On a day-to-day basis, not a lot has changed for Dr. Anthony Galea. Sure, some Canadian pro hockey players have made themselves scarce at the Institute of Sports Medicine Health & Wellness Centre near Toronto since Galea hit the headlines late last year, but wait around the parking lot long enough and you'll run into a prominent athlete or two. Like 2008 Canadian Olympic high jumper Nicole Forrester. "They just don't know him," she says of Galea's detractors. What U.S. law enforcement officials know is that Galea—whose patients have included Tiger Woods, Olympic swimmer Dara Torres, former NFL running back Jamal Lewis and NBA star Chris Bosh—is a proponent of using human growth hormone (HGH) to help heal injuries. Galea's assistant, Mary Anne Catalano, was stopped by U.S. border authorities in Buffalo on Sept. 14 of last year while trying to enter the U.S. in a Nissan Rogue that was carrying a medical bag containing a synthetic human growth hormone, Nutropin, and Actovegin, a derivative of calf's blood that is not approved for use in the U.S. or Canada. Catalano has since been cooperating with U.S. and Canadian investigations of Galea and has told authorities that Galea directed her to bring the drugs into the U.S. On May 18 Galea was charged in a federal criminal complaint with intent to distribute human growth hormone, bringing Actovegin into the U.S. and making false statements to the Department of Homeland Security.
This is an article from the Sept. 27, 2010 issue
Catalano has identified at least eight professional athletes whom she says Galea injected with a mixture of substances that included HGH; seven received their injections in the U.S. and the other in Canada. According to court documents, authorities believe that one of Galea's standard procedures in treating athletes (in addition to his signature platelet-rich plasma therapy, or PRP) has been to add small doses of HGH to the syringes when injecting athletes with a cocktail of other substances. Court documents in Canada suggest that these injections have been such a routine part of Galea's treatment that "it is quite possible that some of the professional athletes are totally unaware of the fact that they were receiving unapproved drugs."
At least five professional athletes have been interviewed by authorities as part of the Galea probe. All the athletes who have been publicly linked to Galea, including Woods, Torres and Lewis, have denied ever using performance-enhancing drugs.
Galea was not allowed by his lawyer, Brian Greenspan, to speak with SI. Greenspan said that it's premature to respond to specific allegations, since the prosecution has not completed its disclosure, but that "no one in the world could ever suggest that Dr. Galea is involved in performance enhancement." Greenspan added that only two milliliters of Nutropin were found in the car, a small amount that he says were two doses for Galea's personal use. Though HGH is restricted to three very narrow medical uses in the U.S. and is banned in sports, it can be prescribed off-label in Canada (page 58). The 51-year-old Galea has admitted using it as an antiaging remedy to help him keep up with his wife, Nela, who is 22 years younger than he is.
Whether it's for HGH or PRP injections, or other treatments that he offers, Galea attracts a broad mix of patients—and business appears to be booming. Come to the I.S.M. Health & Wellness Centre on the right day and you can't help but notice, in addition to the stream of middle-aged men and parents with young athletes, the expensive cars with U.S. license plates: Porsches and Cadillac Escalades that belong to American pro athletes.
According to friends and colleagues of Galea, the media coverage of his alleged involvement with banned drugs has only increased the number of NFL players—currently two or three per week—and others who are seeking his services. "[Galea's] so busy now, the waiting list is like a year to see him," says Anthony Mascia, a radiologist in Toronto who works with Galea and accompanies him on morning bike rides. Mascia notes that Galea's clientele is still "90 percent recreational and adolescent athletes," including middle-aged men to whom Galea prescribes HGH for what he maintains are antiaging purposes.
Galea's rehabilitation work a decade ago with Canadian sprinter Donovan Bailey helped catapult him onto the A-list of sports doctors. Bailey, the 1996 Olympic 100-meter champion and former world-record holder, ruptured his left Achilles in 1998 but came back less than two years later to run the 100 in under 10 seconds; he credited Galea for using therapies such as oxygen treatments in a hyperbaric chamber to help him recover.
Since then more and more sports stars have sought out Galea's services. Galea traveled to Florida—where he reportedly has been under investigation for practicing without a license—to give Tiger Woods platelet-rich plasma injections in his left knee after Woods had cartilage cleaned out in 2008. In PRP therapy, which was pioneered over the last decade by Dr. Allan Mishra of the Stanford University Medical Center, about two tablespoons of a patient's blood are removed and put through a centrifuge. This creates a concentrated dose of soft-tissue-healing platelets that is then reinjected into the patient. In part because no red blood cells are reinjected, PRP treatments are not considered blood doping.
Galea has said that Yankees third baseman Alex Rodriguez was also one of his clients. According to a person familiar with the investigation, Galea visited Rodriguez in New York several times before games last season and injected the slugger's troublesome right hip in the presence of his then girlfriend, Kate Hudson. (A representative for Hudson said Hudson "is not aware" of any such injections. Rodriguez's lawyer declined to comment.)
While many of Galea's U.S. athlete clients have been NFL players (reportedly including Washington Redskins wide receiver Santana Moss), Bosh—a new member of the Heat's all-star trinity—went for what two sources close to Galea said were PRP injections last year when a left-hamstring injury caused him to miss Toronto Raptors training camp. Through his agent, Bosh said Galea's treatment helped him return in time for the season.
Depending on who is talking, Galea, who earned his medical degree at the highly regarded McMaster University in Ontario, is either a supremely talented and progressive healer or a purveyor of impossible cures who disregards rules. The former is the image that has spread through the highest echelon of professional athletes, sometimes to the dismay of team officials.
Last summer New York Mets shortstop Jose Reyes went to see Galea for treatment of a torn right hamstring. He did so on the recommendation of teammate Carlos Beltran, who'd seen Galea for a bone bruise below his right knee after hearing from a friend that the doctor had treated Woods. According to a team official, the Mets, concerned about Galea's methods, sent a member of their medical staff along with Reyes. Two of Galea's colleagues told SI that a Mets doctor had previously called to chastise Galea and his group for consulting with Beltran without the team's approval. (The Mets declined to comment.)
While team doctors tend to be skeptical of Galea's approach, athletes often see him as a medical miracle worker. Four months before last February's Vancouver Olympics, for example, Patrick Chan, Canada's top hope for a gold medal in men's figure skating, went to see Galea about a pesky left-calf injury that had kept him off the ice for a few weeks and that other doctors had struggled to diagnose. Galea quickly identified a muscle tear and treated Chan with ultrasound and PRP therapy. According to an athletic therapist who works with Canadian Olympians, Chan was convinced that Galea had cured the tear in a span of two days. Chan did indeed return to training, but ongoing calf problems persuaded him not to try a quadruple jump at the Olympics.
"If it was a tear, it doesn't heal in 24 to 48 hours," says the athletic therapist. "These PRP injections have science behind them, but not [miraculous] science. Everybody's looking for a magic cure that will help [heal an injury] faster, but nobody's got it."
When Galea addressed his work with Chan, who finished fifth at the Games, at a sports medicine lecture in Vancouver in March, his assessment of the skater's situation was simple: "If we'd injected him earlier, he probably would've won the Olympics."
According to Steve Roest, owner of the Fitness Institute in suburban Toronto, where Galea used to work as an in-house doctor, Galea has "gone Hollywood" in the last two or three years, referring to the prominence of his clientele. "He's not a guy to market himself," says Roest, who credits Galea with helping him recover in 2008 from a torn right biceps he suffered while playing pickup hockey, "but people find him." Galea has long been connected to football—he was the team doctor for the CFL's Toronto Argonauts from 2004 until he resigned last year—and more NFL players found him, Roest says, since he began treating former 2,000-yard rusher Jamal Lewis.
In 2006, when Lewis developed bone spurs on his right ankle while playing for the Baltimore Ravens, his agent directed him to two Canadian chiropractors, Keith Pyne, a rehab specialist, and Mark Lindsay, who, like Galea, works at the I.S.M. Health & Wellness Centre. Lewis soon began working with Galea as well.
Lewis's story helps explain why some athletes turn to "Dr. G," as some call him, even if their team officials don't approve. When it comes to team doctors, Lewis says, "you're depending on somebody else who doesn't have your best interest at hand. They're getting paid by the team and the owners, and they have the owners' best interest in mind."
In a 2000 Ravens playoff game against the Denver Broncos, Lewis says he tweaked his left knee. In his opinion, the injury was never properly addressed as he continued through the postseason all the way to the Super Bowl. The following year he tore the ACL in the same knee on a routine play in training camp. "In my heart, I felt that injury was already set in place the year before and we never got it checked out," he says. (A Ravens spokesman says Lewis was cleared to play by team doctors.)
Lewis's skepticism about team doctors only intensified last season while he was with the Cleveland Browns. He says he suffered a concussion in Week 1 that wasn't properly diagnosed and endured vomiting and other symptoms. (The Browns had no comment, but coach Eric Mangini said last year that Lewis first reported concussion symptoms in late November.) "You can't trust a team physician," said Lewis in an interview before he was released by Cleveland last February. "Anything they tell me goes in one ear and out the other."
Lewis says that in recent years he recommended Galea to teammates. He says he would fly to Canada for treatment because Galea "couldn't do the plasma injections in the States," where he does not have a medical license. But there seems to be a link between Galea and the city in which Lewis played his last two NFL seasons. According to Canadian court documents, of the 25 athletes that Galea treated in the U.S. between July 22 and Sept. 14 of last year, 11 were treated in Cleveland.
To hear people who know him tell it, Galea is an intensely spiritual man. His devotion is to whatever he believes aids healing and to a higher calling, not to United States regulations.
In the final chapter of his 2007 e-book, Dr. Galea's Secrets to Optimal Health—Body and Spirit, Galea writes of his spiritual awakening. After being raised Catholic in the Toronto area, he writes, he became intensely focused on establishing a medical practice and "with my scientific mind I explained away spirituality." In May 2001, after three sleepless nights in his Toronto condo, Galea felt a sudden urge to travel to Jerusalem. A week later, sitting by himself in a small chapel on the Mount of Olives, he says he reconnected with God.
Now a fierce Zionist, Galea volunteers time and equipment and is a major fund-raiser for the Sheba Medical Center in Tel Aviv, the largest rehab hospital in the Middle East, and one that treats wounded Israeli soldiers. It was in Israel, where some medical regulations are less restrictive than in Canada and the U.S., that Galea arranged last year for then Oakland Raiders wide receiver Javon Walker to have a surgical procedure that is not approved in the U.S. and Canada to replace cartilage in his right knee. Walker credited the procedure with slashing his recovery time.
According to his lawyer, Galea has put his regular trips to Israel on hold and will stay in Canada while his legal fate is adjudicated. But Galea isn't entirely cut off from the Holy Land. On Sept. 12 a group of Israeli moviemakers and doctors attended a reception he hosted at the Toronto International Film Festival after the screening of Precious Life, a documentary about a Palestinian baby's fight for survival at the Sheba Medical Center.
At times, Galea talks about human growth hormone in spiritual terms. At his March lecture in Vancouver, Galea discussed HGH while his Power Point presentation flashed pictures of somber medieval monks, meant to bolster his rhetorical point. He said that the sports world is in the Dark Ages when it comes to the healing powers of HGH. "Because we deal with elite athletes and sports and Olympics," he said, "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."
Large doses of Satan's drug can be powerful. A study of recreational athletes—not pros—published last May in the Annals of Internal Medicine found that regular injections of HGH could improve sprint time by .4 of a second over 100 meters. (The gap between Usain Bolt and last place at the 2008 Olympics was 0.34.) The improvement disappeared six weeks after the HGH was discontinued.
Microdoses of growth hormone given briefly during recovery—as Galea has allegedly done with patients—are a far cry from the regular and systematic injections that were administered in the study, however. And those tiny doses are becoming more popular. Says Mascia, who works with professional athletes from around the world, it's not uncommon for pros to get PRP "with different growth factors added in, and growth hormone is one of those."
The Galea case is a topic of serious discussion among doctors in Canada. Michael McKee, a professor of surgery at St. Michael's Hospital in Toronto, says the case has "brought the use of [growth hormone] into the spotlight." McKee adds that many uses of HGH in Canada that were probably not closely watched in the past "are now being scrutinized.
"I think people are now trying to define what the medical uses [of human growth hormone] are," says McKee. "Unfortunately, there's a lack of scientific data. There aren't a lot of good scientific trials looking at use in recovery from orthopedic injuries."
For the time being, with the investigations of Galea continuing, Dr. G and HGH remain cloaked within the same shroud.
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