Dr. Alimorad “Alex” Farshchian was the founder of the Center for Regenerative Medicine in Miami, a clinic ostensibly devoted to helping patients recover from injury or arthritis. Farshchian had regularly traveled with Jackson during the years 2002 and 2003 and was with him during the baby-dangling incident in Berlin. Jackson spent time as a guest at Farshchian’s home in Bay Harbor Islands and visited the doctor’s office during his frequent stays at Miami’s Turnberry Isle Resort. Carter described Michael to investigators as being sharp and “in tune” before his visits to Farshchian but “out of it” afterward. LaPerruque told Santa Barbara detectives that he believed Dr. Farshchian “may have been overprescribing medication” to Michael. Carter advised the same detectives that Farshchian had said Jackson was addicted to Demerol and that he was attempting to wean Michael off the drug. Michael was seeing Farshchian on an almost daily basis when the Bashir documentary aired in February 2003. The Florida doctor flew back to California with Michael a few days later, then stayed on at Neverland Ranch during that period when, according to Dieter Wiesner, Michael was so loaded on opioids that he couldn’t feed himself. In the months before the criminal trial in Santa Barbara County, Farshchian told reporters that he was mainly prescribing vitamins for Michael and the press took to describing him, tongue in cheek, as “Jackson’s vitamin doctor.”
“My biggest gripe about the doctors around Michael is that they didn’t treat him as a patient,” said Marc Schaffel. “They just gave him stuff. And Farshchian is exactly who I’m thinking of.”
Investigators in California had recovered a July 21, 2002, handwritten note from Farshchian to Jackson in which the doctor informed the star that he had just sent him a special “package.” It was “a 5 to 7 day program that offers you the solution,” Farshchian had written. “Buprenex is the potent narcotic I told you about last week, it is just like the D but better.” The “D” Farshchian referred to was the highly addictive painkiller Demerol, investigators believed, and Buprenex, they knew, was a newly developed and even more powerful injectable analgesic.
For Dr. Farshchian, Schaffel said, “it wasn’t about money so much, I don’t think, as the glamour and excitement. I remember Farshchian and his wife had quite a bit of problems at one point, because she did not approve of him leaving his house and family in Miami to go hang out with Michael.”
Before Farshchian, Jackson had relied upon Dr. Allan Metzger to provide his medications. Metzger, a specialist in the treatment of lupus, had accompanied Michael in 1996 on the entire HIStory tour and, according to Dieter Wiesner, “gave him whatever he asked for.” Among Metzger’s other duties on the tour had been videotaping the Michael Jackson–Debbie Rowe wedding in Australia. The Los Angeles County authorities that later reviewed Metzger’s files found one labeled “Omar Arnold/Michael Jackson.” In September 2000 the medical board of California had officially reprimanded Metzger for “fraudulent medical practice based on prescriptions written for an international entertainer, using a false/fictitious name.” That “entertainer,” though, was not Michael Jackson, but his sister Janet, according to Metzger, who insisted that he had not seen Michael Jackson “regularly” as a patient for several years.
Metzger and Farshchian were but two of the countless physicians who over the years had assisted Jackson in obtaining drugs. Helping Michael find doctors who would write prescriptions for him was a crucial task of the enablers who traveled with Jackson as part of his security staff. An MD who demanded anonymity would provide the Las Vegas Review-Journal with a snapshot of the methods Michael and his team used to make new drug connections. After being summoned to Jackson’s hotel suite, supposedly to treat a sore throat, the doctor said, he quickly realized that the entire examination had been “staged” and that “they just wanted drugs.” When he was asked to “call in all these pills under someone else’s name,” the doctor said, he refused and was immediately confronted by a hulking “handler” who gruffly asked, “What do you mean? They always do that.” Frightened, he agreed to see what he could do, and headed for the door, but was stopped by the big bodyguard, who “put a finger in my chest and said, ‘You do that.’”
Both the amounts and the combinations of the drugs Jackson asked for astounded any number of reputable doctors who treated him. Rabbi Boteach recalled an occasion when the Nobel laureate Elie Wiesel had asked his personal physician to attend to the back pain Jackson complained of during a stay at the Waldorf-Astoria. “One of New York’s most prestigious doctors” emerged from Michael’s bedroom “ashen faced” after about fifteen minutes alone with the star, Boteach remembered, and immediately announced that, “Michael has just asked me for a quantity of drugs that would kill a horse.” When he went into the bedroom to ask if it was true, Boteach said, Michael calmly replied, “I have a very high tolerance. I’m used to this. I’ll be fine.” Orthopedic surgeon Mark Sinnreich, who treated Jackson at his clinic in Miami, reported that in 2000 Michael had asked for 200 milligrams of Demerol, four times the dose that would normally be administered to a patient his size. “But he said that he needs more since he had this burn,” Sinnreich recalled. “And I know burns are very, very painful. He said that ever since he was in that Pepsi commercial and burned his hair that he had a lot of pain and that he had a very high tolerance to pain medication.”
That was true, but as doctors who have studied the subject understand, a high tolerance for pain medication equates to a low tolerance for pain. Ordinary aches can become debilitating for a person who consistently refuses to feel them. Clinical studies have consistently shown that heavy use of pain medications changes brain chemistry in ways that profoundly affect perception and can result in a condition known as hyperalgesia, in which taking painkillers causes a person to actually feel pain more acutely. This can advance to the point in an addicted brain where getting off the drugs equates to a sense that one is committing suicide. Michael Jackson consistently described himself that way, telling one person after another that it wasn’t a question of wanting drugs but rather of needing them. “If I stop using drugs, I’ll die,” he told one concerned friend. “I won’t survive another day without them. No one understands that. I need to be here for my kids. There’s no other way. There’s just no other way.”
Tarak Ben Ammar, a Tunisian film producer and distributor who managed the HIStory tour, said he was tempted to describe Jackson as a hypochondriac but hesitated because, “One never really knew if he was sick.” Michael complained constantly of this condition or that one. He truly did suffer from a constellation of autoimmune disorders (most linked to childhood trauma) but whether these caused him real pain or merely discomfort was impossible even for a trained physician to know. Twenty years later, Michael was still using the small patch of scarring from the burn he had suffered during the Pepsi commercial filming as a reason why he needed a new prescription of pain medication. He also would say the rib he had broken while training for the Dangerous tour was bothering him, or that an ankle he had twisted during the HIStory tour was acting up again.
Back pain was what he most often cited when he asked for the opioids that were his drug of choice. Jackson regularly told people that he had fractured a vertebra years earlier. That wasn’t true, though he did suffer from a mild case of arthritis in his lower back. Rabbi Boteach would recall how, after he was jostled by autograph seekers at a charity event in New York, Michael almost immediately began to complain that his back was injured and he needed pain medication. Jackson showed up in Britain for the Oxford speech with his foot in a cast and on crutches, Boteach remembered, claiming he had broken his foot while practicing dance moves at Neverland and needed to see a doctor who could give him Demerol. Over the next few days, he heard Michael tell a number of different stories about what had happened to his foot, the rabbi recalled, “but again, I made nothing of it, thinking that Michael was forgetful.”
People constantly made such mental adjustments to accommodate Michael Jackson. No one showed more flexibility in that regard than hi
s old friend Dr. Arnold Klein. In the process of becoming the most famous dermatologist on earth, Klein had explored the frontiers of pharmacology, an adventure he began right around the time he started treating people’s skin. Back in 1972, one year after graduating Phi Beta Kappa from the University of Pennsylvania School of Medicine, Klein was credited as the coauthor of a book published by the University of Pennsylvania Press titled Drug-Trip Abroad: American Drug-Refugees in Amsterdam and London. During the next two years, while working as a resident at the hospital of the University of Pennsylvania, Klein made a number of trips to Mexico, where he was said to have experimented with and purchased a wide range of pharmaceuticals. He abandoned his Ivy League residency in 1974 under circumstances that were the subject of considerable rumor and speculation, nearly all of it involving the use and distribution of prescription drugs. Klein told colleagues (who did not know he was gay) that he was moving to the West Coast to marry a woman he had met there.
In 1975, Klein became the chief resident in dermatology at UCLA’s School of Medicine. The young doctor swiftly discovered, though, that the skin care business in Southern California is fiercely competitive. Still working part-time at UCLA, he took a position with a small practice in the San Fernando Valley where he spent his time “giving light treatments and picking pimples,” Klein recalled. As bored as he was ambitious, the young Dr. Klein used $18,000 in savings to “venture into the jaws of what was Beverly Hills,” opening his own practice in an 800-square-foot office. The new practice flourished in part because Klein was so adept at developing personal relationships. He obtained his earliest referrals, the doctor remembered, by knocking on the door of every physician’s office in Beverly Hills. Within a year, he had so many patients—many of them celebrities—that he opened a larger office and hired an associate. But television was what lifted him into the stratosphere of the medical business. Klein’s first TV appearance, on The Merv Griffin Show, changed his life overnight. “The next day, people were asking for my autograph, and soon thereafter, I received ten thousand letters,” he remembered.
By the time Klein went on television to discuss his experimentation with collagen injections his office was nearly ten times the size of the one he had started. The practice exploded after that. Within a couple of years Klein’s client list included the largest assembly of stars boasted by any doctor on the planet (though the majority of his patients were merely rich people). That list continued to increase—in fame and wealth, if not in number—when he pioneered the field of Botox injection. His relationships with his celebrity clients, Cher and Dolly Parton among them, were the common currency of Hollywood in-jokes that made their way into at least two feature films, Postcards from the Edge (based on a book by his client Carrie Fisher) and The First Wives Club. He was best known around town, though, for his close personal friendships with two particular clients: Elizabeth Taylor and Michael Jackson.
Klein’s relationships with Taylor and Jackson were forged through what the doctor had done to help Liz preserve her looks well past the age of fifty and how he had cured the acne that had tormented Michael all through his late teens and early twenties.
Klein was more than a physician to his most favored patients, however. Nothing said more about his relationship with Taylor, for example, than the note the actress had written in the copy she had given him of her book My Affair with Jewelry. “My beloved Arnie,” it read, “I love you more than I can tell. I feel you have saved my fading life. I love and thank you forever. Yours, Elizabeth.” The doctor’s mastery of collagen and Botox injections were but two of the four pillars that supported his exalted status in Beverly Hills. The other two were Klein’s intellectual sophistication and his sensitivity to client “needs.” The doctor made no secret of his belief that pain, like need, was a highly subjective concept, and that achieving the proper chemical balance for the full enjoyment of life might involve the judicious use of pharmaceuticals.
How liberally Dr. Klein might be interpreting “pain” and “need” was first publicly suggested in the 1980s when Liz Taylor attempted to kick her by-then-voracious prescription drug addiction. During consultations with the physicians who supervised her rehabilitation, Taylor acknowledged that Dr. Klein—a man she dearly loved—had written her multiple prescriptions for various drugs that included Dilaudid and Ativan. Klein’s name appeared in news columns a second time, in the autumn of 1993, when a deputy sheriff arrived at the doctor’s office in Beverly Hills armed with a search warrant connected to the Jordan Chandler investigation. “Dr. Klein said that prior to the service of the search warrant on November 19, 1993, he removed Jackson’s medical files from his office at [his lawyer’s] direction and kept the files in his home and car,” read the deputy’s report of that encounter. During the 2003 investigation of the criminal charges filed against Jackson in Santa Barbara County, Klein admitted to police that he had prescribed Dilaudid and Ativan to both Michael and Liz Taylor. Tom Sneddon’s office later listed Klein as one of the doctors who had prescribed Demerol to Jackson, under the name Ferdinand Diaz.
He and Michael had first met in 1983, Klein would recall, shortly after he sat in the audience that had cheered madly as Jackson introduced the Moonwalk during his performance of “Billie Jean” at the “Motown 25” show in Pasadena. A week later, he was “sitting in David Geffen’s driveway,” Klein would recall, when he saw Michael Jackson sitting in the backseat of a Lincoln Town Car, looking “very lonely.” Geffen brought Michael to his office just days later, according to Klein, to look at the “butterfly rash” on his face that was accompanied by a severe crusting of his scalp. He had diagnosed Jackson with lupus that day, Klein said, and a relationship that would endure for more than a quarter-century was forged. “Michael was probably the purest person I ever met,” Klein would tell Vanity Fair’s Mark Seal. “He did not have a mean bone in his body.” Carrie Fisher saw the relationship in somewhat starker terms: “They each had something that the other desperately coveted,” the actress would write in her book Shockaholic. “Arnie wanted to be friends . . . with the biggest star on the planet [and] Michael wanted access to the farthest reaches of the medical community 24-7.”
In spite of rampant rumors about the kinds and amounts of drugs Klein was prescribing to Jackson, however, there was little if any follow-up investigation of Klein’s role in Michael’s life by police officials in either Los Angeles or Santa Maria, in either 1993 or 2003. Klein had become immensely wealthy and well connected. He demonstrated how willing he was to fight any accusations made against him during a lawsuit filed in 2004 by Irena Medavoy, wife of former TriStar Pictures chairman Morris Mike Medavoy, who accused the doctor of giving her Botox treatments that brought on crippling migraine headaches. Klein won the case even in the face of evidence that demonstrated how dependent his medical practice was on injection treatments, and that he had collected a good deal of money from Botox manufacturer Allergan. He was by then an eminence in Los Angeles, a cofounder with his friend Rose Tarlow (LA’s most prominent interior designer) of the Breast Cancer Foundation at UCLA and a philanthropist credited with raising more than $300 million for HIV research. He was among Southern California’s leading art collectors and delighted in mentioning that one of his patients had offered to name a new building at UCLA’s School of Medicine for him, but that he had modestly declined, accepting an Arnold Klein teaching chair instead.
Klein was not only a prominent member of a profession that prides itself on self-policing, but projected enormous confidence that he knew where the line was between serving his patients’ “needs” and feeding their addictions. He did not overprescribe, the doctor insisted, to Michael Jackson or anyone else. His friend and patient Marc Schaffel defended this claim as true. “When people go into Arnie’s office, he’s completely different than he is when they’re in his home,” Schaffel said. “I’ve never seen Arnie not be professional with any patient, including Michael.” The problem in Jackson’s case, though, was that Klein’s relationship with Michae
l was just one among the dozens that the star maintained with doctors all over the country and in Europe, each of whom wrote him prescriptions for the medications and sleeping aids that Jackson carted around for years in a large black suitcase that was filled with preloaded syringes, IV bags, and a collapsible IV pole. None of them, individually, needed to overprescribe in order to keep Jackson’s black suitcase full.
“I had lots of fights with these doctors,” Dieter Wiesner would insist. “Michael didn’t need it, that was the problem. When Michael was down you could talk to him, and he got a good feeling again, and everything was all right. But these doctors told Michael, ‘Take this and take this, and you will feel good.’ And Michael would do it. Money, money, money, that’s what the doctors were about. That’s all they wanted.”
Jackson’s drug problem had been a serious one ever since the first sex abuse charges were made against him by Jordan Chandler in 1993. The tabloids began reporting on Michael’s prescription drug addiction in 1999, when the National Enquirer published an article claiming that the entertainer was feeding himself painkillers through an intravenous drip. After their 2000 civil filing against Jackson, Marcel Avram’s lawyers submitted a document proving that two doctors in Munich, Germany, were owed $264,000 for “services rendered” that the concert promoter’s attorneys suggested mainly involved the supply of prescription drugs during Jackson’s HIStory tour. Avram’s lawyers also introduced a monthly budget for Jackson that showed he was running up $10,000 per month in charges at the Mickey Fine Pharmacy, a legendary establishment just downstairs from Dr. Arnold Klein’s offices on North Roxbury Drive in Beverly Hills. In 2003, Myung Ho Lee’s attorneys had submitted documents to the court in Santa Barbara County demonstrating that Jackson owed the pharmacy $62,645. The most graphic evidence of Michael’s drug use, though, was a photograph obtained by the Daily Mail in London that showed what an intravenous line being fed into Jackson’s lower right leg had caused him after months of usage: a huge and horrific-looking black wound that doctors agreed was necrosis—a shin-size patch of dead tissue surrounded by dozens of puncture marks.
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