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Controversial Canadian doctor Anthony Galea: cutting edge or over the edge?

By Amy Shipley
Washington Post Staff Writer
Sunday, June 6, 2010; D01

U.S. and Canadian court documents paint Toronto doctor Anthony Galea as an unscrupulous quack who dashed around the United States last summer making clandestine house calls to 23 professional athletes despite not being licensed to practice in the country.

Yet respected sports officials and doctors close to Galea describe him as a progressive physician who for the past decade has been at the cutting edge of sports medicine, using innovative techniques and alternative therapies to build an almost cult-like following among athletes who regard him as a miracle healer.

By last year, Galea was so renowned in the athlete community that golfer Tiger Woods, New York Yankees third baseman Alex Rodriguez, figure skater Patrick Chan and Washington Redskins wide receiver Santana Moss sought him out.

"You hear this guy is great, and you're trying to find ways not to have surgery," said a prominent athlete who has received treatment from Galea but requested anonymity because of federal charges pending against Galea. "To me, a huge light bulb went off . . . I was just going to him because of his reputation."

According to an indictment filed in U.S. federal court in the Western District of New York on May 18, Galea's unorthodoxy extended so far that between 2007 and late last year, he sent illegal, unapproved and other drugs over the U.S. border with a medical assistant, meeting up with her to provide treatments with an array of drugs to players from the NFL, Major League Baseball and PGA Tour.

Galea's medical assistant, Mary Anne Catalano, told U.S. and Canadian investigators that Galea injected drug cocktails containing human growth hormone (HGH), a performance-enhancing drug banned by nearly every sports organization in the world, into the injured knees of some athletes. Galea has denied giving any athletes any drugs banned by their sports.

The picture that emerges of Galea as the case proceeds through the U.S. and Canadian courts could be critical if concrete evidence links specific athletes to HGH treatments. Though Canadian court documents state that "it is quite possible that some of the Professional athletes are totally unaware of the fact that they were receiving unapproved drugs," skeptical anti-doping officials say ignorance would be no excuse.

They say the athletes that entrusted their livelihoods to Galea were at best reckless and perhaps complicit in wrongdoing. And, if they received performance-enhancing drugs (PEDs) from Galea, whether for healing injuries or bulking up, they should be considered cheaters.

"You go up to see somebody doing experimental treatment, you better be damn sure you know exactly what your doctor is doing," said Steven Ungerleider, an anti-doping expert who has written numerous books on drugs in sport. "Clearly, everybody who went to see him knew this guy was on the edge of the fringe, doing illegal things . . . At the end of the day, it's doping."

Chris Rudge, who led the Canadian Olympic team at the Winter Games in Vancouver as the chief executive officer of the Canadian Olympic Committee, expressed dismay at the "hysterical perspective" contained in some commentary about the case. Rudge, whose half-pipe snowboarding daughter Diane and other family members received treatment from Galea for many years, described Galea as "exceptionally professional" and a "leader" among Canada's top sports medicine specialists.

"I hope at some point this gets into an environment in which the facts are established," said Rudge, who left the COC in April after a seven-year term.

Added Rudge: "From a generic perspective, if we were to deprive innovation in life, society wouldn't advance very quickly, would it? . . . If there is a doctor who has established a reputation for understanding the needs of athletes, and being sensitive to those needs, and recognizing an athlete's injury as something very unique to an athlete, then athletes are going to gravitate to that type of environment."

Multiple connections

Galea has been publicly associated in the past decade with dozens of professional athletes, including NHL players Tie Domi, Adam Foote, Jason Spezzi, Gary Roberts and Steve Moore; Canadian track and field stars Donovan Bailey, Bruny Surin, Perdita Felicien, Mark McKoy, Desai Williams and Mark Boswell; NFL players Javon Walker, Ricky Williams, Takeo Spikes and Chris Simms; Major League Baseball players Huston Street, John Patterson, Carlos Beltrán, José Reyes and Carlos Delgado; and Olympic swimmer Dara Torres.

Few, however, have been willing to discuss their treatment publicly since charges were filed against Galea in the United States. The prominent athlete mentioned previously claimed that Galea did not have a reputation of being a rogue doctor, at least before last fall, and that "hundreds of athletes" and "some of the top athletes in the world" had seen him.

"Figure skaters," the athlete said. "Famous tennis players. NBA players. They've all seen him. It's a last-ditch effort to go to someone who is a little innovative in his technique, and I don't mean PEDs . . . What people want to do is see someone innovative, doing stuff outside the box, so they don't have to go under the knife."

Galea first garnered international attention for his work with Canadian Olympic gold medal winner Donovan Bailey as he made a comeback from a torn Achilles' tendon. After Bailey underwent surgery in 1999, Galea put Bailey's foot in a special shoe rather than a cast while having him undergo daily oxygen treatments in a hyperbaric chamber and workouts in a pool. Despite the severe nature of his injury, Bailey showed world-class speed in the summer of 2000, though he did not perform well at the Olympics because of the flu.

Around that time, Galea also began administering "shock-wave therapy," a rehabilitation technique that involves sending electrical charges through an injured area. He used the treatment on the injured leg of Jamaican sprinter and Olympic bronze medal winner Michelle Freeman -- and many others -- before it was approved for use in the United States. Galea and a colleague had attended a clinic on shock-wave therapy around the time it was undergoing trials by the U.S. Food and Drug Administration, and then brought the therapy back to Toronto, luring many clients from the United States.

Galea, who declined an interview request through his attorneys for this story, told the Montreal Gazette in 1999 that though some innovative techniques had been "boo-hooed as quackery or witchcraft, now we know that if it works and does no harm to the patients, then let's do it. The bottom line is, the results are better and the patients are getting better."

Galea, who served as team doctor for the Canadian Football League's Toronto Argonauts from 2004 until this past January, in 2006 sent former Argonauts running back Ricky Williams -- now with the Miami Dolphins -- into a hyperbaric chamber for four hours a day for several days after Williams suffered a partial Achilles' tear, though at least one fellow Toronto physician publicly dismissed the treatments as nonsense.

By then, Galea was regularly performing plasma-rich platelet injections, the blood-spinning technique used on Woods and, according to the indictment, many of Galea's current athlete clients. Known as PRP, the technique involves taking a blood sample from an injured player, spinning it in a centrifuge to concentrate the platelets and growth factors, and re-injecting it into the site of an injury. Though the jury is out on its effectiveness, the procedure has entered the medical mainstream in the past couple of years.

PRP is allowed by the World Anti-Doping Agency (WADA) under certain conditions, though an athlete needs to obtain a "therapeutic use exemption" before utilizing it. Galea requested one on Chan's behalf last October, and got it. Chan, who had an injured calf, finished fifth in the men's singles event at the Vancouver Winter Games.

"People are discovering [PRP], and [Galea] discovered it long before everybody," said Naama Constantini, an orthopedic surgeon in Jerusalem who is also the medical commission chair for the Olympic Committee of Israel and has worked with Galea during his frequent trips to Israel. "He's done it for years . . . There is jealousy everywhere. He's definitely a pioneer, and pioneers, they're always looked at differently by people who are very conservative and follow the same route. I told [a colleague], 'If you want to be a better doctor, you had better go to Tony in Canada.' "

Added Constantini: "He never, ever suggested anything that could be against the law of WADA."

Assistant stopped at border

Last September, Galea's assistant, Catalano, was detained at the U.S.-Canadian border near Buffalo. In her car, agents found 111 syringes, one centrifuge machine, one ultrasound machine, and a bag with 20 vials and 76 ampules of various substances, including 250 milliliters of the unapproved drug Actovegin, which is not banned by sports leagues, and 2 mililiters of Nutropin, a type of HGH.

Galea's Canadian-based attorney, Brian Greenspan, said the HGH was intended only for Galea's personal use (in Canada, HGH is legal for anti-aging purposes; in the United States, it is legal only for a narrow range of medical conditions), and represented just two daily doses.

Catalano, however, told Canadian investigators she watched Galea administer a "cocktail" of drugs including HGH to seven professional athletes during the visits to the United States. She also said, according to a Canadian search warrant, that she "believed" one of those HGH cocktails was administered last Aug. 12 to the same Washington-area athlete she was on her way to meet when arrested. A U.S. source identified that athlete as Moss.

Moss told his teammates he did not receive HGH from Galea. (Catalano said a different Washington-area athlete received only an injection of the unapproved drug Actovegin and vitamins, neither of which are banned by sports leagues, during a meeting Sept. 3.)

Don Catlin, a prominent anti-doping expert and head of Anti-Doping Research in Los Angeles, speculated that Galea enjoyed the ego boost of having a high-profile clientele and felt pressure to keep such a lineup of heavy hitters happy.

"All doctors like to have a practice full of superstars," Catlin said. "Some are very straightforward and legitimate, and would never dream of doing anything off-color, but Galea sounds a little slippery to me."

Supporters of Galea, however, said he did not have to dispense performance-enhancing drugs to satisfy his big-name clients. Surgeon Marc Philippon, a managing partner of the prestigious Steadman Clinic in Vail, Colo., wrote to the Department of Homeland Security last October, petitioning that Galea be permitted to work in the United States on an 0-1 visa and calling him "one of the world's leaders and most sought-after experts by both physicians, athletes and patients around the globe."

"Dr. Galea possesses and demonstrates a command of tissue regeneration that is unparalleled in the medical field," Philippon wrote, according to a copy of the letter.

May Jacobson, research associate in orthopedics at Children's Hospital in Boston, last year traveled to Toronto to begin research with Galea that has since been tabled. Said Jacobson: "He is credible. If I didn't think so, I would not have initiated anything with him."

Still, other noted athlete doctors such as Frank Jobe, Richard Steadman and James Andrews bolstered their credibility by publishing in medical journals; those three, in fact, have authored or co-authored more than 120 articles. Galea has written a book but has never had a single article published in a peer-reviewed journal.

"I asked him, 'Why aren't you publishing?' " said Adi Fridman, an orthopedic surgeon in Jerusalem who observed Galea's work during a two-month stay in Toronto in 2008. "He said, 'It's not interesting to me. I'm interested in treating people, not publishing.' "

Galea, of course, was also interested in making a living. His road trips across the United States proved very lucrative, according to the charging documents. He typically received $3,500 for a treatment session, as well as travel expenses for himself and Catalano.

Bills to three unnamed witnesses cited in a U.S. affidavit totaled about $200,000.

"It's hard to believe someone can claim to be legitimate when they are meeting in hotel rooms and sending someone over the border one way while they're going another way to treat athletes," said Travis Tygart, the chief executive officer for the U.S. Anti-Doping Agency. "That raises the antennae of even the most liberal thinkers."

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