Dr. Feelgood (19 page)

This initial meeting set off an extensive investigation of Jacobson that took nearly two months. “It took quite a while,”
⁷¹
recalled Rensberger, who headed a team with Dr. Lawrence Altman and nine other reporters, including Jane Brody, and a researcher. This team of twelve interviewed and probed Dr. Jacobson’s patients, studied his records, and dissected everything there was to know about him. This became the
New York Times
’s version of a Watergate-type scandal, and the reporters had an axe to grind, perhaps wanting to prove to the world that they were still on top of what it takes to be investigative journalists. The
Times
team persevered after their first article, even in the face of the pressure they received from Jacobson’s celebrity friends and patients to leave him alone. The reporters would not yield to that pressure.

Jacobson, still deluding himself about the public admiration that would be coming his way, was totally unaware that this was going to be an investigation into his practices, an investigation that could trigger a professional investigation that would bring about the demise of his medical career. He asked his friends and famous patients to cooperate with the reporters. He believed that this was going to be his “coming-out party,” and in that he was not far from the truth. But it was a truth he never suspected when the
Times
outed him to the world.

On December 4, 1972, the Max Jacobson story splashed across the
Times
front page with the headline, “Amphetamines Used by a Physician to Lift Moods of Famous Patients.”
⁷²
Dr. Jacobson’s photo was part of the front page of this multi-page story that exploded on the scene in New York and then spread like wildfire throughout the country. If Max believed he would now be even more famous, he was right. But it was infamy rather than fame.

Up until that time, each state’s private medical societies, the professional associations supposedly governing practice standards, were looked on to police their own physicians. The states licensed doctors, and New York was no exception, but any malpractice or licensing deadlines were basically left to the medical societies. Accordingly, the licensing for a doctor in New York State was left up to the New York State Board of Education. Any discipline would come from a hearing before the New York State Board of Regents.

The medical societies were blamed to have done next to nothing to police their ranks. They had no legal power per se other than to deny membership, but they insisted they had an obligation to investigate complaints and turn violations over to their respective state boards. And although Jacobson’s unorthodox treatments, administered under the cover of prescriptive medicine, were known to the New York County Medical Society, said radio talk show host Don Imus on his program,
⁷³
the society neither took action against the physician nor informed the state department of education, which licenses doctors in New York. To this day, the society contends that it never received a patient complaint about Dr. Jacobson, although there remains some dispute about that claim. Members who knew, the
Times
charged in its exposé, did not inform the state because “unorthodox” medical practice is not cause to lodge a formal complaint against a colleague. There is some potential, argued the critics, for local and state societies’ medical care foundations and peer review systems to not police the incompetent or negligent physician, because they were more concerned with cost and utilization control than quality control. But crusading young reporter, and current Fox television host, Geraldo Rivera also joined the chorus of those demanding that the medical board expose the practices of those doctors dispensing methamphetamines to their patients.

With news organizations revealing the secrets of Jacobson’s medical practices and the New York State Department of Education conducting its hearings into Jacobson, the scandal around him grew.

Max, through Jackie Kennedy, hired the famed attorney Louis Nizer, also a patient of Jacobson. Although Nizer promised to oversee the case, it was turned over to a British associate of Nizer’s firm, who was in far over his head. Max Jacobson in his unpublished memoir recalled that Chuck Spalding called him on May 28, 1973, asking to meet Max. Max’s wife, who took the call, said she wanted Max to rest that day because his first medical panel hearing was on the 30th. Unless this was an “absolute necessity,” she told Chuck, could they push the meeting back to the next week? This was truly important, Chuck said, and he would meet Max the next afternoon.

Chuck called Max at noon the next day and asked that he drop over to his apartment. At the door, Chuck told Max, “Here is somebody who wants to see you.” Suddenly Max found himself hugging Jackie Kennedy, who kissed him, ushered him into the room, and said she was truly upset at all the negative publicity Max was getting. Chuck politely left the room, leaving Max and Jackie together. Jackie said the whole thing was simply unfair and that Max was being targeted by the press. Jack Kennedy’s reputation was also being attacked, and Max asked Jackie who was behind it. The attack on the late president was “vicious,” Max said, reminding her of all that he did for the president. It was Max’s doing that kept the president functioning on the trip to Vienna and to Paris and London. Kennedy performed even though he was under crushing pressures from the import of the summit meetings. But Max had been there, he said, whenever Kennedy needed him, at the United Nations, Carlyle, Washington, Hyannis Port, Gelnars, and West Palm Beach. And Max never asked for a fee.

Chuck Spalding might have called for the meeting, but it was Jackie who was behind it. She was the one who had wanted to meet, wanting to know what Max would say if someone on the panel brought up the stories of Max at the White House. There would be no problem, Max told her, because his regard for medical ethics and discretion when it came to discussing his patients had been part of him for fifty years of practice. He would not broach confidentiality now. Besides, he said, his conscience was completely clear. He had nothing to hide because he was doing the best for his patients.

Max told Jackie Kennedy, whom he had treated a decade earlier, that he was worried about the panel’s license review hearings, explaining that he had already spent $35,000 in legal fees, and this was even before the hearings commenced. He was, he continued, owed $12,000 from his Constructive Research Foundation, money he was due but never collected, mainly because, he claimed, he was never concerned about money, especially from the president. But he was running a huge legal bill and had to be reimbursed.

“Don’t worry,” Jackie reportedly told him. “All will be taken care of.” It wasn’t.

After the meeting, as Spalding escorted Max downstairs, he assured him that help was on the way, suggesting that the foundation write to Jackie addressed to his attention, requesting a contribution, which could then be paid to Max through the foundation instead of through the Kennedys. As relieved as Max said he was after the two-hour conversation with Jackie, the help that Jackie and Spalding promised him never came through. Max was on his own, even though he had promised Jackie Kennedy and Chuck Spalding that he would keep the secret about his treatments of President Kennedy. Max reportedly told them that doctors always keep their patients’ records confidential. But the British newspapers had picked up the story of the Jacobson scandal from the
New York Times
and from Geraldo Rivera’s reporting on New York’s Channel 7, and they spread the news about rumors concerning Jacobson’s treatment of the late President Kennedy.

Another ironic twist to the Jacobson/Kennedy connection that was later reported was that Jacobson’s shots have been speculated as one of the causes of Jackie’s lymphoma that she suffered many years later. C. David Heymann revealed in his book
American Legacy: The Story of John and Caroline Kennedy
, with John F. Kennedy, Jr., that shortly before his death, John Kennedy, Jr., said that he fully believed that Jacobson’s injections brought on his mother’s lymphoma. He based this on a study by the American Multicenter Cohort (MACS) of nearly 2,500 patients, which showed that those who used amphetamines frequently, in the amount of once weekly or more, were nearly five times more likely to develop lymphoma than patients who did not use amphetamines as often.

Max’s first hearing before his license revocation hearing began on May 30, 1973. The charges against Max stated that the New York state investigation resulted in forty-eight counts of unprofessional conduct and fraud in the practice of medicine. At the later hearings in April 1974, the state medical board accused the doctor of giving himself depressant and stimulant drugs for nonmedical purposes, failing to oversee use of such drugs by his patients and employees, failing to adequately examine patients prior to giving them depressants or stimulants, and manufacturing, selling, and delivering adulterated and misbranded drugs not adequately tested for safety, strength, identity, quality, or purity. There were also charges for failure to obtain required applications to test and administer new drugs, failure to keep accurate records of controlled drugs, and selling drugs without the required professional order from the purchaser.

It was former employee Harvey Mann who finally blew the whistle on Max. He gave a firsthand account of the laboratories, the inner workings of the office, how Mann as an out-of-work actor was giving intravenous shots in Max’s office until he nearly killed someone with an air pocket, and how he manufactured drugs that Jacobson shipped as product worldwide. Mann had been a patient of Max since he was fourteen and began to work for him when he was twenty. Others testifying against Max included his nurse Ruth Mosse, actor and former employee Felice Orlando, Otto Preminger, Gerri Trotta (who was Mark Shaw’s first wife), and several former patients who were not identified. One of the patient’s testimonies was, “My last shot was a blood-red thing about a foot long. I went blind for two days, and when my eyesight finally came back, I threw away all my speed and hung up my works on the living room lampshade.”

It was revealed in the report and hearing that the investigators found evidence that at least 90 percent of the doctor’s patients were self-injecting his mixtures. The heavy volume of injections was reflected by the fact that for the periods 1964 to1966 and 1968 to 1972, Jacobson’s office used 463,719 hypodermic needles and 236,646 syringes. This averages out to 1,920 needles and syringes per week, indicating that multiple patients were self-injecting. The investigators were also concerned by the relatively relaxed sterilization standards in the laboratory, including an incident that was reported on October 26, 1970, revealing that “placenta was observed in respondent’s refrigerator dated August 1970, next to bread, sandwiches, storage batteries, and various other types of lunch components.”
⁷⁴

The New York State Board of Regents finally ruled on April 25, 1975, that the State Board of Education revoke Max Jacobson’s medical license for unprofessional conduct. In a unanimous action, the doctor was found guilty on forty-eight counts of unprofessional conduct in eleven specifications and an additional count of fraud or deceit. The decision was based on a 42-page report itemizing 235 findings of fact about Jacobson’s career. Among other things, the document charged he had administered amphetamines without sound medical justification, failed to keep required records on use of controlled drugs, was unable to account for quantities of drugs, and misrepresented injections as treatment for MS without medical evidence.

The
New York Times
headline the next day read, “Jacobson Loses License.”
⁷⁵
The story reported that the New York State Board of Regents had pulled Max’s medical license and that he would no longer be authorized to practice medicine in the state. The
Times
documented the charges against him that the Board of Regents had substantiated and revealed that many of Jacobson’s celebrity clients suffered as a result of his treatments. But the story didn’t stop there.

The hearings against Max set off a firestorm across the nation, resulting in a host of new laws and regulations. Where the various state medical societies had historically policed their own ranks, most states now enacted laws that set up boards of ethics, and soon they oversaw all medical doctors. No longer would the physicians be allowed to go unregulated and not under government control. On March 28, 1973, President Richard Nixon signed Reorganization Plan No. 2 of 1973 proposing the creation of the Drug Enforcement Administration (DEA). Congress accepted the proposal on July 1, 1973, officially establishing the DEA. The War on Drugs, partly inspired by the Max Jacobson case and resulting scandal, had begun.

Max felt he was the “scapegoat” of the FDA, commenting to his friends that if someone asked what amphetamine was, he would answer that amphetamine is simply a drug a doctor prescribes to stimulate the central nervous system and energize the recipient’s body. In Max’s era, even before the early 1960s, amphetamines were prescribed as a weight reducer, particularly for arthritis patients and cardiovascular disease, because weight reduction was a key to longevity and mitigation of pain. But doctors also prescribed amphetamines for a variety of medical problems, including hypertension, diabetes, and in preparation for surgery. Women, too, were prescribed amphetamines for obstetrics and gynecological issues. Amphetamine was prescribed for the treatment of a variety of neurological and psychiatric issues, including narcolepsy, alcoholism, mental depression, post-encephalitic Parkinsonism, barbiturate or morphine poisoning, fatigue, spasm of the gastrointestinal tract, and menstrual cramps. In short, Max believed, amphetamines were routinely prescribed, not just by him, but by other doctors, to make patients feel good by reducing the symptoms that caused them suffering.

Max contended that when amphetamine prescriptions and dosages were left in the hands of the doctor, the administration of the drug was strictly a matter of a doctor/patient relationship. This controlled the illegal purchases of the drug while also controlling the drug’s distribution. However, because the newly created Food and Drug Administration needed to justify its own existence and make sure its workers were paid, the agency needed a scapegoat. That scapegoat was Max Jacobson, the poster boy for drug abuse and distribution. Max seemd to actually believe this.