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Gil Reavill
Swimming groggly back into consciousness in the
early morning hours of April 13, 1999, Alexander Baez, a 47
year-old body-builder and former Mr. Mexico, found himself still
on the operating table at Miami Beach's Ocean Health Center.
Baez felt overwhelming relief to still be alive. Stabbing pain
pierced his upper torso.
He fought to clear his head. Undefined terrors
from the operation he had just undergone seemed just out of his
reach. Throughout the surgery, he experienced a trippy sensation
of being trust down a tunnel that exploded with light and color.
He imagined meeting his daughter and grandfather there. "Donde
estoy?" he kept asking them. "Where am I?"
Now he remembered. He was a patient of Reinaldo
Silvestre, a tall, imposing Cuban-born plastic surgeon he'd gone
to for pectoral implants to boost his fading bodybuilding
career.
But what should have been an hour-and-a-half
surgery had somehow stretched longer than four hours. Surely
that wasn't right. And surely it wasn't right that he had woken
up repeatedly during the operation, moaning in pain. Vivid,
disturbing details poked through the narcotic haze. He
remembered fingers poking endlessly inside a large jagged wound
in his chest.
He remembered a crude-looking instrument --
could that really have been a spatula? --probing the incision.
He tucked his chin to look down at his surgery.
Jesus, Baez thought. The implants look like.. they're too big,
aren't they? What the fuck is going on? With the agonized, slo-mo
movements of a drugged man, Baez gingerly touched his chest.
Moments before sinking back into unconsciousness, Alexander Baez
made a startling but very real discovery.
He was the new owner of a pair of C-cup breasts.
In the coming weeks, Baez would learn that he
was far from the only victim of Silvestre. From the spring of
1998 to May '99, dozens, perhaps hundreds, of people
ventured into Ocean Health Center in search of a cosmetic fix.
They fell into the hands of the mysterious 58-year-old man who
called himself Dr. Reinaldo, even though he was unlicensed to
practice surgery or any other kind of medicine in the United
States.
Armed with flattery, cajolery, and a con man's
gift for fakery--but unencumbered by any discernable medical
skill--Silvestre managed to pass himself off as a successful
plastic surgeon in the nation's 12th largest metropolitan area.
For at least 16 months, he plundered the rich and vainglorious
of Miami Beach, leaving behind a trail of maimed victims and
scarred lives.
"The man was a butcher," says Enrique Tones, an
investigator with the Department of Health’s Unlicensed
Activities Office. “The techniques he used were those of a
medical examiner working on a corpse.
It’s unlikely that Silvestre’s criminal career
could have flourished anywhere but the multicultural free-fire
zone of new south Florida. The vast influx of immigrants has
created an ideal breeding ground for predatory frauds. Members
of the Cuban community in search of professionals naturally
turned to their own, and as a rule were loath to check
references.
Moreover, Silvestre set up shop in a city defined by its culture
of narcissism, where flesh, not fashion, is what truly matters.
In sex-drenched South Beach, women wear bikini halters and men
go shirtless simply for trips to the corner grocer. Pursuit of
the body beautiful has reached the level of mania. It isn’t
surprising that half of all complaints against unlicensed
doctors in Florida involve plastic surgeons. There’s so much
money to be made. A license is just a technicality.
An American
Nightmare
Investigators
are still trying to figure out who Reinaldo De La Concepcion
Silvestre really is and how he managed to pull off his charade
for so long. He claimed to have trained in medicine at the
University of Havana, but a transcript has yet to surface.
From what
authorities have been able to learn, Silvestre’s career as a
“surgeon” began in a different theater—one of war. When a Cuban
expeditionary force fought in the Angolan civil war in the late
‘80s and early ‘90s, Silvestre apparently worked as an army
doctor. It is safe to say that unless you prefer your
rhinoplasty clone with a machete, whatever medicine he practiced
on the killing fields of Luanda was a long way from the delicate
cosmetic surgery in demand in Miami Beach.
Coming from
Africa rather than Havana made gaining entry to the United
States a relatively easy proposition. Shortly after his arrival
in 1992, he began treating patients in his home, joining the
growing list of unlicensed health professionals that are
flooding south Florida.
By 1997, five
years after he arrived in America virtually penniless, Silvestre
had hooked up with a 49-year-old realestate agent named Sophie
Bozza. The couple moved to Hibiscus Island one of the exclusive
yacht heav enclaves just off Miami Beach in Biscavne Bay. Their
small two-bedroom home lay in the less desirable interior of the
island, but Silvestre’s patients didn’t realize that. All
they saw was an unqualified American success story.
In December
1997. Silvestre opened Ocean Health Center, a surgical office.
Just down the hall from Bozza’s Sunshine Realty It was another
prestigious address. But the building was situated at the
low-rent eastern end of the street, among shoe stores and
discount electronics outlets. Using fliers and word of mouth.
Silvestre pursued clients in greater Miami’s 600,000-strong
Cuban community. The animated, sociable Bozza was the perfect
shill for Silvestre’s business.
Silvestre duped
established local physicians into lending him legitimacy A few
real doctors were listed as associates; one, Manual Lozaro
Romero, M.D., received mail at the office. But the only work
done at Ocean Health was by Silvestre.
Still, Silvestre had trouble gaining access to the necessary
medical and surgical supplies, so he was forced to improvise.
Operations at Ocean Health Center were macabre, makeshift
affairs employing instruments that would be more at home in a
master chef’s kitchen. Or a torture chamber.
Screams from
the OR
In June 1998, a
Cuban-born woman from Hialeah, Florida, named Jeannette Bernai
drove across the causeway to Miami Beach and headed for Ocean
Health Center. She was looking for a good cosmetic surgeon.
Bernal, a 31-year-old mental health professional who had left
work since becoming a mom, had heard about Silvestre from a
psychologist cousin who said she had known Silvestre at Fahardo
Hospital in Havana.
When Bernal met
Silvestre, she was impressed. “He was very intelligent and
well-spoken,” Bernal recalls, talking through a translator.
“Totally the opposite of vulgar. He seemed like a person who
knew what he was talking about.”
Silvestre recommended implants. Bernal paid Silvestre $4,500,
half in cash, and made an appointment to have the operation on
June 20, 1998. Still, after her first visit, it occurred to
Bernal that the offices seemed to be hidden from the world,
tucked back along a corridor on the third floor. And there were
never people in the waiting room.
But Silvestre himself was imposing enough to brush aside all
doubts. At six feet and sporting a full salt-and-pepper beard,
he exuded confidence. With Bozza posing as his wife of 20 years,
they were the picture of an established professional couple.
On the day of the operation, Bernal brought her cousin along.
Silvestre’s staff most likely consisted of at least two people
that day: 56-year-old Julio Montesdeoca, who acted as
anesthesiologist; and an unidentified male nurse. They summoned
up the requisite appearance of medical professionals, appearing
in scrubs and latex gloves.
Sitting uneasily in the tiny waiting room, Bernal’s cousin was
distressed to hear moans, sobs, and screams coming from the
operating room. The nurse hurried out of the OR to soothe her.
“Not to worry”
he told her. “She doesn’t feel anything. She’s just having a bad
reaction to the anesthesia.” But the drug Bernal had been given
was not an accepted adult anesthetic at all. As was customary at
Ocean Health, Bemal had received the animal tranquilizer
Ketamine. Widely known as Special K on the club circuit, where
partyers ingest it for its trancelike effects, the drug is
sometimes used on children, but rarely as a standalone general
anesthetic.
As she lay on the operating table, Bernal reacted strongly to
the drug’s psychotropic effects, effects that would linger for
days. “I remember being thrown into a long dark tube in my
mind,” Bernal says. She babbled nonsense during the operation
about being on a boat and bleeding through her shirt.
When Bemal awoke, Silvestre declared the surgery a complete
success. Her breasts, he said, were “beautiful, perfect.” Still
groggy, she was driven home by her cousin.
In the days following the operation, the clumsy cross-stitched
sutures Silvestre had given her began to open. On July 5, Bernal
went back to Ocean Health to get her stitches removed. Silvestre
took out only a few of them, leaving the rest in a desperate
attempt to close the swollen incisions. Although Bernal noticed
with distress that her breasts now seemed lopsided, the left
bigger than the right, Silvestre again told her that the
implants were “perfect” and would heal soon.
“No big deal.’ That’s what his catch phrase was,” Bernal
recalls. Because Silvestre said it to her so often, “they are
the only words I know in English.” But Bernal’s incisions would
not heal. The next months were a downward spiral of more
problems, more assurances from Silvestre—and more operations.
The flesh began to decay around the infected sutures, giving off
a malodorous stench. Bernal was returning to Silvestre almost
daily now, and he would snip away the punky skin with a pair of
surgical scissors.
The nightmarish conclusion to Bernal’s dealings with Silvestre
came on November 15, 1998. She sat on the edge of the operating
table in the little gray-walled room at Ocean Health. Silvestre
seemed undecided about whether to give her general anesthesia;
eventually he administered only local
.
Opening the infected sutures once again, Silvestre began to
force his way under the skin of her chest. Bernal reeled from
the intense pain—and from a deep sense of violation. “It was
very difficult emotionally to see someone’s hand inside my
breast,” she remembers. Still using only local anesthetic,
Silvestre used staples to close the wound. “I cried like I had
never cried in my entire life.”
She would never again allow Silvestre to operate on her. Her
breasts, she says, had become “grossly deformed,” misshapen
masses of scar tissue. The nipples were no longer visible—they
had been turned under the folds of her breasts by the repeated
surgeries. Bernal had stopped thinking in terms of doctors to
solve her problems. Now she was thinking about lawyers.
Holiday
Special: Boob Jobs, Half-Price!
After the Bernal debacle, Silvestre sought to protect himself In
an attempt to put himself on firmer legal footing in case he
found himself in court, Silvestre took his first and only step
toward legitimizing his practice. On November 19, 1998, he
completed the initial application to become certified as a
doctor in the state of Florida.
He then took
the first of numerous exams given to prospective M.D’s. He
failed four times and never again pursued his medical license.
“To Reinaldo Silvestre, the application was simply a matter of
red tape,” Torres says. Throughout this period, Ocean Health
continued its activities unchecked. Silvestre had directed
Sophie Bozza to actively crawl for clients. It was the 1998
Christmas season, and Ocean Health was offering holiday specials
on boob jobs to help drum up business.
One person Bozza called was a pretty, 26-year-old Miami model
named Mileydi Pimienta, who had first contacted Silvestre about
breast enlargement in March 1998. Silvestrc quoted her a price
of 86,000—too high. But on December 1, 1998, while Pimienta was
at the beauty salon where she worked, Bozza called. “You’re in
luck,” she said. ‘We’re having a Christmas special, a
50-percent-off sale: It’s only $3,000.”
Pimienta had the surgery, and complications similar to Bernal’s
soon set in. Her sutures suppurated, leaking a thin liquid which
was at first pink and eventually turned yellow. When she
returned to Silvestre to have them attended to, he resorted to a
makeshift arrangement to intubate the wounds.
“He cut one of the fingers off of his surgical gloves and used
that as a drain,” Pimienta recalls. Silvestre would stuff one
end of the glove’s latex finger into the incision, allowing the
discharge to leak through. Silvestre had Pimienta keep the
bizarre rig in for two weeks, requiring her to come in to change
the latex finger every day—Christmas and New Year’s included.
There were other problems. “One breast was big, one was small,”
Pimienta recalls. “The implants were rotating inside me. I had a
lot of pain.” One breast resembled a lump of clay. Silvestre
constantly reassured her. “He played with my emotions,” she
says. “He made me feel as though the problem was with me,
because he said that I was anemic and diabetic or had AIDS. It
was all my fault.”
As she waited one afternoon in the Hibiscus Island house to see
Silvestre, — Pimienta spied a legal document in a pile of papers
on his desk. Checking to see she wasn’t being watched, Pimienta
gingerly slipped the paper out and examined it. It indicated
that a woman named Jeannette Bernal had sued Silvestre for
malpractice. For Pimienta, already contemplating her own suit
against Ocean Health, this was big news. It meant she was not
alone.
The Case Builds
Bernal had trouble finding a lawyer. She was broke and unable to
work because of the pain from her operations. She was also
unable to have sex, and her boyfriend, the father of her child,
began seeing other women. Eventually he left her.
Then Bernal met Spencer Aronfeld, a young Coral Gables. Florida,
lawyer. The Chicago-born, Kansas-raised Aronfeld had a
reputation for taking on lost-cause cases other attorneys would
not touch—including a bruising baffle against the deep-pocket
lawyers of Disney World. Although Aronfeld was unsure about the
financial prospects of the case, he agreed to take it on. “This
lady’s breasts resembled a double mastectomy when she came to
me,” he says. “They didn’t look like human breasts.”
The lawyer at first thought the case was a typical medical
malpractice suit against a well-insured plastic surgeon who had
botched a simple breast-implant operation. But Silvestre’s
attorneys told Aronfeld that their client was uninsured. At that
point all the money went out of the case. No insurance meant no
insurance company to sue.
Aronfeld had
hit a brick wall. But when Pimienta walked into his office in
June 1999, trailing a hulking bodybuilder who said he was a
former Mr. Mexico, everything changed. As Baez took off his
shirt and showed what The Butcher of South Beach had done to
him. Aronfeld realized he wasn’t in Kansas anymore. This one was
south Florida all the way.
A Mutilation
Caught on Tape
Baez met
Silvestre in spring 1999 at Pancho Villa, a Mexican restaurant a
few blocks from Ocean Health. Baez worked as a musician there,
but his real passion was bodybuilding. Baez liked the smooth,
well-groomed Cuban and his gabby wife. Silvestre flattered him.
“You’re an excellent singer, Alex,” he said. “What are you doing
here in Miami? With seeming casualness, Silvestre mentioned his
Hibiscus Island home and told Baez that he spoke several
languages, talking about his experiences all over the world.
“Immediately you think this is a very, very successful doctor,”
Baez says in his halting English.
The next time Silvestre returned to the restaurant, Baez
mentioned that he wanted to take care of some small indentations
in his chest that he felt might hold him back if he returned to
bodybuilding competition in the over-40 category.
Silvestre told him pectoral implant surgery wouldn’t be a
problem: Baez would be out of work for only a week and back at
the gym lifting weights within a month. He quoted a price of
$2,000, which, he said, covered only his expenses and the fee
for the anesthesiologist. The operation was a go.
In a moment of bizarre overconfidence, Silvestre asked Pimienta
and her boyfriend, David Gonsalez, now working as a driver for
Silvestre, to document the surgery on video. “I’m attending a
Boston plastic surgeons’ conference,” Silvestre said. 1 want to
use this tape to show the other surgeons my work.”
Pimienta and Gonsalez thought a video would be the perfect
document in the malpractice suit they were contemplating against
Silvestre. They agreed to do it themselves and on April 12,
1999, convened at Ocean Health with their camera. If they felt
at all conflicted about their role in standing by while another
patient became victim of medical mutilation, they hid it well.
Baez was
nonplussed when he showed up at Silvestre’s clinic for what he
considered a routine surgical procedure. He found the office
filled with people, “like a party,” he recalls.
I suppose it’s OK, Baez thought at the time. “I’m Mr. Mexico and
maybe [Silvestere] was telling himself, OK, I’m going to put a
couple of implants in Mr Mexico. Time for a party.”
Montesdcoca
administered the Special K. A local FM station provided an eerie
soundtrack of classical music. Silvestre opened a two-inch
incision in Baez’ right breast, just below the nipple—instead of
in the armpit, where pectoral implants are normally inserted.
Throughout the early stages of the surgery. Silvestre seemed to
delight in reaming the wound with his hand—fingering the hole to
enlarge it.
Then Silvestre sliced through Baez’ pectoral muscle—a disastrous
and unnecessary move. To do it to a bodybuilder is tantamount to
cutting the Achilles tendon of a sprinter.
Pimienta, witnessing all but intent on obtaining evidence did
nothing to stop it. “I didn’t know what was happening she says.
“I didn’t know how bad it was for Alex.
The proceedings were punctuated every so often by the
drug-induced incoherent moans of the patient. "Donde estoy?”
Baez sounded like a tape played at slow speed.
“I couldn’t talk,” Baez says. “but I made a big effort because it was
important for me in that moment to know where I was. I was
asking "What's the story?”
To open the
incision further, Silvestre wielded a tool that resembled a cake
cutter, its dirty wooden handle bent per perpendicular. He
inserted a deflated female breast implant under Baez’ skin,
filling it with saline. Bozza joked in Spanish; OK, we have the
Mexican Johnny Weissinuller here, and we’re going to put these
implants in like a Mexican taco with chili.”
It was after
midnight when Silvestre finally finished, sewing up the
incisions with amateurish cross-stitching and neglecting the
crucial step of closing the interior tissue. “Those are things
that a first-year medical student would know, Tones says.
In the following days, Silvestre told Baez not to worry that the
implants seemed large. “This is a normal inflammation, Alex,’ he
said. You have a great deal of muscle. When I put this implant
in, you have a very big inflammation because you are very hard
meat—muscle.
Over the next few weeks, Baez waited for the inflammation to
subside and the implants to assume their normal shape. They
never did. Six weeks after the surgery, with the pain in his
arms subsiding, he stood in front of a mirror and struck a
competition pose. What he was seeing, he finally forced himself
to realize, was not the “very hard meat” of a bodybuilder but
soft, rounded C-cups. “I couldn’t see my torso, my back, because
I had a big moon in my chest,” Baez says, ”It was the first time
I knew for sure this was a female breast.”
By that time Baez no longer had Silvestre to denounce, to sue
for malpractice—or to tear limb from limb. On May 6, 1999,
Silvestre had fled the country. He had simply vanished.
The Doctor Is out...of the Country
Most law enforcement investigators believe Silvestre fled to
a Caribbean or South American country. His native island is the
most likely possibility. There’s no extradition between Cuba and
the U.S., and Cuba’s Stone Age media make it unlikely that
Silvestre’s face has been splashed across TV and newspapers
there, the way it has been in the U.S. and Mexico.
In the wake of Silvestre’s disappearance, a fourth victim came
forward. She is a Colombian woman who had gone to Ocean Health
for an eyelid nip and tuck. She, too, was mutilated, rendered
unable to shut her eyes completely.
Aronfeld arranged for reconstructive surgery for all four known
victims of The Butcher of South Beach. A top surgeon, Dr. John
Cassel of Miami’s Baptist Hospital, donated his services.
Pimienta returned to modeling; Baez returned to the gym. Both
have permanent scars. Cassel reconstructed Bemal’s breasts from
skin left over from a tummy tuck.
Aronfeld filed a class-action civil suit on behalf of Baez,
Bemal, and Pimienta and possible Silvestre victims. He hopes to
widen his suit to include the city of Miami and the makers of
the implants. Without such deep-pocket targets, he is left to
sue a shuttered operation without assets and a con-man fugitive
whom police have so far been unable to locate.
Silvestre, if brought to justice, faces life imprisonment. Bozza
and Montesdeoca are due to stand trial soon in Miami on charges
of practicing medicine without a license and aggravated battery.
If convicted, each faces a minimum of 15 years in jail.
The news of Alexander Baez’ mutilation was banner- headlined in
his hometown of Mexico City. His children were baited on the
playground with cries of “Your papa had titties!”
“I want to kill this fucking guy” Baez says of Silvestre,
“because I trusted him.”
And, odds are, in a large Spanish-speaking city somewhere, a
solidly built man with a smooth professional, demeanor has set
up shop as a physician letting it be known he is seeking
clients. An odd thing, though: His jaw is white and untanned,
almost as if he has shaved off a beard...
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