I dunno.

I just like the headline.

It has contrast (sacred/profane); it has linguistic ambiguity (If English weren’t your first language, wouldn’t you have a bit of a struggle with HEART BACK?).

And then the story itself – a football player at a Catholic college in Connecticut is a pretty significant oxycodone dealer – has some good elements. He’s from Florida, for instance… And down there – Pill Mill Capital of the World – lots of folks sell pain pills… So many that universities might want to take special care with applicants from, say, Broward County (pain pill capital of the pain pill capital)…

Yikes! Let’s get this guy off our backs, pronto! Just a volunteer appointment; didn’t teach; didn’t see patients… In fact, he was the first Assistant Professor of Medicine at the University of Toledo to do nothing! Nothing! Never heard of the guy!

Oscar Linares is now on trial for having “operated a large-scale prescription mill out of the clinic on Laplaisance Road, prescribing OxyContin and other painkillers to up to 250 patients a day, and [having] fraudulently billed Medicare for more than $57 million.”

At the Linares clinic, “employees were given $25 bonuses if the clinic processed more than 200 patients a day.” “Parking attendants were hired to help direct traffic.”

His faculty affiliation at the University of Toledo is featured in the first paragraph of the Toledo Blade article about him, as well it should be. That university gave the guy respectability and cover. Other universities are doing the same thing with other pill mill owners. This blog will provide coverage of each of these professors – as the government catches up with them.

In West Virginia, state Sen. Evan Jenkins said flights on discount airlines between Huntington, W. Va., and Fort Lauderdale, Fla. [pill mills] have been dubbed the “Oxycontin Express.”

UMDNJ’s still boasting about its state of the art anesthesiologist, Barry Ray. Ray’s the latest university physician to turn himself into a pill mill, and, what with America’s outrageous oxycodone appetite, he’ll be far from the last.

This is one university story – medical professors as drug dealers – from which you might be inclined to avert your eyes. But it’s an important, and growing, campus fact.

… will be tracing the infiltration of the prescription drug trade into American medical schools. We’ll follow stories about pill mills housed inside universities. We’ll note increasing numbers of people going to medical school, and choosing anesthesiology and related fields, with the express purpose of being able to write prescriptions for millions of opioids and other drugs.

A hospital affiliated with Cornell and Columbia has recently removed an anesthesiologist drug dealer from its staff of physicians (he worked with other doctors there in the business). He prescribed pills for his girlfriend, who then sold them, mainly online.

His girlfriend is a medical student. Get the picture?

It’ll become clearer (“[I]n a growing number of states, deaths from prescription drugs now exceed those from motor vehicle accidents.”) in the next few months.

… has been arrested for running a pill mill empire.

We will see more and more of these cases, and some of them, UD predicts, will involve not merely people who have hospital privileges, but people who teach in the medical schools.

Between April and October of this year, [83 year old Dr. Felix] Lanting allegedly wrote a staggering 3,029 oxycodone prescriptions to various patients through his private practice. That translates to an average of 15 prescriptions a day, seven days a week, according to court papers. …Neighbors estimated Dr. Lanting saw anywhere from 50 to 140 patients a day.

83 years old and he sees a hundred people a day! Inspiring.

… that the whole Marla Ahlgrimm thing (background here) is nothing, don’t mean a thing, fuck off.

Sandy Wilcox, president of the UW Foundation confirmed Ahlgrimm is currently serving on the UW Foundation’s Board of Directors, and said whether she maintains her seat is up to the rest of the board.

Wilcox said the board does not meet in the near future, and only the board members have influence in her status on the board.

Ahlgrimm’s arrest is a separate issue, not relating to her involvement on the board, Wilcox said.

“Her arrest has nothing to do with what she’s done in the past and the fact of the matter is she hasn’t been convicted of anything,” he said.

There’s everything wrong with this response. Let us count the ways.

1.) Whether she stays on the board is not exclusively up to the board. If she’s convicted of running a pill mill (extremely likely), and the board, for whatever reason, cleaveth to her nonetheless, the university will certainly step in and rip her muy embarrassing name off of this page.

2.) The arrest has everything to do with her involvement on the board. If I were a potential donor to the university, and the first name I saw on the list of 2010-2011 board members was a drug pusher, I’d say Hm. Should I give my money to UW, or should I give it to my coke dealer? … Coke dealer.

3.) Her arrest has everything to do with what she’s done in the past. What she’s done in the past is sit on a university board with extremely serious fiscal and ethical responsibilities, while at the same time apparently pack illegal, expensive, and dangerous drugs for delivery to people all over the world.

4.) No, she hasn’t been convicted of anything. But if the University of Wisconsin Foundation’s only basis for dismissing a member of the board jailed for something this serious is the absence of a conviction, it’s got a big problem.

…how universities are getting caught up in pill mills, she didn’t expect the first such story to happen so soon.

Marla Ahlgrimm, a high-profile University of Wisconsin board member (the board in question is UW’s fundraising arm, the University of Wisconsin Foundation), has been arrested for running a pill mill.

Ahlgrimm’s the leading edge. You should expect more revelations about universities housing, and giving legitimacy to, pill mill proprietors.

Why?

Because now that police are shuttering the cheesy little pain palace storefronts you see people lined up in front of in your cities, and indeed now that many cities are passing anti pill mill laws, some pushers will seek refuge and respectability inside universities.

*****************************

“Incredibly personalized medicine.” Ahlgrimm is interviewed.

… expect a new category of university stories: Physicians at teaching hospitals arrested for various “pill mill” schemes.

Pill mills have so far mainly operated out of storefronts, and have been run by doctors without a university affiliation. But as states begin to crack down on these easily-identified businesses, expect more stories like this one, from Jersey Shore University Medical Center.

Some American universities are being compromised by medical school professors illegally selling pain-killers. It’s a growth industry – universities can expect more cases of faculty or affiliated faculty involved in pill mills.

Some faculty members have formal affiliations with the mills; others, like Leonard Hudson, commit prescription fraud for personal reasons.

Hudson, who for years at the University of Washington taught a course called The Human Face of Medicine, looked online for prostitutes and found one he liked. In exchange for sex, he prescribed immense amounts of opiates for her (she’s an addict).

Pill mills are a very big national story (though Florida is The Pill Mill State). University Diaries will only cover pill mills when they involve universities.

Sports writers are outdoing themselves, describing the merdique behavior last week.

 At 1:28 pm, the stadium’s more sober patrons were already about seven drinks deep. They or their employers had paid good money — in some cases down-payment-on-a-house money — to see something depraved. A streaker who was still wearing pants wasn’t going to cut it… [In] the haze of Topo Chico strawberry guavas, Miller Lites and vodka sodas, the weed, the rain and the mud, the hooting, howling, and the grabassing, no one could be sure they were at a professional sports event. Every other data point suggested that, in reality, they had slipped into exactly where they wanted to be: a black hole of feral manhood… [T]he 10-drink cutoff was a very gentle suggestion. Bartender after bartender told group after group, “If you take care of me, I’ll take care of you.” I watched several men in their 40s and 50s tip hundred-dollar-bills after each round, and their wristbands were never scanned. For many, 10 soon became 20, which became face-planting into a urinal… To visit the toilets was to realize fully that no sporting event embodies its name as cosmically as the Waste Management Open. They stood in an unlit room at the end of a long, wet, musty, unlit hall. By 2:00, the plastic urinals — a green, eight-foot-tall structure where four men at a time pee toward each other — were overflowing, urine spilling onto mud-soaked All Birds. Nearly every Porta Potty around the perimeter was filled with cans of hard seltzers. 

What to do? Hm. Hm.

‘The PGA Tour has continually turned a blind eye toward drinking to excess at golf events, but after this week it no longer can... And if you’re wondering how important beer and alcohol sponsorship is to the tournament, the title sponsor of the Birds Nest, the off-course drinking and concert establishment, is Coors Light and the non-title sponsor is Jamison.’

On it, sir. Right on it.

***********************

But hey. That’s nothin.

Suicide is shadowland.  Stark statistics are always available – most recently, that American gun suicides have reached an all-time high (and basically anybody who is anybody who doesn’t want to be anybody uses a gun) – but the act itself is so unaccountable, so extreme, that we consign it to the shadows.  

We can sort of make out how a very old person beset by terminal pain might want to do it; but the vast majority of suicides remain hopelessly obscure.  Most of us are too wedded to life, and too afraid of death, to get anywhere with them.

Suicide shadows lie deepest where gunshots to the head ring most sharply.  Cowboy states like Wyoming and Montana have outrageous rates of gun suicide, and their state legislatures do practically nothing about it.  Just getting suicide hot lines set up in these locations is a battle.  Shine a light on massive firearm self-slaughter, after all, and you risk giving gun control people something to talk about.

Even the little we do know about suicide is so upsetting that we avert our eyes.  Can it be that there are many people so lonely, so rejected, so alcoholic – and so bitter and angry about this condition – that they derive their last bit of pleasure from the thought of how they’re abandoning and wounding the few people who do care about them?  Or say their motive isn’t quite this ugly.  Can there really be people whose self-disgust is so intense as to make them pull the trigger?  

Yes, and yes.  

Can it be that there are many people so encased in clinical depression, and so resistant to medication, that no pill or therapy regime will be able to free them from it?  

Absolutely.

So we also press suicide into the shadows because we cannot accept the thought that suicidality often eludes cure.  The best doctors, the most loving families, may jolly it away for a while, but people who have come to hate themselves, or hate their lives, to this extent, may despite all try to do the deed.  And a gun makes it so much easier and more certain to cause death than any other form of self-destruction.  

A gun sits in a drawer by the suicide’s bed, beckoning him (statistics again – it’s overwhelmingly men) to do it.  That’s what it’s for – to kill.  It’s not like pills or ropes — innocent objects which you must struggle to make lethal.  Guns positively sing of unconditional easeful escape from anguish.  In a chorus 450 million weapons strong, they sing of instant surcease.  They even have an anthem, if you like: Bach’s Come, Sweet Death.  

Guns are the kingdom of death on earth, and their preeminent kingdom is America.  In our privileged country, we get pretty much everything we want, including a rich array of death-promisers from which to choose.

Here’s some wisdom from a very young juror:

James said that the prosecution’s argument that there was a “perfect storm” gathering, and Murdaugh was on cusp of a devastating financial reckoning was a good theme – but wasn’t a persuasive motive.

“I don’t think I’d ever be able to answer why somebody would do something like that,” he said. “But I know that there are people in the world that don’t make sense, and they do things without making it make sense. So I don’t know that there is an answer other than that it happened and that it shouldn’t have.”

Yup. Here’s UD‘s take, FWIW:

Since that morning, when his firm’s financial officer confronted Murdaugh about his extensive theft from the business and its clients, he had been in a deepening, increasingly unmanageable, panic. Thoughts of his family’s ruination, and the ruin, at his hands, of the proud Murdaugh legacy, gripped him more and more tightly.

I don’t think that when he summoned his family to the rural property (Buster was too far away to summon) he did so with any clear motive of killing them; I think he was simply at wit’s end and wanted their help in some way. Or maybe he wanted to confess to them, the way Bernie Madoff gathered his sons to his office and confessed, as the FBI circled, his Ponzi scheme. I don’t think Murdaugh knew what to do; I think he was melting down, and he, in an unspecified atavistic way, wanted his family around him.

Reveling in the beautiful normality of hanging around with Maggie and Paul, with the dogs and the birds, Murdaugh was suddenly overcome with the pointlessness of it all, the loss of it all, the oncoming nothingness of his shattered existence. This was not excruciating self-punishment, or self-hatred; if it were, of course, he would have grabbed one of the hundreds of available guns and killed himself. It was a bleak nihilistic vision of a demonic world all of whose denizens, including his own wife and son, were committed to destroying him. His wife and son, after all, had been getting into his pills, and they were demanding a family conference in which they clearly intended to give him a hard time about the oxy. His drunk out of control son, who’d already racked up booze-related legal problems – hell, who’d already killed someone – could only benefit from having his existence ended. His wife was a nervous wreck about the tens of millions of dollars the bulldog lawyer the dead girl’s parents had hired was promising to get out of the Murdaughs; and she’d already been driven out of the neighborhood of their primary residence because of the horrible publicity about the lethal boat wreck. All that, plus his unmasking, that morning, as a career larcenist…!

Everyone here, he thought, in his nihilistic panic, would be better off dead.

So in the darkness, in the night, facing trusting heedless loved ones, he grabbed his weapons and began blasting away at Paul and Maggie. Make them go away. Make it all go away.

When it came to it, he couldn’t complete the nihilistic horror. He couldn’t turn the weapons on himself. He knew the rest of his life would be litigation and imprisonment but he simply couldn’t end his life. Narcissism, cowardice, whatever. Couldn’t do it.

***************

But. When all is said and done, remember that great scene in Black Widow, when Debra Winger (as an FBI agent) says to her motive-sniffing boss: “Don’t you understand? No one knows why anyone does anything.”

Diploma mills once charmed me; in the early years of this blog, I couldn’t get enough of bogus outfits that would, in exchange for a few thousands, hand you a suitable-for-framing certificate attesting to your having earned a PhD. In our simulacral era, it’s a way-thriving con.

California Coast University remains a prominent diploma mill, with one particularly prominent purchaser: The Trumplover who – amazingly – remains Inspector General of the Department of Homeland Security, continues to put “PhD” after his signature, and continues – like all pathetic diploma mill grads – to insist that everyone call him doctor.

His main function in the job – currently getting all sorts of media attention – is withholding Trump-incriminating documents from Congress. Congress has had enough of it, and has written to him asking that he recuse himself from January 6-related probes.

So UD’s gonna go on record with the following: The letter writers won’t hear a peep out of Doc Cuffari, currently hunkered down in his office engaged in the same self-comforting activities mad Mark Meadows engaged in as scads of desperate staffers begged him to talk to the president about the ongoing rape and pillage of the Capitol. With his bogus degree and Trumplove and paranoid silences Joseph Cuffari has constructed a personal fantasy world as fragile as that of Blanche DuBois, and like her he will be carried out in a straitjacket.

Yet another American Stakhanovite punished by the federal government for working hard! UD has followed many of these on this blog over the years – doctors whose daily caseloads beggar belief, and what do they get?

A wildly popular physician whose willingness to go above and beyond for his patients was well-known locally, Orusa is now looking at decades in prison. This is a man who even finds ways to treat non-compliant patients.

Trial testimony from former employees and patients described a standing-room-only lobby area at Orusa’s clinic. Patients with insurance coverage were forced to visit the clinic four to six times a month and undergo cortisone shots to receive pain medication and Orusa threatened to withhold pain management prescriptions from those who refused the injections… Cash-paying patients generally were not required to accept injections in order to receive prescriptions. Due to the excessive number of controlled substance prescriptions, Walmart and CVS pharmacies refused to fill prescriptions written by Orusa.

It seems like piling on to point out Orusa is a man of God, “the pastor at God’s Sanctuary Church International,” but UD really wants you to get a sense of the vile reach of the federal government.