Prescription for trouble

The price sounds steep—$3,500, plus expenses, for a house call—but for the kind of people seeking Dr. Anthony Galea’s help, it’s chump change. New York Yankees slugger Alex Rodriguez used his services, as did his on-again-off-again girlfriend Madonna, and Swedish soccer star and Calvin Klein underwear model Freddie Ljungberg, per a well-placed source. Tiger Woods flew him to Florida five or six times—business class, naturally. According to an affidavit filed in court when the RCMP searched Galea’s offices in mid-October, seeking evidence of performance-enhancing drugs, the 51-year-old doctor treated 23 pro-athletes in eight different American cities over a nine-week period last summer. During the last decade, hundreds more from the NFL, NHL, CFL, NBA, major league baseball, track and field, and beyond, have beaten a path to his unassuming clinic, now located near Pearson International Airport, seeking to ease their aches and injuries. And even after Tony Galea’s name has been dragged through the mud for months, fingered as the latest sports “Dr. Feelgood,” the calls still keep coming. When David Beckham tore his Achilles tendon in March, shattering his World Cup dream, he reached out to Galea, looking for a miracle. The doctor turned him away.

On May 18, the U.S. Attorney’s office in Buffalo, N.Y., filed five charges against Galea, including smuggling, distributing human growth hormone (HGH), and introducing an unapproved drug—the calves’ blood extract Actovegin—to interstate commerce. If convicted on all counts, he could face up to 38 years in prison, and $1.25 million in fines. It was simply the latest twist in a saga that has sent the Justice Department and the FBI sniffing around some of the biggest names in sport, seeking evidence of cheating. And it promises to get messier still.

Last Sept. 14, Mary Anne Catalano, then Galea’s executive assistant, was pulled over as she entered the U.S. at the Peace Bridge border crossing near Niagara Falls. In the car, a 2009 Nissan Rogue registered to one of Galea’s companies, officers found an ultrasound computer, a centrifuge, and a medical bag stuffed with 111 syringes, 20 vials, and 76 ampoules of various prescription and homeopathic drugs. Within the bag was one partially used bottle of HGH. The 32-year-old initially told investigators that the supplies were for a medical conference she was flying on to in Washington, but, under questioning, quickly recanted the story. The truth, Catalano said, was she was bringing the drugs across the border at Galea’s behest—the doctor, who has no licence to practice south of the border, had been stopped by U.S. Customs officers at Pearson the February before and feared his file was “flagged.” The real purpose of the trip to Washington, she said, was to treat a member of the NFL’s Redskins.

The border agents seized and searched Catalano’s laptop, BlackBerry and an external hard drive. With her assistance—she has been classified as a “co-operating witness”—they traced Galea’s movements around the U.S. since the summer of 2007, pulling calendars, treatment notes and invoices. The RCMP affidavit, still sealed in Canada, but leaked to the American sports channel ESPN, says Catalano identified seven different pro athletes to whom Galea had administered HGH. The charges filed in Buffalo only make specific reference to one case of growth-hormone use, alleging the doctor provided the drug to a retired NFL player in connection with “quality of life issues.”

Catalano’s Toronto lawyer Calvin Barry won’t discuss what his client has told the FBI. (She’s due back in a Buffalo court June 11, when she hopes the charges against her will be dropped.) But Barry isn’t exactly shying away from suggestions that there is more— much more—to come. He’s fielded calls from investigators from all the major sports leagues, and muses about the possibility of her testifying at U.S. Congressional hearings. “She met a bundle of celebrities. It was an interesting experience for her, a little girl from Etobicoke,” he says.

In the press, Galea is being portrayed as the next Victor Conte, the San Francisco lab owner whose designer steroids fuelled home-run records and Olympic medallists. The charges and the raid on his clinic have brought unwelcome publicity for his patients, including Canadian figure skater Patrick Chan, who sought treatment for an ankle injury in the run-up to the 2010 Vancouver Olympics. Much has been made about the doctor’s “unorthodox” treatments, including the use of platelet rich plasma (PRP), where the patient’s blood is concentrated through spinning, then reinjected into the injury area to help speed healing. For some, it’s uncomfortably cutting edge: the World Anti-Doping Authority (WADA) barely tolerates it because of its potential for abuse, demanding athletes seek a therapeutic exemption.

But that forward-thinking reputation is precisely why Galea attracted so many big-name clients, and such renown among his fellow sports physicians. “Dr. Galea has never engaged in the performance enhancement of any athlete. He’s a healer,” says Brian Greenspan, his Canadian defence counsel. To prove the point he flips through a thick binder of testimonials, many collected as Galea started to seek a U.S. work visa on the basis of “extraordinary ability,” and a Colorado medical licence in the spring and summer of 2009. Bill Knowles, a Vermont sports trainer, wrote that he had referred elite athletes—including Tiger Woods—to the Toronto physician for the past six years. “Tiger has been most impressed and pleased with his level of expertise.” Marc J. Philippon, the Colorado surgeon who operated on A-Rod’s hip last spring, wrote: “Dr. Galea is one of the top one to two per cent of individuals throughout the world currently working within the field of PRP injections in athletes.” The Steadman Hawkins Clinic in Denver had offered Galea a position. One of the principals, Theodore Schlelgel, team physician for both the Denver Broncos and Colorado Rockies, wrote that he would serve as Galea’s sponsor.

It all comes down to who you believe. In a world where millions of dollars hang on wonky knees, twisted ankles and sore elbows, Tony Galea is either a visionary or something a lot more prosaic: an enabler.

Human growth hormone merits a full chapter in Dr. Galea’s Secrets to Optimal Health, a diet, fitness and hormone manual the physician self-published in 2007. The list of benefits he says can be derived from the drug is impressive: decreased body fat and bigger muscles, fewer wrinkles, improved cardiac and vascular health, increased energy and a stronger libido. But he also acknowledges the potential side effects—abnormal bone growth, carpal tunnel syndrome, “copious” body hair growth—and urges caution. “I am currently replacing Growth Hormone in a number of patients. Growth Hormone should only be replaced if it is below the required amount for your age. Replace with the smallest dose necessary to bring it back.”

Mike Kotlajic, a 51-year-old Toronto businessman, went to Galea a couple of years ago seeking help for a severe case of tennis elbow. Other physicians told him it would require surgery. Galea cleared it up with a half-dozen PRP treatments and vitamin injections. After a complete blood screening, Kotlajic also ended up with a prescription for HGH. “I was depleted. I felt sluggish,” he told Maclean’s. The dose was small, and the injections only continued for a month, but Kotlajic says it did the trick. “It was wonderful. I felt very energetic.” He even lost some weight.
In the book, Galea writes HGH “could be the one hormone that actually reverses the aging process.” And judging by his own youthful appearance—drum-tight skin and jet-black hair—that might be true. When he turned 40, the doctor began injecting himself with growth hormone five times a week. A decade later, he continues to be an avid cyclist, snowboarder and skier. In 2003, he married his third wife, Nela, a former patient and junior tennis star, 22 years his junior. They now have three small kids, in addition to Galea’s four children from his previous marriage.

Dr. Galea’s Secrets also makes reference to the use of HGH for the treatment of osteoarthritis of the knee, foot and ankle. “GH and various nutrients are injected directly into the knee to provide relief from pain.” The drug seems to help regenerate cartilage, he writes, offering an alternative to more invasive surgeries or joint replacement.

None of these HGH treatments are illegal in Canada, where the drug is considered safe enough to be used even for “off-label” purposes. In fact, when the RCMP finally got around to charging Galea on Dec. 16, two months after the clinic raid, the hormone was almost an afterthought. Galea stands accused of violating the federal Food and Drugs act by selling Actovegin, an unapproved substance. There are also parallel charges under the Customs Act and Criminal Code for allegedly smuggling, or conspiring to import, the calves’ blood extract into Canada. Only the criminal charge of conspiracy to export pertains to HGH—the partial vial found at the border.
Galea’s lawyer, Greenspan, rattles off the lines of defence. The HGH was for the doctor’s personal use. The Actovegin was not sold, but given to clients (the fee was the same whether the remedy was used or not). And any treatment that took place outside Canada was done at the request of American-licensed physicians.

In the U.S., where HGH is more strictly regulated—there are only four approved FDA uses—it is still a popular anti-aging “cure.” Cenegics Medical Institute of Las Vegas, the country’s largest hormone-replacement specialists, claims to have 10,000 patients, nearly 10 per cent of whom have been diagnosed with “adult growth-hormone deficiency,” reports the New York Times. Ancient Hollywood action star Sylvester Stallone is an unabashed fan. In 2007, he was caught with 48 vials of the drug by Australian customs as he prepared to film Rambo IV in Burma. He says it helped him put on 41 lb. of muscle at age 61. And its use and abuse among pro-athletes is also endemic. Not only can it make you bigger, it can make you faster. A WADA-funded study by Australian researchers, published in early May, concluded HGH could shave 0.4 seconds off a world-class sprinter’s time in the 100-m—that’s almost a tenth of a second more than the spread between Usain Bolt’s winning time at the 2008 Beijing Games and the eighth-place finisher. The drug’s restorative powers are also legendary. Last winter, Tampa Bay Buccaneers’ running back Earnest Graham told a Florida radio audience that he figured 30 per cent of the league was using it, mostly to recover from injuries. “Especially in this game, not having guaranteed contracts, you know, with so much riding on your performance, a game that tears your body down like that,” he said.

HGH has been on WADA’s list of banned substances for years, but a blood test was only introduced in 2004 at the Athens Olympics. And the first positive result came this winter—English Rugby League player Terry Newton was handed a two-year ban. WADA is working on a bio-marker test that may prove more effective. The NFL and MLB don’t even currently test for it.
Galea is certainly aware of the prohibitions surrounding HGH and other performance-enhancing drugs. In the mid-1990s, he was a sanctioned doping control officer for Canada’s drug testing body, the Centre for Ethics in Sports. He spoke out publicly against steroid use. “It’s a huge problem and probably underestimated,” he told the Toronto Star back in 1995. He was the team physician for Canada’s freestyle skiers at the 1998 Nagano Games, and he worked extensively with other Olympians. Donovan Bailey, the 100-m champion in Atlanta, credits Galea with helping him recover from a career-threatening 1998 Achilles tear, getting him back on the track and running sub-10-second times in little more than a year.

For many who know the McMaster med school grad, the swirling allegations don’t add up. Mark Grimes, a Toronto city councillor and current Galea patient (torn ACL and meniscus), says the doctor has a sterling reputation in the community. “I get calls weekly from parents and athletes that can’t get in to see him.” Recently, Grimes pulled some strings to get an injured Ontario Hockey League player a coveted appointment.

The doctor is also a well-known holy roller. In his book, he devotes a chapter (much longer than the HGH one) to his 2001 “spiritual awakening.” Raised a Catholic, he had drifted away from religion until a sudden and overpowering urge to visit Jerusalem kept him tossing in bed at his chic Yorkville condo for three straight nights. A week later he was in Israel, worshipping at the Church of the Nativity in Bethlehem, and walking the narrow streets of the Old City. A mass in a Mount of Olives chapel after days of quiet contemplation was the turning point. “I can only describe what I felt as experiencing an intravenous injection of a combination of love and fire coursing through me,” he writes.

For the past several years, Galea has spent a lot of time in Israel, volunteering and fundraising for the Sheba Medical Center in Tel Aviv, the largest rehab hospital in the Middle East. He has trained its physiotherapists in the latest techniques (sports injuries apparently have much in common with those suffered in conflict) and donated a state-of-the-art isokinetics machine to test and rehab arms and legs. He has also brought influential friends to visit, including Jeff Royer, a general partner for the Arizona Diamondbacks. Dr. Shlomo Noy, the hospital director, marvels at Galea’s dedication. “He’s a very positive guy, lots of enthusiasm and always willing to help,” he says. “We never paid him, or gave him other compensation.”

David Cynamon, the former co-owner of the Toronto Argonauts, was another Sheba visitor. (Galea was the team doctor until his resignation this past winter.) He was so impressed with the physician’s zeal that he purchased a sculpture in Galea’s honour. Welcome, a work by Romeo Britto, now sits outside the Tel Aviv complex. Cynamon, who has known Galea for 15 years, says he can’t reconcile what he reads in the media with the man he knows. Tony drives a pickup, dresses in athletic gear, is the first to reach for the cheque, and has little love for money or fame, he says. “It’s never been about publicity or climbing the ladder,” says Cynamon. “All I know is that he has always had the best intentions. For him, it’s all about the healing.”

When it comes to broken athletes, however, that desire to mend is a little too fierce for some. Galea’s boundary-pushing work frequently raises eyebrows. Paul Melia, head of the Canadian Centre for Ethics in Sport, says athletes and coaches had raised concerns about Galea’s methods in the past. There was no formal investigation, or warnings to athletes to stay away, but plenty of unease about the doctor’s HGH advocacy and PRP use. “We’ve been keeping a watchful eye on all of that,” says Melia. And Actovegin, although now legal, was once banned by WADA after staff from Lance Armstrong’s U.S. Postal Service cycling team were filmed throwing away empty vials during the 2000 Tour de France. Bodybuilding websites suggest the drug boosts the potency of steroids. But no study has been able to confirm that.

Galea also has a history of ignoring rules. At the 2000 Games in Sydney, where he was helping out Bailey and the track team in an unofficial capacity, Australian customs officers stopped him at the airport carrying an undeclared medical bag. (Olympic anti-doping protocols demand supply lists be submitted months in advance.)

But even now, he is hardly a pariah in Canadian sports. A week after the Winter Games, Galea and Melia appeared on the same panel at a symposium on peak athletic performance in Vancouver. The doctor isn’t giving interviews these days, but in a podcast from the conference, he provided something that sounded an awful lot like a defence. Croaking through a painful-sounding case of laryngitis, Galea went on the attack, charging that anti-doping hysteria is threatening to rob sports medicine of all useful treatments. “Unfortunately because we deal with elite athletes and sports and Olympics, severe anxiety and fear has arisen because of what’s known as Satan’s drug—human growth hormone—which has been cloaked in a shroud of evil,” he says. Simply applying a blanket ban to a naturally occuring hormone makes no sense. “We have to establish objective debate and to define the clear border of what is tissue-enhancing and what is performance-enhancing.” Maybe it is more complicated than right and wrong.