His hair is longer than it was in his former life, the life he left behind like a snake shedding its skin. A yellow bandanna wraps around his forehead, and reflective dark glasses cover his eyes, giving him the look of a ski bum trying too hard to hide middle age. Married and divorced three times, he has found serenity in his latest relationship, with an Italian woman named Monica, who runs a small grocery store. It is she who has taken the picture of him after a day in the mountains of northwestern Italy, just outside the storybook ski resort of Courmayeur.

There is a thin smile across Mark Weinberger’s face on this sunny day in 2009. The smile suggests contentment—a contentment distant from the driven, fanatical years he spent marketing himself as “TheNoseDoctor” in a small midwestern town, his local celebrity buoyed by a first-rate pedigree that includes the University of Pennsylvania, U.C.L.A. medical school, and a prestigious fellowship. There is something wry about that little smile in the mountains, something smug and self-congratulatory. Or maybe it is just that he looks so relaxed, at ease, not a care in the world.

He has done it.

He has left behind a trail unlike that of any previous doctor in the U.S., one in which he saddled a wife with more than $6 million in debts and pushed his own father into deep financial trouble; left behind mountains of public documents claiming that in the name of sheer greed he performed hundreds of sinus-related surgeries that not only were completely unnecessary but also made some patients’ conditions worse; left behind accusations that he scared patients into having surgery by showing them hideous but phony images of their supposed conditions; left behind alleged misdiagnoses in which he failed to detect throat cancer in a woman who subsequently died, and missed the tumor on the pituitary gland of an eight-year-old girl while giving her sinus surgery she never should have had, because her sinuses were not yet fully formed; left behind a criminal indictment in federal court on 22 counts of health-care fraud; left behind more than 350 malpractice suits that have been filed against him; left behind a court deposition in which an eminent medical expert called him a disgrace to his profession and the worst doctor he’d ever encountered.

People can say all they want about him: that hundreds of patients in northwestern Indiana are walking around with worthless holes in their sinuses which he put there using an outdated surgical procedure, and that he has billed insurance companies for a myriad of operations that one medical expert says he could only have performed with “twelve hands” in the 25 minutes his notes indicate the surgeries took. “He mutilated people for money” is the way trial lawyer Barry Rooth will ultimately describe his practice in a court proceeding. But this is like talking about a dead man. Because as Christmas nears in 2009, nobody in the United States has a clue as to where he is.

Stories about doctors causing harm by performing surgeries incorrectly, or trying to game the system by over-billing insurance companies, are hardly new. But none come close to the depredations of Mark Weinberger as pieced together through dozens of interviews and an examination of thousands of pages of court records. His is a saga so disturbing, cruel, and bizarre as to be almost surreal. Weinberger himself told his wife at a time when he was still practicing but under increasing scrutiny that he was the victim of a grand conspiracy brought on by other professionals envious of his phenomenal success; they in turn had friends who were trial lawyers, and so the long knives came out. When the first wave of legal actions were taken against him, in the summer of 2004, he painstakingly plotted to combat them.