Blood Sport: Alex Rodriguez, Biogenesis, and the Quest to End Baseball'sSteroid Era

by Tim Elfrink

  The feds’ stance hasn’t discouraged A4M’s adherents. They found a simple loophole: adult hormone deficiency syndrome, a real syndrome in which adults lack normal levels of hormones like testosterone. Across the nation, “wellness” and “anti-aging” clinics sprouted up by the hundreds with the same basic operating model: diagnosing virtually anyone who walks in the door with a hormone deficiency and then selling them testosterone or HGH for up to $12,000 a month.

  Critics say A4M has grossly inflated the disease to sell an expensive drug. “From my perspective, they’ve been trying to go around the regulations by claiming someone has this deficiency,” says Dr. Peter Rost, a former Pfizer vice president who became a whistle-blower over the company’s deceptive business practices, including for its bestselling HGH product, Genotropin.

  Deceptive or not, it was an ingenious solution. Customers were happy to get their drugs. Doctors were happy with their new profit drivers. Drug companies were happy for a new niche market, with HGH pulling in $1.4 billion by 2011 and even outselling better-known antidepressants like Zoloft. The FDA, if not thrilled, could easily turn a blind eye. Unlike other gray-market meds like Oxycodone, HGH and testosterone didn’t leave zombie-fied addicts robbing liquor stores and dropping dead in alleyways.

  “Adult growth hormone deficiency syndrome is very rare,” adds Dr. Thomas Perls, a researcher at Boston University who studies people who live past one hundred years old. “Yet there are huge profits being made by pharmaceutical companies. The growth of those profits makes absolutely no sense in terms of any growth in the increased prevalence of these conditions.”

  As in any drug culture, the new anti-aging boom did spawn its legion of oddball casualties. One enthusiastic early adopter was a handsome ex-cowboy from Arizona named Howard Turley. After reading Rudman’s 1990 study, the fifty-nine-year-old found an illicit HGH supplier in Mexico and started shooting himself up daily. As he told Klatz for his 1997 book, Stopping the Clock, he found that the drug improved everything from his sex drive to his vision.

  Like many of the sci-fi dreamers drawn to the promises of anti-aging, Turley wasn’t content to stop with modest self-improvement. By the late ’90s, he’d changed his name to “Lazarus Long,” after an immortal character in a Robert Heinlein novel, and opened his own clinic in Cancun to peddle HGH. Then he cooked up a scheme for a nation called New Utopia, which he planned to erect on concrete pilings drilled into a shallow reef a few hundred miles offshore from the Cayman Islands. His manmade islands would “out-Cayman the Caymans” as a tax haven, he told a British reporter, and, with him ruling as Prince Long, would offer a regulation-free base for life extensionists.

  Long’s dreams ended when the SEC ordered him in 1999 to stop selling a $350 billion bond for his new nation, and daily HGH injections or not, his plans for Heinlein-esque immortality didn’t work out either. He died in a Florida nursing home in 2012.

  Still, plenty of more levelheaded businessmen recognized Klatz and Goldman’s innovation for what it was: a fantastic profit driver. As one promotional magazine promised, a single anti-aging patient could “bring $4,000 to $20,000 in annual gross revenue.”

  As A4M grew, Florida became the fertile breeding ground for its age-conquering crusade. The state had always prided itself on a Wild West lack of regulation, particularly in its medical market. As a playground for wealthy retirees, it’s full of customers willing to take a needle of HGH with their weekend Botox. By the end of the 2000s, more than 540 anti-aging and wellness clinics had sprouted up. The Sunshine State encumbered those businesses with virtually no rules. They weren’t required to register with the Department of Health, and since most refused insurance money, the state’s Agency for Health Care Administration wouldn’t inspect them. Anyone could own one, and the clinics didn’t even have to list a medical director.

  As a painful round of federal investigations would soon reveal, that combination wasn’t just a recipe for felons and questionable characters to make thousands selling untested drugs—it also created a perfect cover story for a shadow industry procuring PEDs for professional athletes.

  • • •

  Belize is just an hour and a half by air from Miami across the Gulf of Mexico, but its capital city feels light-years from the palm-lined boulevards of Coral Gables.

  Anyone who enrolls at CAHSU expecting a tropical respite is in for a shock. Students, who pay between $4,000 to $6,000 for a degree, live in pastel-painted concrete hovels in a semipaved neighborhood called Los Lagos, where chickens run free between razor-wire fences. The school occupies two aging buildings guarded by chained-up dogs. Inside the low-ceilinged rooms, elementary school–style desks are crammed beneath ancient AC units blasting tepid air. In the anatomy lab, human dissections are possible only when police stumble across a corpse in the jungle and bring it in for an autopsy.

  “They brought that Canadian fellow in here a couple weeks ago,” says Dr. Rudraraju during a visit by an author of this book, referring to an Edmonton missionary whose throat had been slashed by unknown assailants at his nearby house on Christmas Day. “The students all got to watch that procedure in person.”

  For Tony Bosch, the conditions couldn’t have been much more comfortable than his previous foray into medical school in the Dominican Republic. But this time, he stuck it out, for a year at least. In March 2003, Aliette and their two kids moved to the Central American capital and lived with him as he plugged through classes. Although the school won’t discuss his time there, citing “student confidentiality,” officials say he did complete his coursework. “We have very strict policies on attendance and exams here,” Dr. Rudraraju says. “It’s eighty percent minimum attendance or else you’re out.”

  After about a year of basic courses, Bosch and his young family moved to El Paso in 2004. As in Miami, before his med school foray, Bosch looked poised to set up shop as a respectable businessman.

  His mother, Stella, bought the family a $400,000 two-story house with a garage in the dry hills northeast of downtown, while Aliette’s parents helped her open Cafe Mambo, a Cuban restaurant in a nearby strip mall. Tony picked the entrée recipes for the menu.

  While his family sold ropa vieja and mojitos, Bosch continued his studies across the border at the Universidad Autonóma de Ciudad Juarez and took his first true crack at a medical business, incorporating a nutrition consultancy called Nutradoc. Advertising it as “the best weight loss system you will find online,” the clinic provided clients with a rotating diet plan, leading to “a slimmer you in a matter of weeks.” If the clinic was selling hCG, the weight-loss drug popular with steroid users, which Bosch frequently sold in Miami, it wasn’t clearly advertised.

  Bosch could have kept working on his foreign med school credits and tried to get entry into a US program. (CAHSU, at least, did recognize his work in Mexico; in 2007 the school issued him an MD degree that was not recognized in any US state.) But that wasn’t his way.

  “He wanted to be a doctor, but he wanted to do it in six months. He wanted to be a nutritional expert, but he wanted to make millions of dollars right away,” says a member of his extended family familiar with Bosch’s time in El Paso.

  The signs were certainly there that Bosch hadn’t suddenly become a responsible business owner. Even though the family had a free home to live in while his businesses got up and running, Bosch didn’t exactly cut down on expenses. He bought a new GMC Yukon SUV and hired a maid at $200 per week. He enrolled his kids in a top-flight private Christian academy and even bought himself a membership at the posh Coronado Country Club, an enclave of tennis and golf tucked into the rugged mountains outside of town.

  Where did the money come from? The Cuban restaurant wasn’t successful, and Nutradoc didn’t amount to much. In court filings, Aliette says her husband spent ten days every month on the road while they lived in El Paso—a curiously packed travel schedule for a local nutritionist. Bosch didn’t make a name for himself with high-profile, major league clients for another three yea
rs, but it’s possible he was already insinuating himself into the youth leagues and college ranks back in South Florida as soon as he landed back in the United States with an unrecognized medical degree.

  Whatever cash he was making on the side, though, it wasn’t enough to finance the lifestyle he’d built in West Texas. Just as it had two decades earlier—and would again—Tony’s life tumbled apart in a flash.

  Both Nutradoc and Cafe Mambo soon shuttered, and by the beginning of 2007, it was clear his second marriage was over. That March, he made Aliette an offer: If she’d accept a divorce without a legal fight and let him keep the kids, he’d give her $6,000 a month in alimony. She refused and took him to court. His landlord, meanwhile, sued over tens of thousands in unpaid rent at his office space, and Bosch ignored a speeding ticket until he ended up with a warrant. Before long, he added a restraining order to that list.

  Aliette had rejected Tony’s offer of cash for custody, but the warring couple did agree that he could take the kids back to Miami on April 5, 2007, to spend Easter with their grandparents, as long as Tony promised to return ten days later. But April 15 came and went and Aliette couldn’t get her kids or her ex on the phone. Panicked, she started calling around and learned he’d gotten his daughter’s grade-school transcripts and secretly enrolled her in a Miami school.

  Aliette filed an emergency order trying to get her kids back, writing that she was “in fear for the children’s well-being,” and that she couldn’t fly to Miami herself because she was “fearful of what [Bosch] might do.” It was the first fusillade in a bitter divorce that rent Bosch apart in years to come and drove many of his more desperate decisions.

  But for now, as he finally put his kids back on a plane to Texas under the threat of a judge’s order, Bosch was already more focused on his new business prospects. Another marriage may have fallen apart, but back in Miami, Bosch was ready to join the revolution his fellow CAHSU alumni had spawned in his home state.

  His first anti-aging enterprise, VIP Med, opened in September in a strip mall on Key Biscayne, a moneyed, white-collar island a few miles off downtown Miami, where Bosch had rented a condo near the ocean. Bosch was following the blueprint of an A4M establishment invented by Goldman and Katz, offering testosterone therapy and HGH to men and hCG weight-loss treatments to women. His records show that he later attended A4M conferences—even scribbling out a drug regimen for his most famous baseball client on a piece of official stationery from one such meeting of Goldman’s group.

  He cofounded VIP Med with a pair of dubiously qualified buddies: a guy who owned a pawnshop in the suburbs and a former paving company owner.

  Bosch started mining what became a rich vein of clients—the wealthy, mostly Latin crowd who lived nearby on the tiny island and socialized over drinks at the Ibis Lounge, the only bar in town. Bosch was still nothing if not a talented salesman. His pitch was easy: Need to lose a few pounds? Want some extra juice at the gym this week? Stop by on the way across the bridge to Miami!

  Tony Bosch’s handwritten regimen for Alex Rodriguez

  “Whenever you ran into him, he’d talk about different types of supplements that were popular for weight loss, or what would help your workout be more effective,” says Betty Tejada, a neighbor and family friend in Key Biscayne.

  Bosch may not actually have been a doctor, but getting the medication he needed to play the game like an MD wasn’t difficult. Most of the drugs that became his staple commodity are strictly regulated. To get testosterone, steroids, human growth hormone, or human chorionic gonadotropin (hCG, the drug popular both as a weight-loss tool for women and among steroid users because it helps restart the body’s hormone production after a cycle), a licensed pharmacy must issue them using a script signed by a licensed doctor.

  Among Tony’s sources, medical records from his Biogenesis clinic suggest, was his father. Prescriptions were filled using the name and signature of Dr. Pedro Bosch—who remained an active and licensed doctor, well respected among Miami’s Cuban community. Former Biogenesis employees say that Pedro was on the payroll. The elder Bosch has a clean state record, with no discipline from regulators and just a handful of malpractice suits that had generally found against the plaintiffs. He has steadfastly denied any connection to his son’s later troubles.

  But Pedro hadn’t always steered clear of trouble. Two years after Tony opened VIP Med, he was charged by federal prosecutors in a civil case along with more than sixty other local physicians and pharmacy owners, all accused of a kickback scheme to defraud Medicare and Medicaid. The feds claimed Pedro and his cohorts had violated Stark Law, which prohibits doctors from getting payouts from labs where they send patients to bill the government; the rule is meant to discourage frivolous tests on the taxpayer dime. After three years in federal court, the case was closed with no charges or fines levied against the elder Bosch.

  Besides his dad, Bosch had no trouble finding a cadre of other physicians ready to sign off on the drugs he needed. Through his years in the supply business, Bosch had plenty of less-than-by-the-book doctors on his roster. And another reason Florida has become the de facto home of the anti-aging movement is because so many retired doctors with valid prescription numbers live there. Many are happy to “rent” out their license for a set fee; a clinic owner like Bosch could easily plug them into a prescription form and get whatever he needed. Some services even broker such arrangements by dive-bombing doctors’ offices with faxes offering them set fees if they’ll “consult” for anti-aging clinics.

  “That’s aiding an unlicensed practice of medicine,” says Dr. Kenneth Woliner, a Boca Raton physician and vocal critic of Florida’s lack of regulation. “But this is widespread. This happens with a lot of these cash clinics,” referring to operations like Bosch’s that don’t take insurance money.

  Bosch also spent his first years in the business feverishly educating himself about the basics of dosing his patients with hormones and steroids. He turned to anyone who’d be willing to help him out, including a pair of disgraced local doctors.

  One was his de facto medical advisor at VIP Med, a financially troubled physician named Dr. Jose Luis Rodriguez. Rodriguez fought through a federal bankruptcy in 2000 and an IRS lien in 2007 and gave up his own medical license the year before Bosch opened the clinic.

  So did an even more troubled friend, a Spanish-born doctor named Carlos Diuana Nazir. Nazir had been charged in federal court in 2001 with selling unapproved, bogus impotence medications with seductive names like “Vigor” and “Power Gel.” Nazir got two years in federal prison and a $1 million fine for his crimes. And after he got out, Bosch asked him for advice.

  “He was training to learn how you dosify. How do you calculate doses in patients?” Nazir later said.

  Whatever Bosch had learned in Belize, he was still a novice in his new guise of anti-aging guru. He wanted to know everything: “How do you not overdose somebody? What do you do when complications come in? How do you counteract?” Nazir said. “There are hormones for everything. The ones that counteract something that you don’t want.”

  He learned to use synthetic testosterone, ordering it in differing concentrations from compounding pharmacies, which are licensed to combine and remix commercially available products into creams, lozenges, or injectibles; dozens have opened around South Florida to cater to anti-aging clinics. Sometimes he’d order concoctions with ratios more than fifteen times the testosterone that any legitimate patient would need. He bought vials of human growth hormone, and made himself familiar with the newest trend: peptides. The strings of amino acids such as GHRP-2/6 and CJC-1295—each of which are banned by Major League Baseball, the Olympics, and other pro sports—can trigger the body into making more of its own growth hormone. He also stocked up on hCG and learned plenty about good old-fashioned steroids themselves, from Deca-Durabolin to Winstrol to Anavar.

  For now, Bosch was mostly selling the drugs to Key Biscayne’s wealthy beachgoers with a promise of slimmer waists and bigger
biceps. In his own way, he’d finally found a way into the family business. He bought himself a white lab coat and proudly embroidered DR. TONY BOSCH over the pocket. He framed his degree from CAHSU and hung it on the wall at VIP Med.

  But Bosch had always been working toward finding a way into that other exclusive fraternity, where only the most talented men played their days away on emerald fields.

  With his growing arsenal of illicit chemical knowledge, Bosch was poised to reignite that dream as well.

  CHAPTER FIVE

  * * *

  Steroid Spring Cleaning

  In October 2005, Kirk Radomski had a bad feeling. Call it a premonition. “You always know,” says the former bodybuilder. “Listen, you grow up in the Bronx and you see things and hear things, and something just doesn’t feel right.”

  Radomski, whose brash accent makes his regular reminders of the borough of his birth unnecessary, had for nearly a decade cornered the market on providing steroids to major league ballplayers. Athletes rang him at all hours of the day, seeking cycles. Sports agents knew he was the guy to call if their clients were having injury trouble or their statistics were sagging.