At 2:35 p.m. on the afternoon of June 8, 2019, agents from the Austrian Federal Police’s elite Zielfahnder (target investigators) unit arrived outside of a rental apartment in the city’s expensive First District. Normally tasked with tracking down and arresting hardened gangsters on the lam, the Zielfahnder were working in tandem with a representative of the U.S. Federal Bureau of Investigation (FBI) from the American Embassy. The Life Ball — a glamorous AIDS charity event that is the highlight of the capital’s LGBTQ social calendar — was slated for that evening. Bearded drag queen and 2014 Eurovision winner Conchita Wurst, English reality TV personality Kelly Osbourne, and Sex and the City actress and now politician Cynthia Nixon were all scheduled to attend the red-carpet gala. So was a bald, stocky 71-year-old osteopathic physician named Jim Lee, who had flown in from Los Angeles with his husband, Uriel Elon, a handsome Israeli 20 years Lee’s junior.
Dr. Lee never made it to the ball. A celebrated doctor known for his work treating early HIV patients in the 1980s, Lee was wanted in the United States for health care fraud involving the anti-AIDS-wasting drug Serostim, a scheme that prosecutors alleged had cost public and private insurers $7.3 million. Instead of enjoying the Life Ball, then continuing on to Israel for a vacation with his husband, Lee found himself in Viennese detention.
The doctor, who was suffering from heart problems, hypertension, gout and arthritis, was held in a closed medical facility for three weeks. He later claimed to have lost 20 pounds during that time. Lee declined to challenge extradition proceedings, and on July 2, 2019, FBI agents escorted him on a flight back to Los Angeles to face the court.
Six months earlier, in January 2019, a grand jury in the Central District of California had indicted Lee on eight counts of conspiracy and fraud and two forfeiture allegations. The government claimed that, starting around May 2011 and continuing up until at least February 2019, Lee and his longtime office manager, Jenny Trujillo, provided the prescription AIDS drug Serostim to patients who did not have HIV or any other medical need for the drug. The expensive medication is only approved to treat AIDS wasting, a symptom of advanced AIDS that causes extreme weight loss. The condition can result in the emaciated look often associated with early AIDS patients, before such drugs were available.
Serostim is essentially human growth hormone (HGH), and while it can be very beneficial to HIV-positive patients, others have found it can also be used cosmetically, to enhance the effects of exercise and improve muscle definition. The countless HGH supplements on the market claim to support the body’s own production of HGH, but they don’t actually contain the hormone. The U.S. Food and Drug Administration (FDA) has approved human growth hormone injections only for AIDS wasting and growth hormone deficiency.
HGH stimulates metabolic processes in the body, supporting bone and organ growth and the synthesis of muscle proteins; essentially, it reenacts the natural growth process of adolescence. Serostim “works very much the same way as steroids,” says Kevin Ng, a doctoral candidate in immunology at the Francis Crick Institute in London. Some doctors claim Serostim can even counteract the effects of aging, by lowering body fat and protecting a genetic mechanism important for cell replication (though these claims are disputed). The internet is awash with anti-aging clinics and retailers touting the supposedly miraculous benefits of Serostim and other HGH-based medications. Tech billionaire Peter Thiel hopes HGH pills will help him live to age 120.
But Serostim comes with risks too. Human growth hormone can make the body retain extraneous water and develop insulin resistance. Possible side effects include carpal tunnel syndrome and an increased risk of diabetes.
Despite these risks, Serostim, considered by some bodybuilders to be the most effective form of HGH, became popular in the bodybuilding scene as soon as it was introduced in the United States.
In September 1995, Serono Labs, the Swiss pharmaceuticals company that developed the medication, applied to the FDA for permission to market Serostim in the United States. In June 1996, after an initial rejection, the FDA approved Serostim for use. It was initially in high demand. But the cost of a six-milligram daily dose of the medication for a wasting patient was estimated at $75,000 per year, making it prohibitively expensive. That November, while the application was pending, ACT-UP activist and AIDS patient Jeff Getty met with the president of Serono, Hisham Samra, and convinced him to lower the cost of the drug. Samra gave in only reluctantly. Getty later told The Wall Street Journal that Samra seemed unhappy and “hardly touched his calamari.”
But for Serono, the timing of the drug’s introduction was inauspicious. Effective combinations of antiretroviral drugs designed to combat AIDS had just been approved, leading to massive decreases in deaths from the virus. Serostim’s “use as an HIV drug was limited by the fact that wasting is a really late-stage manifestation of AIDS,” says Ng, the immunologist. Advances in other therapies soon meant that the symptom Serostim was meant to treat rarely presented.
In response, Serono launched a marketing blitz. In 1997, it trained sales representatives to broadly “redefine AIDS wasting,” developing an unapproved device to measure “body cell mass” so that more HIV patients would qualify for Serostim. In 2001, federal prosecutors filed a suit against Serono on charges of filing false claims, or illegally promoting the sale of a medication. The firm pled guilty to charges related to bringing a group of American doctors on an all-expenses-paid trip to Cannes, France, in exchange for prescribing Serostim. The suit was settled in April 2005; Serono was ordered to pay more than $700 million. Sullivan, the U.S. attorney in Boston, told The New York Times that 85 percent of all Serostim prescriptions were unnecessary.
At the time that Serostim was introduced to the U.S. market, the drug’s off-label uses were already widely known, and some athletes began experimenting with its effects on their performance. Serostim circulated from HIV patients — who, at the time were often poor and, while many of them were very sick, did not depend on the drug specifically because Serostim does nothing to fight HIV itself — to bodybuilders, who were willing to pay for the competitive advantage they believed Serostim gave them.
In recent years, Serostim use for AIDS wasting has become even less common, thanks to more medical advances. The advent of the prophylactic drug PReP has made new HIV infections rarer, and modern therapies usually prevent the disease from proceeding to AIDS. Wasting is hardly ever a symptom of advanced antiretrovirals. As a result, Serostim prescriptions have drastically declined.
Still, Serostim has its loyalists. California pharmacies — especially ones catering to the gay community — still advertise their access to the drug with pictures of young, muscular men. For some AIDS patients, Serostim retains a powerful emotional hold. “People who took Serostim in the late ’90s, from the time of the onset of effective antiretroviral therapies, and who were helped by Serostim between ’96 and ’99, became very attached to the medicine,” says Michael Gottlieb, an L.A. immunologist who treated some of the nation’s first AIDS patients. “It’s a complicated mix of probably some physical improvement, but a lot of psychological dependence.”
At the same time, entrepreneurial private citizens — seeing Serostim’s potential as what the Los Angeles Times termed “the Cadillac of drugs that help chisel bodies” — also began selling the medication on the black market. Lee’s indictment in 2019 was far from the first time that U.S. courts had dealt with fraud related to the sale of Serostim. In 2002, a California grand jury indicted a San Diego Serostim ring made up of nine people, including a former radiology technician, for fraud totaling $3.5 million. In March 2003, a hospital employee in the Bronx was sentenced to prison for faking Serostim prescriptions then selling them on the black market, for damages of around $1.7 million. In 2006, a lawyer, an unlicensed chiropractor, a personal trainer, a pharmacist and an escort-service owner were indicted in another complex Serostim fraud case. Tom Lavery, the chiropractor, initially obtained the drug from a contact who bought it out of the back door of a Los Angeles pharmacy, as well as from AIDS patients on tight budgets. Lavery’s first customer was Edmund Chein, a Palm Springs doctor whose website claims he can “reverse” biological age using growth hormone. (Chein didn’t respond to an interview request.) Lavery then supplied the medication to a Florida physician who claimed to be shipping 18,000 boxes of Serostim a month to South Africa. (He wasn’t.) On one occasion, the ring needed to find new sources of Serostim because one of its suppliers died of AIDS.
Beyond those large rings, plenty of people who want Serostim have found ways to get it. On a forum called Professional Muscle, where men exchange tips about the best bodybuilding drugs and how to get them, one user suggested in December 2017: “Find an old gay dude with HIV. They sell [Serostim] for cheap.” In February 2021, another wrote: “I’ve used Serostim that I got from an AIDS patient who would actually call the pharmacy in NYC and have me pick it up.” He compared it favorably to other HGH medications: “The ones I got from the AIDS patient literally melted the fat off and transformed my body in 4 months.”
Lee and Trujillo’s own scheme allegedly worked this way: Lee prescribed a group of his HIV-positive patients with Serostim, even though they didn’t have a medical need for it. The patients went to a pharmacy to fill their prescription. Instead of injecting them with the drug at his office, Lee then bought the boxes of the medicine back from his patients for between $200 and $300. He then sold the Serostim to other patients, who used it for cosmetic purposes, for $900 per box. Health insurance companies covering the HIV-positive patients, which included the public insurer Medicare Part D, were billed $2,400 per box. In the roughly seven-and-a-half years that Lee operated his scheme, he may have billed insurance companies almost three thousand times for Serostim.
On February 6, 2019, federal agents executed a search warrant at Lee’s office, located in a modern building on a pretty, palm tree–lined street in West Hollywood. Later that month, a former patient of Lee’s — named only as “Patient-1” in the indictment — met with the doctor. At the instruction of the FBI, the patient was wearing a wire.
On February 28, unaware that he was being surreptitiously recorded, Lee allegedly coached the patient to tell investigators that the checks for Serostim were actually insurance “overpayments” or gifts. On March 3, he allegedly told the same patient to say that they’d received a $100,000 loan from Lee to buy a house. “I just wanna be sure that when you tell the story you’re going to tell the same story that I just told [to FBI agents],” Lee said to the patient on the wire. “And that you and I never discussed it.”
On July 3, 2019, the day after his extradition from Vienna, Lee was arraigned at the district court in Los Angeles. Alexander Porter, the assistant U.S. attorney prosecuting the case, and Shane Bernard, Lee’s lawyer, sparred over pretrial detention measures. (Bernard didn’t respond to an interview request. Porter declined to comment.) In the end, Lee was allowed out on a bail bond guaranteed by his houses in West Hollywood and Florida. Lee was required to remain at home with an electronic ankle monitor, and he was barred from prescribing Serostim. He was also forbidden to contact six witnesses involved in the case.
What makes Lee stand out from others who have been caught up in Serostim schemes is that before his indictment, he was a very popular and respected doctor, a familiar face in his community and at charity events throughout California. Born in 1948 in Philadelphia, he grew up in the suburbs outside the city, and by the age of 11 he had decided he wanted to become a doctor. He earned a bachelor’s degree from the University of Maryland, then, in 1974, a degree from the Philadelphia College of Osteopathic Medicine. He did his residency at the UCLA Medical Center; in 1976, he received his license to practice medicine in California and opened a general medicine practice in West Hollywood.
In early 1981, a few doctors in the Los Angeles area began noticing a strange new kind of “pneumonia” in gay patients. Gottlieb, the L.A. immunologist, was one of the first physicians in the United States to encounter the disease firsthand. Back then, it wasn’t even clear that it was caused by a virus. But when the Centers for Disease Control issued a report identifying its symptoms, in June 1981, doctors all over the country began calling Gottlieb, asking for advice. By the end of 1982, AIDS had killed more than 600 people in the United States.
As a gay physician practicing in West Hollywood, Lee was at the forefront of the epidemic. “He was one of the earliest doctors to treat patients suffering from HIV and AIDS,” Bernard said at Lee’s arraignment. “He did so at a time when other doctors refused to touch these patients. From my perspective, Dr. Lee is a hero.” In those early years, Gottlieb remembers, Lee was one of just 15 doctors in all of Los Angeles accepting AIDS patients.
At the beginning of the epidemic, there wasn’t much Lee — or any other doctor — could do for them. “You could treat their infections. They would come into the hospital with one infection, it would be treated, they’d be discharged. They’d be back in another week with the same infection or another,” Gottlieb recalls. Besides that, he adds, “You could hold their hands.”
Between the advent of the AIDS epidemic and the introduction of the earliest antiretroviral therapies in March 1987, helplessness prevailed. Gay men were abandoned to the disease by their government, much of the medical establishment, and the straight communities in which they lived. “Homosexuals are men who know nobody and who nobody knows,” Roy Cohn tells his doctor in Tony Kushner’s play Angels in America.
But people knew Dr. Jim Lee. He was a pillar of the gay community at a time when solidity was hard to come by.
This desperate period seems to have taken a toll on the young doctor; Lee developed an alcohol addiction during the early days of the AIDS epidemic. But he quickly got his problem under control.
By the time of his arraignment, Lee had been sober for 34 years and had developed a further specialty in treating addiction. He had discovered spirituality through the New Age practice A Course in Miracles, a Christian-inflected “Foundation for Inner Peace” that promotes forgiveness as the path to fulfilled relationships.
Meanwhile, more advanced combinations of antiretroviral therapies, developed in late 1995, made living with AIDS realistic.
Lee’s patients were fiercely loyal to their doctor. He was kind and funny, and he was an excellent listener — for many patients, a rare and important quality among busy general practitioners. In the 1990s, Chip Schutzman, who is now a music marketing manager who has worked with artists such as Madonna and Barbra Streisand, went for a checkup at Lee’s office. Instead of anatomical diagrams, stroke-warning pamphlets and IKEA wall art, Lee displayed posters for the TV shows Bewitched and The Jetsons.
“Within a minute of meeting him, I was like, ‘I definitely would like this guy to be my doctor,’” Schutzman says. He found Lee charismatic and vivacious. Encouraging Schutzman to quit smoking, Lee made jokes, but never scolded. For several years, when Schutzman needed a regular treatment, they saw each other twice a week.
Schutzman also got to know Jenny Trujillo, Lee’s alleged co-conspirator in the Serostim scheme. She was “was very professional, but yet very bubbly,” Schutzman says. “Had sort of this Elvira Witch personality,” referring to the dark-clothed, sassy protagonist of a 1988 comedy-horror movie. Schutzman felt so safe and well taken care of at the practice that he remained a patient there for the next 22 years, until he moved from Los Angeles to Palm Springs.
It’s unclear when Lee met his husband, Uriel Elon. (Elon didn’t respond to multiple interview requests.) But from the outside, at least, Lee and Elon seemed prosperous and happy. In 2005, the couple bought a house in West Hollywood for $1.1 million. A decade later, they got married. They were a cute couple. The pair frequently went out to good dinners, and they adopted adorable dogs. On Christmas they decorated an elaborate tree and posed for photos in matching holiday-themed pajamas. In 2017, the couple bought as second home in Oakland Park, Florida, where Lee also obtained a license to practice medicine. In March 2018, Elon became an American citizen. By all appearances, the two men were living the kind of happy, settled gay relationship that had been hard to picture at the height of the AIDS crisis.
Besides Elon, Lee’s great joy was traveling. In the 2010s, he continued to see patients but also went on frequent trips, often to popular gay vacation spots or AIDS benefit events. He developed a drag persona named Pearl and participated in a bodybuilding competition for over-60-year-olds. (There is no evidence that Lee ever used Serostim himself.) He and Elon flew all over the world: Bangkok in 2014, Rio in 2016, the Dominican Republic in 2018. In January 2019, at the same time the grand jury was moving to indict him, Lee went skiing with friends in Colorado, wearing a white-and-rainbow snowsuit with a unicorn horn sewed on.
As patient and doctor, Schutzman and Lee often swapped travel stories. “I think he was more excited about the journey, rather than the destination,” Schutzman says, “and that just showed in his eyes. I could see that happiness.”
So why would Lee, a seemingly fulfilled and beloved doctor who owned two houses, take the risk of selling a controlled prescription drug like Serostim on the side? Did the extra cash go toward all the houses, meals and trips? Or was he more of a true believer than an opportunist? Did he feel that Serostim would have health benefits for his patients? Or that the federal government had no business examining his practice, considering how abjectly it had failed gay men in the early 1980s? Or did he just do it because, like George Mallory and Mount Everest, the Serostim was there?
The government argued that Lee’s Serostim scheme cannibalized his legitimate medical practice. “The investigation in this case has revealed that he really doesn’t see that many patients at his office and that really there is very little traffic to and from his office,” said Porter, the prosecutor, at Lee’s arraignment. “Quite frankly, he doesn’t see that many patients other than the ones who are involved in the fraudulent scheme.” (Stephen Bernard, Lee’s lawyer, countered in court that his client had been a “healer” in the community for 45 years.)
For Lee, the low workload and high reward associated with the alleged Serostim scheme — both of which would have given him time to travel and spend with his husband — may simply have been too great to resist.
After Lee’s arraignment, his trial was set for March 2020, postponed to November 2020, then pushed back again, to May 2021. If found guilty, he faced the rest of his life in prison: Each of the six counts of health care fraud carried a maximum sentence of 10 years, the two counts of witness tampering 20 years each. But he never got his day in court. On November 29, 2020, Lee died of heart disease at his home in West Hollywood.
An obituary on a memorial website described Lee’s personality: “He was the eternal optimist and spread this to all in his life. He had opinions and was not afraid to express them, sometimes forcefully, but always to benefit others. His protection of his patients was his primary goal, and he succeeded. They were teammates.” According to the obituary, Lee’s emails ended with the message “Life Is Wonderful” and a link to the Aretha Franklin song “Jimmy Lee.”
Coworkers, friends and acquaintances flocked to the webpage to memorialize the doctor. “Words cannot describe what I am feeling. You were a one of a kind boss,” wrote Ruth Arriaga, Lee’s office manager following the departure of his alleged co-conspirator Trujillo. Lee “was a beautiful soul, a truly special person. I will miss him greatly,” a friend posted. Another person added, “There was never a feather boa that did not look good on Jim. He wore them well!”
The case is proceeding in reduced form. In December 2019, Trujillo pleaded guilty to charges that she aided the doctor at each stage of the scheme. Her sentencing hearing was scheduled for June 2021. (Trujillo’s lawyer didn’t respond to a request for comment, and no information about sentencing had been made available as of press time.)
Before Lee died, the court granted him permission to take one final foreign trip. In the summer of 2019, he spent several weeks in Dubrovnik, Croatia, and Mykonos, Greece. The purpose of Lee’s travel was a reunion with Elon’s family; he was especially passionate about seeing his father-in-law, a religious Moroccan Jew who had become a spiritual guide for Lee, but who was slowly succumbing to dementia.
“He has brought me back to religion and spirituality to a new depth,” Lee wrote to the court. “This man is vital to the family and I would like to spend time with him before we cannot do so again. The heart filling sensation of this family is something miraculous, that I did not have previously in my life. I am blessed.”
Lee clearly had intense admiration for Elon’s father, who served as a mentor and guide to him. Many of Lee’s own patients felt the same way about Lee. The Serostim case didn’t change that. Until he was interviewed for this story, Chip Schutzman, who considers Lee one of the most important people in his life, up there with a mentor and his best friend, was unaware of Lee’s alleged fraud. “Shame on him for trying to do that,” Schutzman says. “But I still love him unconditionally.”
The other patients who celebrate Dr. Lee’s decades of care and kindness were mostly unaware of the large-scale fraud the FBI says he committed. The question of what drove him to do so will likely never be answered, as Lee never gave an interview in between his arrest and death.