AMERICAN PAIN (6 page)

When it was time to split the week’s cash that night, Overstreet insisted that Derik leave the room. Derik left, irritated, and when Over-street came out, he was carrying a large stack of cash, thousands, which he pretended to conceal, but Derik could tell Overstreet wanted him to see the money. Overstreet said he was going on a trip and needed the cash. Fishing or something.

Overstreet split the money he and Chris had made in the third week of business at South Florida Pain—his half of the profits was $24,000—and flew to the Republic of Panama. He was taking a weeklong vacation, going fishing.

Overstreet had planned the trip in advance, and a doctor named Rachael Gittens had agreed to cover for him during his absence. Gittens had worked with Overstreet briefly at One Stop Medical. She was planning to work for Jeff’s clinic in West Palm Beach, if he ever got it up and running.

Chris couldn’t get ahold of Overstreet all week. Yes, the doctor was on vacation, but he
never
called in. No one knew where he was. Chris wondered if he had been scared off, thinking he was under investigation or something. Or maybe he just wanted to leave everything behind. Who knew?

The mystery was solved when Overstreet’s wife called Jeff. She had some bad news: The doctor was not just missing. He was dead.

During his vacation in Panama, he’d somehow flipped his Jeep into a ditch. It had taken the local authorities some time to figure out who he was and get in touch with his wife. It seemed like she hadn’t even known where he had gone until the consulate called saying he was dead.

So Overstreet was gone for good. A strange feeling. And bad timing. The clinic had been open only three and a half weeks, and Chris had lost his only doctor. But Chris had no intention of closing—not when the place was just beginning to show its potential.

Dr. Gittens said she was happy to just continue working at South Florida Pain; she liked it there.

Rachael Gittens was a family practice doctor who had gone to med school at the State University of New York, graduating in 1998. Despite her lack of experience in pain management, she wasn’t afraid to write big prescriptions. Sometimes she wrote even higher than Overstreet had, up to 360 oxycodone 30 milligrams, a few times. The patients loved her.

Chris wanted to expand, but he had no idea how doctors found jobs. When they’d been building houses in North Port, Derik had introduced Chris to
Craigslist.org
, the free classified advertisements website. Very few of the other job postings on Craigslist’s medical/health jobs section were for doctors—they tended to be for physician assistants, front desk staff, nurses, physical therapists. But they’d used the site to sell houses, so they figured, why not use it to hire doctors? Chris wrote and posted an advertisement, something along the lines of: “MD with DEA license needed for busy pain clinic, make up to $400 an hour.”

Dr. Enock Joseph responded to the ad, and after a brief interview, Chris hired him. Dr. Joseph was an older guy, short, not much more than five feet tall. Like Gittens, he was black. Heavy cologne, glasses, thick Haitian accent. He’d gone to the State University of Haiti in the 1960s, then did an obstetrics/gynecology residency in Harlem in the 70s. Spoke French and Creole. Most importantly, Dr. Joseph had worked at a clinic named Art of Pain that paid doctors $35 per patient. Chris offered $75 per patient, and Dr. Joseph jumped at the raise.

Pretty soon, Chris realized he didn’t need Overstreet. He’d already learned enough about the business to get by. The doctors were interchangeable, one as good as the next, as long as they were willing to write big numbers. Dr. Gittens sometimes took too much time with the patients, which meant they had to stay open late to accommodate the crowds, but she was an adequate replacement. Same with Dr. Joseph.

And another thing. Chris paid the new doctors $75 a patient, which was half what the clinic charged for a doctor’s visit. Meanwhile, he kept the money he made from selling the meds, offering the docs a $1,000 weekly fee for the use of their DEA registrations, which allowed him to order the drugs. All in all, a much better deal than the 50/50 split on total profits that he’d had with Overstreet.

As the weeks went by, more and more of the patients came from out of state, especially hill-country states like Kentucky and Tennessee, where authorities had cracked down on narcotic painkillers. They were white country people, mostly, and they stood out in South Florida in their pasty winter skin and camouflage baseball caps, scrawny as crack fiends or spilling out of their T-shirts and cutoff jeans shorts. They usually drove down in groups, and they looked and smelled like people who had spent a long time in a car, with their rumpled clothes and sour breath. Some looked sick, sweaty, like they had the flu.

The new doctors liked having Derik around. Things seemed to run better, and he made them feel safe.

One night, Dianna drove Derik home and asked him if he would come on board full-time. The place was growing. They needed him.

Derik wasn’t sure. He’d always made good money in construction, but he wasn’t sure whether he could make ends meet going solo. He still didn’t have a driver’s license, and getting to worksites was tough.

Dianna said: Don’t worry about the money. We’ll give you whatever you want.

So Derik started working every day at South Florida Pain. Chris paid him $1,000 a week to start out. Derik was good with the patients. He came up with ways of dealing with the constant overflowing parking lot, kept order in the waiting room, developed systems for the paperwork. He figured it was a short-term gig. He’d make a little money and return to construction when he got his driver’s license back.

At first, Derik kept mixing up the name of the primary drug they were selling. Dr. Overstreet had told Chris to order generic versions of Roxicodone instead of the better-known but more expensive OxyContin. They were basically the same drug—oxycodone—but Overstreet also believed OxyContin prescriptions were more closely monitored than the generics. Plus, a lot of recreational users seemed to prefer roxies, especially the little blue ones made by Mallinckrodt, which were supposed to be easiest to crush, dissolve, and inject. Derik kept calling them RoxiContins, which apparently didn’t exist, and the others busted his chops about it.

In those early days, everything was loose and easy, and everything was funny. Dianna brought her wiener dog, Moe, to the clinic each day, because they usually stayed open late. When Derik got a phone call from someone he didn’t want to talk to, he’d say that the caller needed to talk to the clinic’s office manager, Moe, but he was sorry, Moe wasn’t available right at that moment. Or he’d put Moe’s name on paperwork. Derik and Chris flew remote control helicopters in the parking lot, and zapped each other with stun guns. Derik kept the fridge in a back room stocked with cold Bud Lights. When the lines in the waiting room got too long and people were getting impatient, Derik would buy a meal for the whole room. The toilet at South Florida Pain was always out of order, so they’d put up a sign directing patients to use the restrooms at C.C.’s Fish Camp across the street. Two hours later, when that bathroom was destroyed, they’d put up a new sign telling people to go to McDonald’s to relieve themselves. People would drive by and see the long lines outside and think the Christian radio station in the bungalow next door was doing a giveaway promotion. Parking was a problem from the get-go. They rented four extra spots from the podiatrist to their east, but that wasn’t enough. Patients parked in neighboring businesses’ lots, wherever they could find a spot. It was chaos, and the most fun place Derik had ever worked.

Neighbors complained, of course. They rarely came over to the clinic, but they did call the cops from time to time. The neighborhood was an odd mix, Derik thought. The clinic sat just inside the border of Wilton Manors, which had gentrified little ranch houses and a significant gay population. But Oakland Park Boulevard itself was more blacks and street people. With either crowd, the white hill folk coming to South Florida Pain stood out.

Chris and Derik learned that certain patients were more valuable than others because they would organize and bankroll entire groups. Cops and druggies called these people “sponsors.” One woman in the neighborhood would go down the street to a free HIV clinic and round up patients, usually homeless people. She’d haul them to the clinic and hand each of them enough money to pay for the doctor’s visit and the pills. Derik would greet the woman in the waiting room, and she would tell him: I got ten new ones for you today, Derik. Best of all, they didn’t even have to offer a group discount for her people. When everyone was done, she’d would just collect the patients’ pills and pay them each $200. Everybody won: the clinic, the woman, her “patients.” It was crazy.

Derik threw himself into recruiting patients and sponsors. He was at a bar or casino or strip club most nights, knew lots of people. When he ran into acquaintances or met someone new, he told them to stop by the clinic. Over the last decade, he’d worked with hundreds of contractors and subcontractors. Many were out of work now and weren’t opposed to earning some money by becoming a patient at South Florida Pain and then selling their pills. They began coming in droves, dozens of them, many from Loxahatchee, where Derik had spent years. The clinic staff called them the Loxahatchee Crew.

The customers kept coming. Thirty a day. Fifty. They opened earlier and earlier, and even at 6:00 a.m. there’d be a line snaking down the street. They’d roll up and the patients would be roaming the neighborhood, causing havoc, but as soon as they saw Derik or Chris or Dianna, they’d snap to attention like dogs looking for a treat, run to grab their places in line. The line got longer every day, and the sight of it each morning amazed Derik. At the end of business hours, there’d still be dozens in the waiting room. Chris didn’t want to turn anyone away, so they never seemed to close up shop before 8:00 p.m. Overstreet had sometimes spent ten or fifteen minutes with patients, but the visits kept shrinking until the new doctors were spending just enough time with the patients to fill out the paperwork.

Derik controlled whether patients got to see the doctors, and he was learning how to turn that power into cash. If the patients wanted special treatment, it came at a price. Patients who’d driven all the way from Kentucky often didn’t want to spend three or four hours waiting to see the doctor, so they’d offer Derik $50 or $100 to be moved to the front of the line. The longer the lines, the more patients were willing to pay. Fifty bucks here, $100 there—it added up to an additional grand or two a week in Derik’s pocket. Before long, he was making more from these payoffs than he was from his base salary.

Nine o’clock one night, Derik was outside smoking a cigarette. It was one of those warm South Florida nights when the bathwater air almost dripped with possibility. Inside, the waiting room was still packed, more patients hanging out in the parking lot, more money to be made. Derik had just ordered pizza for everybody. He was feeling good, magnanimous.

A truck went by, a guy checking out the action, how busy the clinic was that late at night.