AMERICAN PAIN (14 page)

And that’s when Derik saw Dr. Gittens’s brother, working at the new clinic. No sign of Dr. Gittens herself, but her strange recent behavior suddenly made sense, the sudden interest in the inner workings of the clinic, her quitting without notice. She’d obviously decided to go into the business by herself, siphoning off the patient traffic from I-95.

Chris and Derik knew that if Gittens could piggyback on the success of South Florida Pain, nothing was stopping anybody from doing the same thing. The word was out, that there was money to be made in pain management. To stay on top, South Florida Pain needed to grow. It needed a bigger space, more doctors. More pain clinics were popping up every day, and Chris wanted to be the biggest and the best.

That was how Chris was. He’d wrestled back in high school, and he’d win lopsided matches, taking down a weaker opponent over and over. Afterward, his dad would ask why he didn’t just pin the guy, take the quicker victory? But Chris didn’t just want to win. He wanted to dominate the other guy, control him, mash his face into the mat. The more patients the clinic got, the more Chris wanted. He wanted every hillbilly streaming into Florida to know about South Florida Pain.

He began scouting new locations.

The local cops turned up the heat. The clinic sat just within the border of Wilton Manors, but the boulevard was patrolled by Oakland Park cops. They’d park their cruisers just to the east and west of the clinic and roll up on patients as they left the clinic. Patients said the cops would search the cars, question them, arrest them, take their pills. Other times, they’d cruise by the parking lot and scope out the patients’ tags, run them, and then come into the clinic to get them if their insurance or registration wasn’t up to date. Sometimes they’d tow cars right out of the lot.

Chris and Derik figured the
Sun-Sentinel
story had motivated the police to lean on them. Finally, Chris called the station to complain, and two officers came out to the clinic to talk to him and Derik, a regular patrol cop who had pulled over a lot of patients and a lieutenant. Chris and Derik told them they were trying to abide by the laws.

Chris said: Listen, just because they come here doesn’t mean they get pills. They don’t even necessarily get to see the doctor.

The lieutenant seemed to get it, and Chris thought maybe he’d order the junior officer to lay off. But the very next day the guy was still at it, pulling patients over as they left the clinic. Time for a confrontation, Chris thought. So he told a patient what was going on, and hopped in the patient’s car when he was leaving. Sure enough, the cop pulled them over, and Chris dialed his lawyer’s cell phone to report what was happening.

The patrol officer told him to get off the phone, and Chris refused. The cop got annoyed, popped Chris for resisting arrest, and took him to the gigantic concrete Broward County Jail in Fort Lauderdale. It took forever for him to get processed, so Dianna and Derik shared a bottle of tequila at a downtown bar. Derik got hammered and started a fight. They were kicked out of the bar and went to the jail to post bond. Derik caused a scene in the bond unit and almost got arrested right there in the jail. So Dianna drove him home to West Palm at midnight and then went back for Chris, who had to wait for an hour after he got out. Chris yelled at her for making him wait, and Derik felt bad when he heard about it since it was his fault for getting drunk. Chris pleaded no contest to resisting arrest without violence and was sentenced to one day of probation and a fine.

The arrest made up Chris’s mind. It was time to leave Oakland Park Boulevard. He’d been thinking about it for weeks, after everything that had happened that summer. The health department investigator, and the DEA woman who knew his name. The angry neighbors, and the newspaper story. Gittens splitting to open her own clinic, other competitors popping up all over the place. Now, local cops were turning up the heat.

The clinic needed a new home. South Florida Pain had the potential to be a juggernaut, but a juggernaut couldn’t operate out of a shithole bungalow with eight parking spaces.

It was also time to grow and mature. Time to hire more doctors and staff, create some rules, get serious. The clinic was inhaling $40,000 to $50,000 a day. And Chris believed that $250,000 a week was just scratching the surface. Like the railroad-and-oil tycoons of the nineteenth century, or the tech billionaires of the 1990s, Chris and Derik, of all the random people, had enjoyed perfect, exquisite, history-making timing. They’d stumbled into a Bizarro-world, a window of opportunity in which hard drugs were, for the moment, legal. Because if they weren’t legal, how were Chris and Derik able to conduct their business in broad daylight? They had a big sign with red letters saying P
AIN
C
LINIC.
They’d been in the
Sun-Sentinel
, a big color picture of the zombies standing in line. The DEA was receiving their 222 forms every week, tracking their incoming drug shipments. The Florida Department of Health had sent in its inspector to rifle through their patient files. And nobody had shut them down.

But Chris and Derik knew that someone would find a way to end their ride, if they didn’t grow up now. That meant doing something that did not come naturally to them: following the rules. It was time to hire a dog walker, stop bringing Moe in to the clinic. No more fun-and-games, no more letting patients take the neighborhood hostage. No more sloppy record-keeping, letting favored patients slide on their drug tests and MRIs.

And here was the beautiful part: By now, they could
afford
to be tough on the patients. They could kick anybody out, for the most minor infractions. Because for every one they kicked out, there were five waiting to jump in line.

They were going to make millions, many times over, and they had to protect the operation at any cost, even if that meant going straight.

Footnote

* The health department had not yet issued a report about its June 2008 inspection of South Florida Pain.

P
ART
II

4

Once he’d made up his mind to move, Chris George didn’t waste any time. A few days after his arrest, he leased an office suite for the clinic a couple miles west of I-95 on Cypress Creek Road. The new space was huge, about six times the size of the little bungalow on Oakland Park Boulevard. It was in an office complex called the Cypress Creek Executive Court, which backed up to a row of airplane hangars next to the two-strip Fort Lauderdale Executive Airport. The quiet office park was nothing like the haphazard strip of businesses on busy Oakland Park Boulevard. It included travel agencies, insurance offices, and small law firms, and featured pleasant concrete walks, well-tended palms, wooden benches, and most importantly, lots of parking: about two hundred spaces.

After work on Friday, Chris and Derik Nolan went to Home Depot and ordered materials for a quick build-out. The supplies were delivered to the new office on Saturday, and that day they roughed out a ten-foot interior wall with a doorway and a window, to separate the waiting room from the examination rooms and filing areas. It was a makeshift job, with stapled-on particleboard walls propped up by two-by-fours. It didn’t even reach the ceiling because a real wall would have required them to pull building permits. It looked like a temporary triage clinic in a war zone or something. But it would do. They were only planning to be there for a few months. Some other tenants were scheduled to move out soon, freeing up a nicer space.

Sunday, they rented a U-Haul truck and moved everything from one building to the other—the waiting-room chairs, the examination tables that no patient ever lay on, the gun safes where they kept the drugs. Derik had done an inventory of the drugs a couple weeks earlier. He hadn’t wanted to hand-count each of the thousands of pills, so he’d come up with what he thought was a common-sense solution. He counted out and weighed some pills and then weighed them all and did the math. He wasn’t sure what kind of regulations existed regarding the transport and inventory of controlled substances, but he just wanted to make sure no one was boosting pills. The count came out fairly accurate, give or take.

Monday morning, South Florida Pain Clinic opened in its new location. Chris stationed Dianna at the Oakland Park Boulevard building, where she answered the phone and told callers how to find the new location. When patients showed up in person, she gave them flyers with directions to the new clinic.

At the Cypress Creek location, things were slow for about an hour, and then the patients with Dianna’s directions started pulling into the lot.

New location, new rules. From now on, Chris said, every patient had to have a valid MRI report that was less than two years old, and every patient had to take a drug test before seeing a doctor. No exceptions.

The MRI rule created a small problem. MRIs required a prescription, and having the doctors see patients twice would slow things down. So the doctors gave Derik a pad of blank prescriptions they’d already signed, and Derik would just fill it in, charging $50 per MRI prescription. He’d ask each patient where it hurt. If they said lower back, he’d write, “MRI of lumbar.” If they said it was the neck, he’d write that. They’d go get the MRI done and come back for their doctor’s appointment. Derik wasn’t sure how an MRI machine worked or even what the letters “MRI” stood for. But writing prescriptions was simple, he found, not like something you needed to go to med school for anyway.

Under Chris’s new rules, patients had to take a drug test every three months. Derik gave those patients a small clear plastic cup with a blue lid and a panel on the side. The patient took the cup to the restroom and came out with a full cup. Most of the time, no one actually watched the patients pee. Derik collected the cups, and when there was a trayful, he’d snap on rubber gloves and peel back the stickers on the panel to see which drugs were present in the patient’s system. New patients were supposed to have clean urine, unless they said they had been prescribed something already. Return patients were supposed to be positive for oxycodone, but not illegal drugs like ecstasy or cocaine or marijuana.

Patients also were required to fill out numerous pages of paperwork before seeing a doctor, forms and policies Chris and Derik had collected, starting with the documents they’d taken from the other clinic before South Florida Pain opened. There was a pain management agreement, in which patients vowed not to abuse the medication. The one-page agreement instructed the patients to tell their physicians the truth about the intensity of their pain. To not share, sell, or trade pills. To safeguard it from thieves. To not use illegal drugs. To not go to other pain management doctors and South Florida Pain at the same time. Patients who broke the rules would be discharged and no longer welcome at the clinic. One key passage read:

I understand payment of the office visit DOES NOT GUARANTEE MEDICATION. Prescriptions are only written if the Doctor deems it necessary. We reserve the right to deny medication to those we feel are drug seekers or abusers. NO REFUNDS WILL BE GIVEN.