Cindy and the rest of the group were all waiting to see what I would say. The answer was obvious.

I was an in-patient at Sierra Tucson, a drug rehab. My best thinking had taken me to the depths of drug addiction. About a week before, I came very close to killing myself. I couldn’t believe how stupid I had been.

All addicts think that they are smarter then the drugs, but as an anesthesiologist, a drug expert, I was sure of it. I intellectualized everything.  Narcotics are very good at suppressing feelings and I felt nothing. As long as I went to work everyday, I thought I was OK.

I answered the question with a long -winded explanation. The group called me on my shit.  Rehab is about being with other addicts. There is nobody better to tell you your full of it, then someone who is going through the same experience. 

It took a while. I can be a real hard head but eventually I started to understand and more importantly I began to feel again.

I started smoking pot when I was 17. By the time I entered the music business I had tried just about everything. In medical school it was amphetamines and Valium. In the eighties it was cocaine and Quaaludes. 

Drug addiction is endemic in the field of anesthesia. It was not unusual to hear about an anesthesiologist found dead in an on call room.

One day, a friend and fellow anesthesiology resident asked me for a lift to the airport. I noticed he had a vial of Fentanyl. Fentanyl is a synthetic version of morphine and a very strong narcotic. We used it all the time in the OR.

He said he was going to do a little before getting on the plane. I asked him why.

“To take the edge off.” He answered

Fentanyl has to be injected. Although I was interested in the feeling, injecting myself didn’t appeal to me. 

“Moments of terror with hours of boredom” was how I described my days as an Anesthesiologist.

Putting a patient to sleep and especially waking them up were the moments of terror. Once the patient was asleep, as long as the surgeon didn’t do anything stupid (after all they have the sharp instruments) most operations were uneventful. When something did happen it was important to be able to respond quickly.

Maybe Anesthesia wasn’t the best choice for me. Even though I was quite good at what I did, the boredom and stress eventually got to me. Being my own boss and having the keys to the candy cabinet (so to speak) made it even worse. I got over the idea of needles and I tried Fentanyl. It was down hill from there.

In retrospect my arrogance was unbelievable. On my way to work, I went past a church on Lexington Ave that fed homeless drug addicts. I couldn’t understand how they let themselves get in that position. It never dawned on me that in many ways we were the same.

One of the most intense parts of rehab was family week. Addiction affects everyone in your life. Family week is an opportunity for those closest to you to come and understand the process. It also provides a unique opportunity to start the healing. As difficult as it was to face them, I was glad Leann and my parents made the trip.

I went to Sierra Tucson in May of 1989, four years after starting office Anesthesia. I gave it up to a higher power, began to experience the shame, and guilt of what I had done and I started to take responsibility for my life.

Recovery is a process. Rehab is only the first step. I spent the next three years in a comprehensive program monitored by the state. It included going to AA/NA meetings, random urine testing and getting a sponsor. A friend told me about a good meeting held in a large church on the Upper East Side of Manhattan. The speaker that night was very captivating. I had no idea who he was. I asked him if he would be my sponsor. He agreed.

Chris Stamp, former manager of the Who, became my sponsor and helped me through the first two years. It was a particularly difficult time for me.

Conventional wisdom says an anesthesiologist should not go back into anesthesiology once addicted to drugs. I felt strongly that I could. It was about discipline, determination and working a strong program. Sierra Tucson gave me the tools. The state Medical Society provided me with aftercare and I had the motivation.

I retired as an Anesthesiologist in 2002, 12 years after going to rehab. I never had a drug problem again.

Niels Lauerson, one of Manhattan’s elite gynecologists saw as many as 100 patients a day. He was tall and good-looking with curly blond hair and a thick Danish accent. He had patients of all types. Whether they were rich socialites or poor gypsies it didn’t matter. They crowded together waiting for hours until it was their turn.

We operated in his office at least three days a week. Lauerson did as many surgeries as he could out of the hospital including all of his fertility procedures.

Insurance companies considered anything to do with fertility elective surgery. It was true that much of infertility was caused by gynecological problems. But that didn’t change the fact that they were not required to cover those procedures. Lauerson was incensed. He felt every woman had a right to have a baby. 

It didn’t matter if the patient was rich or poor, celebrity or housewife we sent in the insurance forms. We were billing fraudulently. He thought he was justified. I didn’t think I would get caught.

I knew it was a risk, but I figured that they were His patients. I didn’t overbill and I provided good anesthesia. I thought if we got caught it would be Lauerson’s problem. Of course that was foolish thinking. Fraud is fraud and I was guilty. 

When we eventually did get caught, I had two choices. I could be indicted with Lauerson or I could plead guilty to a lesser charge and co-operate with the Feds. They made it easy. My father worked for me. He filled out insurance forms including those from Lauersons patients. The prosecutors threatened to go after him.

I pled guilty to a one count felony and I agreed to work with the government. The first trial ended in a hung jury. The Feds were furious. They wanted to make an example of Lauerson and after the second trial he was convicted.

IRENE MUGAMBI
P.O. BOX 46059
NAIROBI, KENYA
254-2-722037

Honorable William Pauley III
United States District Court Judge
Southern District of New York
40 Foley Square
New York, New York 10007

December 6, 2001

Dear Judge Pauley,

I am a native Kenyan and live in Nairobi. Six year ago I met Dr. Neil Ratner and his wife while visiting Kenya. While speaking to Dr. Ratner, I was touched by his concern for the poor living conditions and lack of medical care in the tribal villages. His concern became more pronounced after he had visited villages in a region of north Kenya called Samburu. It was then obvious that Dr. Ratner and I had a shared goal of improving the health and welfare of these people. During our time in Samburu I arranged a visit for Dr. Ratner with the local chief. With my help in translating we spoke of improving the welfare of his village and the surrounding area. The chief welcomed this and a long-term relationship developed. This focused on, but was not limited only to the health needs of the Samburu people. Dr. Ratner has come to Samburu at least once every year, year in and year out since 1995 with large quantities of medical supplies, which he has bought at his own expense. He set up a primitive clinic in the one of the Samburu huts, and Dr. Ratner would literally see over 100 patients with all types of medical problems. At times Dr. Ratner would recruit other American Physicians to come to the clinic to volunteer their services. In recent years Dr. Ratner and I have been able to get two government nurses to assist and take custody of remaining medication. These medications would be administered to the Samburu people pursuant to Dr. Ratner’s instructions when he is not there. The nurse’s names are Margaret Kinyua and Sylvanus Birongo and they work at the Samburu Intrepids Camp and the Serena Lodge. These two safari lodges are approximately 7 kilometres from the village. Dr. Ratner has also arranged at his own expense, to have medications sent to the village in between the times when he comes so that there will always be a supply of medications for these villagers. The last supplies were received in June 2001 and included an automatic blood pressure monitor as well as a blood glucose monitor.

In addition to his work with the Samburu people I would like to bring to your attention Dr Ratner’s work in relation to the 1998 Nairobi bomb blast that shattered the American Embassy and killed over 250 people. It also left over 5000 people wounded and scarred. Dr. Ratner joined AMREF to come and perform reconstructive surgery on hundreds of Kenyans who had been maimed and severely burned at the embassy site. AMREF is an organisation that was started in Kenya by Dr. Michael Wood to give free medical care to remote areas of Kenya. AMREF has now become an international organisation and continues to provide free medical care in most parts of Africa and has its headquarters in Nairobi. Dr. Ratner recruited other physicians, who on a humanitarian and voluntary basis, performed surgery over long hours in a local hospital that had variable electricity, limited running water, no air conditioning and archaic equipment. This humanitarian mission not only helped badly injured people but improved American government image, by showing that Americans cared for local Kenyans injured during the blast. Those treated by Dr. Ratner and his team are eternally grateful and the whole country could not say enough good things about them. After this hard work in Nairobi, Dr. Ratner traveled to Samburu with a few of his colleagues and treated hundreds of Samburu people. He again brought a lot of medication that he personally had purchased.

Dr. Ratner has continuously showed his desire to expand his participation for the sick and disadvantaged people of Kenya. He also supports another clinic in the Kenya Rift Valley region, in an area called Naivasha, where many Masai people live. He has brought them equipment that is not available for a small clinic in this country. He has also instructed the staff of the clinic how to best and most effectively use the equipment.

Dr. Ratner and I have had many discussion about the needs of the Samburu people. He has always been concerned about clean water, better sanitation, and the need for a proper medical clinic with a full time nurse. It is with this in mind that we have registered a non-governmental organisation called the Conservation Network. This young body works on improving conditions of human life and conserving the environment and its wildlife. With his guidance we are developing a program to teach Samburu communities about health and sanitation, as well as developing a plan for a clinic and clean water. Dr. Ratner has had the greatest respect and devotion to local communities and especially the Samburu people. It would be a terrible blow if Dr. Ratner was unable to continue his good work on behalf of the people there.

As respect for Dr. Ratner and his work on behalf of the people, Dr. Ratner has been made an elder of the Masai people. Also his marriage vows were blessed in a formal ceremony by the greatest Masai Laibon (spiritual leader) here in Kenya. Furthermore he has been made a trusted elder, which is a very unusual honor to be granted to a foreigner. This shows how highly respected and appreciated he is by the Masai. It is clear that Dr. Ratner was made an elder in recognition of his status as a benefactor and true friend of these indigenous people.

William B. Rosenblatt, MD. Plastic and Reconstructive Surgery.
308 East 79th Street / New York, NY 10021-0906 / TEL 212/570-6100 / FAX 212/570-6155

January 4, 2002

Honorable William H. Pauley III
US District Court Judge
Souther District
New York, NY 10007

Dear Hon. Judge Pauley III:

Neil W. Ratner, M.D. and I have worked together for more than 15 years. He came to see me when we were both beginning our practices and starting to do ambulatory office surgery. As my parctice has grown, so has the number of cases he has done with me. His anesthetic technics are examples of the best in the ambulatory field. I have compete faith in him and he has provided anesthesia for thousands of my patients, as well as various family members.

As a practicing physician I feel it is important to us to give back to society with the skills that we have. For example, I have become involved in the politics of organized medicine and work with the country state and national medical societies in order to improve medicine across the United States. Dr. Ratner has decided to do this in Africa. He has told me, and showed me pictures of his trips to Kenya and the tribe that he helps take care of. I helped provide him with medications to give to the local underprivileged peoples. Although invited to go to Kenya to help care for the victims after the U.S. Embassy was bombed there, I was unable to go and I was impressed with the size of the group Dr. Ratner was able to amass and with the good work that they did there.

Dr. Ratner told me of the events and situations that occurred at Dr. Lauersen’s office. I was made aware of his subsequent treatment and rehabilitation for drug abuse. This is not an easy topic for a physician to discuss and he did explain everything that happened to him in full detail. Through my involvement in the Medical Society of the State of New York, I know of our programs with drug and alcohol rehabilitation and I have seen them work effectively.

I believe that Dr Ratner is an excellent example of how physicians can be cured of drug abuse and return to the full practice of medicine. I look at Dr. Ratner as a loyal college and friend. I believe that these events have changed him drastically and he wants to make amends. I believe that he has rehabilitated himself successfully and would like to continue practicing as an anesthesiologist. His service to my patents is invaluable and I believe that his service to the Kenyan’s and other African peoples is also quite invaluable.

In conclusion, I believe that Dr. Ratner understands and knows what he did. I believe that he is remorseful for it and should be granted a second chance.

The prosecutors wrote a strong letter recommending me for probation but the judge had other plans. I was sentenced to four months in federal prison followed by four months of monitored home confinement. After that an additional three years probation.

The worst part about my sentence was the fact that the judge made me jointly responsible for  the entire amount of the fraud, 3.5 million dollars. That was like a life sentence and I had no idea how I could possibly pay the money back. After all I was the Anesthesiologist. I didn’t make nearly what the surgeon did. 

When I got out of prison I had very little money, but I paid back what I could. After Lauerson got out of jail, he pled poverty. The judge found out he was hiding assetts and ordered him to pay the full 3.5 million. I was off the hook.

As I approached the Federal Correctional Institution at Fort Dix, New Jersey, I saw towers and razor wire.

“Holy Shit this is a real prison” The place looked like the penetentiary’s in the old James Cagney movies.

 I thought I was going to a “Club Fed” (take off on Club Med). That was a term used to describe a particular minimum security prison camp in Florida. Back in the day that camp had tennis courts, cable TV, walking paths, better food and most upper echelon white collar criminals.  

When I was sentenced, the judge agreed to allow me to serve time in a minimum security prison camp. They weren’t as cushy as the “Club Feds” of the past and you had to work an 8 hour day. But it was still the best place to do time. They usually had low staff to inmate ratios, dormitories, little or no fences and mostly non violent offenders.

I spent one week in the “The Big House”. I learned the ropes  and I adjusted to prison life. 

Before the summer of 2002 the word camp had a few different meanings for me. It was a place I spent my summers when I was young. Or being in Africa in a tent deep in the bush. I will never  look at that word in those ways again after my time at FCI Fort Dix Camp.

This was a prison camp. A minimum security federal institution. Don’t get me wrong after a week in the low security prison it was a big improvement. The double razor wire fences were gone and there definitely was a more relaxed atmosphere.

In many ways it was a good experience. It certainly was humbling. A vast majority of the inmates were young disadvantaged black and Hispanics. Most in for something to do with drugs. A sad commentary on our society.

Prison was a revolving door. Being inside didn’t give them the tools and skills they needed to avoid returning. More importantly most seemed lost spiritually. They were caught up in the materialistic nature of our society. They bought the lies and having no skills and limited education the only way for them to make good money was to be involved in drugs. A vicious cycle with no end. 

I left FCI Fort Dix on November 8, 2002. A prison van took me to the front gate. My parents were waiting for me. It felt good to drive away. I didn’t look back. In many ways I was a better person then when I arrived.

Charles Lawrence, a friend and shamen, said something to me before I left:

“Neil, a part of you needs to have this experience or you would not have created it. Go and find what that need is”.

He was right. Being locked up is a very humbling experience.

Maybe I needed to be humbled. I certainly needed to learn patience and tolerance and prison was a good teacher.

In the past I had convinced myself that I could live on the edge and get away with it. I did it with drugs and again with business. Both times I knew in my heart that what I was doing was wrong. Listening to my heart instead of my head is something I thought about often during those long prison nights.

The interesting part for me was that I didn’t miss the nice clothes expensive apartment, exotic vacations or fancy restaurants. I missed the freedom to be with my wife, the freedom to talk to my friends and most of all the freedom to live my life as I chose. It’s the little things in life you take for granted that are the most meaningful and they don’t cost anything.

The difficult times in life provide us with the best opportunity for personal growth. I have had time to process both drug addiction and the time I spent in prison. Through these experiences I have become stronger, more self aware and a much more caring person.