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The only side of the story that the town has heard is that these are sisters of mercy, missionaries of peace,” said Mr. Tidwell, who is trying the case because the district attorney is in poor health. “The town has not heard the whole story.”

Dr. Arafiles, 47, who attended medical school in his native Philippines and trained in Baltimore and Buffalo, said his lawyer had advised him not to talk. “I’ve been brutalized and abused,” he said. “I’m the victim in this case, and that is all I can say.”

Several Texas laws would seem to enshrine a nurse’s right, and perhaps duty, to report a physician when he or she believes that patients are at risk. Lawyers on both sides agree that the case will hinge on whether a jury believes that Mrs. Mitchell reported in good faith. In civil whistle-blower cases, the Supreme Court of Texas has held that good faith requires only a reasonable belief that the conduct being reported is illegal.

The hospital administrator, Stan Wiley, said in an interview that Dr. Arafiles had been reprimanded on several occasions for improprieties in writing prescriptions and performing surgery and had agreed to make changes. Mr. Wiley, who said it was difficult to recruit physicians to remote West Texas, said he knew when he hired Dr. Arafiles that he had a restriction on his license stemming from his supervision of a weight-loss clinic.

In a surprise inspection last September, state investigators found several violations by Dr. Arafiles and concluded that the hospital had discriminated against the nurses by firing them for “reporting in good faith.”

But Sheriff Roberts, who has held the post for 18 years, said the state would show that the complaint had been filed in vengeance. “If it’s made to destroy somebody’s reputation or forcing them to leave town,” he said, “then I don’t believe it is good faith.”

Sheriff Roberts called Dr. Arafiles “the most sincerely caring person I have ever met.”

Mr. Wiley said he believed that the nurses had acted in bad faith because they went to the state despite his internal efforts to discipline Dr. Arafiles. But, he said, “I don’t believe they did it on a personal vendetta.”

Mrs. Mitchell said all she saw at the hospital was delay.

“The medical staff needed to make a decision on him,” she said. “You don’t get a second chance to save somebody’s life.”