Mount Auburn. Just after six o'clock on the morning of surgery, he was being prepped by hospital staff and about to be anesthetized. "I had asked them to hold off, because I had a few questions I wanted to ask Dr. Arndt before I went under," the forty-four-year-old recalls. Four and a half hours later, hospital staff told him they had been unable to locate Arndt, and so LaVallee-Davidson got dressed and made the four-hour drive back to his home in Skowhegan, Maine. Four days later, he says, he got a call from Arndt saying he had overslept. LaVallee-Davidson, who says that initially he found Arndt to be "probably one of the most compassionate people I have ever met," is now among Arndt's former patients suing him for malpractice.

Early on the morning of July 10, 2002, Charles Algeri, a former Waltham cabdriver with a history of back problems, arrived at Mount Auburn Hospital and was prepped for fusion surgery on his lumbar spine. Algeri says Arndt arrived late and unshaven, with dark circles under his eyes. "He said his car had been towed because he had parked in a bus stop," Algeri says.

Like most of the cases Arndt took on, the surgery for Algeri would be a complex, all-day affair. According to state investigative reports and interviews with some of the people involved, this is what happened: The first incision was made around 11:00 a.m. In the OR during the afternoon, Arndt twice asked the circulating nurse to call his office and ask if "Bob" had arrived. By the second call, the receptionist informed the nurse that "Bob" was Arndt's code name for his paycheck and told her to tell Arndt the check would be delivered to him there.

Just before 6:00 p.m., Leo Troy, one of Arndt's fellow orthopedic surgeons from their private practice, was passing by the front desk near the operating room when a secretary asked him if he could take the check to Arndt in the OR. Troy had a few minutes before he was scheduled to operate on another patient, so he had planned to look in on Arndt anyway. He went into the OR, handed Arndt the check, and then observed the surgery for a couple of minutes. Then, Arndt asked him if he would watch his patient for "about five minutes." At the time, Arndt was about seven hours into the surgery. Algeri was under anesthesia and had an open incision in his back. It's not unusual for surgeons doing long procedures like this one to step out to use the bathroom. Although he is not a spine surgeon, Troy says he had assisted Arndt before and was "qualified to close up the patient in an emergency." Arndt then turned to a salesman from a medical device supplier-sales reps often sit in on complex surgeries in case there are questions about the equipment-and said, "Let's go."

A few minutes later, a nurse walked into the OR and asked where Arndt was. Told he had stepped out for a few minutes, she said, "I bet he went to the bank." She had apparently overheard Arndt talking about it earlier. Troy and the rest of the OR staff were incredulous. They tried paging Arndt. Hospital administrators were notified. The decision was made to wait for Arndt to return and, if he didn't come in a timely manner, to try to find a spine surgeon from another hospital. Troy, who calls Arndt an excellent surgeon, says he never had any doubt that he would return.

And he did. Thirty-five minutes later. He admitted he had gone to the bank, and the OR staff said he seemed surprised that they would be upset with him. He finished the surgery about two hours later. Mount Auburn suspended Arndt's privileges the next day, and after an internal review process, the suspension was reported to the state medical licensing board.

"This has got to be a joke," Nancy Achin Audesse said after the report hit her desk.

It was July 25, 2002. Audesse is the executive director of the Massachusetts Board of Registration in Medicine. By the summer of 2002, she was more than familiar with the name David Arndt. The board's year-plus investigation into Arndt's conviction on the passport violation was wrapping up. (He would get a formal reprimand.) He told the board he had no choice but to lie-if he didn't, he said, his partner would have been deported to Venezuela, where he said wealthy homosexuals are persecuted and killed. "He was always presenting himself as the victim," Audesse says.

Still, the reason for his suspension from Mount Auburn was so outlandish that she was convinced someone was putting her on. He left his patient in the middle of surgery to go cash a check at the bank?

After doing a round of interviews-Arndt told an investigator he had some "overdue bills" and needed to get to the bank before it closed at 7:00 p.m.-the medical board voted on August 7 to suspend his license. Audesse issued a press release.

At 7:00 a.m. the following day, she was sitting in her dentist's chair, getting extensive work done. At 9:00 a.m., she called her assistant, who was panicked. "You have to get in here now," she told Audesse. "This place is crawling with TV news crews!"

"This story went national so fast," Audesse recalls. "I did sixteen straight interviews, numb and drooling."

In the public, the jokes spread-A Harvard doctor, and he never heard of direct deposit? And then the conjecture-Overdue bills? Who insists on cash these days besides drug dealers and bookies?

As for Arndt's patient, Algeri had no idea what had happened until he got a call from Mount Auburn officials the day before the news was going to break. Told that Arndt had left him during surgery to go to Harvard Square, Algeri, a six-foot-five, 315-pound guy who sports a Boston Bruins baseball cap, a goatee, and a ready laugh, replied, "What, for a cappuccino?" He watched the media circle around Arndt for a week before coming forward with his lawyer, Marc Breakstone, who later filed a malpractice suit.

For a doctor who had always craved attention, David Arndt suddenly had more than even he had ever wanted. The news, when it found its way to his med school friends scattered across the country, took the wind right out of them. They had a feeling Arndt would cause a stir wherever he went, maybe put his career in jeopardy by telling off a hospital chief. But this?

Nearly two years later, Alexandra Page still keeps a newspaper clipping about the interrupted surgery on the desk in her office outside San Diego. It's yellowed now, but when she refers to it during an interview, it produces fresh tears. "We all make mistakes," she says, "but this was so heinous, so volitional. I'm just aching for him, for whatever must have happened in his life that caused him to do this."

During his interview, Sigurd Berven breaks down at the same point. Same with another friend of Arndt's from med school, Saiya Remmler, who is now a psychiatrist in Lexington. "What could be more important? You know, the guy's on the table," Remmler says. "To this day, I don't know how anyone could do that, let alone one of my classmates."

But then how to explain Remmler's reaction when she first read about the incident, how she put down the newspaper, turned to her husband, and said, "It doesn't surprise me." Remmler says that Arndt was funny, charming, and really smart. "I felt lucky to have him as a classmate." But, she adds, "he was also really narcissistic, and I guess I knew there was this compulsive streak about him- addictive almost. And so deciding his needs are more important than his patient's life-that sounds narcissistic to me."