Under the Knife: A Beautiful Woman, a Phony Doctor, and a Shocking Homicide (29 page)

In the cosmetics industry, the problem goes beyond practitioners falsely representing themselves as doctors. There’s also an issue with technicians who, without claiming any false credentials, perform procedures for which they are not qualified. The problem often lies in the way legal definitions are written.

“Technology,” Lustman said, “has outstripped the law.” In most states, the statutes governing the use of lasers are vague and confusing—to physicians, technicians and the public alike. In New York, laser hair removal clearly does not require a medical license and oblative—or invasive—laser procedures demand it. In between, there is a gray area of undefined services. Also open to interpretation is the meaning of a doctor’s supervision when mandated by law. New York is not the only state where no black-and-white standards are spelled out in existing regulations.

Many licensed dermatologists and plastic surgeons in New York want the use of lasers in treatment to be the sole prerogative of licensed physicians, as it is in some states. They claim that laser technology has become increasingly complex and advanced. These strides in technology make a laser in the hands of a non–medical operator a danger to the public. Roy Geronemus said that mishaps at dozens of spas in Manhattan have sent a steady stream of patients to his office. He’s treated models whose careers have been destroyed by burns from laser hair removal. One of his patients went to a spa for the removal of a mole. “She came into my office with a large scar on her lip. In addition to the scarring, there were serious medical concerns. No biopsy was performed, so there was no way to know whether cancer was present or not.”

Unfortunately, it is difficult from anecdotal evidence to assess how much real danger exists and how much is due to the conflict of interest physicians face. There are those who are motivated solely by concerns for the public welfare. Others, however, are more focused on financial interest when they express a desire to make the use of laser as restrictive as possible. “Doctors want to own the beauty industry,” cosmetic technician Muriel Farina said.
“They want you to come to them for laser hair removal and facials so that they can upgrade you to something even costlier like Botox injections and surgery. It’s all about money.”

Technicians like Muriel point out that electrolysis is a far more invasive procedure than laser hair removal, and a medical degree has never been required for the practice of electrology. In fact, many states do not have proficiency testing or licensure of electrologists. Technicians insist that although a doctor is only necessary for oblative laser treatments when infection is a possibility—for example, the removal of spider angiomas, commonly known as spider veins—doctors are attempting to reserve the use of lasers exclusively for themselves with other less risky procedures. Procedures like facials, pimple punctures with sterile lances, microdermabrasion and electrology, they say, require training but not a medical education.

Where does the spin end and the truth begin? These technicians—like the doctors—are biased by their personal financial interests.

It is an issue that needs to be considered by an informed, disinterested third party. Only if legislators educate themselves on the technology, weigh the claims on both sides and ignore lobbyists can they draft laws that protect the public. With increasing numbers of Americans seeking these cosmetic services, the time for a thorough examination and clear, concise legislation is long past due.

Practitioners often skate the edges of legality because they do not understand existing laws. Then there are those who extend their services beyond what they know is legal—people like Dean Faiello, who look a prospective client in the eye and assure him of their medical qualifications; people who manage to pull it off because unethical physicians—like Andrew Reyner and Michael
Jackowitz—aid them in their deception by providing prescription drugs and protective cover.

How, though, could a woman like Maria Cruz be deceived? Highly educated and incredibly smart and knowledgeable about Internet research techniques, she seemed an unlikely client for a man like Dean Faiello.

Why didn’t she check to see if he had a medical license? Why didn’t she ferret out his arrest in October 2002? And if she did, why did she ignore the warning signs? Why didn’t she run from him the moment he asked her to bring cash? If Maria knew the answers to these questions, she took them with her to her resting place.

And what motivated Dean Faiello? Greg Bach pointed to Dean’s insatiable hunger for drugs, but also said, “There is a part of him that really thinks he is Dr. Faiello. I think he can disassociate from himself and believe his own lies because it is too painful to be him.”

Criminal profiler Pat Brown has a harsher assessment. She said Dean Faiello was “a guy who always wants power and control—the usual hallmarks of psychopathy. He simply won’t take himself out of the driver’s seat. He practiced medicine illegally because he liked the powerful feeling he got from it. He got busted and continued to practice medicine because he liked the power.

“Everybody follows patterns. This guy has a history of not giving a damn what is right and wrong—both legally and ethically. He demonstrated little concern for anyone but himself in his past and in this crime.” Because of his psychopathology, she surmised, when Maria Cruz became dangerously ill, he still placed his needs over those of his patient, and acted in his self-interest without a thought for hers.

Wherever Dean fits in this continuum—from an emotionally damaged man seeking admiration and respect, to a narcissist or psychopath who has no real regard for
other individuals—he deliberately created an image for himself that took advantage of others’ gullibility. He was part caring practitioner, part con artist. He is one of the handful of people in every profession whose corruption taints the whole system.

Barbara Nevins Taylor began an on-line essay about the nature of evil with these remarks:

Until a few years ago, I believed that we were all basically good. It seemed to me that most of us, given a little time to think about things, would make the right decisions and behave ethically. Foolish me.

Every day as I investigate one scheme or another, I meet people who are bad, maybe even evil. They are schemers who recognize that people with dreams will believe the most implausible stories simply because they hope that their dreams will come true.

She wrapped up the piece with a warning:

We’ve found that people who get ripped off in any scheme often step into the traps that are set for them with their eyes half closed. They don’t do research about a company, or a contractor, and they are often eager to do things quickly, cheaply and easily.

Unfortunately, they end up learning the hard way and costly way that the bad guys have no conscience when it comes to taking advantage of their vulnerability, making promises for things they will not deliver and taking their money.

From doctors to roofers, be sure you know in whom you’re entrusting your life, your health, your cash. Protect yourself from victimization by doing your homework and questioning everything.

In the oft-repeated words of
Hill Street Blues’
Sergeant Phil Esterhaus at the end of every roll call: “And hey, let’s be careful out there.”

You can do it—for yourself, your loved ones, your friends. I know you can.