SHADY CLINICS' DOCTORS ARE FEELING THE PAIN

Old guys in trouble sometimes figure it would be a good idea to take it on
the lam, but it isn't, federal magistrate Louis Moore observed in court last
week.

His remarks were for the benefit of Joseph Guenther, a far-from-spry
71-year-old doctor who worked in a chain of suburban pain clinics that
prosecutors say was a front for a drug-pushing conspiracy headed by a
registered nurse called Cherlyn "Cookie" Armstrong.

If Guenther were up to a quick move, once his wife had put up the $100,000
bail and the marshals had relieved him of the handcuffs and leg irons, the
best place to head might have been the U.S. attorney's office in hopes of a
plea deal.

Armstrong and two other doctors, Betty De Loach and Suzette Cullins, were
still in custody when Guenther shuffled out of the courtroom. He had time to
steal a march before they were released on bond later.

He and the other four principals may not have much bargaining power,
however. It seems certain that other arrests will follow, and some of the
lesser fry will probably be happy to sing. The feds sent in ringers to buy
drugs and adduced a mountain of evidence in an affidavit filed with a search
warrant application.

Cases often take on a much different appearance once the defense has had its
say, but, by the feds' account, this operation made hardly any pretence of
legitimacy, dishing out such huge quantities of dangerous and addictive
drugs that Guenther, De Loach and Cullins must have gone home each day with
writer's cramp.

All they had to do, though, was attach their monikers, because practically
everyone got the same three drugs, and prescriptions were preprinted. Hordes
lined up outside eager to get their doses of painkiller Lorcet, the
anti-anxiety pill Xanax and the muscle relaxer Sona, which make up a
potentially lethal cocktail much sought after on the streets, where it is
known as the "holy trinity."

If the doctors did develop writer's cramp, they were in more pain than
plenty of their purported patients, who could secure a prescription for
imaginary ailments provided they paid upfront and in cash for a perfunctory
session. These doctors did not waste any time on consultations. Customers
were in and out of there so quickly that they barely had time to say hi.
Doctor visits frequently lasted less than a minute. The fastest one timed by
the feds took 11 seconds. Cullins, who may have been the most prolific of
the three doctors, had 260 prescriptions filled in a single day.

These skimpy services did not come cheap. An initial visit cost $220, a
follow-up $80, plus a $20 penalty for tardiness. Shortly before the bust the
clinics also introduced mandatory physical therapy, at a cost of $20, which
consisted of sitting on a heating pad for five minutes. Prescriptions cost
$40 and were mostly filled by pharmacies at the three alleged pain clinics.
A lot of the drugs were probably resold on the street for a healthy profit.

There must be a few pharmacists who are feeling a little uneasy right now,
as, no doubt, is Armstrong's husband, Steven Prejean, an attorney and joint
owner of the business. The feds found $1.6 million in cash at the couple's
house and also froze $4 million in their bank accounts.

Staff and customers, according to the federal affidavit, rotated around the
clinics, allowing customers to secure prescriptions from each one. The
doctors routinely prescribed drugs long before existing supplies were due to
run out. One of Cullins' patients committed suicide a couple of days after
his last visit, according to the affidavit. At the bond hearing St. Bernard
Parish Coroner Bryan Bertucci testified that the holy trinity is responsible
for 30 deaths a year in his jurisdiction alone.

The doctors, whose target was to see 700 clients in a 35-hour week, can
hardly have been unaware that they were prostituting themselves. Indeed,
Guenther on one occasion signed a prescription after noting that an MRI
showed no medical need. On another he said he was tired of treating people
who had nothing wrong with them. Then he signed a prescription, according to
the federal affidavit.

If even half of what is alleged in the affidavit stands up, these bogus pain
clinics must have raked in more money and wrought more misery than the
biggest heroin dealer in town. A heroin dealer would be liable to a longer
stretch, however, and would be less likely to heed Moore's advice about
taking it on the lam.