Target: Pain Doc

Chapter 1

The day started like every Tuesday with me completely engrossed in work. Suddenly a man appeared in my peripheral vision. I jumped up, startled.

What in the world! What is he doing coming into my office like that? Sandra hasn’t announced him! Before I could even think of a reprimand for her, he spoke.

Dr. Smart?

Yes? What….

Stay seated, he barked. I have a search warrant. Here is your copy. He handed me a paper.

My face reddened with anger. I felt the heat rise to the top of my head, exploding out my mouth like a volcano. What in the world for? I haven’t done anything wrong!

That’s for the court to decide. Anything you say can and will be used against you. Do you have something to say? Go right ahead and say what’s on your mind. He leaned against the filing cabinet.

Unbelievable! What you people won’t do to stop pain management in this country. I run an immaculate practice--one that could be the model for any pain management clinic, yet you raid it. On what grounds? I looked at the face of the warrant.

Medicare/Medicaid fraud! You’ve got to be kidding!

My legs became weak. I fell back in my chair feigning sitting. Sitting was my only option anyway, as he stood so close. Tall and thin, he still had an imposing enough frame that I knew better than to force the issue. Sure wouldn’t want to give them a real reason to arrest me.

I reached for the phone to call up front.

Don’t do that, he hissed.

What do you mean? I need to check on my staff and see if they are okay.

No you don’t.

"You mean I can’t call anyone? My husband?

No. You can just sit there.

I can’t do any work?

No. He handed me his card. Justin Tabor, DHHS Investigator, written in bold cursive letters. He stood there in his blue Oxford shirt and khaki pants, looking dull and boring, but threatening if I crossed him.

How are the girls up front?

Tabor didn’t answer.

How many patients are there? Sandra and Nancy must be going out of their mind scared to death. Visions flashed through my mind of TV news segments showing federal agents holding a doctor’s office staff at gunpoint. Thoughts whirled through my head as I tried to guess what was happening through the office. I tried to appear calm, although my stomach churned and I felt sick. I guess this is going to take a while. May I read?

Okay.

I looked around and chose a Bible lying on the credenza shelf. The pages rattled as I tried to turn them. Damn, Roxie, stop the shaking. He’s going to think you’re hiding something. Calm down. I let the book fall open naturally and started reading. Two verses down, I realized that my eyes were following the words, but the words didn’t stick. I closed my eyes. Lord, calm my spirit. Help me get through this. I pray that the girls up front are okay. Be with them and give them support. Thank you, Lord. I opened my eyes and let them continue to follow the words. Look calm, at least. Your world might be coming to an end, but you don’t need to let on to him! Tabor watched every move I made, like a cat ready to pounce. Tears formed in my eyes, but I forced them away. Anger took their place.

As a small country practitioner, I ran my own office. I didn’t see patients on Tuesday, but I still worked. Claims to refile, referrals to make, letters to write. Never-ending work. I looked at my watch.

Three thirty. I wondered how many patients were in the office when the government stormed in. I bet they were scared out of their ever-lovin’ mind. Since Jefferson and Patty finish at four thirty anyway, there probably weren’t many. I sure wish the media knew about the raid. I better put in my two cents worth quick before people jump to their own conclusion.

After about an hour of sitting I needed to use the restroom.

Can I go to the bathroom? I asked Mr. Tabor.

Yes, that’s okay. Just don’t go anywhere else, and come back here when you are done.

I got up and walked into the hallway where I could see a little of the goings on. Six plain-clothes agents were there.

So Clancy Poag is a part of this! That snake-in-the-grass! Poag strutted his stuff around looking omnipotent as the drug diversion officer in the area.

Mr. Poag. I spoke to him with as much disgust in my voice as I could muster. I hoped my gaze communicated my hatred. The potbellied holster-toting SOB met my gaze and simply nodded his head. He carried the only gun I saw. Did he have it drawn when he came in? What separates him from the criminals? Just that badge attached to his belt loop! Poag always appeared on the dark side.

Poag never smiled. He visited the office in the past during investigations of patients that I had told him were breaking the law. But for the last year he never responded to my calls. Now, looking at him strutting the hallway like he owned the place, I knew. Ah ha! He wouldn’t talk to me about real lawbreakers because he planned to attack ME! He planned to take down another pain management doctor in the War on Drugs. As a former US Attorney had said in the seminar on pain management in Cincinnati, they go where the money is and the guns aren’t.

We want you to move up front to the reception room now, said Tabor as I emerged from the restroom.

`Can I take a book?

Yes.

I walked back into my room and picked up Fibromyalgia.

A lot of good this is going to do me if they shut me down! Hell, maybe seeing me reading a book on pain management might make them feel guilty. NOT! I also reached down to pick up my purse.

Can I take my purse?

No--if there is anything you need out of it, we’ll bring it to you.

I turned and walked down the hallway to the reception room. Through the front window I saw the Sandovie TV station van parked across the street. A reporter stood in the street with her back to the office. A cameraman panned across the office as she spoke. Good! The news media learned about the raid. This is going to be a real embarrassment to the government. Maybe they won’t be so hasty next time, raiding a doctor’s office without just cause. They sure won’t find any insurance fraud here. I wonder what they’re really going to charge me with. They usually go for the good ol’ catchall of prescribing without justifiable medical purpose. But I’ve documented every medical decision well enough to defend that charge. I stood a little taller with pride in my pain management prowess as it gave me some satisfaction. They can look through all the records and won’t find anything to charge me with.

Thoughts continued to swirl through my head as I walked into the reception room. Three agents were standing there. Two moved on, but one remained to watch me. There was no sign of Sandra or Nancy. They had obviously left. I sat down. Looking out the front window, I saw the sun disappear below the horizon.

Tabor sauntered through the reception room as he supervised the destruction—just another normal workday to him.

"Let’s go. American Idol’s on tonight at eight o’clock. We need to finish up."

Good. They should be finished soon. That should give me time to get to the Emmaus reunion group. That gave me my first sense of relief. I didn’t want to miss the group. I’m sure glad I don’t like American Idol. I’d never be able to watch it again. Just hearing the name would bring me back to this moment. I want to erase this from my mind forever. If he’d picked a show I liked to watch, I’d never watch it again.

I opened my book to look busy, but I wasn’t really reading. I wonder if they’re going to shut my doors so I can’t work. That’ll be the end of my business. I can’t keep things going without an income. Will I have to let Jefferson and Patty go? Now I know why Mom died so suddenly. God always provided the funds to keep this business going every time I reached the point of failure before, and He’s done it again.

An agent broke my train of thought. Someone is here to see you. He says he’s your husband.

Okay, am I allowed to talk with him?

You can go out. He can’t come in.

Will I be allowed to come back?

Yes.

I walked out the front entrance and saw Wilson.

What’s going on? What’s with all the cars? Who are all these people? he fired off a round of questions with a worried look on his face.

I’m being raided. They got a warrant to invade my office in the guise of insurance fraud. They’re tearing the place apart. I’d guess about twenty of ‘em.

What do they want? What are they looking for? You haven’t done anything wrong. What grounds do they have? Wilson kept firing questions at me.

They don’t need grounds. They’ve got a list of things they’re taking out, from patient records to computer information to receipt books. They want to shut me down. It’s a fishing expedition. They‘ll use Medicare fraud as a door opener. Then they’ll go through the records and try to come up with something to charge me with. My throat tightened. I could hear a slight wheeze from the constriction. Tears swelled in my eyes and started rolling down my cheeks.

Ten years of building up a practice, many of which I made nothing so that the others could be paid. Bringing Patty into the practice to help Jefferson brought on more hardship. Just starting to give myself a salary, now all those years for naught, coming to an end and no way to pay off the debt. I guess I could declare bankruptcy, but the word bankruptcy does not exist in my vocabulary. I’ll get it all paid off somehow.

I continued speaking, I’m just the next pain clinic on their list. My fists clenched, anger took the place of self-pity. I don’t know what to do to fight them. How do you fight the government? I’ve run a model practice. They could use me as an example for others on how to prevent drug abuse and diversion. Instead, they want to shut me down and force the people to go to the street to get their pain meds. I tried to hold my composure, knowing agents had me under surveillance through the window.

Wilson locked his arms around me and looked into my eyes. We’re going to get through this. I’m here to support you. Is there anything I can do?

No, I don’t think so. The news media was already here. You can go home and see what they say on the news. I should be able to see it at eleven o’clock.

Okay. When do you think you’ll get out of here?

By six, I hope, so we can go to reunion group. I need the support of friends right now.

He hugged me again, turned and started walking back to the car. He’d parked at the shops next door because government vehicles blocked the entrance to the office. I watched him walk carefully over the rough terrain separating the two buildings. Wilson’s cerebral palsy gave him a weak right leg that could cause him to lose his footing. He made it to the car. As soon as he turned the lights on and backed up, I went back inside and solemnly resumed my captivity in the reception room.

After five thirty, I watched the time more closely as I needed to leave by six o’clock. I got antsy. My attempts to read were continually interrupted by thoughts of when they were going to finish.

Let’s go, folks, Tabor hollered in the hallway. "Remember American Idol starts at eight."

I had first thought they would get done in time. But as time progressed it didn’t look like they were wrapping up.

I couldn’t control my anxiety any longer. Tabor walked through the reception area and I asked him, Do you have an idea if you will be done soon? I have a meeting tonight at my church that I would like to attend.

I can’t say when we’ll be finished. You can leave if you want. If we get done and you’re not here, we’ll just throw a board across the door.

I met his sarcastic, ugly reply with a silent glare. I didn’t want to be goaded into saying something. You are such an ass, I hoped I conveyed my thoughts as I looked him in the eye.

Okay, I’m leaving, I wonder where they’ll find a board! I chuckled to myself. I picked up my purse they had brought to me after searching it and walked back through the halls to the staff entrance. Along the way I saw a dumpy bearded Santa Claus type panning around the sitting room with a video camera.

I almost laughed he was so comical. They’re not going to find a lot of value in my wall decorations.

He panned across the portrait of Einstein, and the picture of a girl and her dog. They were cheap prints I bought at an auction.

More agents were standing around in the staff entrance room where supplies and archived patient charts were stored.

One of the agents in the room spoke as I walked toward the exit. Hello Doctor Smart, how are you doing? Realizing the ridiculousness of his ritualistic greeting, he added almost apologetically, in spite of all this. He acted almost friendly. I wondered if I knew him somehow, but I couldn’t place him.

I feel v-violated.

That’s understandable. He glanced down to the floor.

I glared at the agents who were going through the storage boxes. I walked past them head held high with determination, left the building, and got into my car. At the moment the engine started a song began to play on the radio. I listened to Spirit FM, a Christian radio station, since learning about it on my Emmaus Walk. Dum…. dum, dum…….dum….dum, dum. I recognized the first musical bars of the song Praise You in the Storm by Casting Crowns. I liked the song before, but now the words had special meaning. My life had been filled with trials. At one point, I had even separated myself from God during a loss of faith. But He continued to pull at my heartstrings, and I re-discovered my faith. Now a true believer, this song spoke my message. I took it as a message from God for me. It even contained my favorite Bible verse, Psalm 121…I lift up my eyes to the hills, from where does my help come? That verse and that search for doing God’s work brought me to this area. I sat in the car, listening to the song and could not hold back the tears any longer. The floodgates opened. I sobbed and pounded the steering wheel in frustration and anger. I gasped for breath. Lucky for me, darkness gave me privacy where no one could see or hear.

* * *

Elsewhere, a man stood by his office window and looked out over the parking lot. We’ve got her now! We’ve finally got her! She won’t cause us any more trouble. Life here on out will be great. More money, promotions, recognition. A slight smirk crept across his face as he lifted the brandy glass to his lips.

Chapter 2

I phoned Wilson as I left the parking lot. I’m heading home. Be ready. We don’t have much time to make it to church. I had cried myself out by the time I reached home. I dashed inside to check my makeup and cover up my swollen eyes. Wilson was already in the car when I got back. I jumped back into the car and we headed to town.

Six thirty. Well, we’ll be fashionably late, I said

I think they’ll understand.

I want to ask everyone at the beginning to pray over me. I hope they haven’t started yet.

We’ll take the time. Don’t worry.

Thank God for friends.

Our Emmaus reunion group met every Tuesday evening. The Walk to Emmaus is a spiritual weekend for Christians. Following the weekend, participants continue to meet in small groups for support and accountability in their Christian walk.

I thought about the reunion group as I drove. Funny how God prepares you for what you need even before you need it.

A friend and colleague sponsored me on my walk three years earlier. He had made the offer several years before that, but I didn’t have a close relationship with God then. I believed that I could commune with God out in the barn with the horses, or working in the flowerbeds. After my divorce from my former husband, David, I found my faith again, I needed to experience the Emmaus weekend. God wanted to have a relationship with me! I was going to need Him in my life.

Wilson was my third husband. I met Wilson through a computer dating service. A Christian man, unlike my two previous husbands, I had invited him to go on an Emmaus Walk. We became active members of the Emmaus community following his walk, attended the gatherings, helped with the weekends in the background, and joined a reunion group.

In the car Wilson asked. I’ve been worried about you. How are you feeling?

I feel violated--like I’ve been raped. They’re tearing the place apart! I started to cry again. Wilson reached over and put his hand on my thigh.

When we entered the church, the men were already sitting in their room engaged in small talk. The meeting hadn’t started yet. I looked around for the women, but there were none. We walked over and joined the men.

I have a prayer request. We sat down on the sofa. I’m in the process of being raided by the government. They’re in my office right now.

They looked at me with disbelief at first, then shock. One of the men, another physician in town, started the questioning.

Why are they raiding you? What excuse did they give?

Medicare-Medicaid fraud. But you know that is just the door opener. The real reason is pain management.

He nodded his head knowingly. He spoke to the rest of the men. It’s a concern for all of us. They can charge you with fraud for anything. Charge too much for an appointment, or charge too little, they’ve got you. It’s a nightmare. We all just hope they never come into our office.

I don’t know what’s going to happen now. I can’t afford a trial. I’ve just started paying myself a salary after years of not making anything. I guess I’ll lose everything. I started crying and reached for the tissue box. And my patients…what’s going to happen to them? No one else will treat them. I’m the only one in the area who is willing to do it. I do everything right, run a model clinic for what should be done, and yet they raid me and charge me with a fabricated crime to close me down. Right now I need your prayers and support. Tears of grief and fear mixed with anger as I sobbed.

You’ve got it. The men answered in unison. They surrounded me to lay on hands.

One said, Give this woman strength, Father. She is going through a tough time, Lord, and needs Your help.

Another followed saying It is at those times in our lives when there is only one set of footprints in the sand, Lord, that You carry us. Be there with her, and carry her through.

A third spoke. Lord, you know Roxie. You know she is doing Your work helping people. She has been doing this service that no one else is willing to do. Protect her. Guide her. Let her know that You are with her.

Even with my eyes closed, my tears still flowed. I felt a calm and warmth through the laying on of hands, When everyone finished speaking, they hugged me, and I left the group. I went over to another sitting room and worked on my computer, writing my statement to the newspapers while the men talked.

Chapter 3

Life had already given me several knockdown punches over the years. At the young age of twenty I married my first husband, Max—an alcoholic misogynistic military pilot. A very beguiling man as a suitor, he covered up his true nature. I gave up my childhood goal of being a doctor so that he could follow his goals in the military. I switched to teaching which would allow me to find a job wherever I went. Living with a mentally abusive husband gave me coping skills. Through reading books on transactional analysis, a counseling strategy of the time, I overcame my severe low self-esteem and learned how to contradict the esteem-destroying comments he made.

After twenty years of teaching, I had reached a point in my career where I started asking myself questions. I had become the department chair of the science department at a high school near San Felipe, Texas. I taught the best and the brightest students chemistry and advanced biology but most of them weren’t interested in learning. That made me become very disheartened and discouraged. I felt burnout already at thirty-nine years of age.

As the department chair, I worked on getting the department together socially outside of school. At the end of a school year, the department had a swim party at a faculty member’s house. Sitting in a lawn chair by the pool I expressed my disappointment to a fellow chemistry teacher.

You know, Sam, I don’t want to get to be an old burned out teacher that students hate. But it is exasperating. They don’t want to learn. You know, I didn’t start out my life wanting to be a teacher. But now I feel stuck.

What did you want to do?

"Since the age of six I’ve wanted to be a doctor. I even took the MCAT, the Medical College Admissions Test, my junior year, but I married and my medical