Doctors save lives. Doctors deliver our children. Doctors often have a thankless job, as we saw during the height of the COVID-19 pandemic. The advice they give has the power to alter the lives of their patients and the families who support them. And they’re aware of what prescription drugs mean to their patients, including people who often have difficulty affording them. 

After all, people with medical insurance can end up in debt. Imagine what happens to folks who get hurt or sick and aren’t properly insured. Some end up finding unconventional ways to treat their problem, or pay out of pocket for prescription drugs.

Doctors also have a privileged status in society. We put an immense amount of trust in doctors to give us advice that enhances our lives, though history has shown that medical professionals have harmed marginalized communities. Think of a time when a doctor made a suggestion that turned out not to be in the best interest of you or someone you know. 

Over time, Paul Volkman, a doctor trained at the University of Chicago’s medical school, developed a bedside manner that ended many lives. He allegedly prescribed and dispensed millions of dosages of various drugs, including hydrocodone, oxycodone, alprazolam, diazepam, and carisoprodol throughout his career, according to FBI evidence presented at his 2011 trial. 

Volkman is currently serving four consecutive life terms in an Arizona federal prison—the longest sentence handed down on any medical doctor during the country’s opiate epidemic. The crimes he committed is not lost on journalist Philip Eil, who authored Prescription for Pain: How a Once-Promising Doctor Became the “Pill Mill Killer.”

When Volkman wasn’t working at Chicago hospitals, including Bronzeville’s Mercy Hospital (1977-1979) and Michael Reese Hospital (1979-1981; the hospital shuttered in 2009), he made trips to southern Ohio, where the opioid epidemic would ravage communities. 

Volkman ran pain clinics where patients paid for drugs in cash while watched over by armed security guards. Thirteen of these people died by overdose on the drugs Volkman wrote scripts for. Investigators also explored his ties to more than thirty other deaths. 

Eil’s book, which took twelve years to write, is a tough read. While the national conversation around prescription drugs has inspired a range of works such as Hulu’s 2021 miniseries Dopesick, Prescription for Pain gets into the weeds of what it all means—starting and ending with Volkman, who earned every bit of his “Pill Mill Killer” nickname.

Eil writes: 

“Dale had the sense that her mother’s amputation was preventable. She felt that whatever had happened in the lead-up to her mother being sent home from the emergency room on the day she saw Volkman, the process seemed flawed. She recalled hearing that her mother was clearly in pain from the moment she had come home from the ER, which, in Dale’s eyes, seemed to indicate a lack of proper care and attention from whoever had treated her at the hospital. She did not believe that the lawsuit was frivolous, as Volkman claimed. 

Whatever the exact events that had preceded the amputation, she told me that the aftermath was devastating. Her mother was forced into an early retirement by the surgery and had to learn to live with one arm.”  

At times, Prescription for Pain made me really angry. At some point, many of us—most notably, the elderly—have utilized prescription drugs for one ailment or another. It reminded me of a South Side neighborhood near the Skyway dubbed “Pill Hill,” whose name is derived from its status as an enclave for the scores of doctors who worked at the nearby South Chicago Community Hospital. 

Eil, the former news editor of the shuttered alt-weekly The Providence Phoenix, sat down with the Weekly to discuss his personal connection with Volkman’s story, what he learned about his father (who was a classmate of Volkman twice over), the institutions that aided Volkman in his evasion of justice, and Volkman’s agreeing to be interviewed for the book.

This interview has been edited for length and clarity.

✶ ✶ ✶ ✶

Why did you decide to write this book? What piqued your interest in Paul Volkman’s story?

The first time I heard of [Volkman] was when I was twenty-three years old. I had just started a career in journalism. And I learned that this guy who had once been a classmate of my dad’s at this prestigious University of Chicago MD/PhD program had been charged—he hadn’t gone to trial yet—with this massive prescription drug dealing scheme that, according to authorities, had gone on for nearly three years. It had made a lot of cash [and] had basically flooded an area of southern Ohio that was already struggling with addictions and overdose with massive amounts of opiates and other prescription drugs. And most horrifyingly, the government prosecutors said that this conduct had caused the deaths of over a dozen of Volkman’s patients. 

So my dad, who is a mild-mannered, nerdy, soft-spoken endocrinologist in my home state of Rhode Island and nearby Massachusetts, is not the kind of guy who knows a lot of people who are charged with these kinds of heinous crimes. And so I was immediately just struck by what happened to this guy who had once been so bright. He was a high school valedictorian, and the federal government had paid for his education at the University of Chicago … So what drew me in was the mystery of it. My dad had fallen out of touch with this guy after medical school, so he didn’t really have any answers. I also knew early on that Volkman had lived on Lake Shore Drive [now DuSable Lake Shore Drive]. In fact, he was arrested on Lake Shore Drive; his apartment [was] on North Lake Shore Drive, right across from Belmont Harbor, when he was first indicted in 2007. Even before I knew a lot of the other details of the story, that image of law enforcement arresting a guy at his upscale Lake Shore Drive apartment kind of grabbed me from the jump.

Doctors have a certain amount of power over peoples’ lives. Do you think that played into Volkman’s psyche and why he was able to get away with his crimes for so long?

You know what, that is certainly one of the big questions. How did he do this for so long? And what I found in my reporting was that by the time that Paul Volkman started working down in Ohio in 2003, oddly enough, he never moved there completely. He was working down there during the week and commuting back up to Chicago for the weekends. By the time he started doing this kind of work in cash-only pain clinics that were not affiliated with local hospitals, he was a really desperate guy. He had tried a number of different medical specialties. He had started out in research. He had gone into pediatrics. Pediatrics wasn’t paying the bills. He had started working in emergency medicine in Chicago on the weekends. That wasn’t really paying the bills and [from when] he had started through a good chunk of his career, [he was] traveling around to various hospitals across the Midwest and taking temporary emergency room gigs for weeks or months at a time. And he was sued a number of times for cases stemming from his pediatric practice in Chicago, but also these emergency room gigs, and found himself uninsurable in the early 2000s. He’d basically try to find a job anywhere he could, and wound up finding this job at a pretty sketchy pain clinic down in Appalachian Ohio—a really poor part of the state—that was owned and operated by a woman who didn’t even have a college degree, that didn’t have any kind of medical training. 

So to get into his head, I think there was certainly a power trip when he was down there. He was a guy who was taking care of patients who [were in the clinic] either because they were financially desperate, or in a lot of pain, or maybe struggling with addiction, or maybe all of the above… And so he did have a lot of power in the room with them. But underlying that, I think the reason he was there was because he was backed into a corner professionally. He had very few options left for him. And he took a job that a lot of doctors would have dismissed out of hand. He had bills to pay. His rent on Lake Shore Drive at that time was upwards of $4,000 a month. So it was a combination of things: financial desperation, but also his particular personality, which is arrogant. Doesn’t really listen to other people. Doesn’t work well with other people. So it’s kind of a combination of factors.

You spoke with some of Volkman’s medical school classmates. One described him as the “foggiest, shadiest” character, while another said they wouldn’t have been surprised if he had won the Nobel Peace Prize. What was it like hearing like that?

Well, you know, one of the areas of my reporting that I started with [was] these medical school classmates because I had close access to one of them—my dad, you know. I could just call him up and interview him, which I did a number of times. And in a lot of senses, these folks were helpful in portraying the Volkman that they remember. They described him as smart, a little bit nerdy, a little bit socially awkward. The one you quoted was a roommate of his who thought he was so promising that he might open the paper one day and see that Volkman had been given the Nobel Prize in medicine. But the memories from these classmates were decades old. Nobody had really stayed in touch with this guy. They had all fallen out of touch with him pretty early on, and so in addition to whatever memories they had, they were pretty much unanimously just shocked and stunned at what had happened to this guy. It’s such an unusual thing to happen, for a guy with this kind of background and pedigree to find himself in this situation. So I used the portraits I collected from these University of Chicago classmates [and] included those in an early chapter in the book that describes his time there, but to get answers about what happened after that, I had to go digging in a lot of other places.

Investigative reporting is painstaking, but can also be expensive at times. Do you have any thoughts on how to show people that this kind of journalism is needed? It’s because of those reasons that we don’t see much of it.

I had a couple people along the way down in Ohio who accused me of being interested in this story out of greed because I was in it for the money. I understand why people down there would be hesitant at this point to embrace people from out of town coming to cover the story, because the coverage of southern Ohio has been pretty negative at times. I definitely want to correct the record that writing any kind of nonfiction book—but particularly a true crime book, and especially a true crime book that took over fifteen years—is not a get-rich-quick scheme, or even a get-rich scheme. I started this project when I was in my early twenties and didn’t have a lot of journalistic experience, and didn’t necessarily know all the costs that go into any deep-dive investigative story, but particularly a crime story. So there’s the cost of travel and lodging and gas and food. 

But there are also costs that are specific to this kind of reporting: namely, court records can be actually quite expensive to access. Whether you’re contacting the clerk’s office directly and having them sent to you, or whether you’re talking to a court reporter whose whose job it is to transcribe them—and they are used to selling these transcripts to lawyers who don’t really bat an eye at a $3 per page rate, but that’s certainly expensive for a journalist. I don’t say any of this as a plea for sympathy from readers, but I do think people have gotten the misunderstanding that this stuff is free to produce, especially in our era of online news, where so much of it comes for free. Fact-checked, slow-moving stories are really important.

Can you outline the institutions you discussed in the book and why you believe they may have failed people by enabling Volkman to get away with things for as long as he did?

I think when you look at the opioid epidemic in general, we see so many institutions that have failed people, whether that’s the FDA or Purdue Pharma or academic doctors who took up the cause of OxyContin and preached the gospel of OxyContin when they maybe should have known that there were reasons to be much more cautious. I think the Volkman story is more of a case of individual irresponsibility—namely Volkman’s, and the people who owned his clinics, and the one pharmacist mainly who filled his scripts. There are a lot of individual bad actors here. But I don’t want to ignore the institutional part entirely. I don’t blame the University of Chicago for not knowing in the 1970s that this guy was going to wind up a criminal. I don’t think they really could have known that, although the book might be useful in medical schools for people to learn some of the early warning signs that they should keep an eye on a doctor. 

Now, with that said, I do think it’s an open question why it took so long for authorities—local, state, national—to bring this guy down. He was practicing or committing these crimes for nearly three years, from April 2003 to February 2006. That’s a really long time. And a lot of people died along the way. So I do think it’s worth asking, why did it take so long?  

But why haven’t other actors in the opioid epidemic, pharmaceutical companies, for instance, faced more criminal charges? There just seems to be a kind of glaring lack of criminal accountability with some of the people higher up in the chain above the doctors, whether those are pharmaceutical companies or medical distributors, or a lot of the people we’ve [only recently] seen being sued for their role. But we haven’t seen as much criminal prosecution.

What would you say that the book’s main takeaway should be?

Well, at this point, we are so many years into the opioid epidemic that I think a lot of folks have become numb to the statistics about the really staggering numbers of deaths that have resulted from this, whether those were earlier on via prescription drugs, or subsequently from heroin or fentanyl. I was compelled to tell the story of about a dozen people who went to this one doctor who was practicing in a down-and-out part of Ohio and commuting back to Chicago on the weekends. And with that story, I had a chance to really try to resensitize people to what it means to see these lives cut short, people who were in their thirties or forties. People who had kids. Who had loving spouses. Who had loving parents, and who really were not treated well by a doctor who they ought to have been able to trust. To tell a story of a person who is no longer around to speak for themselves is one of the biggest challenges that journalists can face, one of the biggest responsibilities that journalists can face. That’s one of the reasons I took so long to work on the story—because it was a really heavy responsibility to tell those stories well. But that’s what I tried to do, to hopefully honor the lives of the folks who went to Volkman and later died.

You traveled to Chicago pretty frequently to do research, to talk to people and walk around the University of Chicago campus, researching and getting ready to write a book that’s pretty heavy in nature. What was that like? 

Well it was interesting, because there were really two reasons why I was doing it. I was doing it to write the story of Paul Volkman. But I was also retracing my dad’s steps [because] I would have never known about this story, or had the interest in this story, had this guy not been a classmate of my dad’s and a friend for about ten years, first at the University of Rochester and then for six years at the University of Chicago. So when I was doing these things, going to libraries at the University of Chicago to track down Paul Volkman’s thesis or walking the halls of buildings to look for a photograph of their graduating class on the wall, I wasn’t just looking for Paul. I was looking for my dad, too. People who read the book will see some of those photos. Anytime a journalist works on a story for this long—I’m sure you can relate to this—there’s got to be some personal [and] emotional connection to it to keep you going. And for me, it was a few different things. It was the importance of the story and doing justice to the victims. But initially, at least, there was also this personal motivation of wanting to learn more about my dad. And I did do that during the process.

Well, what did you learn about your dad?

Well, for most of my life, he was not just a doctor who saw patients, but an endocrinologist, which is a specialist who sees patients day in and day out, mainly folks with diabetes. What I didn’t know was that he and Paul were trained, really, to be researchers. They weren’t really trained, or expected, to go into the everyday practice of clinical medicine. It turns out both of them did do that for quite different reasons. But I learned that my dad and Paul were really trained as medical scientists, which is to say, researchers: people who were expected to do research and publish that research and have an impact on public health in that way, as opposed to seeing patients everyday. So it really changed my view of what my dad had trained to do, and what he wound up doing.

You spoke with Volkman. What was it like interviewing him and hearing him still deny any wrongdoing? What was it like to see his face, his eyes, mannerisms and expressions, knowing that all these people passed away in his care and he continues to not take any responsibility?

It was wild, Evan. I reached out to him just a few months after hearing about his case. And though if he had checked with his defense attorney—he was awaiting trial at that time—I’m sure they would have told him, “Don’t speak to this young journalist.” But he didn’t do that, and he agreed to speak with me. So I first drove out to Chicago in December 2009 and interviewed him over the course of two days for about ten hours in his apartment. And what an unusual and odd experience that was. I was listening to him, but also looking at him and asking the same questions that you indicated, looking at a guy and wondering: is there something about a person? Do they look different if they’re charged or have committed these crimes? Are there tells, so to speak, that indicate a person is capable of such horrifying stuff? He didn’t completely convince me of his innocence by any means. People who read the book will see that. But he’s a very persuasive and compelling guy who’s very smart, very qualified, and very forceful in his answers. And he had an answer for just about everything.  

I talked in the book about how I met a number of people who knew Volkman in Chicago who did believe his account of what happened down there, and believed he was an innocent guy. But when you go down to southern Ohio, to this part of the country that has been so hard hit by unscrupulous doctors and sketchy pain clinics and addiction and overdoses, those doubts I had really disappeared almost immediately. Because if you go down there like I did—and I went down to this part of Ohio ten times—people down there just don’t have any belief that these doctors were doing the right thing. They look at these local pain clinics that were cash-only, prescribing high amounts of opiates and other medications, as just a flat out criminal operation. So I’m glad that I got to talk to Volkman and hear his side of the story, and I include that side of the story in the book. But I’m equally glad—more glad, even—that I went down to the scene of the crimes, and spent a lot of time down there hearing the stories of the people there. 

They will tell you a very, very different story from the one you get from Paul Volkman.

Prescription for Pain: How a Once-Promising Doctor Became the “Pill Mill Killer” by Philip Eil. 416 pages. Steerforth Press, 2024. $29.95 Hardcover.

✶ ✶ ✶ ✶

Evan F. Moore is an award-winning writer, author, and DePaul University journalism adjunct instructor. Evan is a third-generation South Shore homeowner.

Leave a comment

Your email address will not be published. Required fields are marked *