Edition: U.S. / Global

The Toxic Pharmacist

By Robert Draper
Published: June 8, 2003

He worked in an obscure little room, 9 feet by 9 feet. For several hours a day, he sat in his white lab coat before a white table in the center of the room, mixing powders and creams in a sterile compartment beneath a ventilator hood. The labor, though humdrum, required great dexterity and care: smoothing gritty chemicals into paste, drawing precise dosages of toxins into saline solutions and, in the end, creating medications from scratch. For nostalgia-prone types in the pharmacy profession, drug compounding was something of a lost art, conjuring up images of cloaked and bearded apothecaries hunched over foaming test tubes. Such romantic notions held no sway over Robert Courtney. He was, at the bottom of his soul, a man of commerce.

His customers at Research Medical Tower Pharmacy in Kansas City, Mo., had no inkling of this. After Courtney would emerge from the sterile compounding room with their medications in hand, he greeted them with an Old World civility that complemented his fastidious haircut and the crisply professional dress beneath his lab coat. ''What a gentleman,'' Delia Chelston exclaimed to her husband after the pharmacist offered her a seat while he filled her prescription. Through her oncologist, Chelston also received from Courtney's pharmacy the chemotherapy medication known as Taxol, which she was taking to battle ovarian cancer. By early 2001, it dawned on her that she had been experiencing none of the drug's crippling side effects. After considering the spectrum of possibilities, Chelston did as most cancer patients would. She took the Taxol's seeming benignness as an encouraging sign that she was defeating the odds.

Another of Courtney's customers, Mary Ann Rhoads, sadly notified her longtime pharmacist one day that her new insurance company required that she obtain her interferon from another outlet. It surprised Rhoads when Courtney followed her out to her car, tapped on her window and said quietly: ''I think I can help you. Bring your insurance cards and come inside.'' He then refilled her prescription as always and continued to do so thereafter. ''I considered it a favor,'' she recalls.

And so on a summer day in 2001, when Rhoads discovered that the syringes of medication she had just purchased from Research Medical Tower Pharmacy were barely half full, it did not occur to her to suspect the accommodating Courtney of anything other than human error. After Rhoads returned the syringes to Courtney, he reacted with surprise. Then he disappeared into the obscure little room. He emerged, in time, with freshly filled syringes.

Touching her arm, the pharmacist assured her, ''We'll take care of you.''

Today, Courtney is a ward of the Federal Bureau of Prisons. For perhaps the next 30 years, he will inhabit a prison cell more or less the size of the room where he committed his crimes. That he has earned his confinement no one, not even Courtney himself, denies -- not after he confessed last year to diluting the medications of thousands of individuals during a nine-year spree of avarice. Mary Ann Rhoads was among the 10 grim-faced cancer patients or surviving loved ones who gave statements during Courtney's sentencing Dec. 5. Since the pharmacist's crime was a novel abomination -- apparently no one had ever sought to dilute chemotherapy medications for profit -- the hearing was charged with anguish and vendetta to a degree seldom seen except at war-crimes trials.

When it was Courtney's turn to speak, he said in a tiny voice, ''It's very traumatic listening to these people.'' Still, in an attempt to explain his actions, he could manage only a stammering, ''I don't know why I did this.'' Then Robert Courtney was led away, a pallid, elfin figure in chains, consigned to freakdom in the annals of pharmacology.

He fit no one's profile of malevolence. Born an itinerant preacher's son in Hays, Kan., in 1952, the source and shape of Robert Ray Courtney's middle American yearnings crawled under the radar of his peer group and teachers alike. They did not appear to blossom until 1986, when the druggist one day asked his boss of 11 years if the latter would be willing to sell his pharmacy in the Research Medical Tower in Kansas City. By the time he acquired a second pharmacy in Merriam, Kan., Robert Courtney was nearing 40 and affecting the vanilla swagger of a suburban Turk. He drove a Mercedes and owned a mammoth house in the exclusive Tremont Manor enclave, situated in the northern reaches of Kansas City. In 1990, Courtney divorced the mother of his two daughters and retained custody of the children. As part of the divorce agreement, Courtney paid her a lump sum of $196,000.

He promptly began wooing an attractive woman he had known since childhood, when his father was a minister in Scott City, Kan., and hers preached to a congregation 50 miles away. She was now living in Detroit, and when she came to visit him, Courtney had charms to dangle. He proffered the keys to his ex-wife's Jaguar. He showered her young son with gifts. He took her out in a horse-drawn carriage. Two months into their courtship, the pharmacist presented her with a four-carat diamond ring. She agreed to a wedding on Valentine's Day 1991. But just after Christmas, Courtney talked her into an elopement.