The Internet Internist

Dr. Pietr Hitzig of Maryland has prescribed a fen-phen panacea for all manner of ailments to thousands of patients he has never met. One of them, Alvin Chernov, killed himself.

Phoenix-based DEA agent Tom Babicke says Hitzig's protocol reminds him of a movie from the late 1960s:

"Remember Valley of the Dolls? Remember all those actresses in that up-and-down syndrome--on amphetamines to lose weight, then not being able to sleep at night so they take sleeping pills, downers? Up and down, up and down. That sounds like the, quote, balance this guy is talking about."

Chernov's last employer, Paul Coppinger, says his brief interaction with Hitzig convinced him that the doctor is dangerous.

"Pietr Hitzig is an accredited con man," says Coppinger, co-owner of APPS Software International. "I'll stand by what I told him last summer."

What Coppinger told Hitzig via e-mail last August 8 was this: "I am very disturbed by the fact that you have prescribed such a powerful drug to Alvin without any direct consultation whatsoever. Even the most shady practitioner will require a face-to-face visit before 'forking over the goods.'

". . . Your electronic hucksterism is threatening the safety of not only Alvin, but the lives and livelihood of myself, my family and my employees. Further, your quest for profit has needlessly involved the attention of numerous police, judicial and medical professionals who must deal with the consequences of your actions and pick up the pieces of Alvin's shattered psyche."

One evening in August 1996, participants in an Internet "chat group" were gabbing about Pietr Hitzig.

"I am seeing a lot of anger against him," someone wrote, "but I have failed to see any posts actually posted by him. Someone fill me in please!"

Hitzig himself responded to the inquiry from his e-mail address, fenphen "I am the most competent to answer that question considering the quality of the responses you received. For instance, 'He's a creepy quack doctor who you should avoid at all costs!'"

To the contrary, Hitzig said, he was an Ivy League-educated (Harvard and Columbia) doctor who had developed "protocols re addiction and treatment of Persian Gulf illness, fibromyalgia and chronic fatigue syndrome."

He called himself the "creator of the term Fen/Phen (March 1993) and owner of the patent office's service mark for same . . . Creator of the Hitzig Fen/Phen protocol that has successfully stopped bulimia, alcoholism, depression, cocaine addiction, anorexia nervosa, Gulf War Syndrome, asthma, Chronic Fatigue Immune deficiency, post-traumatic stress disorder . . . (Please note that those success rates cannot be equalled in any other office, and that those who dispense these medications without being part of the Hitzig Fen/Phen team are doing so at the risk of damage to the patient.) I hope that gives you a better idea of who I am and what I do."

In another message around that time, Hitzig added, "I get pleasure out of helping patients, establishing the validity of what I do, and, frankly, make money. There is no reason to believe that they should be in conflict . . . I am not trying to sell you beach fronts in Arizona or the Brooklyn Bridge."

Not everyone on the Internet bought the doctor's pitch.
"He is the fen/phen guru and will explain to you how it's good for everything from depression to the gout," someone wrote. ". . . [Hitzig] doesn't let a little thing like a 100 percent financial stake in the protocol stop him from offering unbiased opinions. Needless to say, proceed at your own risk."

As he did with Debbie Knight, Hitzig referred chat groups to his Web site. There, he said, they could find all they needed to know about fen-phen, including the effectiveness of his program on "depression:"

". . . Resolution of depression usually occurs in 60 to 90 minutes. In a study of severely depressed alcoholics, 16 of 19 had normal psychological tests after two weeks of Fen/Phen treatment."

An internist by training, the doctor told the chat room he'd practiced general medicine for 20 years "before devoting himself to the exclusive treatment of patients" by prescribing fen/phen.

He said his regimen was "an exciting new treatment for many illnesses comparable in its potential to heal with the claims of 'snake oil' cures of the past. That idea that one treatment could help everyone has been a part of our society for thousands of years. Fen/Phen is THE medical treatment able to help society, and back its claims with research and testing . . ."

In August 1997--a month before Alvin Chernov died--Hitzig's Web site page said the cost for the first six months of his fen-phen program "is only $1,154," including a $350 down payment.

"Since July of 1996, we have been able to monitor patients by phone," Hitzig noted, "allowing continued treatment of patients outside of the Washington, D.C., area. Although we greatly prefer to see everybody in the office when the program is started, we can make exceptions if there are strong reasons that you can't make it to the office."

Alvin Chernov was one of those "exceptions." From the time he started taking fen-phen treatments in March 1997 until he killed himself six months later, he and Hitzig communicated only by e-mail or phone.

"A doctor makes decisions by listening, looking, by assessing the total picture presented by a patient," says Dr. George Lundberg, editor of the Journal of the American Medical Association. "If you don't even know what the patient looks like, then you don't know if the patient is conjuring, lying, misrepresenting or anything else. The Internet strips away much of that ability to communicate."

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