While most Americans are doing their best to stay out of hospitals and physicians' offices, Eric Kimmel Plough is doing his best to get in. And his best, say those who have had contact with him, is extremely good.
So good, in fact, that Plough convinced surgeons at a respected medical center that he needed a major operation he did not need. The operation provided him with a scar that he now allegedly uses to convince other physicians he was treated for cancer, and needs narcotics.
Yesterday, a federal grand jury indicted him on 47 counts of federal drug law violation stemming from his visits to 17 Washington doctors in January and February of this year.
The scar is just the beginning. Plough also has a stack of medical records-some totally fictitious and some apparently altered-from three hospitals and several physicians, and all the records are "very convincing," says one of the Washington physicians who says they were duped by Plough.
"He's a con man and a pretty good one at that," says another internist whom Plough visited. "He really doesn't have any basic, underlying disease. Those who examined him, who did lab studies, found him basically sound."
There are two basic theories about Plough's motivation: Law enfforcement officials believe he is duping phsicians in order to obtain narcotics. The federal grand jury, which indicted him yesterday, charged him with obtaining narcotics under false pretenses, possession of narcotics with intent to distribute and possession of narcotics.
One local physician, however, believes Plough to be a classic example of Munchausen's Syndrome, a psychiatric disorder in which healthy persons, craving the attention of medical personnel, fake serious illness in order to be hospitalized.
Plough, who first agreed to meet with a reporter and then failed to keep the appointment, would only say of his motivation, "maybe I'm crazy. What do they say?"
What "they say" is that what ever Plough's motivation, he is extremely bright, clever, and familiar with medical literature.
In interviews with a reporter, four of the 17 physicians visited by Plough say he told them he suffers form Cushing's Syndrome, a disorder of the hormone-producing adrenal glands; from degeneration of the spinal column, as well as diabetes and hypertension, and has been operated on for cancer of the adrenal glands. And they say he had records to prove his claims.
The records date back to 1972, when he was a patient in Fairfax Hospital from Sept, 15 to Sept. 27.
According to the copy of the record physicians say they were shown by Plough, X-rays of his spine showed him to be suffering from "compressive spinal osteoporosis ... which explained the patient's complaint of moderate lower (back) pain."
The copy of the record also states that the final diagnosis in Plough's cases was chronic active hepatitis and possible Chushing's syndrome.
Based on the diagnosis of osteoporosis, a painful condition in which the vertebrae become spongy and compress, local physicians gave Plough various prescriptions totalling about 1,500 pills of Dilaudid, a morphine-derived pain killer that costs about 19 cents a pill in drugstores and according to authorities sells for about $3 to $4 a pill on the street.
Asked if he was selling the Dilaudid, Plough replied, "I use them, I don't sell them. But I'm not a wealthy man, and I would be if I was selling them."
According to sources, Faifax Hospital's official copy of Plough's discharge record mentions nothing of spinal X-rays, nor a spinal ailment nor Cushing's Syndrome as a possible diagnosis.
Plough's packet of records also contains a discharge summary, completed on official stationary, from Alta Base Hospital, in Berkeley, Calif., stating that he was a patient there from Sept. 8 to Sept. 23, 1975.
The final diagnosis states that Plough has cancer of the right adrenal and severe osteoporosis of the spine. The record also describes him as having Cushinghs Syndrome, which can be caused by cancer of the adrenals.
Eunice Buddehagen, executive assistant to the hospital's executive vice president, said the hospital has no record of Plough ever having been admitted for treatment, nor had it may record of the physician whose name appears on the discharge ever having been a member of the hospital's staff, or ever having admitted patients to the hospital.
Asked about the dicrepancy, Plough replied, "ask the people at MCV how they got the records from Atla Base if I wasn't a patient there."
And that brings up the matter of Plough's expericence as a patient at the Medical College of Virginia, in Richmond, in December 1977 through January 1978.
He got there from the Virginia state prison system where he was serving a 10-month sentence for forgin drug prescriptions.
"He showed us a group of records," said Dr. Dan Sapir, now a surgical resident at MCV and an intern in surgery when Plough was a pateint. "Our own tests were borderlilne abnormal, but his story was pretty complete and his records were there."
So the doctors at MCV operated on Plough for suspected cancer of the adrenal gland, an extremely serious procedure. "This is a major operaiton," said Sapir, "we said 'we were taken. The guy's a major con artist'," Sapir said of Plough, who, the surgery revealed, was healthy.
The surgery provided Plough with the scar to back up his claim of cancer, but it may also be the portion of Plough's medical meanderings where things went slightly awry.
"That wasn't supposed to happen," said Plough, his voice slipping from its normally quite, matter-of-fact tone. The surgery, he said, "was not supposed to occur."
But did he not try to convince the physicians of his illness?" "It was their diagnosis," said Plough. "There were no records involved"-a contention disputed by Sapir.
Record's were involved in his visits to Washington physicians, such convincing records, in fact, that some physicians say they did not even examine Plough before writing prescriptions.
"Sometimes you believe people," said one prominent internist, "sometimes you should believe people. I didn't examine him but, 'I want you to come back.' It's only the second time in my life I've prescribed Dilaudid. I never use it" for patients.
Said Dr. Denis Hand, medical adviser to RAP Inc., a drug abuse counseling program and another internist visited by Plough: "My impression , in retrospect, is he's a con man. But he presentself as a very plausible patient.Physically, he looked like someone who suffered from Cushing's syndrome," with the typical pale skin, slight acne, protuberant abdomen and moon shaped face.
"His lab values were off," said Hand, who examined Plough, but "that could be accounted for because he was taking medications. Taking big enough doses of Cortisone could produce a Cushinoid appearance," he said.
According to police, Plough was arrested after suspicious pharmacists reported filling prescriptions for Dilaudids for Plough on tow consecutive days from two different internists.
A spokemen for the Medical Society of the District of Columbia said that about once every year to two, an individual passes through Washington who, like Plough, "has a very good story" and fools physicians into prescribing unneeded drugs.
Is Plough a victim of Munchausen's Syndrome?
According to Dr. Thomas P. Hackett, chief of Harvard Medical School's psychiatry program at Massachusetts General Hospital, "usually Munchauses don't do their act to get drugs. Thaths the odd thing-nobody know's why they do it. . . If a person does it for drugs, then one can disqualify him from the diagnosis of Munchausen.
One other question remains about Eric Plough, and that is Eric Plough at all.
"What name do you have for me?" he asked a reporter.