What Is One Thing That a Fashion Dermattologist Responsible for
The Unlikely Improvement of the 'Pill-Popping Dermatologist'
July 9, 2014 dawned hot, dry and cloudless, the New York sidewalks shimmering in the heat. Dr. Cheryl Karcher, a frequent dermatology expert on CNN and shows like "The Doctors," had no idiot box appearances scheduled that 24-hour interval, but, equally always, was camera-ready in her olive dark-green Theory pants and crisp foam blouse.
She said her "I honey y'all/I love y'all more"southward to her children later they and her husband dropped her off at her Park Avenue office, and she was readying a laser for her starting time patient of the solar day. At that place was a knock on the door.
"Cheryl, in that location are police hither," the receptionist shouted. The staff causeless information technology was about a former employee. Two weeks earlier, a medical assistant had been fired when it was discovered she had been buying Percocet for the office and stealing information technology for her drug-dealer boyfriend.
A SWAT team in military garb converged on Dr. Karcher. The receptionist started crying, and the office manager screamed, "Wait, y'all've got the wrong girl."
Information technology was not about a medical assistant. They did not take the incorrect daughter.
"Celebrity Doctor Indicted for Illegal Possession of Prescription Meds," blared The New York Post, which labeled her the "Pill-Popping Glory Dermatologist." The New York Times (which in May had merely featured Dr. Karcher in an article discussing a new fatty-zapping ultrasound treatment whose hurting level could be quelled with Percocet) reported that she was involved in an declared drug "scheme."
She was led off in handcuffs and brought to the Police Section'south 19th Precinct. A 50-count indictment, referring to activity that occurred two years earlier, charged criminal possession of a controlled substance, fraud and falsifying business records, and illegal dispersion of narcotics.
Reporters were gathered outside, shouting: "Medico, did y'all steal the pills? Doctor, did yous sell the pills? Who'd you sell them to? What are y'all going to tell your patients?" One police officer shielded her confront from cameras with her Michael Kors bag.
"Yous know, after that day, I threw out that outfit, and fifty-fifty that beautiful bag, which had been given to me as a gift. I but couldn't stand the clan," she says, over tea at an Upper East Side diner (with the unfortunate name Midnight Limited).
In her belatedly 50s, Dr. Karcher has the toned body of a lifelong athlete. She wears sheer makeup and sunscreen on her pare, and she touches me frequently as she talks. She is nervous. This is the first fourth dimension she has discussed her abort and its consequences publicly. She laughs at the suggestion this has fabricated-for-TV-movie potential.
"Yep, there are a lot of heart-aged actresses who'd similar to play a dermatologist taken in past a SWAT team," she says.
Existence defendant of illegally selling narcotics is one of the worst things that can happen to a doc. Beingness labeled a drug addict isn't much better. And nevertheless ii years subsequently the abort, Dr. Karcher is dorsum and very, very decorated, sharing wellness advice, favorite dazzler products and tidbits from her one time-again robust social life on her lively Facebook page. ("Summer is in full-on swing and besides the hot days, longer nights and BBQs, it's also the season where beer and booze seem to be flowing a bit more freely — which means your skin and body are existence put through the ringer," reads one recent entry.)
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There was no jail time. Instead of being adjudicated in criminal court, she was turned over to New York'south Judicial Diversion program, without having to plead guilty and thus losing her medical license. She was allowed to attend a rehabilitation program while still seeing patients.
Many have wondered how this was possible. Was Cheryl Karcher's penalization the kind of sweetheart bargain accorded only the most privileged in our lodge? Or was it an entirely fair result, a reflection of club'south changing attitudes toward substance abuse?
Possibly it was both.
What cocaine was to the '80s, opiates are to the 2010s. Prince'south recent death from a fentanyl overdose has quickly get emblematic of a national scourge: According to the National Institute on Drug Abuse, the number of overdoses from opioids is college than ever. In a 2014 presentation, the institute reported that the number of prescriptions of opiate medications rose from almost 76 million in 1991 to nearly 207 meg prescriptions in 2013.
Moreover, some physicians have been responsible non only for overprescribing, only also, in certain high-profile cases, flooding the black market with pills. In March, for case, the Manhattan physician Moshe Miriashvili was convicted of writing more than 13,000 phony prescriptions to dealers, resulting in the distribution of 1.2 1000000 oxycodone pills and about $2.iv million for himself.
As the habit specialist Brad Lamm, founder of the Breathe Life Healing Centre in Los Angeles, tells me, "I've seen more than and more doctors fall into the honey trap."
At our meeting, Dr. Karcher is wearing a sleeveless blouse, and I ask her about a prominent scar on her shoulder. It turns out that over the course of 3 years, she had v surgeries, including a complete shoulder replacement. Those surgeries, she says, are when her issues began.
At first she took Percocet for pain. So she took Percocet for fun — "or what I thought was fun," she says. She had a thriving practice, a relatively new union and, at that betoken in her early 50s, two children younger than five.
"Some people would have wine," she says. "Me, I would come home and pop ii Percocet. And so I'd skin the apples to cook, clean the house, do the laundry, I'd make my telephone calls, write my papers. I'd do everything I needed to practise. So I'd crash. Next day, I'd wake up, practise it all once again."
This went on for several years, she says. By 2012 Dr. Karcher knew she had a serious problem. She wanted help, just in add-on to being addicted, she was aback. She didn't want to become to the New York Health Committee for Physician Health, a plan funded by the Medical Society of the State of New York to identify and treat doctors with mental health or drug problems, she says, "because I didn't desire anybody to find out."
Nobody wants to admit defeat or weakness; just only doctors (and airline pilots) thought to have drug problems have such rigorous drug-testing programs, according to Terrance M. Bedient, the managing director of the Commission for Md Health. Some lose their livelihoods temporarily, some permanently.
Prototype
At get-go Dr. Karcher told her husband, Duncan Karcher, she was fond, simply he didn't quite believe her. "He works in risk direction, he'southward obsessive-compulsive almost playing past the rules, but he just didn't sympathize," she says, because he didn't encounter her behaving oddly. It took a while for him to realize that Superwoman needed a fix.
She tried to quit. Repeatedly. She failed. "I tried and then difficult to do it myself," she says. "I could cry when I recollect about it."
Dr. Karcher couldn't quite describe what information technology was like to get cold turkey, and then I asked a friend who is a physician and is in the throes of quitting opiates, and who agreed to talk only if I did non name him. Information technology's not just body aches and flulike symptoms.
"It's the feeling that life is pointless, that there will never exist joy again," he told me. "What'southward worse is that it erases any memory of joy or fifty-fifty of the simple quotidian pleasures of everyday life." When my friend had written this to me in an email, he had stopped taking the methadone. A week subsequently he was dorsum on information technology and planning to spend a week by himself, leaving his friends and family "because it is simply as well horrible being around me" during withdrawal.
"This is a chronic, progressive and fatal illness," Dr. Karcher tells me. "I accept a friend of mine whose husband used to be an addict and she said, 'Cheryl, I really believe it would accept been easier for him to kill himself than to get sober.'"
Not that Dr. Karcher always felt sympathy for addicts. Far from it. "I actually felt they were lowlifes," she says. "Like, 'What is wrong with you lot, just don't drink that glass of wine' or whatever. A lot of doctors feel this way."
Growing up in Florida in a center-course home that looked perfect on the outside but in reality was cold and tense, Cheryl was the family goody-two-shoes: great grades, smashing athlete and certainly no drugs, even though she went to the University of Florida (which has been ranked equally one of the Top 10 Political party Schools by The Princeton Review).
"I was afraid I'd ruin my brain cells," she says. "Everyone was out at the movies. I was studying." She was published in The New England Journal of Medicine (an article on vitamin E and the way information technology permeates the peel) even before she was in medical schoolhouse. "A lot of stuff in my life has taken dedication," she says. "This isn't about being undisciplined. I have a load of cocky-control."
Enough, in fact, that when the SWAT team descended, Dr. Karcher had already been drug free for about a twelvemonth and a half (a particular not reported in the articles near her arrest).
Around the terminate of 2012, with her habit out of command, she sought handling with Dr. Kenneth Rosenberg, an habit psychiatrist in Manhattan. She insisted he drug examination her every week. She likewise joined Caduceus, a 12-step-based recovery program for people in health care. (The name refers to the staff entwined with two snakes that is a symbol of the medical profession.) While she was struggling, she withal regularly appeared in many outlets, including T: The New York Times Style Magazine.
Before long she was chairing weekly sessions of the group, and was the contact person for frightened newbies. It became, she says, "my secret life."
"Cheryl was at every meeting, and I've been going four years," says Reggie, a physician and an acquaintance of Dr. Karcher's who agreed to talk if he was allowed to maintain the anonymity provided in the recovery group. He treated his bipolar disorder with a variety of drugs, and had been hospitalized for attempted suicide. "The thing well-nigh addicts, and particularly those of us in medicine, is that nosotros think we're somehow unique," Reggie says. "We are not unique, except perchance in our access to medication."
Notwithstanding, when she was arrested, Dr. Karcher was non 100 per centum surprised. She always had a feeling this solar day might come. After all, even though she had non sold drugs, which eventually the narcotics office best-selling, she had an function worker who did. "Of form they thought I sold," Dr. Karcher says. "If I'd been them, I would accept idea then, likewise."
Too, fifty-fifty without the selling, hers was non a victimless crime. Information technology was a form of identity theft. Citing privacy laws and the fact that the case is sealed, the New York City Office of the Special Narcotics Prosecutor would not put me in touch with the v people whose names Dr. Karcher mined for her ain prescriptions.
Paradigm
But with the change in the prescribing laws that require physicians to check a patient's controlled-substance records, these v people may have to explain to their future doctors why they were taking large quantities of Percocet (and Ambien and Adderall); they could be denied medications they actually need.
And in that location was 1 affair Dr. Karcher did, she says, that was unforgivable: She got her nanny — a woman who was not a Usa denizen and could hardly say no to her — to choice upward prescriptions written in the nanny's name and mitt over the medication to her. "She was a part of our family unit, and I never saw her again later on the arrest," Dr. Karcher says. "I become to bed many nights wishing I could apologize."
The postal service-arrest fallout was swift. Dr. Karcher had worked at Sadick Dermatology, a tony practice owned by Dr. Neil Sadick, with offices on Park Avenue, W 15th Street and on Long Island, and had to leave until her case was decided.
She also lost her lucrative consulting contract with Avon and was devastated when, within a week, ii dermatologists she considered practiced friends tried to take the chore. One other consulting gig remained: She is the dermatologist with the Miss Universe Organization, recently sold by Donald Trump.
"When I saw what happened with her, my theory was that someone was trying to go publicity," says Paula Shugart, the president of the organization. "I mean, why would there be media at the courthouse if someone hadn't alerted them?"
Why stick by Dr. Karcher? "Outset of all, We had a Miss USA who went to rehab in 2006, and Cheryl stood behind usa," Ms. Shugart says. "2nd, non to sound besides clichéd, but nosotros are an organisation run past women that supports women, and standing up and doing what's right. This was a no-brainer for united states."
The near painful memory of that time came when Dr. Karcher realized the event on her children. Her girl was too young to read the newspapers, so would have been unaware were it not for the talk among friends' parents and older siblings.
"Soon subsequently the arrest I was picking my daughter up from this petty parade, and I heard her say, 'Where's my mommy?'" Dr. Karcher says. "And I started to say, 'I'm here, honey,' when the niggling girl standing next to her said, 'She's probably in jail.' And my daughter only lost information technology, crying and crying. Totally inconsolable."
A few weeks after the arrest, the initial daze wore off. Discussion got out to patients and colleagues that Dr. Karcher was not the person in her office who had been selling drugs for coin but indeed had had a drug problem herself. That's when empathy began to kick in.
"She'due south so good, so professional," says Dr. Doris Day, a fellow dermatologist who considers Dr. Karcher a good friend. "I felt guilty, like I had let her downward because I never noticed anything was wrong."
Wendy Lewis, a plastic surgery consultant who has run physician practices, says: "She'southward someone I would never hesitate to recommend. She's not a salesperson, not greedy, not dishonest. You never heard an unkind word well-nigh her from other doctors, in the field where unkind words are the norm."
But if they really liked her personally, they were still wary professionally. After her arrest, referrals, a large part of any dermatologist'due south business concern, dried up. Besides risky to them, they said.
Simply with patients she already had, there was an enormous outpouring of support. "You lot have to understand, she took care of some of the most loftier-profile people in the city, in publishing and style," Dr. Neil Sadick says. "And they loved her."
"When I heard well-nigh this, the first affair I did was write a alphabetic character to the judge," says Ronna Lichtenberg, a business strategist and author who had been a patient for several years. "I accept a lot of complex medical weather, and oft with doctors you have to choose between technical competence and bedside way. With Cheryl, I didn't have to cull."
Was writing these prescriptions stupid? Of course, Ms. Lichtenberg says, and patients gossiped about information technology. "Perhaps with some other md, the terminate result would be different," she says. "But it doesn't surprise me that everyone I know is dorsum. People accept ane question when something like this comes up: Are we safe? And the answer is yes."
"I don't think at that place is such a thing as a victimless crime, just this was nearly her personal hurting," says Marie Komisar, the executive director of the National Association of Women Judges, who considers Dr. Karcher both her medico and friend.
"I can tell y'all this: This is non a adult female who's cavalier about drugs," Ms. Komisar says. "A few years ago, I called Cheryl to endeavour and prescribe some medication for my daughter, who has terrible migraines. Nosotros live in Washington, D.C. And information technology was a weekend. Cheryl was very apologetic, only wouldn't do information technology. She had never examined my daughter, and she was worried she could brand something worse. I didn't want to go to the Eastward.R., but we did, and I totally respected that decision."
"I went to her for all the usual cosmetic things, but this was unlike," says Dee Dee Ricks, a hedge fund consultant and cancer-patient abet who documented her battle with breast cancer in the HBO special "The Education of Dee Dee Ricks."
Ms. Ricks had a blister on her toe that wouldn't go away. Some other dermatologist had told her it was probably aught, just if it didn't heal in a few weeks she should come in and take information technology examined again. Ms. Ricks ignored information technology. Then i day, she was seeing Dr. Karcher for a Botox session and mentioned the blister.
"Cheryl looked at it, and I saw all the color bleed out of her face," Ms. Ricks says. "'Let's biopsy this right now,' Cheryl said. It turned out to be Stage 3 melanoma." Ms. Ricks lost her toe, but says "Cheryl saved my life."
In March 2015, Justice Richard M. Weinberg of the New York State Supreme Court ruled on Dr. Karcher'southward case: She could enter a drug-treatment program without pleading guilty to the charges (which would have forced her to lose her license). "The consequences to this medico if I brand her plea to the counts of indictment would be infrequent circumstances that could destroy her career and destroy her life with no redeeming value," Justice Weinberg said.
The New York Post described the estimate as "star-struck," and many saw the ruling as likewise lenient. Dr. Karcher is a pretty blond physician at the top of her game, with a lot of well-to-exercise clients. Would she have gotten this consideration if she weren't a person of means, or nonwhite, or both?
Dr. Karcher is well aware of the advantages of her position and race: "I was mistaken for a lawyer on more than than one occasion." Only at the same fourth dimension, she thinks in her example her treatment had less to do with privilege and more to do with the fact that New York State is very much alee of the bend in treatment of addicts who are not otherwise engaged in criminal beliefs.
"I saw people with less privilege, less educational activity, treated the aforementioned way I was," she says. "The judge in my case understood addiction so well. It'southward a illness."
And that is what many in the addiction field call back nosotros should remember: non that Dr. Karcher didn't take advantages — she did — but that she got the kind of treatment that more substance abusers should get. Physicians in New York State take some of the best outcomes in the country, according to Brad Lamm.
"It's not that they're improve people or improve addicts," he says. "It'due south but that the oversight board gives you more than leverage" over their behavior. Mr. Lamm treats a number of physicians at his Exhale Life Healing Heart in W Hollywood, Calif., and says that given their admission to opiates, he doesn't desire to care for them unless an oversight board is involved. California doesn't have one like New York's; Mr. Lamm believes New York City should be the model nationwide.
Dr. Karcher has nothing but praise for the Committee for Physicians Health and the Office of Professional Medical Misconduct, which oversees medical malfeasance. "Somebody has to look out for the public interest," she says. "Yous know, when I went up to come across them in Albany, they asked, 'Take you ever been arrested?' and I was like, 'Are y'all kidding me? A SWAT squad came to my office!' and the woman said, 'I know, but believe it or not I've had doctors look me in the eye and say no.'"
Dr. Karcher is unequivocal that doctors who are using should lose their licenses, but in that location has to exist a road dorsum. "Some states are more progressive, more than understanding and more educated than others," she says. "Nobody asks for this affliction. Nobody wants to be addicted. But the good news is there's a style out. And it can actually plough a life into i of groovy gratitude, humility and joy. I wouldn't trade my life for anyone else'due south."
It's been a lesson not just in breaking addiction, she says, only in overcoming shame. She had to fight the urge to isolate herself, to disappear from friends and colleagues and wallow.
These days, Dr. Karcher is not only dorsum in the white-on-white part of Dr. Sadick, but she has likewise opened her ain practice, offering "bespoke cosmetic care" in the Fifth Artery digs of Dr. Virginia Wade, an anesthesiologist for plastic surgeons. Information technology was Dr. Wade who took her in when no ane else would. Even Dr. Sadick, her champion, would not let her practice in his role until she was cleared of all charges.
"Her story was and so familiar to me," says Dr. Wade, who points out that there are many fond people in health care. In anesthesia in particular, she says, "in that location seems to be a magnet on the door.
"I knew she was drastic. I said: 'Y'all know what, you don't get the keys to the office, you lot've had an addiction that is more powerful than your will. I need to let yous in every single time, and I need to be in that location with yous.'"
Dr. Wade's colleagues warned her not to do it, that the liability was too great.
"Only everyone deserves another gamble," she says. "And also I would know in about two seconds if her behavior was altered."
The drug cabinets were locked; the file cabinets, where patient data is kept, were locked. "And Cheryl did everything, everything she needed to do to exist acquitted: going through the court system, drug tests, hearings, all of it," Dr. Wade says. Somewhen she got the key to the office.
Merely the habit of letting Dr. Wade know she is there has not left. "She walks in at present, and the first thing she shouts out to me is 'Beloved, I'm home,'" Dr. Wade says.
Dr. Karcher says she will never forget that kindness, nor the fact that it fabricated her do something she wouldn't have had the backbone to do otherwise. "I know this sounds strange, but before this happened I never had the guts to accept my own do," Dr. Karcher says quietly. "I thought I wouldn't get in."
Every bit she excitedly tells me near some of the latest treatments she was offer — the ThermiVa, a laser for bringing dorsum vaginal office; using platelet-rich plasma to encourage hair growth; a new fractional light amplification by stimulated emission of radiation called the Halo — I detect she is rubbing her neck a flake.
The next solar day, it turns out, she was scheduled for some other surgery. Her spinal cord was constricted, and she needed small bone grafts inserted to widen the aqueduct. She would not be using opiates for this, or for any other surgery. Nor will she prescribe them anymore. Of procedures similar liposuction, later which she once sent her patients dwelling with Percocet, she now says (with a flicker of a smile), "Tylenol's plenty because I'm that good."
"I am very, very lucky to be where I am today," Dr. Karcher says. "And besides — well, this isn't true, but colleagues have said it, 'You lot're 1 tough bitch.'"
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