AMERICAN PAIN (46 page)

Adams said: You all just hang out here in the car. I’m going to talk to Ms. Mason, see if she’ll agree to talk to you.

He got out. The agents sat in the cruiser, feeling conspicuous, studying the fields, the barn, the tethered roosters. Presently, Adams returned to the cruiser and said Alice Mason had agreed to speak to them. They got out and smiled at the little woman. She was short and round and covered with dirt.

Adams said: Now, Alice, this here is Mike, who is with the DEA, and this is Jennifer, who is with the FBI. They’re here to talk with you about Stacy.

Alice invited the agents to come inside the house. Inside the simple house, Alice told the agents how she’d found her son behind the barn, how she’d gone to Florida to speak to the doctor. She cried during the story, and clasped Turner’s hand. Turner cried too. Alice took them to the barn, to show them where they’d found his body. She gave them the pill bottles she’d found in Stacy’s jacket pocket that day, and said she felt a great relief. Turner said the pill bottles would be great evidence in the case against Dr. Cadet.

Alice said: I knew God would send you.

Turner knew the little country woman would make a compelling and sympathetic witness, even if a South Florida jury couldn’t make out everything she said. Turner asked Alice if she’d be willing to come to Florida one more time. If Dr. Cadet went to trial, would Alice come and testify about Stacy’s death? Alice said she would.

Chris George pleaded guilty and received a seventeen-and-a-half-year sentence.

Derik did the same and got fourteen years.

The sentence lengths were based upon the number of pills each defendant was deemed responsible for. Because it was a conspiracy case, the ringleaders were considered responsible for all or most of the drugs distributed by the entire network. Thus, Jeff George got fifteen and a half years, and Ethan Baumhoff got eleven years, because he entered the conspiracy later.

The doctors were held responsible only for their own prescriptions. Dr. Beau Boshers got six and a half years. Dr. Roni Dreszer and Dr. Michael Aruta got six. Two of the elderly doctors died before they could be sentenced, one who had worked at Executive Pain and Dr. Jacobo Dreszer.

Chris George told the judge he’d pressured his wife and mother into working at the clinics, but Dianna Pavnick George and Denice Haggerty still received two and a half years each.

Steven Goodman, the drug wholesaler, received two and a half years of home confinement because he weighed 524 pounds and would have been a tremendous burden for any prison to care for. A doctor testified at his sentencing hearing that Goodman was not expected to live much longer anyway.

The defendants were given a few weeks to get their affairs in order before reporting to different federal prisons between April and June of 2012. They all held out hope that they would get their sentences reduced. They’d been given no promises, but they knew if they cooperated at Cadet’s trial, Schwartz would likely ask the judge to slash their time.

One defendant who’d initially cooperated with the feds—Dr. Joseph Castronuovo—had second thoughts and refused to sign a plea bargain. Dr. Castronuovo, seventy-two, had worked at Executive Pain for about a year. Before working at the pain clinic, he’d been a prominent specialist in internal and nuclear medicine at several hospitals around New York. When Castronuovo stopped cooperating, the federal team began looking into overdose deaths they could tie to him, as they were doing with Cadet.

In July 2012, a second indictment charged Cadet and Castronuovo with distributing narcotics “outside the scope of professional practice and not for a legitimate medical purpose” that resulted in the death of patients. Seven death charges for Cadet, two for Castronuovo.

Over the next eleven months, the doctors’ defense teams pored over 1.2 million documents tied to the case; the documents filled four rooms and the government spent a quarter million dollars on photocopy costs alone. The defendants also exchanged pre-trial blows with the prosecution, claiming the death charges should be thrown out. Schwartz’s team had acted vindictively, they said, punishing the two doctors for not accepting plea deals. The judge disagreed.

Both doctors wanted to be tried separately. They’d worked at different clinics and barely knew each other. Dr. Cadet didn’t want a jury to associate her with Dr. Castronuovo, who had allegedly told the feds: “This place was illegal, my motivation was financial, and I needed the money.” For his part, Dr. Castronuovo didn’t want to be tied to a co-defendant who was facing seven death charges. The judge said one trial would suffice.

Dr. Cadet’s attorneys outlined her defense in a ninety-page motion. They asked the judge to dismiss the death charges and argued that Cadet had, in fact, complied with Florida’s standards for pain treatment. She’d discharged patients who showed signs of illicit drug use or didn’t have valid MRIs. If patients lied to her, they were in violation of the Pain Management Agreement they had signed. She said it wasn’t illegal to treat out-of-state patients, even if the DEA considered that a red flag for pill mills. She cited e-mails from patients thanking her for getting them back on their feet. She argued that Chris George and Derik Nolan had created a system of paperwork and policies designed to bamboozle the Florida Department of Health, and it was so successful that it had also fooled her. Despite years of work, months of wiretaps, and numerous undercover operations, the government had no concrete evidence that showed she had knowingly engaged in a conspiracy to deal drugs.

The prosecutors said they didn’t have to prove that Cadet and Chris George had had a formal agreement to unlawfully prescribe pills together. Circumstantial evidence was enough. The trial brief referred to a 2006 ruling by the US Court of Appeals for the Fourth Circuit that upheld the drug convictions of Ronald McIver, a pain doctor in North Carolina. In that case, the appeals court said federal prosecutors had to prove only that McIver “actually knew of the conspiracy or that he was willfully blind to it by purposely closing his eyes to avoid knowing what was taking place around him.”

Flanked by federal marshals, Derik Nolan entered the courtroom and headed for the witness box. It was hard to swagger wearing leg irons, but he managed.

Seated in the box, he leaned back, cocked his head to the side. He tried to be cool, but inside, his heart was thumping hard. He didn’t look at Cynthia Cadet, but she was over there to his right, sitting at the defense table, as girlish as ever, a quiet little librarian type, defenseless. He couldn’t believe what he was about to do to her, but he had no choice. He’d been behind bars for thirteen months. No way he’d make it thirteen more years. He believed the prosecutors would ask the judge to slash his sentence by a third or even by half, if they approved of his cooperation. He was thirty-five years old. If he could get out by his early forties, he figured he still had a chance to live a semi-normal life, maybe even have a family.

He wore a blue short-sleeved jail-issue shirt that showed off his tattooed arms. He didn’t feel remorseful, and he didn’t put on a display of it either. The prosecutors wanted Derik to be himself in front of the jury, in all his outlaw glory. During a prep session with the prosecutors, he’d called himself “a wolf in wolf’s clothing,” and Paul Schwartz had loved it, his eyes rolling to the ceiling in jubilation.

Schwartz had said:
Exactly
like that. Say it exactly like that.

So now, as Schwartz asked him questions, Derik let loose and told the whole grand tale as it deserved to be told, head bobbing and shaking, gesturing with his manacled hands. He explained how he’d gotten to know Chris and Jeff building houses in North Port, how Chris had met Dr. Overstreet, how Derik helped build out the clinic and gradually took on more duties. How they’d played it fast and loose the first six months on Oakland Park Boulevard, then gradually, as the lines outside the clinic grew longer and longer each morning, reined it in. How they’d grown the staff, tried to curb the junkie stunts, hired the hot girls and muscle guys, lost doctors then hired more from Craigslist, including Cadet. His stories rambled on and on, until the defense lawyers were objecting and the court reporter was asking him to
please
slow it down.

Day Two, he was happy to see his sister sitting among the agents and defendants’ relatives in the rear of the courtroom. He’d asked her to come. A year earlier, his sister had driven him to Louisiana so he could turn himself in at FCI Oakdale. Derik hadn’t been willing to face his last hours of freedom sober, so he’d asked a cab driver where he could get some coke. He’d still been high when he reported to prison.

Now, in the witness box, Derik worked in Schwartz’s favorite line when the prosecutor asked him whether everybody—meaning Cadet—had seen him discharging patients, sometimes through threats or manhandling.

“Was it out in the open?” Schwartz asked.

“Yeah, man,” Derik said. “I mean, look at me. I’m not a wolf in sheep’s clothing. I’m a wolf in wolf’s clothing. I mean, I don’t hide nothing from nobody.”

Derik’s sister chuckled, along with a couple of jurors, when Derik told the story about the guy who’d had the MRI that showed a tear in his uterus. Derik really loosened up after that. His voice took on a
no-shit-Sherlock
tone, as if he couldn’t understand why Schwartz was asking him all of these questions that he already knew the answers to. He said one of the hot girls was “a whore.” Derik’s sister winced when he said they’d hired another woman because she had a “nice ass.” Schwartz put a picture of the big Dixie Highway building on a screen, and Derik gestured at it proudly, saying, “Look at that building. That’s awesome. I mean, that was going to be our headquarters.” When they played the wiretaps, Derik in the recording bragging that he was the “fucking underboss” of the organization, Derik in the witness box couldn’t help but smile, embarrassed at how full of shit he sounded. He covered his face with his hand, looked at his sister, then away.

His smile faded when Schwartz played a recording in which Derik told Chris that Ethan would be the first to flip. “When the shit goes down, God forbid something happens, where we all get arrested, you know, and the cops come in just to question us or something like that, that little faggot is going to squeal like a fucking pig with a knife in its neck. He’s gonna squeal. He knows too much.” It wasn’t easy to sit in a witness box and listen to himself call someone else a rat.

Schwartz began tying the whole crazy scene to Cadet. Was the doctor in a position to witness the chaos in the waiting room, the patients having seizures, the garbage cans brimming with cash, rival clinic employees handing out cards? Derik answered: Yes.

On cross-examination, Cadet’s lawyer focused on the fact that Cadet hadn’t started working at American Pain until
after
Chris and Derik had strengthened the clinic’s policies and paperwork. Derik agreed that during Cadet’s time, patients were regularly discharged for failing drug tests, for being pregnant, for out-of-date MRIs. Derik agreed, the big building on Dixie Highway looked like a legitimate business. After Ethan’s dress-policy changes, Derik agreed that even he eventually began wearing conservative office attire, slacks and dress shirts.

The lawyer asked if Derik believed Cadet had been fooled by the clinic’s legitimate exterior, but Schwartz objected, since Derik had no way of knowing what Cadet truly believed. The judge sustained it.

But then, Cadet’s lawyer asked Derik about the time he called Cadet, right before he’d flipped. Had Derik assured Cadet that he would tell the prosecutors that she hadn’t known what was going on at American Pain?

Derik didn’t know what to say. He was exhausted. It was after 4:00 p.m.; he’d been answering questions since 9:00 a.m. Schwartz’s eyes bored in on him from the prosecutor’s table. He felt lost. He rambled, trying to explain how he’d felt when he’d flipped.

“Listen, I was one of the last ones—pretty much the last one to go in there,” he said. “I don’t want
anybody
, even the people I don’t like in this case, in jail. I’ll do whatever. It is what it is. I don’t remember my exact conversation with the government, you know. I said I like Dr. Cadet. She’s an awesome person. She’s my friend. I don’t want to see anybody hurt, but I wanted Dr. Cadet to take a plea bargain. Everything would be easy, be done with, you know. I feel horrible.”