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.

One clue to the amount of fen-phen Alvin Chernov ingested comes from receipts his father found after the suicide. Gary Chernov says the receipts for fen-phen and the other drugs totaled more than $3,500--more than three times what Hitzig's Web site says it would cost for six months.

The drugs phentermine and fenfluramine long had been available through prescription: The FDA approved phentermine for short-term use with a low-calorie diet in 1959, and okayed fenfluramine as an appetite depressant in 1972. But neither drug had grabbed a foothold because, individually, they were only mildly effective. Like most drugs, they have side effects--among them, depression with fenfluramine and, in rare cases, psychotic episodes with phentermine.

In 1992, the nation's pharmacists filled only about 60,000 prescriptions for fenfluramine.

Then, in July 1992, a researcher issued findings that caused the popularity of what became known as fen-phen to soar. Dr. Michael Weintraub claimed the drugs, taken in tandem, melted away pounds while negating each other's side effects.

Weight-loss clinics based almost solely on fen-phen--including at least five in the Valley--popped up after Weintraub's findings were publicized. In 1996, druggists filled more than six million prescriptions for fen-phen.

Pietr Hitzig was one of the first to jump on the bandwagon. In late 1992, he coined the term fen-phen. And he was savvy enough in the early 1990s to recognize the burgeoning communication device called the Internet.

Alvin Chernov's life was difficult long before he heard of Pietr Hitzig, fen-phen or the Internet. He was the third of four children in the tumultuous Phoenix household of Gary and Martha Jean Chernov.

Severely asthmatic, Alvin spent most of his time as a child indoors, honing a bent for mathematics and science. His sister Debbie says Alvin never had many friends, but the few to whom he warmed knew an intelligent, serious and sensitive young man.

Gary Chernov scraped by in a variety of small business ventures, some of which made money. His wife ran the household, which Debbie Knight--now 27--describes as volatile.

In the early 1980s, Martha Jean Chernov disappeared for about a month. She later told Debbie Knight she'd planned to starve herself to death--haunted by what she said was sexual abuse by her own father as a child.

"I don't know how our mother was so good to us with all of her own problems and a lousy marriage, but she was," Knight says. "I didn't know until after Alvin died how much she really meant to him."

Chernov attended Phoenix Central High, an honor student who kept to himself and seemed destined for a career in computer science. He never had a girlfriend, either in high school or at college, though not because he didn't want one. He wasn't bad-looking, but his family members agree he lacked basic socialization skills.

Chernov enrolled at ASU after graduating from Central in 1990. He moved out of his parents' home and, according to sister Debbie, began to blossom.

"I was just so proud of him," she says. "He was working out and he looked great. He was even showing some dance moves. He wasn't just this little computer dork anymore."

In June 1992, Martha Jean Chernov again disappeared. Passersby found her skeleton in late 1993 at the base of a cliff in the Superstition Mountains. Pinal County authorities ruled the death an "accidental fall."

For reasons he kept to himself, Gary Chernov never told his children about his wife's death. Debbie Knight wouldn't learn of it until August 1994, when she called the Pinal County Sheriff's Office for an update on her mother's missing-person case.

To his family, Alvin seemed unfazed by news of his mother's death. He wasn't. After he killed himself, police scanned a disk in his computer for clues. Data on the disk included a journal--he called it his "book"--Alvin began in his last months. Titled How I Think, it starts with a dedication to Martha Jean:

"I never told you this, but you were my hero. I looked for guidance about everything. You were the only person I felt I could tell anything. When you died, a part of me died with you. There were many times I wondered how I would make it through life. I had not yet learned all you wanted me to learn. What was wrong with you? Why did you leave me before I had the strength to carry on with your work?"

After learning of his mother's death, records show, Chernov got a prescription for the anti-depressant drug Prozac from doctors at ASU. But anguish didn't dampen his academic achievements. Chernov graduated from ASU summa cum laude in May 1996, with a degree in engineering.

That summer, he went to work as a software engineer for Xantel, a Phoenix firm. Though the reasons are murky, he was fired in late 1996. Months later, after Xantel gave Chernov a poor referral, he mailed a former boss a photo of the bombed federal building in Oklahoma City.

Chernov apparently started taking fen-phen between jobs, in March 1997.
"Alvin told me that spring that he'd been taking this medication for depression," Debbie Knight recalls. "He said, 'It's all about chemistry,' that he was playing with the levels he was taking, that his head was better and he was losing weight, too. It sounded great, and I completely believed him. I had no idea it was through the Internet."

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