Field of Schemes

J received drugs from Signature Pharmacy at least three times, paying about $1,000 for a combination of steroids and HGH generally used for a one-month workout cycle. "There were a bunch of little bottles of liquid and syringes," he said, describing the first package, which included "growth hormone, testosterone, muscle builder, stuff to balance it all out. It was more complicated than I expected." He says he called PBRC for instructions. "I didn't want to inject the wrong thing — this into that or in the wrong order or whatever, and have something bad happen."

Doctors believe the combination of HGH and steroids is popular among athletes because HGH helps the muscles get bigger and the anabolic steroids then make the muscles stronger. But the long-term dangers include nerve pain, elevated cholesterol and glucose levels, and an increased risk of cancer — growth hormone causes everything on the body to grow, the logic goes, especially tumors. Side effects of steroid use include testicular atrophy, back acne, and psychological instability.

Albany prosecutors say operations like PBRC appeal to tech-savvy young athletes who might not know the damage they are doing to their bodies.

J said he was desperate to maintain his lifestyle. Even if it was a poor existence as a minor-leaguer, it was all he knew.

"I've never had a real job that wasn't playing ball," he said. "If I decide I'm done with this, I might as well start working on a boat somewhere or mowing lawns."

The idea behind the scheme, prosecutors allege, was to create a profitable pipeline. A doctor stamped the prescriptions, for which he was paid $5,000 a week. Signature could legally make the drugs itself, often from raw ingredients originating in China and not approved by the FDA. Then PBRC simply needed to drum up potential HGH consumers, taking advantage of the most powerful (black) marketing tool ever: the cavernous anonymity of the World Wide Web.

The doctor was Robert Carlson, of Sarasota, a youthful 51-year-old heart surgeon with a successful practice before, prosecutors say, he got involved with Signature. In 2002, Carlson — who did not return repeated phone messages from New Times — bought into a business with his brother-in-law, Joseph Raich, a muscular 45-year-old whose family has lived in Palm Beach for several generations. Rounding out the team were two brothers, Glenn and George Stephanos, from the Northeast. Glenn was PBRC president, and George was the marketing director. They opened the Indiantown Road office, which became the call center that dealt with customers like J. (Neither Raich nor the Stephanos brothers responded to New Times's calls for comment.)

Earlier that year, the U.S. Supreme Court had established the legality of compounding pharmacies, which manufacture prescription drugs from raw ingredients in their own labs — instead of reselling FDA-approved substances. The ruling created what is now an estimated $2-billion industry.

Signature's equipment could convert a single gram of raw HGH into thousands of doses — the way an Internet business can turn a few drug purchasers into thousands, or a few dollars into millions. A single HGH dose might cost a consumer $150 or more. That same dose, investigators say, cost PBRC about $18 and cost Signature about $4. In 2002, Signature did about $500,000 worth of business. In 2006, prosecutors say, the pharmacy made an estimated $40 million.

Last July, Raich pleaded guilty in Albany to one count of felony conspiracy. He was ordered to pay $200,000 in fines and agreed to testify against the Stephanos brothers and the Signature owners. He was also sentenced to four years of probation. Three weeks after Raich pleaded, Carlson, his brother-in-law, followed suit, pleading guilty to one count of felony insurance fraud. He agreed to testify against Signature owners and anyone involved with PBRC who didn't plea. Under the agreement, Carlson must pay $300,000 in fines but will likely be able to continue practicing in Florida.

The prosecution says establishments like PBRC are operations that began without ever intending to provide legitimate services. Defense attorneys, however, say the PBRC case, which could go to trial by summer, is an issue of technology, and laws that haven't kept up.

Back at the spring training fields in Jupiter, fans were discussing New York Yankees pitcher Andy Pettitte, whose press conference to address his use of HGH had been playing around the clock on ESPN. "Do I think I'm a cheater? I don't," Pettitte had told a swarm of cameras and reporters.

A man on the bleachers mumbled, "So many of 'em are on juice. You can't even think about it when you watch 'em."

"There should be a designated steroids-free player like they have the designated hitter," joked a man who'd brought his son to the ballpark.

As for the PBRC crew, the Stephanos brothers remain free on bail. There is still no trial date set in New York; there are motions to dismiss the charges on technicalities. The defense remains confident that if this case goes to trial, it will be a landmark in the field of tele-medicine.