December 10, 2025 • 43 mins
As the fallout widens, patients uncover troubling new information about who was providing their care. Their discoveries trigger a wave of questions — and draw the attention of both state regulators and criminal investigators.
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Episode Transcript
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Speaker 1 (00:00):
This episode contains discussion of childhood sexual abuse. Please take care,
will listening.
Speaker 2 (00:06):
You can't ovulate harder if you think about it better
and you pay more attention to it. You can't do
anything like that. So all we have is what people
sell us, and unfortunately we will buy whatever you are
selling when you're in this.
Speaker 1 (00:21):
When Sarah Davis begins trying to get pregnant in her
mid thirties, she discovers a world of products for sale,
promising to increase her fertility and give her a child.
Speaker 2 (00:33):
I read every article, I followed every summit company on Instagram.
I fell down the rabbit hole of the wellness industry
that is just utilizing Instagram to sell you crap you
don't need.
Speaker 1 (00:48):
Sarah now works as a creative director for a clothing company,
but she spent her twenties as a fashion designer in Nashville,
sewing the Dazzled Tour costumes for icon Dolly Parton. When
I first talked to Sarah on the phone, she came
across as street smart and impervious to bullshit. But the
quest to get pregnant can un more even the most
(01:10):
grounded among us.
Speaker 2 (01:12):
I racked up so much debt trying to do all this.
At one point, I was on like four hundred dollars
a month, where the supplements everything's ninety dollars and last
for thirty days, and it's just it's so much.
Speaker 1 (01:25):
Online it's easy to find other people's advice on exactly
what you need to do to get pregnant, which may
or may not be scientifically rigorous. Drink lots of pomegranate juice,
take coke ten, keep your feet warm to warm your uterus.
And there's even some funny IVF superstitions, like eating McDonald's
(01:46):
french fries on the way home from your embryo transfer.
Speaker 2 (01:50):
There is literally a blog that lists the ninety some
odd things she did to get pregnant. All the cleaning
supplies have to be changed, all the soaps, all your shampoo,
all of your toothpaste. You can't put chapstick on your
lips because it's got to be organic and free range
or whatever the heck it's going to be. Sounds crazy,
but that's how I felt. That's how I felt, like
(02:10):
that's what I need, because that's what's going to get
me pregnant.
Speaker 1 (02:13):
Sarah went all in. She tried expensive teas that claimed
to have a higher success rate than IVF a special
bracelet that tracked her fertility seed cycling, which is when
you eat specific seeds during certain phases of your monstrual cycle.
Speaker 2 (02:30):
You're supposed to take these two seeds in your smoothie
for the first two weeks of your cycle, then these
two seeds in the second two weeks of your cycle,
and it's supposed to balance out your hormones.
Speaker 1 (02:40):
And she even resorted to magical thinking.
Speaker 2 (02:44):
I had gone to a crystal shop and gotten a
special crystal that was supposed to I don't even know.
I was supposed to waste money. That's what it was
supposed to do. That's exactly what it did. It's supposed
to sell me on something I didn't need.
Speaker 1 (02:57):
Fun fact, I bought a crystal too.
Speaker 2 (03:00):
You can buy a spell on eBay and someone from
like Transylvania will say a spell over you and your
uterus from Afar.
Speaker 1 (03:07):
Paying a stranger real dollars to cast a spell to
help you get pregnant. Just take a moment to let
that sink in. To an outsider, it may seem ridiculous,
but I understand it, just like I relate to those
fairy tales about infertility from the past. These stories all
revolve around the same idea. When you want to get
(03:31):
pregnant this badly, you will do anything, no matter how uncomfortable, bizarre, inconvenient,
or expensive, to get a baby in your arms.
Speaker 2 (03:43):
Let's freaking do it. I will drink disgusting tea. I
will take all these supplements, I will do all the
things I need to do if that will get me
to my end goal.
Speaker 1 (03:52):
Let's do it.
Speaker 2 (03:54):
We're tired, we're broke, we're emotional. We just want it.
Speaker 3 (04:00):
To be over.
Speaker 2 (04:01):
Unfortunately, people have figured out that this group of people
are easy to take advantage of because we're desperate.
Speaker 1 (04:09):
I'm Melissa Jelson from School of Humans and iHeart podcasts.
This is what happened in Nashville Episode three. Do you
think that's your ovary?
Speaker 4 (04:28):
Human fertility as a subject matter and as an important
role in societies dates back literally thousands of years. If
you go back and look at some of the Egyptian
papyriy that were then able to be interpreted after the
discovery of the Rosetta Stone, there are actually fertility therapies
(04:50):
that are described in great detail in hieroglyphics.
Speaker 1 (04:54):
This is doctor Allan Penzius, a board certified reproductive endercinologist,
an associate professor at Harvard Medical School. He's talking me
through the history of fertility medicine.
Speaker 4 (05:07):
So the fact is that fertility and infertility were recognized
not only as problems thousands and thousands of years ago,
but also recognized that there were potential treatments that could
then alleviate the suffering of those who weren't becoming pregnant.
Now to us in the twenty first century, looking back
(05:27):
at some of the methods they used, some of them
were really remarkably insightful. Others were quite way else to mark.
Speaker 1 (05:35):
In ancient Greece, for example, women were told to fill
a cloth pouch with ground lead and iron, dip it
in breast milk, and insert it into their vaginas. In
medieval Italy, one suggestion was to bury an egg nearer
cathedral for eight days, then dig it up and eat it.
Speaker 4 (05:53):
But as we moved through human history and throughout the
Renaissance and then into the eighteenth in nineteenth century when
started discovering things, being able to look at cells under
the microscope and seeing motile sperm, and ultimately in the
nineteen sixties nineteen seventies we started to see medicines that
allow women to ovulate more regularly.
Speaker 1 (06:15):
The seventies saw one of the biggest advancements in fertility treatment.
Speaker 4 (06:19):
The Watershed event that broke the dam and allowed millions
of women to be able to become pregnant. West In
July of nineteen seventy eight, Louis Brown was born the
first human baby born as a result of in vitro fertilization.
Speaker 2 (06:32):
We can now hand it.
Speaker 3 (06:33):
To the baby Pride.
Speaker 5 (06:38):
At twenty seconds.
Speaker 6 (06:40):
Doctors reported that the baby was doing fine and eating well,
and the parent they reported were doing fine too.
Speaker 1 (06:51):
After the birth of the first so called test two
baby in England in July nineteen seventy eight, the race
was on for the United States to follow. Fertility clinics
began springing up across the country, including one at Vanderbilt
University in Nashville, Tennessee. It quickly became a magnet for
ambitious reproductive endercinologists eager to stake out their claim in
(07:15):
the new and fast expanding field of IVF. One of
those physicians was doctor George Hill, who spent his early
career at Vanderbilt before breaking off in the early nineteen
nineties to open his own practice, the Nashville Fertility Center,
a clinic that still exists today.
Speaker 7 (07:35):
What I was cold when I arrived at Vanderbilt was
that Vanderbilt was the fork IVF program in the country
and that Vanderbilt had the fork IVF baby in the country.
So it was one of the early IVF programs. We
had patients coming from all over the country. No, we
had a pretty big drawing area here, so I'd been
(07:55):
very busy at Vanderbilt. It was a smooth transition going
in the product practice.
Speaker 1 (08:01):
Doctor Hill wasn't the only IVF doctor to branch out
on his own after his time at Vanderbilt. Doctor Jime
Vasquez also followed a similar path. After graduating from medical
school in Chile, Vasquez moved to the US, where he
got his medical license. According to his bio, he held
faculty positions at Thomas Jefferson University and the University of
(08:24):
Wisconsin Madison before joining Vanderbilt's faculty in nineteen ninety one,
where he served as director of the Division of Reproductive
under Chronology and Infertility. In nineteen ninety five, he left
to open his own clinic, the Center for Reproductive Health
or CRCH. Let us help you make your dreams become
(08:45):
a reality by calling us at the Center for Reproductive Health.
Newspaper ads from the time showed doctor Vasquez recruiting staff
a receptionist who could juggle many activities simultaneously, lab techs
willing to work with weekends. He filed paperwork with the
state outlining a quote high volume infertility practice unquote with
(09:07):
its own operating rooms and lab. Vasquez was envisioning what
the future of IVF was going to look like and
planning accordingly. Doctor Vasquez declined to sit for an interview
with me, but I was able to find promotional videos
of him talking about the science of fertility, his clinics,
approach to treatment, and his own reasons for choosing this work,
(09:28):
which offers some insight.
Speaker 8 (09:30):
The patient is my boss. Clinical science can allow me
to make a prediction about what treatments are more likely
to be successful. I give them all the options, and
I say, I think that this is more likely to
be successful. But I don't have a crystal ball. I mean,
the patient decides a different treatment, which try it. I
(09:55):
would not argue with the patient and try to force
it to go into a different direction. It is her
decision to make.
Speaker 1 (10:04):
Even as he worked to build a modern IVF clinic,
Vazquez described his mission in personal terms, rooted in love, children,
and legacy.
Speaker 8 (10:15):
When I see my kids, I'm amazed. That was a
gift straight from God and my wife, and I'm so
fortunate to have that. Not having that would make me
feel very empty. So probably I should find to help
(10:35):
capitals with infertility to have their family.
Speaker 1 (10:39):
I was able to glean some information about the clinics
early years from federal records. Since nineteen ninety two, federal
law has required fertility clinics to report their outcomes to
the CDC and CRH first appeared in a nineteen ninety
six report. By then, the clinic had already joined the
Society for Assisted Productive Technology, also known as SART, a
(11:03):
kind of trade group that works to establish and maintain
standards that members must follow. A few years later, doctor
Vasquez's laboratory earned accreditation from the College of American Pathologists CAP,
a private organization recognized by the federal government to ensure
compliance with national laboratory standards. By all appearances, doctor Vasquez
(11:27):
was making sure his new clinic would be at the
cutting edge of medicine, technology and care. It took some
time to build up the clinics clientele, but eventually it
found its rhythm as a smaller, more intimate operation, providing
around an average of one hundred IVF cycles for patients
a year. While it was the smallest clinic in Nashville.
(11:49):
This was framed as a selling point.
Speaker 8 (11:53):
Our philosophy of care is to be a family and
to help your family to grow, and we want to
use clinical science to do that, but we want to
do it in a personal way.
Speaker 1 (12:08):
The Center for Reproductive Health's website also boasted that the
clinic was responsible for the birth of more than two
thousand babies since its opening in the nineties. Patient testimonials
reinforce the message that new patients were in the right place.
Speaker 9 (12:25):
I've always joked that doctor Vasquez no sperm and eggs
like no one else.
Speaker 2 (12:29):
I know that sounds.
Speaker 9 (12:30):
Terrible, but it's so true. He has always been so
warm and friendly.
Speaker 5 (12:37):
Doctor Vasquaise was somebody who he sits down with you,
took time, answered questions, just approached it differently. He'll do
a lot of testing up front, but that testing helps
him figure out exactly what's right for you.
Speaker 6 (12:50):
When the babies were born and came to see our
children and us and then nick you several times.
Speaker 5 (12:55):
I mean, I don't think we would have gotten that
from one of the larger multi position centers.
Speaker 1 (13:01):
This personal approach continued behind the scenes too. Doctor Vasquez's wife, Nancy,
managed the facility for two decades. The staff was described
as tight knit and many worked there for years. One woman,
a lab tech, stayed for well over a decade. Others,
though like in any small business, cycled through quickly. Over
(13:22):
the years, doctor Vasquez had employed other doctors, nurse practitioners,
and physicians' assistants, but there were also stretches where he
was the only doctor on site managing patient care. The
one constant at CeRh was doctor Vazquez himself. The clinic
was his baby and he was involved in all aspects
of its operations. But as doctor Penzius explained to me,
(13:47):
running an IVF clinic is a big job.
Speaker 4 (13:50):
It's a very complicated circumstance. There are so many components
to a well run IVF program that it is complex.
It's doable, but it takes a good sized team with
a lot of experience to be able to pull it
off well.
Speaker 1 (14:05):
In twenty nineteen, Vasquez his wife retired due to health concerns,
and their daughter, Elena, came on to assist with this.
The clinic was going through some big changes and doctor
Vasquez needed some extra help on the patient side, so
in twenty twenty he hired someone new, Doctor Hill, who
ran a competing IVF clinic less than a mile from
(14:27):
CRH heard talk of this new hire.
Speaker 7 (14:30):
He had someone there that he called his fellow. I
don't know much about the person that he was calling
his fella. I mean, obviously we knew nothing about what
was going on over there.
Speaker 2 (14:49):
There are two things in this world that I have
absolutely no doubt that I can do. So and take
your children.
Speaker 10 (14:56):
Those are the two things that I'm like, got it.
Speaker 2 (14:59):
I do remember in kindergarten, I was like, all right,
I gotta have a boyfriend, because you gotta have a
boyfriend to have a husband, and you gotta have a
husband to have a baby. I was like putting it
together at five and was like, Okay, I gotta start now.
Speaker 10 (15:12):
I gotta start with a boyfriend now.
Speaker 2 (15:13):
I remember that thought process because the end goal was
always a baby.
Speaker 1 (15:19):
In pursuit of her lifelong dream. Sarah poured money into supplements, herbs,
and teas that promised miraculous results, but never delivered so
much as a positive pregnancy test. By early twenty twenty three,
after two years of trying, she's feeling burned out and
disillusioned by the trendy fertility hacks advertised on social media.
(15:42):
So when a coworker suggests she tried the Center for
Reproductive Health, she's eager to begin a relationship with a
trained medical professional she could trust. No more woo woo solutions,
just science data and someone qualified to guide her.
Speaker 2 (15:58):
He was very nice, He was very friendly. He was sarcastic.
He cussed with me. I grew up with a dad
that is a sailor and I am the same way.
And it was like, okay, this guy he is. It
felt like a friend. It felt like I was sitting
down to talk to a friend.
Speaker 1 (16:20):
Sarah isn't talking about doctor Vasquez. In fact, during her
entire time as a patient at SIERRH, she says she
never even met doctor Vasquez. Instead, she sees another provider,
doctor Ferrera Dyer, the man doctor Vasquez hired in twenty twenty,
significantly younger than doctor Vasquez, doctor Dyer had an easy going,
(16:42):
jocular demeanor, where Vasquez's bedside manner could be academic and
long winded. Dyer was funny and personable.
Speaker 2 (16:50):
He was super friendly. He was super positive.
Speaker 1 (16:55):
In their initial consultation, Sarah tells Dyer about her years
of trying to conceive and her uncertainty about whether or
not she's ovulating, and he seems receptive to her concerns.
Speaker 2 (17:09):
And I was like, oh my god, this is amazing.
Someone is finally listening to me. It felt like such relief.
And he spent a lot of time going over the
basics of how the body works, going over just stuff
that you're like, no one else.
Speaker 10 (17:25):
Took the time to go over this.
Speaker 1 (17:29):
Before turning to IVF, Sarah says, doctor Dyer recommends to
try intrauterine insemination or IUI. This is a procedure where
sperm is inserted inside the uterus right around ovulation, so
the timing has to be exact. I've done four iuis.
You strip half naked and lie on a bed with
(17:50):
your legs and stirrups. Then the medical provider inserts a
thin catheter into your uterus and deposits the sperm, giving
it essentially a head start on its journey to the egg.
It's not usually painful, but it's uncomfortable or at least
awkward for me personally. It was emotional and stressful, and
(18:11):
success rates are low. It could feel like I'm going
through all of this and is it even going to
work still. Iuis are often the first step in fertility
treatment because they are a lot faster and cheaper than IVF.
While doctor Vaska has handled the more complicated IVF cycles
at the clinic, Dyer did most of the iuis, and
(18:33):
in September of twenty twenty three, DIYer performed Sarah's first
IUI at the Center for Reproductive Health. The experience goes smoothly,
but she does not get pregnant.
Speaker 2 (18:45):
I mean, it's soul crushing. You just think, okay, great,
now what do we do? You spend twelve hours being mad,
and then you're kind of like, all right, they told
me the first one wouldn't work. You google the crap
out of it and you find out that it doesn't
work for a lot of people, and that a lot
of times people get pregnant on the second one or
the third one, and you're like, okay, we'll figure it
(19:06):
out financially. Now I know what to expect. This is
in September. We'll do another one in October. We'll do
another one in November. We were taking my husband's family
to Texas to Fort Worth for Christmas. We were renting
a house and we were going to go down there.
I had these grandiose plans. If either of those worked,
I was going to have pajamas mailed to the house rapped,
(19:27):
and one of them is going to be baby pajamas.
And like, I had this whole plan planned out.
Speaker 1 (19:32):
But the rest of twenty twenty three does not go
as planned. On Sarah's next cycle visit in October, she
has a large cyst and she's prescribed birth control to
shrink it before continuing in November. She's hopeful about moving forward,
but when she goes in for her appointment, the normal
ultrasound tech is not there, and the woman who's supposed
(19:56):
to perform her exam seems confused.
Speaker 2 (19:59):
She's like, Okay, I don't really know what I'm doing,
and I don't really know how to do ultrasounds. I'm
just a nurse, but they've got me back here. Then,
while the wind is inside of me, she goes, I,
do you think that's your ovary? I'm sorry, I don't,
are you You can't be talking to me. There's got
to be somebody else in the room because I don't
(20:20):
I don't know, do am I supposed to know what's
compying on a screen? And I was just like, this
is literally determining whether or not we move forward with
the next cycle, whether I have a sister or not.
So I'm gonna need you to know what my ovary
looks like.
Speaker 1 (20:34):
Sarah complains to the front desk staff and another employee
does a repeat ultrasound, but it's not entirely clear what's
going on inside Sarah's body. She decides to cancel the cycle.
It's around this time that Sarah starts to question if
the clinic is functioning properly.
Speaker 2 (20:54):
I was like, okay, this is not good. And since
we had been there, a bunch of the people the
front desk had gone. The girls at the front desk
would kind of be like, I don't know what's going on.
Speaker 1 (21:05):
Sarah and her husband are losing confidence, and they decide
the next IUI will be their last at CRH. If
it doesn't work, they'll move on to another clinic.
Speaker 2 (21:15):
We entertained the idea of not going back at all,
but that would have delayed everything because you have to
do testing and you have to wait for the appointment
and you have to so it's like, we might as
well do one more and then in the interim be
looking for someone else, and that way, at least we're
not wasting a ton of time.
Speaker 1 (21:33):
Sarah says. She also begins to have concerns about Dyer himself.
Speaker 2 (21:38):
When I first met with Dyer, a thyroid was high.
TSH was high, and he prescribed the thyroid medicine. When
I went to pick that thyroid medicine up, it had
doctor Vasquez his name on it. And I was like,
this is weird, asked the front desk. They said, oh,
Vasquez just signs all the prescriptions. It's his account that
assigns all the prescriptions, so we just do it all
(21:59):
under him because he's owner of the planet. All right, fine, whatever.
Then all of the fertility drugs were in Vasquez's name
when I pick those up, and I ask again, and
at that point it was kind of like, okay, all right,
it's fine, it is what it is. But I had
definitely noticed it and thought it was weird.
Speaker 1 (22:19):
Sarah decides, next time she's in the clinic she should
just check Dire's credentials.
Speaker 2 (22:24):
I had told myself before that appointment with him, make
sure you look at the wall to make sure there's
a medical degree, because his name wasn't on any of
the meds and I was like, I need to make sure.
I just need to check that.
Speaker 1 (22:35):
So at her next appointment, she looks around the exam
room and there it is on the wall, a framed
medical degree with Dire's name on it. It gives her
the confidence she needs to move forward with her second
IUI with him in February twenty twenty four. It doesn't work,
and so, as planned, she and her husband seek care elsewhere.
(22:58):
The following week, Sarah is sitting in an office of
a new fertility clinic. When she's asked about her previous provider.
Speaker 2 (23:07):
She asked me who I was seeing, and I told
her doctor Dyer. She goes, you know he's not a
reproductive endocrinologist, right. It's a pretty small field, and I
know most of the people in a like a pretty
a big vicinity. I know at least of their names.
And I was like, okay, you know, you leave that appointment.
You're just focused on the next step, You're focused on you.
Speaker 1 (23:29):
But the comments linger, and so she decides to do
some research. If Dire isn't a reproductive endocrinologist, maybe he's
just a general practitioner. She looks Dire up on Google,
but finds nothing. Nothing on social media either. She tracks
down the website that lists licensed doctors in Tennessee, runs
(23:49):
his name through, and nothing comes up. She can't even
find his name on the Center for Reproductive Health's website.
Speaker 2 (23:56):
I was like, you know what, this can't be this
hard to find, right, Like am I Just every other
website in Nashville has all the doctors listed. They're on
the door. So it's like, Okay, this is weird. There's
no mention of him with the board, there's no mention
of him with a license in the state of Tennessee.
Speaker 1 (24:12):
There's nothing Sarah wants answers. Over the next few weeks,
she keeps trying to get a hold of doctor Vazkaz
so he can explain what's going on.
Speaker 2 (24:23):
I called office and I said, listen, something's going on.
I left a message. There's some questions about Dyer's qualifications.
Speaker 1 (24:33):
No one calls her back. On Tuesday, April ninth, Sarah
tries calling the clinic once more.
Speaker 2 (24:40):
It rang and rang and rang the front deskin pick
up and then it went to the emergency service and
she was like, I can't help you. I'm just here
in case of emergency. Call back later, she didn't know
what was going on.
Speaker 1 (24:56):
A few days later, she comes across Sydney's news article
and learns that the Center for Reproductive Health had suddenly closed.
Unsure of what all this means, Sarah contacts news Channel five,
the same news outlet that broke the initial story about
crch's closure.
Speaker 2 (25:13):
I knew that if one person had given up on
this journey because of anything that these idiots had said,
that they needed to know what was going on.
Speaker 1 (25:20):
They run another segment about the clinic, this time focusing
on the questions swirling around Diyer's qualifications.
Speaker 10 (25:28):
Stunning new allegations tonight against the Nashville fertility Clinic, now
being sued by the Tennessee Attorney General.
Speaker 2 (25:35):
Tonight another bombshell, Why did the man who treated so
many of these women hold himself out to be a doctor?
Speaker 1 (25:47):
Patients are already reeling from the Center for Reproductive Health
sudden closure. They've suffered canceled IVF cycles, lost money and time,
and nearly twelve hundred embryos are still behind locked doors. Now,
a new and devastating fear emerges had they been treated
(26:07):
by someone who wasn't a licensed doctor. After Sarah goes
to the press, she has lingering questions about if what
happened at CRH might be considered a crime, so she
files a complaint with the Metro Nashville Police and the
Special Victims Unit sets up a dedicated email address for
former patients to recount their experiences at the clinic. In
(26:31):
the wake of the news segment, as many as sixty
five families contact police, according to reporting by news Channel five.
For some, like Penny co, a thirty five year old
scientist who had been a patient at the clinic for
a year, the fear isn't just about the quality of
the medical care she received. It's also about feeling violated.
(26:55):
She had been treated by a person who she worried
might not have had the training or legal as authority
to do so. This man saw and performed procedures on
her half naked body.
Speaker 11 (27:06):
I still feel kind of gross, I still feel fringing.
Even though I know it's not my fault or anything
I've done, but it happened to me. So I'm like, yeah,
I don't at anybody in my space. Anytime someone puts
their hand on my shoulder, I'm just like like inching
away and just like I just don't. After something like
that happens, you're like, if they can be deceiving, how
do you know somebody else is deceiving? Like it starts
to play my game. Unfortunately, there's so many emotions that
(27:30):
go on with that because I was sexually assaulted as
a child, so it kind of starts pulling back trauma
from younger ages.
Speaker 1 (27:38):
Penny is sitting in her obgian's office reading an article
on her phone when she learns that Dyer had no
medical license.
Speaker 11 (27:47):
I felt like I was going to pass out from
anxiety because I was like, there's no way this is real.
Like I starts really spiraling. I could fill my face
like get bright red. I can tell it was like
a panic attack.
Speaker 1 (27:58):
During her time as a patient is, she had undergone
several EUIs with Dire. She had put her trust in
him and his training, and as part of the procedures,
he had touched her private areas and used medical equipment
inside her body, so when she learns he isn't a
licensed physician, she feels an overwhelming sense of betrayal. For Penny,
(28:22):
it's a pain that's horribly familiar if you've ever.
Speaker 11 (28:26):
Been sexually assaulted. It puts you back into that category
again where you're just like, I don't want anybody touching me.
I don't want my own husband touching me. Like you
just feel disgusting, you feel violated, you feel manipulated, like
all of the emotions. You know at that point you're deceived.
Speaker 1 (28:42):
Penny told me that because she was sexually abused as
a child, seeking fertility care as an adult had been challenging.
She found the EUIs, in which she had to take
off her clothes and lay still as dire inserted sperm
inside her mortifying.
Speaker 11 (28:58):
I mean, I honestly had to the whole time I
had the procedure done, I laid back close my eyes
because I just didn't want to see. Your legs are up,
you're completely naked from the waist down. You feel the
doctor like kind of touching you, even with my own
husband in the room. I was like, I'm embarrassed, Like
I don't want him seeing me that way either. It's
just a different level of embarrassment.
Speaker 1 (29:24):
Penny, Sarah and other women who saw doctor Dyer in
the clinic feel that he wasn't honest about his credentials
and presented himself as something he was not. This is
an accusation that Dyer denies in full.
Speaker 10 (29:39):
If there is one sound bite that you use as
a part of this, it is everything that doctor Dyer
did was appropriate under all applicable laws and regulations.
Speaker 1 (29:51):
That's Chanelle Atchison. When I first reached out to Dyer
for comment, he wouldn't speak with me, but Atchison, his
lawyer did. I eventually caught up with DIYer a few
months after this, and we'll hear from him later in
the show. But his attorney talked me through his position
and presented the case that he did nothing wrong.
Speaker 10 (30:11):
First, I want to say that the fertility journey is
an extremely emotional, traumatic, difficult journey anyway in the best
of circumstances, and I can absolutely understand and empathize with
the trauma that these women are feeling.
Speaker 3 (30:33):
I cannot imagine the heartache, and I want to be
clear that nothing I am saying negates that takes away
from that all of those feelings.
Speaker 10 (30:44):
Are real and valid.
Speaker 3 (30:47):
That said, nothing that doctor Dyer did was inappropriate. He
practiced the way that every single doctor that has ever
pursued a medical license in the United States has practice
which is under the purview of the license of another
doctor while he was pursuing his own.
Speaker 1 (31:07):
Atchison told me that doctor Dyer was working under the
medical license of doctor Vazquez while he was seeking his
own license. She explained that Dyer, although an American himself,
attended and graduated from a medical school in England called
Saint Christopher's in two thousand and seven. Back in the States,
he began taking the medical licensing exams required to practice
(31:29):
medicine in the US and passed some but not all
of them.
Speaker 10 (31:34):
Doctor Dyer passes first two licensing board exams, and then
his mother fell ill, and so he stopped everything to
take care of his mother. For a number of years,
everything for him took a backseat, and unfortunately she ended
up passing away, and then he started pursuing his own
career again.
Speaker 1 (31:55):
Atchison said that in twenty twenty, thirteen years after Dyer
graduated from Meta school, he started working at the Center
for Reproductive Health as a fellow, believing it would help
him advance in his dreams of becoming a licensed doctor.
Although foreign medical school graduates like Dyer must complete a
formal three year residency to obtain a medical license in Tennessee,
(32:18):
something Dire had not done. Atchison says that Dyer was
told his work at CRH would set him up for
an alternative route to licensure.
Speaker 3 (32:28):
He was called if he would work for two years
at the Center for Reproductive Health, then doctor Vasquez would
sponsor him towards this licensure issue, and that kept getting
bumped out, and the final thing that he was told
was four years, so he was just short of his
four years.
Speaker 1 (32:42):
Atchison didn't provide any additional details about this fellowship, and
it's unclear if Azcuez was even authorized to offer such
an option. But beyond the fact that Dyer didn't pass
all the required tests or complete a residency, there are
also questions about the medical school he attended, Saint Christopher's
(33:02):
in Luton, England. Today the school no longer exists, and
in two thousand and five, during the time Dyer was
a student, it was the subject of critical reporting by
the BBC questioning its legitimacy. The UK's licensing body ultimately
chose not to recognize Saint Christopher's in Luton as an
(33:23):
authorized medical school because it couldn't provide proof it was
offering education up to the UK's standards. As a result,
graduates from that school cannot get licensed to practice medicine
in the UK. In the US, some states have barred
graduates of Saint Christopher's in Luton from obtaining a medical license. Texas,
(33:45):
for example, has the school on its most recent list
of fraudulent or sub standard institutions. It won't recognize. New York,
where I live, also hasn't accepted it in the past. Now,
what about Tennessee. The state has specific rules surrounding international
medical schools, and it's not entirely clear whether this school
(34:05):
would be accepted or not. I reached out to a
state spokesperson to clarify, but they declined to comment. Still,
Dyer's lawyer points out to me that American authorities permitted
Dyer to take the US medical licensing exams, and claims
a number of his classmates from Saint Christopher's have successfully
gotten their medical licenses in the States and are currently practicing.
(34:30):
Atchison emphasized that Dyer was only working as a fellow
under doctor Vazquez's supervision. She says he didn't assess patients,
prescribe medication, make diagnoses, or design treatment plans. He only
carried out plans created by Vazquez. She says that Dyer
was upfront with patients about his role and that it
(34:52):
was entirely appropriate for Dyer to use the title doctor
as he had earned a medical degree.
Speaker 3 (34:59):
Anytime that doctor Dyer would come into the room and
introduce himself to somebody, he would say, you know, my
name is doctor Dyer.
Speaker 10 (35:06):
I am doctor Vasquez, his extern or his fellow.
Speaker 3 (35:09):
I practice under the supervision of doctor Vasquez.
Speaker 10 (35:13):
Doctor Dyer's white lab coat said fellow on it.
Speaker 3 (35:16):
You know, it was always made very clear that doctor
Vasquez was the one making the decisions. I understand that
there is perhaps a propensity to see a white coat
and say that's.
Speaker 10 (35:27):
The person making the decisions, but that's not, in fact
the case.
Speaker 1 (35:31):
In Atchison's telling, doctor Dyer is not a villain in
this story. He's another person failed by doctor Vasquez. She
said that the fellowship arrangement benefited Vasquez because he didn't
have to pay dire a doctor's salary.
Speaker 3 (35:46):
Doctor Dyer was paid peanuts for his time there. The
benefit to doctor Vasquez was cheap labor. Essentially, doctor Vasquez
sort of left a trail of victims. You know, I
absolutely understand that. And primary among that is the women
who were left kind of high and dry, and that
you know, this is trauma on top of trauma. Like
I get that doctor Dyer is another victim.
Speaker 1 (36:13):
I asked doctor Vazquez's attorney about these allegations, but haven't
received a response. Atchison told me that Dyer's life has
been ruined by the news coverage around this case.
Speaker 3 (36:25):
His life has been taken away from him because of
these news stories.
Speaker 10 (36:30):
The torches and pitchforks are very much out.
Speaker 1 (36:32):
He's now suing news Channel five for publishing and broadcasting
allegedly false and defamatory statements about him, namely claiming he
is not a doctor when he holds an MD, and
implying he was acting illegally or improperly. News Channel five
is standing by its reporting. In a court filing, their
lawyers wrote that the news segment quote did not portray
(36:56):
plaintiff in a false light, let alone one that would
be highly af fec to a reasonable person. I can't
confirm if Dyer did accurately represent himself as a fellow
to every patient he met with, as he claims. I
was able to identify two patients that said they knew
he was a fellow at the time, but Penny doesn't
(37:17):
recall Dyer identifying himself as anything other than doctor. She
believed he was a licensed doctor in the state of Tennessee.
More so, she believed he was her doctor. I read
through some of her portal messages from the clinic, and
Penny pointed out to me what she thought was a
telling back and forth. During one of her IUI cycles,
(37:39):
a staff member reached out to her to tell her
that her estrogen was higher than expected, and then wrote, quote,
I have doctor Dyer reviewing your chart and we'll get
back to you with his thoughts on moving forward or not.
Later they added, Okay, he says, let's go, but he
only wants you to take one clomied tablet a day
instead of two. I read through portal messages of other
(38:02):
patients too, and saw Dyer refer to in the same
way as if he was a doctor giving medical guidance.
Perhaps Dyer was consulting with doctor Vasquez on patient care,
as Atchison says, but this wasn't clear to Penny or
some others I spoke with, like Sarah.
Speaker 2 (38:21):
I never once heard the word fella ever being mentioned.
I never once heard anything other than I'm doctor Dyer
and I'm going to get you pregnant.
Speaker 1 (38:30):
That's it. Penny and Sarah both told me they hoped
that doctor Dyer and doctor Vasquez would face some sort
of professional or criminal repercussions. Like a number of other patients.
They had both filed police reports about Dyer's actions and
complaints with the Tennessee Department of Health. Five months after
they reached out to authorities, they finally got some news.
(38:54):
Here's Penny, we got that whole.
Speaker 6 (38:56):
We're sorry to inform you, and you know, honestly, I've
gotten more sympathy from losing on a bottle cap, you know,
opening one of those bottle caps. Sorry, you're a loser,
like you didn't win. That's kind of what it felt like.
Speaker 1 (39:07):
Penny received a letter from the District Attorney's office explaining
that while Dyer may have violated ethical standards, it did
not appear he had broken the law. The DA had
considered a rarely used sexual assault charge called rape by fraud,
but found the evidence didn't meet the law's criteria. I
(39:28):
had never heard of this and looked it up. The
charge is defined as unlawful sexual penetration of a victim
accomplished by fraud. When I spoke with the assistant DA,
she explains that the act would have to be done
for sexual gratification, something they said there was no evidence
of here. A second letter from the Department of Health
(39:49):
arrived shortly after, stating that its investigation into Dyer had
been closed with no further action. The letter states there
was quote not evidence to conclude that for rare dire
practice medicine in Tennessee without a license. Under Tennessee law,
licensed doctors like doctor Vasquez are free to delegate what
(40:12):
they consider to be routine technical tasks to non licensed
employees like dire As far as the State of Tennessee
saw it, that's what doctor Vasquez had done.
Speaker 6 (40:24):
So I just leave you with a bunch of questions.
Speaker 1 (40:25):
In the end, Penny, like a number of patients I
spoke with, was confused about why a person without a
medical license would be allowed to perform an IUI, a
procedure that is precise, time sensitive, and takes place inside
the uterus. In many other states, iuis must be performed
(40:49):
by a licensed clinician, typically a physician, but sometimes a
physician's assistant or nurse practitioner. But when one former CRCH
patient reached out to the District Attorney's office to ask
about this, she says they told her it would be
legal in Tennessee for a janitor to perform an EUI
if a doctor delegated it. I'm not sure this is
(41:11):
quite correct. From my read of the Tennessee Board of
Medical Examiner's delegation policy, it seems like handing off iuis
to an untrained janitor would indeed be a violation of
the rule. Either way, Penny is troubled by the DA's response, So.
Speaker 6 (41:29):
Like, what kind of example is that? Setting moving forward
for other doctors, but stopping other doctors from doing that
in the future.
Speaker 1 (41:36):
The whole response by the state left the patients feeling
dismissed and gas lit.
Speaker 2 (41:42):
A group of extremely educated women and their spouses did
not misunderstand anything. We are being treated like we're a
bunch of dumb girls who don't know how to read
and that's unfair and it's wrong. We know exactly what
was going on. It was presented to us exactly as
(42:04):
we've said. He was our doctor. He was the only
person that was giving us treatment. And it feels terrible
to be told that we're a bunch of dumb girls
that don't know better. We're not stupid.
Speaker 1 (42:17):
Next time on What Happened in Nashville. After months of
little news and growing panic, the state finally starts to
inventory what's inside the tanks and the results are deeply troubling.
Speaker 10 (42:31):
They're talking about women and receiving the wrong embryos.
Speaker 2 (42:34):
And then I get this letter that says we have
ten and we're only supposed to have eight.
Speaker 7 (42:38):
At that point, I like, I didn't.
Speaker 2 (42:40):
Know how else I was going to hit more rock bottom.
Speaker 10 (42:43):
I don't trust the state adency to haable my healthcare.
Speaker 6 (42:47):
We would just never accept this in other areas of medicine.
Speaker 1 (42:54):
What Happened in Nashville is a production of School of
Humans and iHeart Podcasts, written, reported, and hosted by me
Melissa Chelson. Our producer is Etily's Perez. Our senior producer
is Amelia Brock, with additional production by Emily Seiner and
Carl Catle. Theme song by Jesse Nice Swanger. Sound design,
(43:14):
scoring and mixing by Jeremy Thal and Jesse Nye Swanger.
Fact checking by Savannah Huglee and Austin Thompson. Our production
manager is Daisy Church. Executive producers are Jason English, Virginia Prescott,
Brandon Barr, and Elsie Crowley. If you're enjoying the show,
tell everyone you know and don't forget to leave a
(43:35):
rating in your favorite podcast app
This episode contains discussion of childhood sexual abuse. Please take care,
will listening.
Speaker 2 (00:06):
You can't ovulate harder if you think about it better
and you pay more attention to it. You can't do
anything like that. So all we have is what people
sell us, and unfortunately we will buy whatever you are
selling when you're in this.
Speaker 1 (00:21):
When Sarah Davis begins trying to get pregnant in her
mid thirties, she discovers a world of products for sale,
promising to increase her fertility and give her a child.
Speaker 2 (00:33):
I read every article, I followed every summit company on Instagram.
I fell down the rabbit hole of the wellness industry
that is just utilizing Instagram to sell you crap you
don't need.
Speaker 1 (00:48):
Sarah now works as a creative director for a clothing company,
but she spent her twenties as a fashion designer in Nashville,
sewing the Dazzled Tour costumes for icon Dolly Parton. When
I first talked to Sarah on the phone, she came
across as street smart and impervious to bullshit. But the
quest to get pregnant can un more even the most
(01:10):
grounded among us.
Speaker 2 (01:12):
I racked up so much debt trying to do all this.
At one point, I was on like four hundred dollars
a month, where the supplements everything's ninety dollars and last
for thirty days, and it's just it's so much.
Speaker 1 (01:25):
Online it's easy to find other people's advice on exactly
what you need to do to get pregnant, which may
or may not be scientifically rigorous. Drink lots of pomegranate juice,
take coke ten, keep your feet warm to warm your uterus.
And there's even some funny IVF superstitions, like eating McDonald's
(01:46):
french fries on the way home from your embryo transfer.
Speaker 2 (01:50):
There is literally a blog that lists the ninety some
odd things she did to get pregnant. All the cleaning
supplies have to be changed, all the soaps, all your shampoo,
all of your toothpaste. You can't put chapstick on your
lips because it's got to be organic and free range
or whatever the heck it's going to be. Sounds crazy,
but that's how I felt. That's how I felt, like
(02:10):
that's what I need, because that's what's going to get
me pregnant.
Speaker 1 (02:13):
Sarah went all in. She tried expensive teas that claimed
to have a higher success rate than IVF a special
bracelet that tracked her fertility seed cycling, which is when
you eat specific seeds during certain phases of your monstrual cycle.
Speaker 2 (02:30):
You're supposed to take these two seeds in your smoothie
for the first two weeks of your cycle, then these
two seeds in the second two weeks of your cycle,
and it's supposed to balance out your hormones.
Speaker 1 (02:40):
And she even resorted to magical thinking.
Speaker 2 (02:44):
I had gone to a crystal shop and gotten a
special crystal that was supposed to I don't even know.
I was supposed to waste money. That's what it was
supposed to do. That's exactly what it did. It's supposed
to sell me on something I didn't need.
Speaker 1 (02:57):
Fun fact, I bought a crystal too.
Speaker 2 (03:00):
You can buy a spell on eBay and someone from
like Transylvania will say a spell over you and your
uterus from Afar.
Speaker 1 (03:07):
Paying a stranger real dollars to cast a spell to
help you get pregnant. Just take a moment to let
that sink in. To an outsider, it may seem ridiculous,
but I understand it, just like I relate to those
fairy tales about infertility from the past. These stories all
revolve around the same idea. When you want to get
(03:31):
pregnant this badly, you will do anything, no matter how uncomfortable, bizarre, inconvenient,
or expensive, to get a baby in your arms.
Speaker 2 (03:43):
Let's freaking do it. I will drink disgusting tea. I
will take all these supplements, I will do all the
things I need to do if that will get me
to my end goal.
Speaker 1 (03:52):
Let's do it.
Speaker 2 (03:54):
We're tired, we're broke, we're emotional. We just want it.
Speaker 3 (04:00):
To be over.
Speaker 2 (04:01):
Unfortunately, people have figured out that this group of people
are easy to take advantage of because we're desperate.
Speaker 1 (04:09):
I'm Melissa Jelson from School of Humans and iHeart podcasts.
This is what happened in Nashville Episode three. Do you
think that's your ovary?
Speaker 4 (04:28):
Human fertility as a subject matter and as an important
role in societies dates back literally thousands of years. If
you go back and look at some of the Egyptian
papyriy that were then able to be interpreted after the
discovery of the Rosetta Stone, there are actually fertility therapies
(04:50):
that are described in great detail in hieroglyphics.
Speaker 1 (04:54):
This is doctor Allan Penzius, a board certified reproductive endercinologist,
an associate professor at Harvard Medical School. He's talking me
through the history of fertility medicine.
Speaker 4 (05:07):
So the fact is that fertility and infertility were recognized
not only as problems thousands and thousands of years ago,
but also recognized that there were potential treatments that could
then alleviate the suffering of those who weren't becoming pregnant.
Now to us in the twenty first century, looking back
(05:27):
at some of the methods they used, some of them
were really remarkably insightful. Others were quite way else to mark.
Speaker 1 (05:35):
In ancient Greece, for example, women were told to fill
a cloth pouch with ground lead and iron, dip it
in breast milk, and insert it into their vaginas. In
medieval Italy, one suggestion was to bury an egg nearer
cathedral for eight days, then dig it up and eat it.
Speaker 4 (05:53):
But as we moved through human history and throughout the
Renaissance and then into the eighteenth in nineteenth century when
started discovering things, being able to look at cells under
the microscope and seeing motile sperm, and ultimately in the
nineteen sixties nineteen seventies we started to see medicines that
allow women to ovulate more regularly.
Speaker 1 (06:15):
The seventies saw one of the biggest advancements in fertility treatment.
Speaker 4 (06:19):
The Watershed event that broke the dam and allowed millions
of women to be able to become pregnant. West In
July of nineteen seventy eight, Louis Brown was born the
first human baby born as a result of in vitro fertilization.
Speaker 2 (06:32):
We can now hand it.
Speaker 3 (06:33):
To the baby Pride.
Speaker 5 (06:38):
At twenty seconds.
Speaker 6 (06:40):
Doctors reported that the baby was doing fine and eating well,
and the parent they reported were doing fine too.
Speaker 1 (06:51):
After the birth of the first so called test two
baby in England in July nineteen seventy eight, the race
was on for the United States to follow. Fertility clinics
began springing up across the country, including one at Vanderbilt
University in Nashville, Tennessee. It quickly became a magnet for
ambitious reproductive endercinologists eager to stake out their claim in
(07:15):
the new and fast expanding field of IVF. One of
those physicians was doctor George Hill, who spent his early
career at Vanderbilt before breaking off in the early nineteen
nineties to open his own practice, the Nashville Fertility Center,
a clinic that still exists today.
Speaker 7 (07:35):
What I was cold when I arrived at Vanderbilt was
that Vanderbilt was the fork IVF program in the country
and that Vanderbilt had the fork IVF baby in the country.
So it was one of the early IVF programs. We
had patients coming from all over the country. No, we
had a pretty big drawing area here, so I'd been
(07:55):
very busy at Vanderbilt. It was a smooth transition going
in the product practice.
Speaker 1 (08:01):
Doctor Hill wasn't the only IVF doctor to branch out
on his own after his time at Vanderbilt. Doctor Jime
Vasquez also followed a similar path. After graduating from medical
school in Chile, Vasquez moved to the US, where he
got his medical license. According to his bio, he held
faculty positions at Thomas Jefferson University and the University of
(08:24):
Wisconsin Madison before joining Vanderbilt's faculty in nineteen ninety one,
where he served as director of the Division of Reproductive
under Chronology and Infertility. In nineteen ninety five, he left
to open his own clinic, the Center for Reproductive Health
or CRCH. Let us help you make your dreams become
(08:45):
a reality by calling us at the Center for Reproductive Health.
Newspaper ads from the time showed doctor Vasquez recruiting staff
a receptionist who could juggle many activities simultaneously, lab techs
willing to work with weekends. He filed paperwork with the
state outlining a quote high volume infertility practice unquote with
(09:07):
its own operating rooms and lab. Vasquez was envisioning what
the future of IVF was going to look like and
planning accordingly. Doctor Vasquez declined to sit for an interview
with me, but I was able to find promotional videos
of him talking about the science of fertility, his clinics,
approach to treatment, and his own reasons for choosing this work,
(09:28):
which offers some insight.
Speaker 8 (09:30):
The patient is my boss. Clinical science can allow me
to make a prediction about what treatments are more likely
to be successful. I give them all the options, and
I say, I think that this is more likely to
be successful. But I don't have a crystal ball. I mean,
the patient decides a different treatment, which try it. I
(09:55):
would not argue with the patient and try to force
it to go into a different direction. It is her
decision to make.
Speaker 1 (10:04):
Even as he worked to build a modern IVF clinic,
Vazquez described his mission in personal terms, rooted in love, children,
and legacy.
Speaker 8 (10:15):
When I see my kids, I'm amazed. That was a
gift straight from God and my wife, and I'm so
fortunate to have that. Not having that would make me
feel very empty. So probably I should find to help
(10:35):
capitals with infertility to have their family.
Speaker 1 (10:39):
I was able to glean some information about the clinics
early years from federal records. Since nineteen ninety two, federal
law has required fertility clinics to report their outcomes to
the CDC and CRH first appeared in a nineteen ninety
six report. By then, the clinic had already joined the
Society for Assisted Productive Technology, also known as SART, a
(11:03):
kind of trade group that works to establish and maintain
standards that members must follow. A few years later, doctor
Vasquez's laboratory earned accreditation from the College of American Pathologists CAP,
a private organization recognized by the federal government to ensure
compliance with national laboratory standards. By all appearances, doctor Vasquez
(11:27):
was making sure his new clinic would be at the
cutting edge of medicine, technology and care. It took some
time to build up the clinics clientele, but eventually it
found its rhythm as a smaller, more intimate operation, providing
around an average of one hundred IVF cycles for patients
a year. While it was the smallest clinic in Nashville.
(11:49):
This was framed as a selling point.
Speaker 8 (11:53):
Our philosophy of care is to be a family and
to help your family to grow, and we want to
use clinical science to do that, but we want to
do it in a personal way.
Speaker 1 (12:08):
The Center for Reproductive Health's website also boasted that the
clinic was responsible for the birth of more than two
thousand babies since its opening in the nineties. Patient testimonials
reinforce the message that new patients were in the right place.
Speaker 9 (12:25):
I've always joked that doctor Vasquez no sperm and eggs
like no one else.
Speaker 2 (12:29):
I know that sounds.
Speaker 9 (12:30):
Terrible, but it's so true. He has always been so
warm and friendly.
Speaker 5 (12:37):
Doctor Vasquaise was somebody who he sits down with you,
took time, answered questions, just approached it differently. He'll do
a lot of testing up front, but that testing helps
him figure out exactly what's right for you.
Speaker 6 (12:50):
When the babies were born and came to see our
children and us and then nick you several times.
Speaker 5 (12:55):
I mean, I don't think we would have gotten that
from one of the larger multi position centers.
Speaker 1 (13:01):
This personal approach continued behind the scenes too. Doctor Vasquez's wife, Nancy,
managed the facility for two decades. The staff was described
as tight knit and many worked there for years. One woman,
a lab tech, stayed for well over a decade. Others,
though like in any small business, cycled through quickly. Over
(13:22):
the years, doctor Vasquez had employed other doctors, nurse practitioners,
and physicians' assistants, but there were also stretches where he
was the only doctor on site managing patient care. The
one constant at CeRh was doctor Vazquez himself. The clinic
was his baby and he was involved in all aspects
of its operations. But as doctor Penzius explained to me,
(13:47):
running an IVF clinic is a big job.
Speaker 4 (13:50):
It's a very complicated circumstance. There are so many components
to a well run IVF program that it is complex.
It's doable, but it takes a good sized team with
a lot of experience to be able to pull it
off well.
Speaker 1 (14:05):
In twenty nineteen, Vasquez his wife retired due to health concerns,
and their daughter, Elena, came on to assist with this.
The clinic was going through some big changes and doctor
Vasquez needed some extra help on the patient side, so
in twenty twenty he hired someone new, Doctor Hill, who
ran a competing IVF clinic less than a mile from
(14:27):
CRH heard talk of this new hire.
Speaker 7 (14:30):
He had someone there that he called his fellow. I
don't know much about the person that he was calling
his fella. I mean, obviously we knew nothing about what
was going on over there.
Speaker 2 (14:49):
There are two things in this world that I have
absolutely no doubt that I can do. So and take
your children.
Speaker 10 (14:56):
Those are the two things that I'm like, got it.
Speaker 2 (14:59):
I do remember in kindergarten, I was like, all right,
I gotta have a boyfriend, because you gotta have a
boyfriend to have a husband, and you gotta have a
husband to have a baby. I was like putting it
together at five and was like, Okay, I gotta start now.
Speaker 10 (15:12):
I gotta start with a boyfriend now.
Speaker 2 (15:13):
I remember that thought process because the end goal was
always a baby.
Speaker 1 (15:19):
In pursuit of her lifelong dream. Sarah poured money into supplements, herbs,
and teas that promised miraculous results, but never delivered so
much as a positive pregnancy test. By early twenty twenty three,
after two years of trying, she's feeling burned out and
disillusioned by the trendy fertility hacks advertised on social media.
(15:42):
So when a coworker suggests she tried the Center for
Reproductive Health, she's eager to begin a relationship with a
trained medical professional she could trust. No more woo woo solutions,
just science data and someone qualified to guide her.
Speaker 2 (15:58):
He was very nice, He was very friendly. He was sarcastic.
He cussed with me. I grew up with a dad
that is a sailor and I am the same way.
And it was like, okay, this guy he is. It
felt like a friend. It felt like I was sitting
down to talk to a friend.
Speaker 1 (16:20):
Sarah isn't talking about doctor Vasquez. In fact, during her
entire time as a patient at SIERRH, she says she
never even met doctor Vasquez. Instead, she sees another provider,
doctor Ferrera Dyer, the man doctor Vasquez hired in twenty twenty,
significantly younger than doctor Vasquez, doctor Dyer had an easy going,
(16:42):
jocular demeanor, where Vasquez's bedside manner could be academic and
long winded. Dyer was funny and personable.
Speaker 2 (16:50):
He was super friendly. He was super positive.
Speaker 1 (16:55):
In their initial consultation, Sarah tells Dyer about her years
of trying to conceive and her uncertainty about whether or
not she's ovulating, and he seems receptive to her concerns.
Speaker 2 (17:09):
And I was like, oh my god, this is amazing.
Someone is finally listening to me. It felt like such relief.
And he spent a lot of time going over the
basics of how the body works, going over just stuff
that you're like, no one else.
Speaker 10 (17:25):
Took the time to go over this.
Speaker 1 (17:29):
Before turning to IVF, Sarah says, doctor Dyer recommends to
try intrauterine insemination or IUI. This is a procedure where
sperm is inserted inside the uterus right around ovulation, so
the timing has to be exact. I've done four iuis.
You strip half naked and lie on a bed with
(17:50):
your legs and stirrups. Then the medical provider inserts a
thin catheter into your uterus and deposits the sperm, giving
it essentially a head start on its journey to the egg.
It's not usually painful, but it's uncomfortable or at least
awkward for me personally. It was emotional and stressful, and
(18:11):
success rates are low. It could feel like I'm going
through all of this and is it even going to
work still. Iuis are often the first step in fertility
treatment because they are a lot faster and cheaper than IVF.
While doctor Vaska has handled the more complicated IVF cycles
at the clinic, Dyer did most of the iuis, and
(18:33):
in September of twenty twenty three, DIYer performed Sarah's first
IUI at the Center for Reproductive Health. The experience goes smoothly,
but she does not get pregnant.
Speaker 2 (18:45):
I mean, it's soul crushing. You just think, okay, great,
now what do we do? You spend twelve hours being mad,
and then you're kind of like, all right, they told
me the first one wouldn't work. You google the crap
out of it and you find out that it doesn't
work for a lot of people, and that a lot
of times people get pregnant on the second one or
the third one, and you're like, okay, we'll figure it
(19:06):
out financially. Now I know what to expect. This is
in September. We'll do another one in October. We'll do
another one in November. We were taking my husband's family
to Texas to Fort Worth for Christmas. We were renting
a house and we were going to go down there.
I had these grandiose plans. If either of those worked,
I was going to have pajamas mailed to the house rapped,
(19:27):
and one of them is going to be baby pajamas.
And like, I had this whole plan planned out.
Speaker 1 (19:32):
But the rest of twenty twenty three does not go
as planned. On Sarah's next cycle visit in October, she
has a large cyst and she's prescribed birth control to
shrink it before continuing in November. She's hopeful about moving forward,
but when she goes in for her appointment, the normal
ultrasound tech is not there, and the woman who's supposed
(19:56):
to perform her exam seems confused.
Speaker 2 (19:59):
She's like, Okay, I don't really know what I'm doing,
and I don't really know how to do ultrasounds. I'm
just a nurse, but they've got me back here. Then,
while the wind is inside of me, she goes, I,
do you think that's your ovary? I'm sorry, I don't,
are you You can't be talking to me. There's got
to be somebody else in the room because I don't
(20:20):
I don't know, do am I supposed to know what's
compying on a screen? And I was just like, this
is literally determining whether or not we move forward with
the next cycle, whether I have a sister or not.
So I'm gonna need you to know what my ovary
looks like.
Speaker 1 (20:34):
Sarah complains to the front desk staff and another employee
does a repeat ultrasound, but it's not entirely clear what's
going on inside Sarah's body. She decides to cancel the cycle.
It's around this time that Sarah starts to question if
the clinic is functioning properly.
Speaker 2 (20:54):
I was like, okay, this is not good. And since
we had been there, a bunch of the people the
front desk had gone. The girls at the front desk
would kind of be like, I don't know what's going on.
Speaker 1 (21:05):
Sarah and her husband are losing confidence, and they decide
the next IUI will be their last at CRH. If
it doesn't work, they'll move on to another clinic.
Speaker 2 (21:15):
We entertained the idea of not going back at all,
but that would have delayed everything because you have to
do testing and you have to wait for the appointment
and you have to so it's like, we might as
well do one more and then in the interim be
looking for someone else, and that way, at least we're
not wasting a ton of time.
Speaker 1 (21:33):
Sarah says. She also begins to have concerns about Dyer himself.
Speaker 2 (21:38):
When I first met with Dyer, a thyroid was high.
TSH was high, and he prescribed the thyroid medicine. When
I went to pick that thyroid medicine up, it had
doctor Vasquez his name on it. And I was like,
this is weird, asked the front desk. They said, oh,
Vasquez just signs all the prescriptions. It's his account that
assigns all the prescriptions, so we just do it all
(21:59):
under him because he's owner of the planet. All right, fine, whatever.
Then all of the fertility drugs were in Vasquez's name
when I pick those up, and I ask again, and
at that point it was kind of like, okay, all right,
it's fine, it is what it is. But I had
definitely noticed it and thought it was weird.
Speaker 1 (22:19):
Sarah decides, next time she's in the clinic she should
just check Dire's credentials.
Speaker 2 (22:24):
I had told myself before that appointment with him, make
sure you look at the wall to make sure there's
a medical degree, because his name wasn't on any of
the meds and I was like, I need to make sure.
I just need to check that.
Speaker 1 (22:35):
So at her next appointment, she looks around the exam
room and there it is on the wall, a framed
medical degree with Dire's name on it. It gives her
the confidence she needs to move forward with her second
IUI with him in February twenty twenty four. It doesn't work,
and so, as planned, she and her husband seek care elsewhere.
(22:58):
The following week, Sarah is sitting in an office of
a new fertility clinic. When she's asked about her previous provider.
Speaker 2 (23:07):
She asked me who I was seeing, and I told
her doctor Dyer. She goes, you know he's not a
reproductive endocrinologist, right. It's a pretty small field, and I
know most of the people in a like a pretty
a big vicinity. I know at least of their names.
And I was like, okay, you know, you leave that appointment.
You're just focused on the next step, You're focused on you.
Speaker 1 (23:29):
But the comments linger, and so she decides to do
some research. If Dire isn't a reproductive endocrinologist, maybe he's
just a general practitioner. She looks Dire up on Google,
but finds nothing. Nothing on social media either. She tracks
down the website that lists licensed doctors in Tennessee, runs
(23:49):
his name through, and nothing comes up. She can't even
find his name on the Center for Reproductive Health's website.
Speaker 2 (23:56):
I was like, you know what, this can't be this
hard to find, right, Like am I Just every other
website in Nashville has all the doctors listed. They're on
the door. So it's like, Okay, this is weird. There's
no mention of him with the board, there's no mention
of him with a license in the state of Tennessee.
Speaker 1 (24:12):
There's nothing Sarah wants answers. Over the next few weeks,
she keeps trying to get a hold of doctor Vazkaz
so he can explain what's going on.
Speaker 2 (24:23):
I called office and I said, listen, something's going on.
I left a message. There's some questions about Dyer's qualifications.
Speaker 1 (24:33):
No one calls her back. On Tuesday, April ninth, Sarah
tries calling the clinic once more.
Speaker 2 (24:40):
It rang and rang and rang the front deskin pick
up and then it went to the emergency service and
she was like, I can't help you. I'm just here
in case of emergency. Call back later, she didn't know
what was going on.
Speaker 1 (24:56):
A few days later, she comes across Sydney's news article
and learns that the Center for Reproductive Health had suddenly closed.
Unsure of what all this means, Sarah contacts news Channel five,
the same news outlet that broke the initial story about
crch's closure.
Speaker 2 (25:13):
I knew that if one person had given up on
this journey because of anything that these idiots had said,
that they needed to know what was going on.
Speaker 1 (25:20):
They run another segment about the clinic, this time focusing
on the questions swirling around Diyer's qualifications.
Speaker 10 (25:28):
Stunning new allegations tonight against the Nashville fertility Clinic, now
being sued by the Tennessee Attorney General.
Speaker 2 (25:35):
Tonight another bombshell, Why did the man who treated so
many of these women hold himself out to be a doctor?
Speaker 1 (25:47):
Patients are already reeling from the Center for Reproductive Health
sudden closure. They've suffered canceled IVF cycles, lost money and time,
and nearly twelve hundred embryos are still behind locked doors. Now,
a new and devastating fear emerges had they been treated
(26:07):
by someone who wasn't a licensed doctor. After Sarah goes
to the press, she has lingering questions about if what
happened at CRH might be considered a crime, so she
files a complaint with the Metro Nashville Police and the
Special Victims Unit sets up a dedicated email address for
former patients to recount their experiences at the clinic. In
(26:31):
the wake of the news segment, as many as sixty
five families contact police, according to reporting by news Channel five.
For some, like Penny co, a thirty five year old
scientist who had been a patient at the clinic for
a year, the fear isn't just about the quality of
the medical care she received. It's also about feeling violated.
(26:55):
She had been treated by a person who she worried
might not have had the training or legal as authority
to do so. This man saw and performed procedures on
her half naked body.
Speaker 11 (27:06):
I still feel kind of gross, I still feel fringing.
Even though I know it's not my fault or anything
I've done, but it happened to me. So I'm like, yeah,
I don't at anybody in my space. Anytime someone puts
their hand on my shoulder, I'm just like like inching
away and just like I just don't. After something like
that happens, you're like, if they can be deceiving, how
do you know somebody else is deceiving? Like it starts
to play my game. Unfortunately, there's so many emotions that
(27:30):
go on with that because I was sexually assaulted as
a child, so it kind of starts pulling back trauma
from younger ages.
Speaker 1 (27:38):
Penny is sitting in her obgian's office reading an article
on her phone when she learns that Dyer had no
medical license.
Speaker 11 (27:47):
I felt like I was going to pass out from
anxiety because I was like, there's no way this is real.
Like I starts really spiraling. I could fill my face
like get bright red. I can tell it was like
a panic attack.
Speaker 1 (27:58):
During her time as a patient is, she had undergone
several EUIs with Dire. She had put her trust in
him and his training, and as part of the procedures,
he had touched her private areas and used medical equipment
inside her body, so when she learns he isn't a
licensed physician, she feels an overwhelming sense of betrayal. For Penny,
(28:22):
it's a pain that's horribly familiar if you've ever.
Speaker 11 (28:26):
Been sexually assaulted. It puts you back into that category
again where you're just like, I don't want anybody touching me.
I don't want my own husband touching me. Like you
just feel disgusting, you feel violated, you feel manipulated, like
all of the emotions. You know at that point you're deceived.
Speaker 1 (28:42):
Penny told me that because she was sexually abused as
a child, seeking fertility care as an adult had been challenging.
She found the EUIs, in which she had to take
off her clothes and lay still as dire inserted sperm
inside her mortifying.
Speaker 11 (28:58):
I mean, I honestly had to the whole time I
had the procedure done, I laid back close my eyes
because I just didn't want to see. Your legs are up,
you're completely naked from the waist down. You feel the
doctor like kind of touching you, even with my own
husband in the room. I was like, I'm embarrassed, Like
I don't want him seeing me that way either. It's
just a different level of embarrassment.
Speaker 1 (29:24):
Penny, Sarah and other women who saw doctor Dyer in
the clinic feel that he wasn't honest about his credentials
and presented himself as something he was not. This is
an accusation that Dyer denies in full.
Speaker 10 (29:39):
If there is one sound bite that you use as
a part of this, it is everything that doctor Dyer
did was appropriate under all applicable laws and regulations.
Speaker 1 (29:51):
That's Chanelle Atchison. When I first reached out to Dyer
for comment, he wouldn't speak with me, but Atchison, his
lawyer did. I eventually caught up with DIYer a few
months after this, and we'll hear from him later in
the show. But his attorney talked me through his position
and presented the case that he did nothing wrong.
Speaker 10 (30:11):
First, I want to say that the fertility journey is
an extremely emotional, traumatic, difficult journey anyway in the best
of circumstances, and I can absolutely understand and empathize with
the trauma that these women are feeling.
Speaker 3 (30:33):
I cannot imagine the heartache, and I want to be
clear that nothing I am saying negates that takes away
from that all of those feelings.
Speaker 10 (30:44):
Are real and valid.
Speaker 3 (30:47):
That said, nothing that doctor Dyer did was inappropriate. He
practiced the way that every single doctor that has ever
pursued a medical license in the United States has practice
which is under the purview of the license of another
doctor while he was pursuing his own.
Speaker 1 (31:07):
Atchison told me that doctor Dyer was working under the
medical license of doctor Vazquez while he was seeking his
own license. She explained that Dyer, although an American himself,
attended and graduated from a medical school in England called
Saint Christopher's in two thousand and seven. Back in the States,
he began taking the medical licensing exams required to practice
(31:29):
medicine in the US and passed some but not all
of them.
Speaker 10 (31:34):
Doctor Dyer passes first two licensing board exams, and then
his mother fell ill, and so he stopped everything to
take care of his mother. For a number of years,
everything for him took a backseat, and unfortunately she ended
up passing away, and then he started pursuing his own
career again.
Speaker 1 (31:55):
Atchison said that in twenty twenty, thirteen years after Dyer
graduated from Meta school, he started working at the Center
for Reproductive Health as a fellow, believing it would help
him advance in his dreams of becoming a licensed doctor.
Although foreign medical school graduates like Dyer must complete a
formal three year residency to obtain a medical license in Tennessee,
(32:18):
something Dire had not done. Atchison says that Dyer was
told his work at CRH would set him up for
an alternative route to licensure.
Speaker 3 (32:28):
He was called if he would work for two years
at the Center for Reproductive Health, then doctor Vasquez would
sponsor him towards this licensure issue, and that kept getting
bumped out, and the final thing that he was told
was four years, so he was just short of his
four years.
Speaker 1 (32:42):
Atchison didn't provide any additional details about this fellowship, and
it's unclear if Azcuez was even authorized to offer such
an option. But beyond the fact that Dyer didn't pass
all the required tests or complete a residency, there are
also questions about the medical school he attended, Saint Christopher's
(33:02):
in Luton, England. Today the school no longer exists, and
in two thousand and five, during the time Dyer was
a student, it was the subject of critical reporting by
the BBC questioning its legitimacy. The UK's licensing body ultimately
chose not to recognize Saint Christopher's in Luton as an
(33:23):
authorized medical school because it couldn't provide proof it was
offering education up to the UK's standards. As a result,
graduates from that school cannot get licensed to practice medicine
in the UK. In the US, some states have barred
graduates of Saint Christopher's in Luton from obtaining a medical license. Texas,
(33:45):
for example, has the school on its most recent list
of fraudulent or sub standard institutions. It won't recognize. New York,
where I live, also hasn't accepted it in the past. Now,
what about Tennessee. The state has specific rules surrounding international
medical schools, and it's not entirely clear whether this school
(34:05):
would be accepted or not. I reached out to a
state spokesperson to clarify, but they declined to comment. Still,
Dyer's lawyer points out to me that American authorities permitted
Dyer to take the US medical licensing exams, and claims
a number of his classmates from Saint Christopher's have successfully
gotten their medical licenses in the States and are currently practicing.
(34:30):
Atchison emphasized that Dyer was only working as a fellow
under doctor Vazquez's supervision. She says he didn't assess patients,
prescribe medication, make diagnoses, or design treatment plans. He only
carried out plans created by Vazquez. She says that Dyer
was upfront with patients about his role and that it
(34:52):
was entirely appropriate for Dyer to use the title doctor
as he had earned a medical degree.
Speaker 3 (34:59):
Anytime that doctor Dyer would come into the room and
introduce himself to somebody, he would say, you know, my
name is doctor Dyer.
Speaker 10 (35:06):
I am doctor Vasquez, his extern or his fellow.
Speaker 3 (35:09):
I practice under the supervision of doctor Vasquez.
Speaker 10 (35:13):
Doctor Dyer's white lab coat said fellow on it.
Speaker 3 (35:16):
You know, it was always made very clear that doctor
Vasquez was the one making the decisions. I understand that
there is perhaps a propensity to see a white coat
and say that's.
Speaker 10 (35:27):
The person making the decisions, but that's not, in fact
the case.
Speaker 1 (35:31):
In Atchison's telling, doctor Dyer is not a villain in
this story. He's another person failed by doctor Vasquez. She
said that the fellowship arrangement benefited Vasquez because he didn't
have to pay dire a doctor's salary.
Speaker 3 (35:46):
Doctor Dyer was paid peanuts for his time there. The
benefit to doctor Vasquez was cheap labor. Essentially, doctor Vasquez
sort of left a trail of victims. You know, I
absolutely understand that. And primary among that is the women
who were left kind of high and dry, and that
you know, this is trauma on top of trauma. Like
I get that doctor Dyer is another victim.
Speaker 1 (36:13):
I asked doctor Vazquez's attorney about these allegations, but haven't
received a response. Atchison told me that Dyer's life has
been ruined by the news coverage around this case.
Speaker 3 (36:25):
His life has been taken away from him because of
these news stories.
Speaker 10 (36:30):
The torches and pitchforks are very much out.
Speaker 1 (36:32):
He's now suing news Channel five for publishing and broadcasting
allegedly false and defamatory statements about him, namely claiming he
is not a doctor when he holds an MD, and
implying he was acting illegally or improperly. News Channel five
is standing by its reporting. In a court filing, their
lawyers wrote that the news segment quote did not portray
(36:56):
plaintiff in a false light, let alone one that would
be highly af fec to a reasonable person. I can't
confirm if Dyer did accurately represent himself as a fellow
to every patient he met with, as he claims. I
was able to identify two patients that said they knew
he was a fellow at the time, but Penny doesn't
(37:17):
recall Dyer identifying himself as anything other than doctor. She
believed he was a licensed doctor in the state of Tennessee.
More so, she believed he was her doctor. I read
through some of her portal messages from the clinic, and
Penny pointed out to me what she thought was a
telling back and forth. During one of her IUI cycles,
(37:39):
a staff member reached out to her to tell her
that her estrogen was higher than expected, and then wrote, quote,
I have doctor Dyer reviewing your chart and we'll get
back to you with his thoughts on moving forward or not.
Later they added, Okay, he says, let's go, but he
only wants you to take one clomied tablet a day
instead of two. I read through portal messages of other
(38:02):
patients too, and saw Dyer refer to in the same
way as if he was a doctor giving medical guidance.
Perhaps Dyer was consulting with doctor Vasquez on patient care,
as Atchison says, but this wasn't clear to Penny or
some others I spoke with, like Sarah.
Speaker 2 (38:21):
I never once heard the word fella ever being mentioned.
I never once heard anything other than I'm doctor Dyer
and I'm going to get you pregnant.
Speaker 1 (38:30):
That's it. Penny and Sarah both told me they hoped
that doctor Dyer and doctor Vasquez would face some sort
of professional or criminal repercussions. Like a number of other patients.
They had both filed police reports about Dyer's actions and
complaints with the Tennessee Department of Health. Five months after
they reached out to authorities, they finally got some news.
(38:54):
Here's Penny, we got that whole.
Speaker 6 (38:56):
We're sorry to inform you, and you know, honestly, I've
gotten more sympathy from losing on a bottle cap, you know,
opening one of those bottle caps. Sorry, you're a loser,
like you didn't win. That's kind of what it felt like.
Speaker 1 (39:07):
Penny received a letter from the District Attorney's office explaining
that while Dyer may have violated ethical standards, it did
not appear he had broken the law. The DA had
considered a rarely used sexual assault charge called rape by fraud,
but found the evidence didn't meet the law's criteria. I
(39:28):
had never heard of this and looked it up. The
charge is defined as unlawful sexual penetration of a victim
accomplished by fraud. When I spoke with the assistant DA,
she explains that the act would have to be done
for sexual gratification, something they said there was no evidence
of here. A second letter from the Department of Health
(39:49):
arrived shortly after, stating that its investigation into Dyer had
been closed with no further action. The letter states there
was quote not evidence to conclude that for rare dire
practice medicine in Tennessee without a license. Under Tennessee law,
licensed doctors like doctor Vasquez are free to delegate what
(40:12):
they consider to be routine technical tasks to non licensed
employees like dire As far as the State of Tennessee
saw it, that's what doctor Vasquez had done.
Speaker 6 (40:24):
So I just leave you with a bunch of questions.
Speaker 1 (40:25):
In the end, Penny, like a number of patients I
spoke with, was confused about why a person without a
medical license would be allowed to perform an IUI, a
procedure that is precise, time sensitive, and takes place inside
the uterus. In many other states, iuis must be performed
(40:49):
by a licensed clinician, typically a physician, but sometimes a
physician's assistant or nurse practitioner. But when one former CRCH
patient reached out to the District Attorney's office to ask
about this, she says they told her it would be
legal in Tennessee for a janitor to perform an EUI
if a doctor delegated it. I'm not sure this is
(41:11):
quite correct. From my read of the Tennessee Board of
Medical Examiner's delegation policy, it seems like handing off iuis
to an untrained janitor would indeed be a violation of
the rule. Either way, Penny is troubled by the DA's response, So.
Speaker 6 (41:29):
Like, what kind of example is that? Setting moving forward
for other doctors, but stopping other doctors from doing that
in the future.
Speaker 1 (41:36):
The whole response by the state left the patients feeling
dismissed and gas lit.
Speaker 2 (41:42):
A group of extremely educated women and their spouses did
not misunderstand anything. We are being treated like we're a
bunch of dumb girls who don't know how to read
and that's unfair and it's wrong. We know exactly what
was going on. It was presented to us exactly as
(42:04):
we've said. He was our doctor. He was the only
person that was giving us treatment. And it feels terrible
to be told that we're a bunch of dumb girls
that don't know better. We're not stupid.
Speaker 1 (42:17):
Next time on What Happened in Nashville. After months of
little news and growing panic, the state finally starts to
inventory what's inside the tanks and the results are deeply troubling.
Speaker 10 (42:31):
They're talking about women and receiving the wrong embryos.
Speaker 2 (42:34):
And then I get this letter that says we have
ten and we're only supposed to have eight.
Speaker 7 (42:38):
At that point, I like, I didn't.
Speaker 2 (42:40):
Know how else I was going to hit more rock bottom.
Speaker 10 (42:43):
I don't trust the state adency to haable my healthcare.
Speaker 6 (42:47):
We would just never accept this in other areas of medicine.
Speaker 1 (42:54):
What Happened in Nashville is a production of School of
Humans and iHeart Podcasts, written, reported, and hosted by me
Melissa Chelson. Our producer is Etily's Perez. Our senior producer
is Amelia Brock, with additional production by Emily Seiner and
Carl Catle. Theme song by Jesse Nice Swanger. Sound design,
(43:14):
scoring and mixing by Jeremy Thal and Jesse Nye Swanger.
Fact checking by Savannah Huglee and Austin Thompson. Our production
manager is Daisy Church. Executive producers are Jason English, Virginia Prescott,
Brandon Barr, and Elsie Crowley. If you're enjoying the show,
tell everyone you know and don't forget to leave a
(43:35):
rating in your favorite podcast app
Host
Melissa Jeltsen
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