…I haven't taken a shower in two days. I have been sleeping in my clothes. Why should I bother or even care? For the first time in 30 years, I have no responsibility, no friends and only one acquaintance, Yakov. However, it's Saturday and he is a religious Jew. I have no personal or professional obligations. I certainly do not want this situation to last but I am not necessarily optimistic that anything is going to change very soon. In fact, odds are that things will never be anything like they once were for me. What an amazing contrast this is from my days as a successful professional. My hair is long. My beard is out of control. I dress like a bum, intentionally stain my clothes with coffee grounds and play guitar on the street for money.

From Chapter One:
 
…I would assume that if the average person were asked to describe or recall the single worst day of his or her life, one or maybe two events would come to mind. This is not the case for me. I have many from which to choose. That’s why maybe the worst day of my life occurred when I received a call from an attorney whom I hardly knew and who certainly hardly knew me. I can remember his exact words. “Dr. Cohen, your medical license has been suspended.” …

From Chapter Five:
 
…When he called me about the emergency suspension of my medical license, Lewis’ immediate reaction was to say, “There is something unusual here. It doesn’t add up.” Something did not add up for sure. I was totally naïve about health care law and asked what the basis was for the emergency suspension. Lewis could not give me a good answer. As it turned out, Florida’s Secretary of Health, John Agwunobi, really did take the law into his own hands. He acted autonomously. He had an agenda. He decided to be judge jury and executioner. What happened to the cherished right to “Due Process” that our Constitution provides? It has been more than two years and I still have not had a chance to tell my side of the story or vindicate myself…
 
…Sometime in November 2004, an unlicensed osteopathic physician named Bach McComb injected himself and three others with what he thought was a therapeutic dose of botulinum toxin, the active ingredient in Botox and Tritox (the knockoff product). .McComb made possibly one of the most boneheaded dosage errors in the history of medicine. It is estimated that by using this raw material so to speak, McComb gave anywhere from 10,000 to 20,000 times the normal cosmetic dose of the botulism toxin. The cases of botulism that followed were all over the news but it was rarely, if ever, mentioned that a massive dosage error was responsible…

From Chapter Fourteen:
 
…Being an Ob/Gyn doctor was like living a soap opera. I heard it all. I was exposed to the deepest and most intimate thoughts and secrets of many women. I heard stories about partner swapping, infidelity, sexless marriages and much, much more. It was a unique way to view and learn about human nature, humane desires and human frailties. I saw the good, the bad the ugly and the “magnificent”. I shared in people’s happiness and in their grief. I got to look at naked women all day long and they paid me to do that. What guy would not want a job like that?!

From Chapter Sixteen:
 
What’s So Funny About Naked Women Anyway?
 
…No insider’s look at the specialty of Ob/Gyn would be complete without a few of the more famous (or infamous) jokes unique to the specialty. Since they stand on their own and need little if any embellishment, I will simply resort to just dutifully reporting them in between relaying some of my funnier moments and occasional antics as a doctor…
 
…A man walks into a doctor’s office. The doc looks at him and says, “My God, you look terrible.” The man responds, “But I feel great.” The doctor insists and says, “Impossible, you look terrible.” Again the man says, “I feel great.” Of course this goes on and on for several minutes until the doc finally says he needs to look this one up. He grabs his reference book and starts going through the index. He mumbles, “Looks great –feels terrible. No, that’s not it. Looks terrible feels terrible; no not that either.” Then he says, “Oh here it is. Looks terrible, feels great. Says here you must be a vagina.” Bada Bing!
 
…One of my favorite lines came when the patient was lying helplessly on the table, her legs up in the air and a metal speculum inside her vagina (the ultimate southern exposure as we used to say). “So that’s where they buried Jimmy Hoffa.” It usually got a laugh or at the very least got us through the Pap smear…

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From Chapter Nineteen:
 
…The day after the baby incident was a perfect day in the Keys. I had flown down early in the morning and as per my routine, took a cab and met Mike at the dock. I would often take my wife or a friend along because I liked to use fishing as a social occasion. However, this was midweek and I was alone…
 
…This fish was so big that when it was coming straight at me it appeared wide enough and long enough to be a shark. Permit are, as I have said, perhaps 4 inches wide. This one was close to twice that wide…
 
…My knot had failed and unraveled. There was simply no excuse for this. It was angler error and a mistake I would never make again…
 
…I could not stop thinking about this for days. It almost became an obsession. Then in an instant it all changed.
 
When I walked in the nurses (about three of them) stopped what they were doing and started applauding and said, “You’re a hero around here.” It was then that I realized that maybe losing the fish of a lifetime because I tied a poor knot was just my way of looking at the glass half empty. When I looked at the glass half full, I realized that what I had simply taken for granted, saving a baby’s life, made me a hero in the eyes of my colleagues.

From Chapter Twenty-six:
 
…After taking the initial course and another general laser course, I needed to present at least three cases before getting approval from the hospital to perform the procedure. You ask, how was I supposed to present three cases when I did not have permission or credentials to do them? If a doctor is not permitted to do a new procedure until he or she has presented three cases, how is that doctor going to get those three cases to present? Was this another “Catch 22”? Good question.
 
…About the only way to get the three cases to present for credentials was to have someone who has already been approved to do the procedure, serve as your proctor. The only doctor who had privileges for this procedure, was Charlie Lawrence, an old adversary from what I will refer to as the “wart wars.” He had two good reasons for not helping me. He hated me because at the unpublicized request of the hospital administrator, I questioned the necessity of his bringing young coeds into the operating room to laser a few genital warts when topical treatment in the office was the industry standard. Shortly after opening this can of worms (at the discreet request of the administrator), I received a threatening letter from Dr. Lawrence’s attorney.
 
…The biggest complement I could get as a surgeon was when a colleague or co-worker entrusted her care to me or referred a family member. I performed an endometrial ablation on the head nurse in the operating room. That alone speaks for the confidence that my colleagues and co-workers had in me. Of course, this was before we nearly killed Annette.

From Chapter Twenty-eight:

…The laser at the hospital where I was performing most, if not all, of my ablations was an antique. The only advantage that it had over the more modern lasers at the other hospitals where I could have worked is that it had the power needed to successfully perform an effective ablation. Therefore, I was pretty much committed to using the laser at this one particular hospital.
 
…The more procedures I did and the better I became, the more my frustration level with the laser rose. I finally decided to take a different route as far a strategy. I wrote a letter to Sheryl, the Nurse Risk Manager. This was followed by a face-to-face meeting to discuss my concerns. A Risk Manager’s position in a hospital is very high on the totem pole. Hospitals and hospital corporations are extremely sensitive and hopefully responsive to liability and potential liability issues. I figured I would appeal to them on a level that might actually make a difference.
 
…Of course, at the time that I wrote the letter to Sheryl, I did not know or suspect that both a laser malfunction and nursing error would ever occur simultaneously. I just wanted a new laser. What I got a few weeks after the meeting was the reassurance that a repairman had been called and the laser had been “fixed.” Three weeks later Annette died on the operating table; at least for while.

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From Chapter Thirty:
 
…I am not going to say there was an attempt to cover it up. Instead of correctly noting in the medical record that an additional 2000 cc had run in and needed to be added to the 1700 that was already accounted for, the nurses only added an additional 200 cc. They missed a zero. The total was in actuality 3700 cc of fluid but because of the error, the chart indicated 1900. This accounted for an 1800 cc error and an excess of 1700 cc of fluid beyond the normal cutoff.

From Chapter Thirty-one:
 
…It was just a matter of time before I built the foundation for what has become one of the more successful Ob/Gyn practices in Boca Raton. Eventually, I was run out of the very practice that I started and the office that I had expanded from 750 square feet to over 2500. Greed is greed and when deals are done on a “handshake” there is always risk that the “what have you done for me lately’” philosophy will kick in. Despite this setback, I still managed to yet again, reorganize my professional life and did well for several more years.
 
…Typically what would happen is a managed care company would infiltrate an area and start to round up doctors. The approach would be, “You can’t beat us so you have to join us.” The companies would tell the doctors that as more and more patients, and companies that provided health insurance benefits to their employees were signing on to their managed care plans. Patients were going to have to entrust their care to the least successful and probably least talented doctors. Those were almost invariably the ones who were the first to enthusiastically sign on. It meant instant success to someone who had otherwise been marginally successful.
 
…The one day course launched my career as a vein treatment doctor. Doctors take one day or weekend courses and come back declaring themselves experts. If this sounds exactly like what I did then perhaps I should elaborate on just how I started after my initial one day course. Years later, I ended up being perhaps one of the most knowledgeable, and for a time, one of the most well respected doctors in the “vein business.”

Chapter Thirty-two:
 
…1994 was a tough and intense year. Several things happened which contributed to forever changing my life. The two most dramatic were a business that I helped start which went completely haywire and an eight week malpractice suit brought against me and two former partners by one of South Florida’s most infamous malpractice attorneys.
 
…There were times during my medical career when I had found myself up to my elbows in amniotic fluid, feces and blood while delivering an uncooperative patient on a stretcher in the middle of the hall on the way back to the delivery room. However shoving my arm up an ostrich’s ass was where I drew the line. Fish farming seemed to be a more realistic and cleaner option. If I was going to lose my shirt, I might as well do it in an industry close to my heart and I am not talking about the smell.
 
It was the floating shit that got us. Its beauty was in its simplicity. Its fatal flaw was that it only worked for sinkers, not floaters!
 
…Larry started spending the contingency budget like a drunken sailor by testing all kinds of other conventional filters. Murphy’s law was invented with fish farming in mind. Everything that could go wrong did. We did indeed at one point have a mass fish kill. Tilapia go bad pretty fast. I am told that in just a matter of hours the smell was terrible though I doubt anything could have rivaled the legendary “lost tampon.”

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From Chapter Thirty-three:
 
…Initially, when you tell someone something like this there is disbelief and denial. In Merry’s case that was certainly true. We both wanted to believe that the donor who was now HIV positive was negative years before when Merry had received his or her blood.

Merry had the test. I can only try to describe the look on her face when I had to sit there and tell her that it was positive. The look was the proverbial “deer in the headlights” mixed with confusion and disbelief.
 
…That night I received a call through my answering service from her husband. Of course, I called him back immediately. There was not much I could say. I will never forget what he said to me. “You have condemned my family to death.” Of course, her second child was HIV positive and odds are that he was also at that point.
 
I tell of this incident, in part, because it was not too long after it that I had myself convinced that I was going to become HIV positive. .
 
I can make light of some of this now. However, my words do not really do justice to the amount of agony I suffered during this year of my life just from this incident alone. I literally lived from one test to the next. I could seldom stop thinking about it or keep from being preoccupied by the though of becoming afflicted with AIDS. .when the six month test came back negative as well, my wife and I celebrated but not without protection. She had an IUD but I used a condom anyway. As I relate this I smile and think about the Spanish lady in whom Phil and I had placed an IUD even though her tubes had been tied.

From Chapter Thirty-four
 
…I wish I had kept notes. Even if I could get my hands on the court reporter’s transcription of the trial, I doubt that I could adequately express the pain, anger and humiliation to which I became subject during eight weeks of my life.
 
…Kate’s uterus had been infected with a very common and generally harmless bacteria called Group B strep. Many men and women carry these bacteria and most are seldom treated for it. My partner did everything right. He made sure to get bacterial samples from the placenta and even have the placenta examined microscopically to prove that there was indeed an infection. This was probably critical to our defense of this case.
 
…When the case went to the jury, our malpractice carrier decided to offer a settlement. We offered “policy limits.” Kate had $750,000 or at least a portion of that in hand but decided to take her chances with the jury.

From Chapter Thirty-five:
 
…I was sitting in my office reading a medical journal. I usually found the advertisements more interesting.
 
As fate would have it, an ad jumped out at me in the “Practice Opportunities” section. It read something like, “Seattle. Outstanding Ob/Gyn practice. 1.3 mil gross. Guarantees.” And, of course, there was a number to call. I knew then and there that I was looking at the “Golden Goose.” In actuality, I was really just going to get goosed – big time. I already had myself thinking, “This is in the cards.”

From Chapter Thirty-six
 
…These meetings, along with the very conspicuous absence of the 13,000 patients, led me to do a bit of after the fact investigating. Dr. Step did indeed retire from practice on a medical disability. That was where the truth stopped. What I had not been told is that prior to his retirement, there had been as many as 11 malpractice cases filed against him and Blue Cross of Washington had accused him of insurance fraud. I learned that he had negotiated with the State Medical Board, to voluntarily give up his license.I guess a good strategy for protecting oneself from litigation is simply to retain every lawyer or law firm in a city. Step had come close.
 
…Given the controversial nature of my predecessor and the fact that I was a newcomer to a geographic area that was extremely proper and protocol oriented, one would think that I would have gone all out to be on my best behavior. In retrospect, more than once I have thought, “What the hell was I thinking.” However, in reality, the answer is that I was not thinking. I was just being me. I did what made sense; what I knew would work. As a trusting person, I put too much trust in someone who I did not even know. The only one to get hurt was me.

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From Chapter Thirty-seven:
 
…In Florida, during the Harley craze they had a word for guys like me; JOB. That stood for “Jews on Bikes.” I would typically ride to the hospital, park my Harley at the entrance to labor and delivery and go to work. I went from outlaw to doctor in a matter of minutes. I always found these ironies personally amusing. It was even more amusing to see the expression on some one the expectant husbands’ faces when I would often walk into the labor room before changing. The wives and nurse would always reassure them that what they were seeing was not what they were getting. One time a husband asked me, “Who are you.” To which I quickly I said, “The janitor.” I think that story is still being told on labor and delivery even today.
 
It probably was not a great idea coming to the hospital in Burien, Washington dressed like a Hell’s Angel.
 
A few days later, I was sitting in my office when I received a call from the head nurse of labor and delivery. She then went into a very stern and concerned discussion about my use of Pit in an off label manner and my attempt to lie about it or conceal it from the nurse. About the only smart thing I did was not to argue with her at the time.
 
…The last baby I ever delivered was a boy just before the week of Christmas 1995. A few days after that, my temporary privileges expired. I then entered into a period of “limbo.”
 
One of my interviews was at a clinic in Jacksonville, Florida. It was a vein treatment clinic that was established by one of the ex partners of my old friend Roger King. At one point Roger had as many as six clinics throughout Florida and four physicians working under him. He lost it all but that is another story. Rumor has it that one of his problems that led to a messy divorce was that he violated the eleventh commandment. “Thou shall not place thy rod in thy staff.”
 
It was May 1996. I had not received a paycheck since November.
 
…In February 1997, I received my first paycheck in 15 months. What a great feeling that was. I was back. It wasn’t all perfect, but it was far better than Seattle; at least while it lasted.

From Chapter Thirty-eight:
 
…During the first year, one of the bosses would come down about once every two weeks and eventually just once a month to check on things. I am going to call them Groucho and Harpo because I have run out of stooges.
 
One month after my first year anniversary, I was asked to come to North Carolina for our first annual business meeting. Totally unexpectedly, the bosses especially the senior one, Groucho, started ripping into me. This came completely out of left field. I had no idea it was coming and it seemed bizarre and unusual.
 
Again, things just seemed incongruous and bizarre. Our revenue for the year had improved by at least 10 –15% and yet I was accused of letting the practice run down. I was far too intimidated to even mention that.
 
…After being subject to this bizarre show for the better part of an hour by Groucho, as if on cue Harpo spoke up. He said, “Norm, we want to make you an offer you can’t refuse. We want to sell you the practice and we will make it easy for you.”
 
Not more than five minutes later the phone rang. The next four words were the only ones I can repeat in public. They were, “Norman, this is Groucho.” I did not know there was such a tremendous number of ways to use “four letter words.” For the next five to seven minutes, Groucho ranted and screamed at me with about every other word being profanity. I was literally shaking.
 
…In October, at the age of 48, I became the owner of the practice and took on close to three quarters of a million dollars in debt. It was the last thing I wanted but I had little choice. Less than three years later, I had my first heart attack but that did not slow me down much.

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 From Chapter Thirty-nine:
 
…Despite this minor personnel glitch, I pushed forward. I started a medical training program. I started to research and add other services. I started acquiring more and more high tech equipment and would pride myself on being the very first in Jacksonville to introduce it to the public. I essentially became a “Med Spa” before the concept was even invented. We offered Botox, Collagen, Photorejuvenation using high tech lasers or intense light machines and a variety of other beauty enhancing procedures.
 
…I introduced the training program and placed a few ads in a popular medical journal. The response was beyond my expectations. Within a few years, I was turning people away. I gave a three day comprehensive course. I came off as being a “professor.” What started out as a few type written pages of advice for my students, eventually turned into an elegant training manual. My name was out there. One of the companies that sold a certain laser used to treat varicose veins latched on to me and began sending their clients to my office for training.
 
The training course along with my books, videos and other practice support material was good for me and good for the practice. It gave us national recognition. Eventually, the rather smug society devoted to vein treatment, known as The American College of Phlebology (ACP), could no longer ignore me. One year I sent them more new members than anyone else and for two other years, I was among the top three in referrals. I reached my peak with the ACP when they asked me to participate at their large annual meeting in Ft. Lauderdale. I gave a creative, humorous and informative lecture that people still remember called “Fishing for Veins.” It got very high marks when people submitted their evaluation forms. My star was rising with the ACP. I was asked to serve on several committees and to help organize the next annual meeting, which was a huge honor. This all ended rather abruptly. I became someone whom the ACP clearly wished to not have as an insider. It became very obvious that they wished to distance themselves from me as much as possible.
 
…My video on cosmetic sclerotherapy was so good that two years after being ostracized by the society, I was asked by old Groucho, who was now a member of the Board of Directors, if they could show my video at an annual meeting. My gut feeling was to tell him and the ACP that I knew what they could do with my video but I doubt anyone would have been able to see it if they placed it where I wanted to tell them to put it. I guess the ACP figured I was OK to sleep with but marriage was out of the question! They used Groucho as a pimp.
 
Of course, after the license suspension, the laser company dropped me as well. The deck just ended up being way too stacked against me. I could have probably survived the assault from Dr. John Agwunobi. I probably could have regrouped and reorganized. However, more bad luck was just around the corner and just as I was making a slow but steady comeback another disaster occurred.

From Chapter Forty:
 
…When the news of my license suspension hit the media, friends told me the public had a short memory. To an extent, this was true. We did indeed rebound. In fact, we actually sold more Botox in the months following the incident than we did before. I could not buy it from Allergan even after the license suspension was reversed. For me failure was not an option.
 
…I was determined to have “my day in court.” Dr. John Agwunobi had decided to bypass the system when he took the law into his own hands. I never had any opportunity to defend myself, either with the Board or the media. After 18 months there was very little movement on the part of the Board. A few doctors had made settlements but the Board did not seem to be pushing the issue. The settlement they offered me was totally outrageous.

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From Chapter Forty-one:
 
…Since this is a matter of public record and also since the patient appeared in the media on multiple occasions, I see no reason to pay attention to any confidentiality issues.
 
Dorothy (“Dotty”) Hartman came to me with complaints about her legs.
Dotty’s procedure was uneventful. She went home about an hour after its completion as was typically the case. The following day I received a call from Dotty. I saw her that afternoon.
 
I had never seen a case like this before and I had only heard about it in passing, oftentimes from the media rather than medical articles. It is commonly known as a “flesh eating bacteria infection.” This condition is fatal about 25% of the time. Additionally, it seemed that with the rapidity of spread and the fact that it was affecting the entire leg, the likelihood of a life saving amputation was very high. As in the case of M whose uterus had to be removed to help combat a life threatening infection, it appeared that Dotty was going to lose her leg for the same reason.
 
…I found out about the impending lawsuit when a request for her medical records arrived by certified mail.
 
In what can only be described as an attorney grandstanding in the worst possible way, Dotty’s lawyer, Sean Cronin, called a press conference to announce his pending action against me. The media, always hungry for an opportunity to be predatory, was all over this. He paraded Dotty in front of the television and newspaper reporters. They accused me of not using sterile instruments. Of course, no mention was made of the fact that the instruments, needles, catheters, etc., used for the procedure were all disposable and sterilized by the manufacturer but why tell the truth?
 
…In the wake of this, I became amazed that someone could make those statements in public with no personal consequences for them and little to no recourse for me. The lawsuit had not even been filed. Cronin was only announcing his intention to sue me. Mrs. Hartman was in front of the media saying that I was unfit to practice medicine because I used non-sterile instruments. When I spoke with the attorney I had retained to take the action against Judath about the possibility of me countering with a defamation lawsuit, he politely refused. He was not going to sue another local attorney.

From Chapter Forty-two:
 
…I knew my career was closing in on me. I had always done my best to protect myself and those around me, especially the people who were committed to me. I was failing them. However, most of my staff realized and respected the effort and sacrifice I was making and with the exception of one more major betrayal, they stayed behind me.
 
Then out of nowhere, Dr. Elizabeth Queen comes up to the booth with a great big smile and bubbly personality. Apparently she had come to this meeting with an agenda as well and I was exactly what she was looking for. I needed someone relatively urgently and she seemed perfect for the job. I also believed that all the representations she made to me about the practice and my future once she took over were sincere. She played me like a fine violin.
 
She became a physician later in life. Apparently, two years was enough. She wanted out. She wanted a cosmetic practice. She also wanted to move from North Carolina to Florida. It was all too perfect. As I have already stated, they (whoever “they” are) say, “If something seems too good to be true, it usually is.”

From Chapter Forty-three:
 
…I became somewhat disenchanted with her early on but never said a word. She had made it clear to me on several occasions that she was going to buy the practice and make sure that she provided for me because I deserved it. There were times when the conversations of this nature were quite heartfelt. Of course, I had disclosed everything to her almost from the time we first met. I left nothing out. There were times during our conversations, when I came close to tears about what had happened to me. During those times it was hard to believe that her apparent kindness and sensitivity was not sincere. Perhaps I should have spoken with one of her ex husbands! The woman had ice in her veins.
 
…Three days before the closing was supposed to happen, Lizzie came to me down in the mouth. She said that she could not come up with the $300,000 down payment that we had agreed upon. She asked if I would accept $150,000 and take a secured note for the other $150,000. I had little choice but to say yes.

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From Chapter Forty-four:
 
…I had not been out of the office and semi-retired for more than ten days when I received the first of many calls that day from the press. They asked me to comment on the settlement that had just been announced by my old friend Mr. Cronin. Apparently, he and Dorothy called another press conference to announce that they had received a settlement of $100,000 from my insurance company. This was the limit of my coverage and Cronin knew that he was not going to get anything additional by suing me since I am certain he did an asset and credit check and found that I was in pretty poor fiscal shape.
 
This entire unfortunate event should have never happened if the attorney that was assigned to me by the insurance company, Mr. Dickey, had done his job.
 
…About four weeks after I had officially said my goodbyes and unceremoniously left the office, I was asked to give a lecture to a group of doctors in North Carolina. …If I could generate income as I was doing by giving this lecture as well as my other professional activities and consulting business, I could quickly resolve the remainder of my debt. I love it when a plan comes together. I thought mine had done just that. Then the call came.
 
…My cell phone indicated that Lizzie was calling. In retrospect I can almost see the grin she must have had when she said to me. She had just been handed a golden opportunity.

From Chapter Forty-five:
 
…Home for my wife and I was a three-bedroom manufactured home in small town south of Daytona called Edgewater. It was my dream place. We lived about 15 miles from the space shuttle launching facility. Life was good in Edgewater, at least until I got the call from Lizzie. At that point my life and lives of my wife and daughters were turned upside down and inside out. 
 
From the last several chapters:

…So the decision to move to Israel was easy to make. I had little choice. However, just because the decision was logical does not mean that it was not agonizing. It was that and then some. I sobbed like a schoolgirl when I heard that my visa had been approved. I could not look at Hank without agonizing over how I was going to miss him. I could not explain things to him and I wondered if he would miss me. I tried as best I could to detach myself from the little home on the water that I had grown to love. None of this was easy to say the least.
 
…I managed to maintain my composure when I said goodbye to my wife and oldest daughter at the Atlanta airport. When I first saw Tel Aviv as our plane approached after an all night flight, again tears came to my eyes. In the weeks and months that followed, there were moments when my resolve was tested. Even after six months there would be times when for no specific reason, I would get tearful. It did not take much. There were lots of poignant memories that I could not always suppress or deal with on a logical basis.

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