AMERICAN PAIN (42 page)

Derik also needed money. He was kicking himself for blowing everything. When the clinic owner who bought American Pain’s phone number offered him a job doing the same thing he’d done at American Pain, he took it.

He lasted one day. The clinic was depressing. The doctors were low writers, wouldn’t prescribe more than 180 oxy 30s a month. They didn’t know how to play the game, and everybody was spooked after the American Pain raids.

The feds had not raided Pain Express, the clinic Chris and Jeff had launched a month earlier in Georgia. Nevertheless, it shut down shortly after the raids. The doctor just quit, no doubt alarmed by what had happened in South Florida.

A few weeks after the raid, Derik pulled together a little money and financed another pain clinic in Vero Beach with Dr. Cadet’s boyfriend, a doctor who’d worked for a few weeks at American Pain. But Derik couldn’t spend much time there because he didn’t want to tip off the feds that he’d started another operation. Within two weeks, the doctor quit, saying there weren’t enough patients to make it worth the risk. The place just folded, and Derik lost his stake. Derik believed if he could have been present, he could have kept it going. But with a federal investigation hanging over his head, no one respected or feared him any longer. And after the Vero Beach clinic closed, no one wanted to work with him.

Derik waited to get arrested, growing depressed and anxious. He popped more and more Xanax. He barely ventured outside the big house in Black Diamond Estates.

The search warrants changed everything for the American Pain task force too. Information, once so scarce, now threatened to inundate. The raids gave Jennifer Turner and her colleagues a massive document trove to explore, including more than twenty-seven thousand patient files from American Pain alone. They had video from the clinic’s surveillance system and photos the agents had taken of all the clinics and homes they’d raided. And then there was everything stored on the hard drives of the computers they’d confiscated. Chris George’s money was stashed in nine different bank accounts, but the largest haul had been in several safes in the attic of his mother’s house on Primrose Lane, where the search team had found $4,553,400 in cash.

Working ten hours a day for two months, a team of agents and lawyers began combing through the patient files, trying to quantify the scope of the George operation. They reviewed ten thousand files by hand, and found they were all essentially the same. Between July 2008
^*
and the raid, the doctors of South Florida Pain and American Pain wrote 66,871 prescriptions for various medications. Ninety-six percent of the prescriptions were for oxycodone or alprazolam. More than 80 percent of the patients were from out of state.
^*
The five American Pain doctors under investigation wrote prescriptions for fourteen million oxycodone pills. Executive Pain’s six doctors wrote for almost four million oxycodone pills. Boshers was the biggest writer, personally responsible for prescribing 3,601,860 oxycodone 30-milligram pills. Altogether, doctors targeted at both clinics had prescribed enough oxycodone to have given every man, woman, and child in Florida a pill.

Then there was the wiretap. The task force had intercepted approximately four thousand of Chris George’s cell phone calls between November 2009 and March 2010, plus twice as many text messages. The wiretap recordings had to be mined for exchanges that could be used as evidence that Chris George was in charge of American Pain and understood the clinic’s impact. That meant listening to dozens and dozens of phone calls during which Chris George mumbled interminably with a buddy about something stupid. But here and there among the idle chatter, a nugget of conversation illuminated the operation and mind-sets at work, something they could use to show a connection between parties or to establish culpability.

In January 2010, for instance, two months before the raids, Chris George and Ethan Baumhoff had a series of discussions about a questionnaire sent to them by the Harvard Drug Group. The Michigan drug wholesaler—no connection to the university—was one of American Pain’s oxycodone suppliers. Baumhoff had lied on the forms about how many patients they saw and what percentage were from out of state. Then he’d asked the doctors to sign the forms.

GEORGE: Was it hard for the doctors to sign those, or did they just sign them right away?

BAUMHOFF: Oh they signed them right away.

GEORGE: Signed them right away. Well, what did you tell them they were?

BAUMHOFF: I told them it was a questionnaire for a wholesaler.

GEORGE: Wholesaler. Did they even read over it?

BAUMHOFF: No. Aruta looked at it and he goes ‘this, is this number really accurate?’ and I said mmm, probably not.

On January 3, Chris George and a friend discussed a time-share operation that Jeff was running.

FRIEND: But that scam’s gonna end. I mean, people are onto that one, that makes the news almost as much as pain clinics.

GEORGE: (unintelligible) it’s not killing anybody, though. That’s the difference.

The agents also took note of this text-message exchange between Chris George and Dianna Pavnick two months before the raids.

PAVNICK: I’m scared to go away for a long time, but I keep going for you.

GEORGE: Going where?

PAVNICK: Prison.

For a time after the search warrants were executed, the wiretap on Chris George’s phone was still operational, though George was suddenly more guarded on the phone. Three weeks afterward, Dr. Cadet sent George a text.

CADET: Hang in there Chris. Let’s hope this will all be resolved in time.

GEORGE: Well, it will take time for sure probably while I’m in jail and hopefully no one else with me.

An assistant US attorney named Paul Schwartz was assigned to lead the case. Schwartz was in his mid-fifties and had spent much of his career prosecuting South Florida branches of the Colombo, Lucchese, and Gambino families, leaning hard on alleged
caporegimes
with nicknames like “Fat Tommy” and “Carmine The Snake” and “Ronnie One Arm.” He’d used RICO laws to go after a Bloods-affiliated street gang in Mira-mar. During a Gambino prosecution in 2004, it was alleged that mobsters were planning to murder Schwartz, and that wasn’t his first death threat.

Schwartz was hard and foul-mouthed in meetings with defendants but quick to call defense attorneys and apologize afterward. In court, he fired his cross-examination questions in semiautomatic staccato bursts. His Bronx patter was so profuse that even veteran court reporters had to ask him to slow down. A fanatical exerciser, his twice-a-day workouts were legendary in courthouse circles. During trials, he woke at 4:30 a.m. and strapped on a forty-pound weight vest to run one hundred flights of stairs at the courthouse. He said it relieved the stress of his job. He was fit but lacked athletic grace—his movements, like his speech, were herky-jerky, stiff. His diet was as rigid as his workouts: oatmeal and fish and no french fries. He was of average size, but you could see the chest and shoulders under his dress shirts, and his face was lean and creased and hard. He approached his job with a fierce joy, whether he was interrogating wiseguys or studying textbooks. He was always learning something new, and that kept him interested. He was very glad the US Attorney’s Office had no mandatory retirement age.

Jennifer Turner believed Schwartz was a perfect fit for this case. Not just because he was a warrior, but because he was willing to stray from his niche. Many prosecutors stuck to cases that fit into their realm of experience. But this case was the first of its kind, in many ways. It called for a prosecutor who was not only willing to learn a new field but one who could think creatively about how to apply old laws to a new kind of crime.

Most of the people who’d worked at the George brothers’ clinics had hired lawyers, tying up many of the most prominent criminal attorneys up and down the Gold Coast. Most of the high-level targets weren’t talking to the federal agents, including Derik Nolan and Chris George. However, the agents had nabbed early interviews with two doctors. Dr. Michael Aruta had met agents from the FBI and IRS at a restaurant the morning of the raid. Dr. Beau Boshers talked to agents two days later. They both said they weren’t aware of illegal activities at the clinic, that they ejected patients they suspected of abusing drugs. Boshers said, yes, Appalachian patients came to the clinic in carloads, but they were just carpooling to save on costs.

The doctors seemed to believe they’d broken no laws. How could they have broken the law by simply prescribing legal medication? That was their job, after all.

Schwartz wasn’t accustomed to having to persuade targets that their actions were criminal. Wiseguys knew they were violating the law. For them, lawbreaking was a way of life. They had to be persuaded only that the prosecutors had enough evidence to find them guilty at trial.

These pill mill people, especially the doctors, were another story. The whole idea that they could have broken the law seemed unacceptable to them. Schwartz knew that before he could educate them about their culpability, he needed to educate himself. He needed to know more about pain medicine than the doctors did.

He embarked on a self-guided medical education. He read everything he could find: med-school textbooks, academic journal articles, magazine stories. He flew to New York City to grill leading pain management experts. He learned about pain diagnosing and opioid weaning. Schwartz’s colleagues joked that his mother would finally be proud of him, now that he was a doctor.

Schwartz wasn’t ready to make arrests yet, but the DEA believed it did have enough evidence to revoke the American Pain doctors’ certificates of registration, which allowed them to prescribe controlled substances. All five doctors requested hearings, and the cases were adjudicated in Miami at the same three-day hearing in July 2010.

At the hearing, DEA special agent Mike Burt testified about the deaths of two patients, based on reports he’d received from Barry Adams, the Rockcastle County deputy sheriff. One was Stacy Mason. The other was a forty-five-year-old man, also from Rockcastle, named Timothy York. Early in January 2010, York had seen Dr. Boshers at American Pain. On the way home, he began to overdose in a car somewhere on I-75 in Tennessee. Panicked, the two women in the front seat tried to find a medical center on their GPS device. The device instead routed them to the Williamsburg Police Department, where police found York in the back seat, dead.