Hustling Hormones

Hustling HormonesHustling Hormones

I scored black market drugs to get my ovaries high — and mighty.

There was no avoiding the flash of drug dij` vu. Stand in line at the bank because the source wants more cash than you can get from an ATM; wonder what the teller’s thinking as she counts out $600 in small bills; worry about getting robbed en route to the parking lot; drive to meet the connection, praying the stuff is good.

Fifteen years ago, I’d have been meeting the sleazoid would-be producer who paid his rent by selling party-time coke to my friends and me. Now it was a series of strangers, and expeditions that weren’t about pleasure but desperation. The deals I made were for ampuls of human menopausal gonadotropin — brand name Pergonal — which, injected, would goad my ovaries into making masses of eggs each month, one of them good enough, I hoped, to produce a child. I grew up on mind-altering street pharmaceuticals, but I reached a new appreciation of the surreal during the year I spent buying black market fertility drugs.

Two forces got me there: generational mass delusion and capitalism. I was one of those women who considered the notion of the biological clock to be patriarchal hogwash. “I — I can’t believe it – I forgot to have children!” proclaimed the T-shirt I actually wore proudly at 26. It wasn’t until I was just past 40, dazzled with love for my new daughter and motherhood — when my efforts to conceive another child were going absolutely nowhere — that I realized what a moron I’d been.

Enter the system: Yes, medical intervention might get me pregnant, but I’d have to pay through the nose for it. Even the relatively low-tech tactic of ovarian stimulation coupled with
insemination cost more than $2,000 a try, and it rarely worked the first time. (In vitro
fertilization, at 10 grand a pop, wasn’t even an option.) More than half the expense was drug related; pharmacy Pergonal ran $60 per amp, and a typical cycle required at least two dozen.

But one day, I noticed that my doctor’s bulletin board had ads from women who were ending treatment and recouping costs by selling drugs they hadn’t used. Secondhand Pergonal was going for as little as $15 a hit. Trading in prescription medication is illegal, not to mention that you can’t be sure what you’re getting. But with $1,000 a month at stake, who cared?

I actually recognized the first phone number I wrote down. It was that of the wife of an old friend, who, after four years of effort and maybe a dozen miscarriages, was about to deliver child No. 2. I called, made the deal and two days later exchanged a handful of bills for a white paper bag full of drugs. They’d been purchased in central Mexico by the friend of a friend who had family there, then smuggled across the border. (Customs will allow small amounts of medication for “personal use,” but she’d been stockpiling and her original order was too big to qualify.)

I was thrilled at how easy this was. I now had a hefty supply of product for only $14 per amp, and the fact that it had come from someone who’d gotten pregnant seemed like a good omen. (Fervent belief in signs and portents is vital when you’re infertile; otherwise you have nothing to cling to but the cold, immutable laws of biology.) Two months later, I’d shot it all up, popped over a dozen eggs and been basted in sperm, but it hadn’t worked. I was back on the phone.

Suddenly I was immersed in a sea of commerce and pain. I’m a journalist, used to intruding in strangers’ lives, but I’d never before learned the state of someone’s reproductive organs within five minutes of a meeting. “Here — I bought them for $60 each, but I’m only asking $20,” said my next bulletin board contact, an Indian immigrant in her late 30s, as she handed over the medication in her mid-Los Angeles living room. “My eggs are no good. I am waiting for a donor.”

“We had to do IVF,” cheerfully confessed a blond, clean-cut and surfer-attractive husband with Pergonal bought in Tijuana, Mexico, to sell. “My wife’s 42 and I have, uh, a count problem.”

Maybe that part wasn’t so strange, since just admitting we were part of this same, awful world made us instantly intimate in a way we couldn’t be even with friends. With someone else who’d been there, the mere sentence “Yep, trying for three years now” carried a weight of emotion and imagery — the needles, stirrups, plastic cups, hope, tears, regret and sweaty, grunting sex giving way to something scheduled and grimly determined. And yet this profundity would be followed by the most banal social chat.

“Like my new patio cover?” asked the low-count man shortly after he gave me drugs and talked obsessively about his wife’s successful medication regimen. (They’d hit the jackpot — she was eight months pregnant with twins.)

“Very much,” I said truthfully. “We could use one just like it.”

“Home Depot!” he answered immediately, offering aisle directions. The patio and yard, like the rest of the house, were frighteningly immaculate. I wondered if he and his wife knew what two little boys would do to the place.

Two more cycles, 14 more eggs, still no baby. For my next buy, I followed directions to an expensive neighborhood at the top of the Hollywood Hills. Security cameras focused on me as I parked, catching, humiliatingly, my dirty, 15-year-old car. A maid opened the door. Inside, glass walls revealed a huge swimming pool and stunning views.

I walked down a hall, past a Diane Arbus print that looked real, to where my seller, a wan blond, sat in a light-filled bedroom nursing a very tiny girl. The baby had come a month early, the woman told me; sometimes that happened with older mothers.

“I’m 41. How old are you?” she asked. It was the question, in the doctor’s waiting room, on the infertility bulletin boards I’d compulsively begun to cruise. I’d answer and sense mental gears spinning: She’s even older than me! I’ve still got a chance!

Was I doing IVF, too? the woman continued in a dreamy voice. Too bad. Was I seeing the charismatic senior partner in the fertility clinic? He was fabulous, brilliant; it had taken several tries, but she couldn’t have done this without him, and she was going to do it again, just as soon as she could. She showed me a box full of drugs she’d gotten from Europe — I had no idea how, but they looked legit. I counted out my money, resentfully this time. The house, the view, the $30,000 baby — couldn’t she just give me the stuff in the name of barren-gal solidarity? Apparently not. She dropped the bills in a desk drawer and the maid saw me to the door.

My upper-class drugs failed, too. As a new cycle began, the doctor scanned my ovaries to make sure they were healthy ($150), and asked if I needed a prescription for drugs. “I have my own,” I told her. We’d gone through this before; the one time I mentioned what I was using, she replied, you to do this.”

I got the same line from the nurses who had showed me how to take a one-and-one-half-inch needle and stab myself in the butt. It was a joke, considering that I was finding my illicit, used, cut-price foreign goods through this very office, and I wondered sometimes why my doctor and her partners, who operated a very prosperous, big-league clinic, didn’t worry about being busted themselves. Instead, it was “Don’t ask, don’t tell,” and I suspect the fiction allowed the doctors to feel they were “helping” patients by enabling them to save money. (Of course, it never occurred to them they also could do this by lowering their own prices.)

Just like the desperate crowds in the doctor’s waiting room, the number of notes on the bulletin board never seemed to decrease. “I WILL GIVE SOMEONE THESE LAST FEW AMPS FOR FREE — THEY WORKED!!!” announced one ad, but when I called, they were already gone. Instead, I bought from a 44-year-old Asian would-be screenwriter who lived near a notoriously violent west L.A. housing project and had just lucked into insurance coverage that would pay for future drugs. The house had bars on the windows and scripts on the floor. “I think sometimes, ‘Why did I wait so long to have a baby?'” she said, trying to smile. “But I can’t remember.”

I bought from an Iranian, in her early 40s, whose face was haggard with stress and who would meet me only away from her home, in a cafe. “I give you these because I am done with it all,” she said, handing over a brown paper bag.

“Does your husband help you in your effort to have a child? That’s good. Mine did not. Never gave the shots. Never went to the doctors. He comes from a very traditional family; they told him that since I was barren, he should divorce me and marry a woman who was younger. He did not want to at first, but the trying wears you out. You stop making love. You feel like a failure. I gained 30 pounds and became unattractive. So now we are divorced, and he will find someone else. I have no husband and no child; this is not what I thought my life would be, and I am too tired to care.”

I murmured my sympathies. “No,” she insisted, “it doesn’t matter. I really don’t care.” She reached out suddenly, hugged me and kissed me on both cheeks. “I think these will work for you. You will get what you want. Tell me what happens.” I left her outside the cafe, lighting a cigarette. When her drugs failed too, I couldn’t bear to make the call.

I took some time off from the fertility game after that, and when I returned to the doctor’s office, the for-sale notices had been cleared from the board. When I mentioned my intent to buy in nearby Tijuana, a nurse darkly warned against Mexican drugs, some of which, she said, were proving counterfeit.

In a year, I’d grown paranoid enough to listen. Instead, on a Web site, I found out about a Paris pharmacy that shipped product made in Spain. I faxed a prescription and credit card number, and two weeks later received a carton wrapped in brown paper, bearing the customs declaration “Produits de beauté.” My youth potion.

Sometimes, when I snap the tips off the glass ampuls and mix the white powder inside with water, I wonder if the defeated Indian ever got her donor baby. Have two toddlers trashed that pristine house, and have their parents learned not to care? Did the screenwriter have a child, did the rich white girl manage another, has the brokenhearted Iranian put together a new life? Their phone numbers are gone, and I’ll never know.

Instead, I shoot my new drugs — from Paris, city of lovers, a good omen, right? — and when the needle goes in, I get a high unlike any I’ve felt before. No euphoria or adrenaline rush, but I know that out of sight, my ovaries are charged up, flaring and, like some Fourth of July fireworks finale, sending up everything they’ve got before the show ends for good, and the sky goes dark.

The Veterinarian Brings His Healing Presence to Pets of the Unhoused



The man standing outside the tent on Skid Row in downtown Los Angeles clearly doesn’t live in the neighborhood. Tall and fit, he’s dressed in jeans and a doctor’s blue scrub shirt and carries a medical bag. The tent, one of many rough structures on the stained sidewalk, sits amid heaped wooden pallets, old furniture and trash. But the man’s eyes are fixed on the dog lounging nearby.

“Hi, how are you?” he says when the tent flap opens. “I’m a veterinarian, Dr. Kwane Stewart, and I offer free pet care to people experiencing homelessness.” He gestures at the dog. “Can I examine your pet?” 

First comes confused silence—you’re who?—then suspicion: Is this animal control, here to take my dog? Finally, a slow nod. Stewart, who calls himself the Street Vet, kneels, pulls out his stethoscope and goes to work.

These Skid Row streets hold the nation’s largest concentration of homeless people who are not staying in a shelter, and at first glance it’s an unrelieved landscape of despair: mental illness, poverty, addiction. But love exists, too, including the love of pets. Across the nation, 10 to 25 percent of the people who are homeless keep pets, and there’s no reason to think the number is lower in sunny Los Angeles. Cats sit on sleeping bags, pit bulls, scruffy terriers and mutts trot alongside filled shopping carts, and chihuahuas ride in bicycle baskets and the laps of people who themselves are in wheelchairs. Various local groups and volunteers help the owners of these animals care for them, with weekly and monthly clinics, mobile spay and neuter vans, handouts of flea meds and food. 

Stewart, 50, has usually worked solo, walking the streets and looking for animals and people in need. “Maybe it’s because when I began this work, it wasn’t uncommon to find a pet that had never received care,” he says. “Everyone I met looked at me as if I’d just dropped out of the sky.”

Stewart grew up with dogs, loved them and science, and by the time he was 10 knew he would become a veterinarian. It was an unusual ambition for a Black track star in Albuquerque. Once, a coach asked about his future plans and laughed with disbelief when Kwane told him. “I’ve never met a Black vet,” the coach said. Stewart goes on, “At the time I didn’t think much about it. But here’s the thing: He was Black himself.” Decades later the number of African American veterinarians is still so small the Bureau of Labor Statistics has reported that it might as well be zero. 

Stewart graduated from the University of New Mexico, got his DVM degree from Colorado State University College of Veterinary Medicine and Biomedical Sciences, and headed to San Diego. He spent a decade there treating a suburban clientele with “bottomless bank accounts.” Then, in 2008, he relocated to Modesto, in California’s Central Valley, for a job as the veterinarian for Stanislaus County. And everything changed. 

The Great Recession flattened Modesto, a city of around 200,000, with plummeting home prices and 17 percent unemployment. And when humans go broke, animals often pay the price. Pet surrenders surged until the area’s aging shelter, built for 200 animals, held twice as many, and its euthanasia rate became one of the nation’s highest.

“I was destroying 30 to 50 animals every morning,” Stewart says softly. “Healthy dogs and cats. It was killing my soul. I felt like God was keeping score and I was losing. I didn’t go to school all those years to destroy animals. I wanted to help and save them.”

At first that meant he helped a homeless man he encountered almost daily by treating the man’s dog, which suffered from a bad flea bite allergy. Then he held a free clinic at a local soup kitchen. And then, on his own time, he began to walk around Modesto and some Bay Area sites looking for pets to help. He moved to Los Angeles to serve as chief veterinary officer for the American Humane Association, which makes sure animals are treated well on film sets, and his ramblings shifted to San Diego and Los Angeles. He wore scrubs to identify himself, carried a bag filled with meds, vaccines and syringes, nail trimmers, and he did what he could, free of charge. 

He was stunned by what he found. Like many people, he questioned why homeless people had animals to begin with—if humans couldn’t take care of themselves, how could they be responsible for pets? And yet they were. In fact, numerous academic studies over the years have revealed the vital role pets play in the lives of unhoused men and women—providing structure, purpose, meaning and love. “Researchers have consistently found very high levels of attachments to pets among the homeless,” Leslie Irvine, a sociologist, writes in her 2012 book about the phenomenon, My Dog Always Eats First.

Stewart agrees. “Pets were a lifeline to the people I met,” he says. “Most of them were great pet owners. They did remarkably well with the resources they had, and made sacrifices for them well beyond what you or I would. The bond between them was on a completely different level. They needed each other.”


For five years, his efforts were a kind of secret hobby that he says even his family—he has three children—didn’t know about. Then, in 2017, he and his brother, Ian, produced “The Street Vet” as a reality TV series­—it has aired on broadcast TV in Scandinavia and Eastern Europe and in the States on a Utah cable channel­—and Stewart acknowledges he’s now a “media personality.” These days he’s founding a new veterinary practice in San Diego and writing a book about his experiences on the street.

Last September he started a nonprofit, Project StreetVet, raising money on GoFundMe to cover the cost of treating pet medical problems beyond the scope of a sidewalk exam. He has occasionally volunteered with larger organizations assisting people who are homeless. Though he says “there are probably more efficient ways I could spend my time,” he likes doing it his way. 

“The wound is healing well,” he reassures a man named Ben, whose pet rat had been attacked by a cat. (“I’ve seen birds and snakes, but this was my first rat.”)

“The puppies look great,” he tells Julian, a tattooed man who has lived on the same stretch of pavement for two years and whose dog recently gave birth. (He also vaccinates the pups.) 

Stewart marvels at the generosity of a young man named Reggie, who lives in a school bus and uses his own cash to make lemonade that he gives away to his neighbors. Stewart vaccinates the man’s dog, Daisy. “You’re doing a good job,” Stewart says.

“Oh, this is such a blessing,” the young man replies. 

Most Americans Have Pets. Almost One Third Can’t Afford Their Vet Care

Since mid-2020, more than a thousand low-income families have brought their sick and suffering pets to the nonprofit Pet Support Space, housed in a tiny Los Angeles storefront. One 14-year-old dog had a tumor that a veterinarian had quoted $5,000 to remove. A four-year-old pit bull had been vomiting for days, a cat’s painful bladder stones required surgery, a pug limped from the foxtail embedded in its paw. Skin and ear infections abounded. Neither the animals’ problems nor their owners’ inability to afford help for them was a surprise.

recent nationwide study found almost 28 percent of households with pets experienced barriers to veterinary care, with finances being the most common reason. In low-income households, the researchers found, financial and housing insecurity can increase the risks that animals will not receive the care they need. Sociologist Arnold Arluke, author of Underdogs: Pets, People and Poverty estimates that 66 percent of pets in poverty have never seen a vet at all.

The “why” behind those numbers is complex. Of course, money is the primary problem. Veterinary care is expensive. A majority of practitioners work in for-profit clinics, consolidation in the industry has increased emphasis on profit margins, and vet prices have risen faster than the overall rate of inflation. That has checkups starting at $50, dental cleaning going for $70-$400, and blood work and x-rays at $80-$250. If a dog breaks a leg or eats a sock, surgery costs begin at four figures.

High prices aren’t necessarily about greed. Michael Blackwell, a former Deputy Director of the Center for Veterinary Medicine at the FDA, is the chair of the Access to Veterinary Care Coalition (AVCC) that was formed in 2016 to study this very problem. Veterinary training, he said, teaches vets to practice a “gold standard” of care, which means running every possible diagnostic test and pursuing every treatment option, even when a client’s budget is limited. (Many pet owners don’t know they can decline a recommended procedure, such as blood work, and even fewer are willing to decline care for fear of looking heartless.)

Some private vets offer struggling clients discounts, added Jeremy Prupas, DVM, Chief Veterinarian for the City of Los Angeles, but they themselves carry an average of $150,000 in student loan debt, so they simply “can’t carry the immense existing need on their own.” Telling clients you can’t help them because they have no money is one of the leading causes of burnout in the veterinary profession, according to Prupas. Pet insurance might help defray costs but requires monthly premiums and comes with such a complicated array of deductibles, co-pays, caps, and exclusions that one how-to guide recommends hiring an attorney to review the policy. Credit cards designed for medical care financing, if one can qualify, can carry punishing interest rates as high as 26.99 percent.

Equally critical is a long-term failure on the part of the animal welfare movement to consider, much less prioritize, the needs of low-income pet owners. Since the 1990s, the rescue/humane world has poured vast amounts of funding and energy into cutting shelter euthanasia through adoption, but far less into helping those without money take care of the pets they have. “If you can’t afford an animal,” the thinking went, “then you shouldn’t have one.”

“Until recently, we focused on shelter-centric challenges,” acknowledged Amanda Arrington, senior director of the Humane Society of the United States’s Pets for Life Program, which assists low-income pet owners. “There was a lot of judgment and making determinations on who was or wasn’t deserving of support and resources that was influenced by what I think a lot of society is influenced by, which is classism and racism. We conflated a lack of financial means and access with how much someone loves their pet or desires to care for it.”

In fact, owners can be punished because they can’t afford veterinary care — “most humane neglect cases stem from an inability to get care for a pet,” said Prupas. In Michigan, for example, failing to provide an animal with adequate care, including medical attention, is a misdemeanor that can carry 93 days in jail and/or a fine of up to $1,000. With a second violation, it becomes a felony.

The distorted belief that ‘those people’ don’t care about their pets has never been true.

What exists for pet owners in poverty is a patchwork of low-cost care options, ranging from local efforts — such as Emancipet in Texas and the Philadelphia Animal Welfare Society — to well-funded national enterprises such as Pets for Life, which operates in several dozen cities. The great majority, however, offer only basic services like sterilization, vaccination, and flea treatments. “We are not a full-service veterinary clinic and do not treat sick or injured pets,” warns one low-cost option on its website. Another suggests that needy people travel, since “vets in smaller towns may charge lower fees,” or start a GoFundMe. As a result, many types of care are largely unavailable: emergency care (by some estimates one in three pets will have an emergency need each year), management of chronic conditions such as diabetes or kidney disease, medication, dental care (dental disease affects perhaps 80 percent of older dogs), and the mercy of humane euthanasia (which can run $50-$300).

The final piece of the care gap is a practical and cultural disconnect. Because many economically challenged neighborhoods are “vet deserts,” with few if any practitioners, it’s not easy to find care, and reaching it can require wrangling an unhappy animal over distance and/or arranging private transportation. Keeping an appointment at an office with weekday-only business hours or a once a month clinic can mean losing a day’s pay. Paperwork raises the fear of immigration status inquiries. The veterinary profession also remains one of the country’s whitest: Just as people who feel alienated or unwelcome don’t utilize human health care options, pointed out Arluke, they don’t utilize care for their pets.

The result has been suffering: most directly for animals that remain untreated, die from what vets call “economic euthanasia” (putting an animal down because treatment costs too much), or end up in shelters. Fear of a looming vet bill, and the mistaken belief that all shelter animals receive medical care, is a prime cause of owner surrender.

But people pay, too.

Some sick animals can infect their humans. Roundworms, for example, can pass through contact with pet feces and cause lung, heart, and eye problems. Blackwell reports meeting an optometrist who practices in a low-income Florida community who has seen increasing numbers of children with roundworm larvae in their eyes.

The psychic toll is just as real. Families in poverty who love their pets and for whom “they offer an emotional core and possibly one of the only sources of joy” face “mental and emotional” devastation from the unimaginable choice of weighing that love against potential financial ruin, said Blackwell. Professor Katja M. Guenther, author of The Lives and Deaths of Shelter Animals, called the rupture of an animal-human bond “a kind of community violence” in a 2021 webinar.

Change seems increasingly possible. Covid-19 and the country’s recent racial and economic reckoning has prompted humane organizations to examine their assumptions and biases about who has the “right” to a pet’s love, and, said Arrington, there’s increasing recognition that “racial and economic injustice really impacts animal welfare.” Meanwhile, AlignCare, a new program out of Michael Blackwell’s Program for Pet Health Equity, is trying to create a national model of something like Medicaid for domestic animals. Under the program, families already found to be struggling (because they participate in SNAP or a similar program) and who ask for help at a shelter or veterinary clinic will be signed up and paired with a veterinary social worker or support coordinator. They’ll then be directed to a veterinarian who has agreed to offer preventative, dental, and even critical care, for a reduced fee; AlignCare will pay 80 percent of the cost. After three years of pilot programs in 10 disparate communities, it’s taking on its biggest challenge yet, Los Angeles, where one in five people live in poverty.

AlignCare won’t offer “gold standard” care, instead emphasizing preventative, incremental, and cost-saving measures (such as offering telehealth appointments and limiting diagnostics that won’t change treatment options) when possible. But it will expand the human safety net to include the animals most of us now consider part of our families. And while the effort is currently funded by grants from Maddie’s Fund, the Duffield Foundation, and Petsmart Charities, Blackwell’s goal is “community ownership:” The combined involvement of local vets, city animal services departments, social service agencies, rescue and community organizations, pet food and product manufacturers, and affluent pet owner-donors can make the model self-sustaining.

There is no perfect solution for low-income pet owners who need help accessing veterinary care. But growing awareness of the problem is a big step forward. “What we call ‘animal welfare’ is changing,” said Lori Weise, whose nonprofit, Downtown Dog Rescue, runs the Pet Support Space. “The distorted belief that ‘those people’ don’t care about their pets has never been true. People can’t afford care. Sometimes they don’t even know what’s out there; they themselves have never been in a hospital. As more people are brought into the system, we’ll see the first generation to get proper veterinary care.”