American Pain

by John Temple

  They didn’t bring their homeless security guard along to the new location. The guard was nearly useless at preventing problems in the parking lot. He still couldn’t even operate the walkie-talkie. But Derik didn’t want to fire him outright, so he instead posted the vagrant employee at the old location and told him to hand out flyers directing patients to the new place up the road. The homeless man liked being in on the real action of the clinic, and he looked crushed when Derik gave him his new duties.

  Before long, patients began approaching Derik, irritated, asking why his guy was charging for directions from the old location to the new location. Five bucks a pop.

  Derik went down to the old location and spied on his employee from an adjacent parking lot. The vagrant man stood near the entrance of the old clinic, waving down patients as they pulled in looking for American Pain. He did his crazed little dance steps, gesticulating with his skinny arms, exchanging flyers for bills through the car window, like a corner boy with a bag of drugs.

  And then, the final straw. He sidled over to some trash cans, extracted a pipe from its hiding place, lit it, and took a pull. He was back on crack.

  Derik fired the homeless man. He slipped him a few hundred bucks and never saw him again. Later, the cleaning lady said the ex-staffer had asked her to tell Derik he was sorry and he wanted his old job back. Derik just laughed and forgot about it.

  The clinic wasn’t the same laid-back place it had been when it was operating out of the bungalow on Oakland Park Boulevard. Chris and Derik knew the DEA was watching them now, along with the TV reporter, Carmel Cafiero. Something fundamental about the operation had changed when Chris hired Ethan and changed the name. The clinic had become a place where there was too much at stake to keep a crack-addicted stray dog around for laughs.

  South Florida Pain was gone. The future belonged to American Pain.

  Derik took the clinic gang out for an office Christmas party at the Solid Gold strip club. Most of the others came, including Chris and Dianna, who were back together, some staffers, and three of the new full-time doctors: Beau Boshers and both Dreszers, father and son. Derik didn’t invite Ethan Baumhoff. After the move, Ethan had tried to assert more control over the operations, which was Derik’s territory.

  He’d say to Derik: We gotta get this thing more legal. This could really be big.

  Derik told Ethan to stay out of his business, go back to counting the money.

  So Ethan had started in on Chris. He wanted the staff to start dressing more professionally, dress shirts and slacks Monday through Thursday, and casual Fridays. Derik had responded to this directive by showing up for work in a nice pair of $300 jeans with a T-shirt that read “Fuck You.” He didn’t need Ethan at the Christmas party.

  Solid Gold had a high-end steak house inside with glittering chandeliers and tablecloths as soft and white as a fresh snowfall, so they had dinner first. Derik had the beef Wellington and picked up the $1,500 tab. Then they headed into the club for drinks. Dr. Boshers was off-the-chain, buying lap dances for everybody. The younger Dreszer was a party animal too. He liked cocaine and prostitutes and once dropped $300,000 on a private poker game. It was a fun time, one of those blurred nights when the events of the previous year seemed like a colossal and astonishing practical joke. Twelve months earlier, Derik had been losing his mind in St. Lucie County Jail, his life in pieces—no driver’s license, no job, no friends, no prospects. Now he was running the biggest pain clinic in Florida, surrounded by friends, awash in money.

  He’d even hired a personal driver. The DEA agent’s warning about Derik’s illegal driving had scared him—the thought of getting a long prison sentence for such a minor thing, especially when he was so close to being set for life. So he’d called his cousin up in New York, and told him to move down to Florida. Derik’s cousin liked guns, carried a couple of registered .45s in his belt everywhere he went. The cousin moved in with Derik and became his driver/bodyguard. You couldn’t be too careful.

  Derik’s plans were vague but glorious. He and Chris talked about it sometimes, the future. They planned to keep going for five, six years, until Derik was in his mid-thirties and he’d personally banked some millions, and then they’d sell the clinics. Derik would find a woman like Dianna, and the four of them would hit the road or the open seas, travel the world together.

  But that was the future. Right now, South Florida was everything a man could want. It was the pink heart of a grain-fed steak filet wrapped in a flaky perfect pastry shell. It was pure, wonderful, fresh-off-the-boat Miami cocaine. It was beautiful women who would take off their clothes and do what you wanted, because you had a thick roll of bills to spend on them. It was the anticipation of holding primo tickets to the Dolphins game or the UFC fight. It was the supple leather passenger seat of your own purring Mercedes, driven by a strapped bodyguard who was also your cousin. It was that invincible inner hum from monster doses of steroids flowing through your bloodstream.

  South Florida during Christmas 2008 was all of those things to Derik, everything that was the opposite of Binghamton, New York, and its icy winters and dark memories. South Florida was paradise, and Derik and his best friend were its kings.

  Footnotes

  * Others who worked at the clinic later said that Derik did, on occasion, sell pills directly.

  * The Bank Secrecy Act of 1970 requires US financial institutions to help the government fight money laundering by reporting suspicious activity and filing reports of cash transactions exceeding $10,000. Banks may refuse to handle clients in high-volume cash businesses if they believe the business might be illegitimate or illegal.

  † The kidnapping is described briefly in court documents and testimony. The version of events told here is how Derik Nolan recalls it. Other sources declined to talk about it.

  5

  On New Year’s Day 2009 in Rockcastle County, Kentucky, Alice Mason got a call from her son’s girlfriend, Lisa. Alice was, as usual, on her farm at the end of Hummingbird Lane.

  On the phone, Lisa said that Alice’s son had up and run off. No one knew where Stacy was.

  The news surprised Alice. Stacy and Lisa had been together for five years, living together almost as long. They had their ups and downs, like couples do, but those two loved each other, and Alice hoped and expected they’d get married someday. Alice talked to them if they brought up problems, but otherwise she didn’t meddle. She knew enough after fifty-three years of life to let them work things out on their own.

  But Alice had been fretting about Stacy ever since his accident in August, four months earlier. Stacy made good money pouring and finishing concrete, $700 or $800 a week when work was steady. But that meant long days during the warm months, out the door before sunrise. Stacy was behind the wheel of his Tacoma pickup at 5:30 a.m. one day, heading to a job site, when he dozed off on Interstate 75. A trucker saw the Tacoma drifting and blasted the horn. Stacy jerked awake, overcorrected the wheel, and flipped his pickup. The impact crushed the Tacoma’s roof into the passenger seat. On the other side of the cab, Stacy was flung about but not really hurt. He called Alice and said the truck was totaled, but he was fine, in fact he was catching a ride to work. Later that day, on the job, someone bumped into Stacy from behind, just a little nudge, but the pain shot down his back, and Stacy realized he wasn’t fine. He was hurt bad.

  The pain grew as the days went on. Stacy went to see a local doctor, and she prescribed him some painkillers.

  Throughout the fall, Stacy tried to go back to work, but he couldn’t lift a wheelbarrow. His gait was a little off, and he had a hard time lifting his legs, especially going up stairs.

  But when Stacy and Lisa had driven out to the farm for Christmas dinner, everything seemed fine. Stacy was loaded down with gifts. A Mossy Oak camouflage hunting jacket for his little brother, Kevin. A toaster oven for Alice. A guitar-and-drums setup for the video game player.

  Now Lisa was calling, saying Stacy was gone, wasn’t returning her calls. Had Alice see
n him?

  Alice said she sure hadn’t seen Stacy. Not since Christmas dinner.

  Lisa said: Well, we got into it. He left, and he said he was going out to the farm to stay in the trailer.

  Lisa didn’t say what they’d argued about, and Alice didn’t ask.

  Alice said: Well, good Lord, Lisa, if he’s down there, he probably about froze to death. It was cold last night.

  Alice got off the phone and left the main house, tromping past the barn and the ever-sniffing beagles and the game roosters leashed to their blue plastic barrels and Stacy’s bulldog Red. Over the frozen ridge and down to the white single-wide where Lisa and Stacy had lived through one winter and one summer, on the Mason farm but just out of sight from the main house. Stacy wasn’t there.

  Kevin, Alice’s youngest, was home for the holiday, so Alice told Kevin to call his brother’s cell phone. Kevin dialed the number, and Stacy picked up. Stacy said he’d be home later that day. He didn’t say where he’d been.

  Alice was only partially relieved. She was a worrier. She worried about all three of her boys. Even though Stacy had just turned thirty, she still called him her “young’un.” Stacy smiled like a boy, open and friendly. If there were kids around, they were climbing on Stacy like he was a tree. Or he was rolling around on the floor with them. Until he hurt his back.

  At one time, Stacy used to drink a little bit, but what he loved was pot. Alice had heard that more than once, and she didn’t like it. But he hadn’t done those things around her or his daddy, never talked about it. And now he was with Lisa, a clean-living girl who didn’t tolerate drugs or alcohol. Lisa wouldn’t even take an aspirin if she had a headache. Stacy had straightened out once they got together.

  But now, something was going on—Alice could sense it. She knew that when there were problems, mothers were generally the last to hear.

  At the time Stacy took off, he and Lisa were living in town, which was Mount Vernon, about ten miles from the Mason farm. Their little white house in the steeply pitched yard belonged to Lisa’s mother, and Lisa had grown up there. The night before, New Year’s Eve, Lisa had called her mother over and over, frantic with worry about Stacy’s whereabouts.

  Lisa said she knew Stacy was lying about something. It was out of character for Stacy to be hiding something. He was usually so open, even when he’d done something wrong.

  Lisa’s mom, Shelby, had known Stacy since he was a teenager. She didn’t know his mother and father—they kept to themselves out on the farm, went to a little backwoods church. Stacy was a good-looking boy with broad cheekbones and wide pale-blue eyes. A polite country boy, all “yes, ma’am” and “no ma’am.” But he had a rebel streak, to Shelby’s mind. He favored T-shirts with cutoff sleeves that showed off his strong arms, pulled back his long blonde hair into a ponytail that Shelby didn’t like. He created his own heavy-metal band named Feel and wrote song lyrics that sounded to Shelby like devil music. He was the lead singer. The band never really took off, but Stacy kept writing songs. After he and Lisa got together, Stacy sat down with Shelby and talked to her about the lyrics, and she came to believe that the words were darkly spiritual.

  Shelby grew to love Stacy like he was her own son. He and Lisa were so different. Stacy had grown up with nothing but the beautiful slice of Kentucky hilltop that his family owned, and that’s all he really wanted. Lisa wanted more and was willing to work hard for it. Lisa was a pretty girl with reddish-blonde ringlets, a hard worker ever since she was a teenager. She’d worked her way into a good job at a nearby tourist attraction. Somehow, she and Stacy fit each other.

  Like Alice, Shelby didn’t want to get in the middle of the argument. She figured Lisa and Stacy would work things out, because that’s what couples did. They had arguments, and then they worked them out. But it worried her that Lisa said she’d been calling Stacy over and over.

  The next morning, New Year’s Day, Shelby noticed a message on her phone from Stacy. It had come early that morning. He sounded upset, even scared. Stacy said he needed a ride. He didn’t understand why nobody cared enough to come pick him up. Something happens to me, Stacy said, you’ll be sorry.

  He wasn’t making much sense, didn’t sound like himself, and Shelby was worried. She started calling around, looking for him.

  Later that morning, a friend of Stacy pulled up near the house where Shelby was staying, and Stacy got out of the car. He looked pale and weak. He moved funny as he climbed the steps to the house. Shelby asked if he was all right.

  His reply was breathless: Yeah, yeah. Where’s Lisa?

  Shelby said Lisa was up the highway in Berea, returning a new TV to the Walmart where Shelby worked. Lisa and Stacy had bought it for Christmas, but money was tight since Stacy hadn’t been able to pour concrete for months, and Lisa had decided they couldn’t afford it.

  Shelby said: Stacy, come in and sit down, you need to sit down.

  Stacy said: No, no, I’m fine.

  Shelby said: Stacy, you need to get some sleep. You don’t look good.

  Stacy said he didn’t need sleep, he was fine. He got back in the car, and his friend drove away.

  Kevin was alone at the farm about 3:00 p.m. that afternoon, sprawled on the couch watching the Georgia Bulldogs bowl game, when Stacy came in carrying a garbage bag. The brothers didn’t say much to each other. Maybe they nodded. Maybe they exchanged a word or two. Kevin certainly didn’t start questioning Stacy about where he’d been all this time, while everyone worried. Mom would do that later.

  Stacy dropped his bag in the back bedroom and headed back outside.

  At halftime, Kevin got up and looked outside but didn’t see Stacy or the friend who’d brought him home. A few minutes later, his parents came home. Kevin told them Stacy had returned, but he might have taken off again. Alice and Eugene left the house to check the trailer. Kevin kept watching the game.

  A few minutes later, Kevin heard his mother hollering, and he looked outside and saw her running down the hill toward the house, screaming for him to call the ambulance, and suddenly everything clicked in his mind and he knew exactly what had happened even as he refused to believe it.

  Alice returned to where they’d found Stacy hunkered over a barrel behind the barn, on his knees like he was praying. She held his body on the cold ground. Eugene lay beside her. Kevin came up to the barn after calling 911, and he just sank to the ground too, leaning his back against the barn, bewildered.

  Rocking and crying and holding Stacy as tight as she could, Alice felt something hard against her ribs, something inside Stacy’s jacket. She slipped her hand into Stacy’s jacket pocket and pulled out two pill bottles. She gave them to Eugene and went on grieving.

  The ambulance took forever to find the farm at the end of Hummingbird Lane, maybe thirty-five or forty minutes. When the paramedics finally got there, they called the coroner’s office.

  In town, Shelby got a call from Stacy’s cousin. They’d spoken earlier in the day during her hunt for Stacy.

  He said: Something’s wrong. I called some neighbors down there and they said there’s a bunch of ambulances and stuff on Hummingbird Lane. Police cars and stuff.

  Shelby hung up and starting looking for a ride from someone who knew where the Mason farm was. Before she could find a driver, Stacy’s cousin called back.

  He said: Stacy’s dead.

  Shelby went to Lisa’s house and told her. Lisa lost it. Screaming, waving her hands, running in circles. She said it was her fault. She said she shouldn’t have argued with Stacy.

  Shelby took her to the emergency room at Rockcastle Regional. Shelby’s son-in-law had to carry Lisa inside.

  Billy Dowell knew the Mason family the way he knew most Rockcastle County families: He’d embalmed and buried their ancestors. Dowell was a funeral home director and also the elected coroner of Rockcastle County since 1966. Now in his seventies and well over six feet tall, he towered over everyone else at death scenes. Local cops called him “The High Coroner.”

>   He loaded Stacy’s body into the dark blue van that bore the letters ROCKCASTLE COUNTY CORONER on the side and carried it to Dowell & Martin Funeral Home. The body spent the night in the funeral home cooler, and the next day, Billy Dowell loaded it again and drove eighty miles to the state medical examiner’s office in Frankfort. He rode with the body up to the third floor, weighed it, and then, as was his custom during the postmortem, went to the break room to have a cup of coffee and yak with whoever was around. He’d watched autopsies before and believed if you’d seen one, you’d seen them all.

  The autopsy technicians disrobed Stacy and recorded his height, weight, hair color, skin color, tattoos, and scars. No obvious needle puncture marks, no track marks or drug residue on nostrils. No evidence of natural disease. They removed blood from the femoral vein near the groin, urine from the bladder, and vitreous humor from the eyeball. Those fluids were packaged, labeled, and sent to a toxicology laboratory in Indiana to be screened for drugs.

  The techs made a Y-shaped incision from the upper chest to just above the groin, and the organs were removed, weighed, examined. The most significant finding was that his right lung weighed 920 grams, and his left weighed 720 grams. A normal pair of lungs typically weigh approximately 1,000 grams together. There was no infection or lesions in Stacy’s lungs—they were just sodden with fluid buildup.

  And even without the tox screen, that finding pretty much nailed down the cause of death. Heavy, congested lungs are the hallmark of respiratory depression caused by opioid overdose. High doses of opioids mute pain, and they also mute the psychological discomfort caused by carbon dioxide buildup, the useful rush of panic you feel after too long underwater. Carbon dioxide is produced by the body’s metabolic processes, and it’s flushed out of the blood with each pump of the lungs. When the lungs slow, receptors in the brainstem detect higher levels of the chemical and trigger a breathing reflex. That’s why you can’t kill yourself by holding your breath. Even if you managed to hold it long enough to pass out, the breathing reflex would kick in.