Collateral Damage: Inside the UNC/DUKE Syndicate of Harm
Syndicate File 002 A working man. A preventable injury. A chart rewritten to hide the harm.
Published May 2025 From The Event Horizon
This is the story of how two powerful institutions—Duke and UNC—coordinated a cover-up so complete it left one man permanently disabled, and nearly erased from care.
And how that same system is designed to do the same to you.
Imagine, if you will, a football match where the referees don’t merely favor the other side, they’re owned by them. A game so rigged, so structurally unsound, that Team Public never had a chance of scoring, let alone winning. Welcome to healthcare in North Carolina, where a double helix of power—Duke and UNC—has twisted around the throat of patient autonomy, choking out competition and suffocating justice.
The rules? Superficially, they exist, etched in governmental stone, laid down by bodies with acronyms like CMS and JCAHO. These rules are stringent, binding, and absolute. In theory, anyway. But what happens when adherence to these guidelines threatens the billions in federal funding, bond ratings, and the neatly woven web of institutional partnerships that stretch from Winston-Salem to Brentwood, Tennessee?
Suddenly, rules become mere suggestions, optional guidelines to be ignored, manipulated, or blatantly broken. Compliance? A convenient illusion, nothing more.
The Labyrinth
Picture a working-class man. Unremarkable to academic elites nestled in billion-dollar ivory towers, but extraordinary in the quiet dignity of his labor. A man who believes in showing up on time, every day, putting in an honest day's work, and trusting the professionals who swore an oath to “do no harm.”
Now, imagine this man suffers a life-threatening, temporarily debilitating medical event—one with every expectation of full recovery, to be systematically destroyed by the very people and institutions he trusted to guide him back to full health. Any reasonable person would expect immediate, humane, and competent care. But what if, at the moment he’s most vulnerable, someone with the power vested in a white coat decides he isn't worthy?
Not because he was misdiagnosed. No, nothing so accidental, but rather because he was deliberately, maliciously categorized as expendable. Disposable. A man whose rough hands bore the grease stains of labor rather than the refinement of privilege, thus deemed undeserving of proper care.
The heart attack he suffered wasn’t minor.
It was a Widowmaker.
Anyone familiar with the term knows exactly what it means. Say it aloud and people go still. Eyes go wide and people reflexively gasp. Women of a certain age instinctively clutch their chest. It’s the kind of cardiac event that doesn’t often leave second chances — and most people know it.
And yet, just five days after release from Cardiac ICU, seven days after the most lethal heart attack a person can survive, he was ordered back to work!
Yes, let me repeat that for those who couldn’t believe their eyes:
He was ordered back to work, with no restrictions, just seven days after a Widowmaker.
Not because he’d stabilized. Not because he’d recovered.
But because someone in a white coat had already decided he wasn’t worthy of the recovery timeline others are afforded, the one laid out by the American Heart Association, the American College of Cardiology, and CMS.¹
There was no rest. No imaging. And while cardiac rehab was technically ordered, the hospital never scheduled it. No referral. No handoff. Just a piece of paper and the unspoken message: Handle it yourself.
Handle it yourself, while your wife, the one expected to take care of you, is still in shock from nearly losing you when you coded in the cath lab.
What was the job he was expected to return to?
That man is a Ford-certified, Four-Star Senior Master Technician — a specialist in diesel engines and commercial trucks.
Even his employer refused to accept the return-to-work order.
They knew what it was.
They demanded a second opinion.
What he received wasn’t clearance.
It was punishment.
And that was only the beginning. What follows is far darker.
1. Clinical guidelines suggest that most patients can return to work within 2 to 3 months after a myocardial infarction, depending on individual recovery and job demands. A study published in PubMed indicates that the majority of patients resume work by three months post-discharge. PubMed, AHA, ACC
Before returning to work, especially in physically demanding roles, patients typically undergo evaluations such as an echocardiogram to assess heart function and an exercise tolerance test to determine safe activity levels. These assessments help tailor a safe and effective return-to-work plan.
Participation in a structured cardiac rehabilitation program is strongly recommended post-STEMI. Such programs include supervised exercise training, education on heart-healthy living, and psychosocial support. Engaging in cardiac rehabilitation has been shown to enhance recovery, reduce the risk of subsequent cardiac events, and support a successful return to work. www.heart.org
For comprehensive guidelines on the management of acute coronary syndromes, including recommendations for rehabilitation and return to daily activities, refer to the National Institute for Health and Care Excellence (NICE) guidelines. NICE
The Centers for Medicare & Medicaid Services (CMS) provide coverage for cardiac rehabilitation programs following a myocardial infarction. These programs typically involve 36 sessions over 12 to 18 weeks, with potential extension to 72 sessions over 36 weeks if medically necessary. Outpatient cardiac rehabilitation is generally initiated 1 to 3 weeks post-discharge. While CMS does not mandate a specific duration off work post-STEMI, the return-to-work timeline should be personalized based on individual recovery and job demands, as determined by the healthcare provider. Centers for Medicare & Medicaid Services
The Syndicate
You see, Duke and UNC do not exist alone. They've carefully woven together alliances—secondary, tertiary, spreading like veins across the state and beyond. Institutions such as Novant, WakeMed, and LifePoint have pledged fealty to this syndicate, bound by shared financial interests and a mutual unspoken, “professional courtesy” commitment never to expose each other’s mistakes.
The bait was alluring: interoperability of electronic health records, seamless patient portability, the promise of streamlined lower cost care. But what patients didn’t grasp, what none of us grasped, was how easily this information would be weaponized. A single, malicious mischaracterization, a negative flag in one hospital's chart, follows you forever, carried dutifully forward by partner institutions. Not just for the patient, but for caregivers as well. No matter where you turn, the damage is already done, encoded in the digital chains of your record.
We’ve already seen what happens when hospitals characterize caregivers as difficult or problematic. Take the case of Maya Kowalski, a pediatric patient at Johns Hopkins Children’s Hospital in Florida. Her mother, Beata Kowalski, a licensed nurse practitioner, became a threat the moment she advocated for care the staff didn’t understand. Diagnosed by an outside physician, Maya had a rare condition, but Beata’s insistence on proper treatment led to accusations of Munchausen’s by Proxy, an act of institutional character assassination. The result? Medical kidnapping, family separation, and Beata’s eventual suicide.
“What they did to Beata Kowalski wasn’t just malpractice, it was a system preserving itself. Netflix called it Take Care of Maya.”
Breaking Legs
And like Beata, what if you attempt to resist? To cry foul, to demand accountability? You'll find yourself navigating a maze designed to confuse, exhaust, and humiliate. Gaslighting becomes your constant companion, humiliation your daily bread. Care delayed, denied, obfuscated. Complaints rerouted, emails vanished. Risk Management becomes Risk Suppression. Legal departments, ostensibly there to protect patients and uphold ethical standards transform into apparatuses designed to silence, intimidate, and bury inconvenient truths.
It’s deliberate. It's strategic. And if you’re poor, minority, or perceived as lacking in influence or intelligence, it’s inevitable. They’ll crush you without hesitation, secure in the belief that no partner institution will ever risk billion-dollar alliances to correct another's wrong.
They’ll break your legs to carry their mistake across the goal line. And no referee will blow the whistle, because the referees have always belonged to them.
And they’ll do it while telling you it’s for your own good!
The Reckoning
But even the most intricately woven web can fray. Documents leak. Records exist. Patients, just ordinary people, those once viewed as disposable will inevitably find the courage to speak out. And when they do, suddenly the carefully constructed edifice begins to crumble.
It begins with whispers. Then murmurs. Then a cacophony too loud to bury beneath the chart.
That reckoning, dear readers, is upon us.
Stay tuned, for there is much more yet to come.
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