Whatever his problems, Lauersen continues to have something hospitals want. "Unfortunately, medicine's changed so much that cost control is the only issue," says an OB-GYN at New York Hospital, a former colleague of Lauersen's. "Lauersen has these malpractice suits; it's a pattern. But a hospital will take anyone if he can bring in a lot of patients, and Lauersen has a following."
Deliberations in the fraud case were held up half a day when a woman who had been in the gallery approached three jurors outside the courthouse and said, "He's a good doctor." She turned out to be one Vivian Fan, of Bayside, Queens, a patient of Lauersen's who didn't seem to realize she'd done anything wrong when she showed up the next day; the judge, William Pauley, banished her for the duration of the trial. (Though his tone was less severe than with the patient who blew Lauersen a kiss; he instructed her to stand up, declaring that he wasn't sure where she'd learned such behavior -- acting school, perhaps -- but it wasn't tolerated in his courtroom.)
On the fourth day without a verdict, the jury asked to review prosecution evidence, and Lauersen seemed doomed.
"Oh, my God, the jurors, they've gone backwards," he said as he headed toward a conference room for lunch with his lawyers. His hands trembled. "I would lose my practice. I could go to jail. It's not fair to all these women."
Lale Djuric entered and made himself a plate of food. "Is like a chess match," he said. "Twelve people, twelve minds." Lauersen offered him some chocolates.
The lawyers discussed Christine Chung. Her spirits seemed very high today. Still in her thirties, she has the typical young-and-hungry profile of a government crime-fighter. She has already tried several big cases, most notably a prosecution of Don King.
"Don King, I know him," Djuric said. "I would love to see Snake against him."
Lauersen perked up. "You know Don King?"
Ted Wells rolled his eyes.
"I should have had Geraldo testify," Lauersen said. "Liv Ullman said she would do it, too."
Lauersen said, "One of my patients is an astrologer. I'll ask her to do the voodoo with the chicken blood." He laughed.
Wells stared at his can of soda. "I've been waking up every night at 3 a.m.," he said. "You ever watch the Weather Channel for three hours straight?"
Lauersen said, "All the women who testified, they all said I'm a good person."
There are currently thirteen states in America with some sort of mandate that insurance companies cover infertility. In New York, such legislation may be close to resolution by year's end. In 1998, the United States Supreme Court ruled that reproduction constitutes a "major life activity"; a woman who is medically unable to reproduce falls under coverage by the Americans With Disabilities Act.
Infertility affects one out of every six couples. But, says Pamela Madsen, director of the American Infertility Association, only 20 percent of them go on to seek treatment, "because access is so dear." High-tech therapies start at $5,000 to $12,000 per treatment cycle. A study published in Fertility and Sterility found that in Massachusetts, which promises comprehensive coverage, insurance companies have had to pass on a monthly rate hike of only $1.71 on average.
There are more than 30 in vitro-fertilization programs around New York. Several cutting-edge infertility centers, such as Cornell's, NYU's, and St. Barnabas in New Jersey, have conception rates among the highest in the world. By comparison, says a leading advocate of women's health-care issues, "Niels doesn't have the resources to really compete. He has a very middle-of-the-pack operation. He's not a star in the infertility community. He takes people who can't get in elsewhere. His business has some high-profile patients, but that's via his high-profile girlfriends. I would send a patient to him, but that would depend on the patient."
Although his defense hinges on the line that Lauersen did not perform infertility treatments at the expense of unwitting insurance companies, there's a steady undercurrent to it that says, So what if he did? "The government's calling me Robin Hood, robbing from insurers and giving to my patients," Lauersen says, smiling at the characterization. "Insurance companies should be paying for these women."
Wells says, "Even if he did what they say he did, why is it criminal? They shouldn't be putting a man away for that."
In October, the Archives of Internal Medicine published a poll of 169 doctors, in which 57 percent said they would deceive an insurer in order to help patients obtain coverage. But is Lauersen's case that simple? Falsely reporting a surgery would constitute more than a bending of the rules.
"If he did what the government was saying, it's very unusual," Warner Nash says. "But look: Insurance companies have pushed us into the garbage can. I always thought doctors were gods. We loved caring for our patients. Now we are forced to nickel-and-dime with everyone."
Still, if Lauersen did it, why? He has patients who could have paid for their treatments. And he sees so many patients -- rich and poor -- without charging. Nobody thinks he needed the money.
"He has a great sense of the importance of what he's doing," Nash says.
Lauersen's insurance-fraud trial ended on a Monday, and by noon Tuesday he was back to a full schedule. He starts his typical day at the office between 10 and 11 a.m., usually beginning with surgery, then holding office hours, and then going eventually to Mr. Chow's or Elaine's or an appearance at a dinner party he feels bad for having held up. "I like also to go to after-hours clubs," he says. "And I'm a member of Doubles, the Metropolitan Club. Union Club, well, no, but I'm like a member. I have friends. I can go there anytime. I take the doctors to all these clubs. Most doctors don't know these places. So it's a cultural experience for them that improves their lives."
Lauersen's office is a warrenlike operation behind the lobby of a Park Avenue co-op. In the entryway, there's a bronze plaque of a pregnant woman holding one breast and a drawing of a shaggy nude couple gazing soulfully at each other -- it looks very early-edition Joy of Sex. One of his consultation rooms has a framed certificate from the International Star Registry in Switzerland declaring him a member, "redesignated" by his star number, and a plaque that says doctor lauersen at you're sic cervix. The men's room is full of porno magazines. "So the men -- you know, jerking off," he says. "The nurses buy them. Some of the men can't do it without their wives in there. One guy, he needed to lie down. Everyone's little sex things -- so fascinating, so funny."
Even with his hours, 100 patients are a lot to squeeze into a day, and by 6 p.m., the office is standing-room-only, with patients getting their blood pressure taken in the hallways. A few weeks ago, as he moved through his appointments, he emerged from an examining room to the expectant stares of a dozen patients. Without breaking stride, Lauersen groped at their hands, one quick squeeze after another, like a candidate reaching over police lines. "You'll get pregnant, you'll get pregnant, you'll get pregnant," he said to each.
Lauersen disappeared for twenty minutes. When he came back out, he said he'd seen "four or five" patients. "I was just with a woman who says I got her pregnant just from vitamins and reading my book," he said. (He is keen on first instructing a woman to eat healthy, to sleep on her left side after sex, to have sex at certain times of the day.) Twenty minutes later, Lauersen was back in the hall to say he'd taken care of another "five or six" women, and a young couple whom he'd left with the advice: "Work during the week, sex on weekends."
Lauersen took a break at his desk for some chocolates he'd been given by a patient, and mentioned that he'd gotten a call from one of the jurors. "She said she thinks she's found a new doctor. She's not like" -- he referred to another juror. "That one was such a bitch, you know? The nice one wants to come in to see me this weekend." She just called him out of the blue? "Maybe she called my friend Stuart. He knows some of the jurors."
Stuart, in truth, had been tracking down jurors to see if they had advice for the retrial. Nonetheless, the juror did ask to meet Lauersen -- she says she "felt strongly about acquittal and wanted to tell him that" -- and in fact appeared taken with his presence. "I got the impression that he was a very childlike and a nice person, paying for a staffer's lawyer, co-signing a mortgage for one."
"I think she was smitten," Matelsky explained.
"She liked me. She thinks I'm a good person," Lauersen said.Lauersen prepared to go down to St. Vincents for his midnight rounds, with a stop on the tanning salon at the way. "It has not been a good year," he said as he got into his car. "I don't know why people keep doing this to me. Maybe they don't realize that I'm a good person."