The Barbarian | Chapter 7

"Tom, may I speak directly?"

"Please."

We were sitting at the Coffee Bean in Calabasas. Tom had chosen a table toward the back. He was under investigation by the Department of Justice and no longer assumed a private conversation would stay private. He spoke quietly.

The day before, I had walked into his medical office without an appointment. Tom had already called me three times and left two voicemails, and I had not returned any of them. In one, he mentioned Lessons From Prison and told me he'd read it and thought it was exceptional.

I should admit that got my attention. Compliment my book and I am more likely to listen. Ego; I still had one.

Alan Eisner had given Tom the book. I'd met Alan about a year earlier at El Caballero Country Club, where a former Merrill Lynch broker interrupted us mid-conversation to deliver his verdict.

"You're a psychopath for talking openly about your crimes," he said.

Several people standing nearby looked away, the way people do when someone says something uncomfortable in public; they suddenly become interested in the carpet. Alan didn't look away. He defended me, right there, in front of everyone, and later became a friend and golf buddy. When Tom turned up under investigation, Alan handed him my book and told him to call me.

I ignored those calls. After my meeting with Michael at McDonald's, I decided to start returning every one. I had more than a hundred numbers from people who'd reached out over the years. Tom had tried repeatedly, and I still hadn't called him back, so I didn't start with a phone call. I drove to his office.

The receptionist looked at me like I'd walked into the wrong building.

"Do you have an appointment?"

"Negative. But I promise you, I won't say guarantee because that feels slimy, that he'll be interested in speaking with me."

She stared, then disappeared down the hall. A few minutes later, Tom came out.

"Hey, Doc. Can I call you Doc? My grandpa was a doctor. He hated being called Doc," I said.

"Tom is better," he said.

"Tom it is."

He brought me into his office and closed the door. I apologized, told him I'd gotten his messages and failed to return them, and admitted there was no good explanation; I'd been avoiding work, calls and parts of my own life.

Tom said his life was collapsing. A former employee had turned whistleblower. The government alleged his practice had overbilled Medicare, and Tom had an explanation ready for nearly all of it: Medicare changed a code. The patients needed care. The billing rules were confusing. His staff handled some of it. There were no better options for certain patients. He hadn't woken up one morning intending to steal from the government.

Some of that may have been true. Billing rules are complicated, codes change, employees make mistakes, and a doctor can spend so much time seeing patients that he stops checking what happens after the appointment. Some of what the government alleged was also true. Alan was trying to keep the case civil, and Tom's early cooperation had helped, at least for now, but he might still have to repay close to a million dollars, and his license could go with it.

He couldn't sleep. He could barely eat. He was terrified of what could happen to the practice and his license.

"I should have called you back," I said.

"Yes."

"I deserved that."

He almost smiled. I told him Michael was home and we were starting to work together again.

"The Kingpin?"

"You read the book closely," I said.

Michael had been called the Kingpin in Chapter 10 of Lessons From Prison, and Tom remembered it. We agreed to meet the next morning, back at the Coffee Bean.

A Poem and a Mistake

Tom wanted another story, so I told him about Ovid.

Before his exile, Ovid was one of the best-known poets in Rome, with money, status and access to powerful people. In 8 AD, Augustus banished him to Tomis, a distant city on the Black Sea, for what Ovid called carmen et error, a poem and a mistake. Historians still argue about the mistake. Ovid never fully explained it himself. Whatever happened, Augustus sent him away and ignored every request he made to come home.

"Here I am a barbarian, because I am understood by no one," Ovid wrote.

"That is exactly how I feel," Tom said.

Of course he did. His patients knew him as a doctor. His wife knew him as her husband. His sons knew him as their father. He'd spent years building a practice and caring for people. Now agents had his billing records, his emails and a former employee describing what happened inside his practice. That was how they knew him.

"You are not Ovid," I said.

Tom leaned back.

"Ovid's mistake is still a mystery two thousand years later. Yours isn't. Parts of what the government is saying about you are right."

He was quiet.

"So let's not live in make-believe. You did some of it. Own it."

Ovid never explained his mistake. Tom had emails, billing codes and claims a jury could read. He wanted the government to see the doctor his patients knew, but denying records that were right in front of him would not get him there. Ovid wrote letters to Rome. Tom had not written anything yet.

Writing to Rome

Ovid spent his years in exile writing home, appealing to friends, to Augustus, later to Tiberius, describing his life in Tomis and asking to be let back in. None of the letters worked. Augustus died. Ovid stayed in Tomis.

Ovid died in Tomis after years of sending letters. I told Tom the same thing could happen in his case; he could write a narrative, change his billing procedures and still lose his license. No promise.

The letters left Ovid's account of his exile. The government's account of Tom was already taking shape through emails, billing claims and the whistleblower. His narrative would add his account. The government could disagree with it.

"Do the agents have my emails?" Tom asked.

"Assume they have everything."

"My texts?"

"Everything."

"Then what am I supposed to say?"

"Begin with what you did."

Tom wanted to correct the parts he thought were wrong, defend his employees, separate sloppy billing from an intent to steal. He would get his chance. The four allegations supported by the evidence had to come first.

The government had ten allegations. Tom disputed six. He wanted to deny all ten because he believed admitting four would weaken his argument about the other six. Denying the four made it easier to dismiss everything he said.

Michael started helping him write the sentencing narrative, even while Alan was still working to keep the case civil, before anyone knew where it would land. The narrative had to address the four. What did Tom do? What was he telling himself at the time? His years as a doctor belonged in the narrative, but they did not answer those questions.

He also had to show what he'd do differently, so Michael started him on a compliance program: real policies, training for Tom and his staff, a way for an employee to flag a problem without losing their job over it, regular billing reviews instead of hoping nothing slipped through again.

Tom had to actually use it. The training had to happen. The billing reviews had to happen. His employees had to know they could report a problem. A binder wasn't enough.

Tom had the narrative and the compliance program. In one, he could say where he agreed and disagreed with the government. Inside the practice, he could show what was changing. I told him the government might ignore all of it. Ovid knew something about that.

"What if they don't care?" Tom asked.

"They may not."

"Then why am I doing all this?"

"Because you don't know who reads it later."

I mentioned his wife and sons. His wife would not read the narrative the same way a prosecutor would. His sons might find it years later. A licensing board could care about one procedure an investigator overlooked. I didn't know.

Ovid had no idea we would still be reading his letters two thousand years later. He kept sending them, probably hoping one would get him home. Tom was not thinking about history. He wanted to save his practice and his family. None of us knew who might read what he wrote, or if it would help.

The Barbarian

Tom finished his coffee.

"Do you think they see me as a criminal?"

"They may."

"I'm a doctor."

"To them, you're both right now."

He didn't like that answer either.

Tom kept saying he was a doctor. I understood. The government did not know him the way his patients did. Still, the billing records came from his practice, and some of the allegations were true.

The government's record was already being written. Tom's narrative would add his admissions, his disputes and his explanation. The compliance program would show whether the new training, reporting process and billing reviews were actually happening. I had no idea if any of it would help.

"When do we start?"

"I'll call Michael."

"The Kingpin."

"I think he prefers Michael."

Chapter 7 Reflection Journal

Ovid called the cause of his exile "a poem and a mistake." Tom could not call all ten allegations a mystery; four were supported by evidence. Which part of your story remains disputed, and which part are you pretending is still unclear?

Ovid wrote to Rome even though Rome never allowed him to return. If the person or institution with power over you never changes its decision, why would your account still be worth writing?

Tom wanted to deny ten allegations because he disputed six. Which true accusation are you fighting because admitting it might weaken your argument about the others?