by John Temple
In December 2011, Alice was feeding the game roosters when a police cruiser pulled up the long gravel drive of the farm on Hummingbird Lane. Barry Adams was driving. Alice knew who he was, but she’d never met him. Adams had been a deputy sheriff of Rockcastle County, but now he was assistant chief of police in Mount Vernon. There were two others in the car: a tall blonde woman and a broad-shouldered man. Alice couldn’t imagine what these strangers wanted with her.
The Mason farm was so remote that even Barry Adams had a hard time finding it. Adams parked the car and turned to speak to Jennifer Turner and Mike Burt.
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.”
On Derik’s third day of testimony, Paul Schwartz was angry on his redirect, and Derik was scared he’d lost any chance of getting out of prison before his late forties. Schwartz’s movements were even jerkier than usual, his questions like bullets.
“Sir, yesterday on cross-examination you said the words, ‘There was nobody innocent there, everybody knew what was going on,’ ” Schwartz said. “What were you referring to?”
“Everybody . . . Everybody that I . . .” Derik stuttered, wanting to get this right, correct any damage he’d done to the prosecution’s case yesterday. “. . . knew what was going on. Nobody . . .” Then, simply: “There’s no children here.”
“You say everybody knew what was going on,” Schwartz said. “Explain that.”
“You’ve seen the videos,” Derik said. “It’s hard to comprehend the fact that anybody could not know that we were a pill mill.”
“Did you tell the government that she was a criminal?”
“I did, but I tried to downsize her role in it because, I don’t know, I guess I want to take . . . I’d rather take responsibility than pass it off on somebody else.”
“What does that mean?”
“I don’t know,” Derik said. “I try to be a stand-up guy sometimes when I shouldn’t.”
“Did you tell the government she was a criminal?” Schwartz barked again.
“I did.”
“How did American Pain make its money?”
“Selling pills.”
“Was that the plan?”
“That was the plan.”
“Did Dr. Cadet participate in that plan?”
“She did.”
“Could the plan have been carried out without the doctors?”
“Could not have.”
“Were you a drug dealer?”
“I was.”
“Was Christopher George a drug dealer?”
“The biggest.”
“Was the staff at American Pain drug dealers?”
“We all were.”
Extra emphatic: “Were the doctors drug dealers?”
“They are.”
“Did you ever sit down with any doctor, including defendant Cadet, and say, ‘We’re operating a pill mill?’ ”
“No.”
“Was it necessary?”
“No.”
The Cadet/Castronuovo trial took two months.
The American Pain gang was reunited during that time, having been called back to South Florida from their various federal prisons and camps. They spent the trial on the two floors of the Palm Beach County Jail that housed federal prisoners. They all had prison-life stories by now, especially about the interminable and inexplicable bus and plane rides from one facility to another, fueled only by bologna sandwiches. Dr. Patrick Graham had faced the toughest stretch. He’d been incorrectly assigned to a Mississippi prison for illegal immigrants, and before his transfer could be worked out, a riot broke out, and his neck was grazed by a bullet. After that, he spent six weeks in solitary confinement. The co-defendants spent long days together and they weren’t supposed to talk about the trial, so they compared notes about their various sentence lengths, about their different prisons, about their kids. And they talked a lot about the future, where they might live wh
en they got out, what jobs they might pursue. In the evenings, they watched the Miami Heat win the 2013 NBA Finals.
Day by day, different individuals were pulled out to testify. Ethan Baumhoff had gone first, followed by Derik Nolan, then some lower-level guys, then Dianna Pavnick, Roni Dreszer, Chris George, Beau Boshers, and Michael Aruta.
After almost three years behind bars, Chris George’s hair was streaked with gray, his build beefier. He looked fifteen years older than the twenty-seven-year-old who’d opened South Florida Pain five years earlier. He was the star witness, of course, and the prosecutors had wanted him to testify earlier. But Ethan Baumhoff had told Jennifer Turner that Chris had had a jailhouse telephone conversation with his father about Ethan’s testimony. Turner had seen John George watching the proceedings from the spectator rows, scribbling in a maroon spiral notebook. The prosecution team dug up a recording of the call and everyone listened to it, John George telling his son what questions he could expect on cross-examination. The defense objected to Chris George being called as a witness. He was clearly doing illegal homework, they said. He wanted to provide the most damning possible testimony against Cadet and Castronuovo, they said, in hopes of winning an extra-large sentence reduction. The judge chewed out John George the next day and pondered the mess for a while before deciding to allow Chris George’s testimony. Chris testified for most of three days, retelling the story Derik and Ethan had already told. Unlike Derik, whose nervousness in the witness box had made him sprawl out and jabber, Chris turned inward. He sat stock-still, and his voice was even more of a monotone than usual.
Alice Mason testified also, her third real trip outside of Kentucky and the first time she’d ever flown. The federal agents had sent her a plane ticket, and when her husband dropped her off at Blue Grass Airport in Lexington, the attendant asked her for an identification card. She hadn’t thought to bring one. She explained that she was going to Florida to testify about her son’s death in a big court case, and she just had to get on that flight, no matter what. The Delta officials asked her a lot of questions and finally, reluctantly, let her on board. The shuddering takeoff scared Alice to death—it just wasn’t natural to be way up in the air—but it was beautiful up above the clouds. Mike Burt met her at the airport in West Palm Beach, took her to her hotel. In the courtroom, Alice saw Dr. Cadet out of the corner of her eye but wouldn’t look right at her. She cried through much of her testimony, which embarrassed her, and the judge didn’t let her tell how she’d gone to American Pain to talk to Cadet. She couldn’t understand half of what the lawyers said, but at the end, gasping through tears, she said what she’d come to say.