Anthony agreed with Sobek that his invention might sound “too science fiction” to the layman, but it was commonplace for him. He described the surgery in which his father had implanted the four titanium bolts into the top of his skull. The snaps would never need maintenance, and the hairpiece should last about four years. The initial investment was $4,000, and Dr. Pignataro said he had already done about a hundred of the procedures for men from all across America who had flown into his West Seneca clinic.
The AP story that appeared in most papers around the world caught the interest of all forms of media. Anthony and his invention were mentioned on CBS Nightly News and by Tom Brokaw. GQ and Esquire had short articles on the lifetime hairpiece system. He appeared on the Maury Povich Show and on Hard Copy. Anthony Pignataro was finally enjoying the public attention and the accolades he had wanted for so long. The only place he felt he didn’t get enough press was Buffalo. His contribution to bald men—and women—was widely accepted.
Money rolled in.
Anthony had another favorite project, which he had been working on since 1994. He envisioned a kind of bra that would fit under the skin of the breasts. Not all the women who came to see him needed breast implants; some were suffering only from the pull of gravity. Mastopexy (a breast-lift) worked, but Anthony wasn’t happy with the scarring that often resulted.
His answer was his invisible bra, a concept that he tested on female corpses in a medical school anatomy lab. His test subjects could not complain if the under-skin brassieres should prove to be uncomfortable.
“Several materials were tested,” he wrote in his book. “Ultra-thin silicone sheeting seemed to have all the right qualities. Though not originally patented this way, a thin, lightweight underwire of implantable titanium forms the framework for implantation below the breast. Multiple devices, such as screws, metal sutures, and anchor were already approved and in use.”
Again, he referred to himself in the third person but quickly slipped back into using “I”:
“Anthony would never see those clinical trials [of the inner brassiere]. I would be remiss if I did not recognize the personnel of the local anatomy laboratory, who provided invaluable assistance to my research. Innumerable hours were spent working with different materials, methods, and cadavers, with surgery going into the late-night hours. They were always accommodating. Without such perdurable assistance, the entire endeavor may never have been possible. This research had consumed him [me].”
But this was one invention he could not test on himself, and it didn’t sound all that comfortable. He put off testing it on a human being. He had, however, progressed to doing breast implants and lifts in his basement surgery. Business was good: men flew into West Seneca to have bolts implanted in their skulls, and women arrived to have breast augmentation.
Anthony believed in advertising and marketing. His was a service like any other business. Why should doctors be so hesitant to compete for business?
Anthony saw everyone he met as a potential patient, and he wasn’t shy about approaching them. He gained several patients at the sports club he frequented. He took before-and-after pictures of his breast enhancement patients and showed them naked on the Internet. He advertised his hair replacement system in the sports section of local papers, figuring all men would see them there.
Probably his most unusual and innovative approach was to convince a Buffalo radio station to award a free breast enlargement to the winner of a contest. Anthony offered free consultations to the finalists: the contestants went on the air to tell why they needed their breasts enlarged, and Anthony explained what would transpire in the consultations and offered his easy-pay financial plan for those who didn’t win.
As fate would have it, the woman who won never had the surgery, and it may have been a fortunate thing that she hesitated for so long.
One of Anthony’s many out-of-state patients was a woman from Virginia. Her name was Moira* and she was an “exotic dancer” in polite terms but a “stripper” in reality. Her chosen career demanded full and nondrooping breasts. She came to Anthony for her surgery. He found her stunning as she was, and irresistible after he inserted saline implants that increased her bust by two cup sizes. In a way, he felt like her Pygmalion.
Moira was an attractive if bizarre-looking woman. She had a tattoo on her back from the nape of her neck to below her waist. Anthony had always favored anything that smacked of the upper class—private schools, country clubs, exclusive restaurants, and fine cars—but he quickly became besotted with Moira. She was different from any woman he had ever known.
Moira was delighted with her surgery and appreciated Anthony as her doctor, but she wasn’t initially attracted to this married man with the strange—if well-fitting—toupee.
Anthony pursued Moira for a year, only tantalized by her coyness. He bought a new car, a red Lamborghini, and he lavished gifts on Moira.
Debbie had no idea that Moira existed.
7
By 1996, Anthony was not only a faithless husband but an oblivious father. Debbie knew that he had never learned how to be a father; Dr. Ralph had always been working when Anthony was growing up. Anything Anthony learned about playing ball or sports he learned from the elder Pignataros’ neighbors. The family pattern was repeating itself. Anthony had no time for Ralph or Lauren.
“He wasn’t what I’d call a ‘hands-on father.’ He grew so cold,” Debbie recalled. “There was no love or affection for me—or for the kids.”
But Anthony had never been known for his warmth. Debbie thought his removed attitude was due to his involvement in his practice. Ralph was almost 10, and Lauren was 7. They were very nice, smart kids. They didn’t lack for things that money could buy. They were attending the Nichols School, the exclusive private school Anthony had gone to when he was a boy. Debbie drove them to all their extracurricular activities. Lauren studied gymnastics, and Ralph was active in sports—ice hockey in the winter and football in the autumn. He was a natural. Aside from bragging about his children’s victories, Anthony didn’t seem to care about their daily lives. His eyes clouded over with disinterest when Debbie tried to share their experiences with him.
He continued to express his temper when he didn’t get his way. On June 15, 1996, he was driving his Jeep in Depew, New York, when he cut off a Pontiac Firebird driven by a woman from Cheektowaga, New York, forcing her to the shoulder of the road. When both cars stopped for a red light on Transit and Broadway, a male passenger from the Firebird got out and confronted Anthony, who claimed later that the man had hit him in the face several times.
Anthony grabbed the .380 caliber handgun that he always carried with him, walked over to the car, and fired one shot at the Firebird. Fortunately, neither occupant was hit. Still outraged, Anthony called the police from the nearby home of a patient. He was arrested on charges of reckless endangerment and discharging a firearm.
“Maybe I was right—maybe I was wrong—for shooting at him,” Anthony said. “But when you get punched in the face…I was only protecting myself. I didn’t shoot at him. I could have easily got him, but I just shot to scare him off.”
The reckless endangerment charge was dropped, but Anthony lost his pistol permit for a year: harsh punishment for a man who loved guns and hunting.
It was one more humiliation for Debbie, but she swept it under her conscious mind, where she had swept so many other disturbing incidents.
By now, Debbie didn’t resent being virtually a single parent; she loved being with her children. But she began to have health problems that made it difficult for her to be responsible for everything around the house. During one of their trips to Florida to spend time with Anthony’s brothers, she was injured in a boating accident. Antoinette’s then husband, Allan Steinberg, was driving the boat while Debbie held Lauren and Anthony held Ralph. When Allan had to swerve suddenly, Debbie pitched toward the deck. “I could have broken my fall if I’d let go of Lauren, but she would have been hurt, so I held on to her and hit so
hard that I broke my ribs,” she said. “But there was more damage to my neck. In the three years between 1996 and 1999, I had to have five surgeries on herniated cervical disks to stabilize my neck.”
Anthony ignored her pain. “We were hardly speaking to each other,” Debbie remembered. “He was just never there. Not for me and not for the kids.”
Debbie’s neck injuries were extremely painful, and her orthopedist prescribed painkillers. When she needed them, however, she noticed that there were far fewer in the container than there should have been. There was only one explanation: Anthony was taking them.
At that point, a more sophisticated wife than Debbie Pignataro might have recognized the classic signs that her husband was having an affair. His new red sports car was one, and the frequency of trips away from home was another. His obsession with his own appearance increased. He’d already had his nose reshaped with plastic surgery, but now he got cheek implants. He had eye surgery to correct his vision, and he bought the most expensive toupees. All were indications that Anthony was trying to impress someone—but not Debbie.
“After winning several collegiate boxing tournaments,” Anthony wrote in his book in his odd third-person voice, “the doctor was very principled in the virtues of exercise and diet. His medical school education served to reinforce his commitment to personal training. He often referred to exercise as a form of mental therapy. Medical science has proposed the ‘endorphin theory.’ To Dr. Pignataro, this was not [just] a theory…He struggled to find the time to work out. He would skip his lunch break to make it to the gym four or five times a week.”
In truth, not all of Anthony’s habits were healthy. He drank pitchers of tequila margaritas, and he sometimes seemed so out of touch that Debbie wondered if he might be on drugs—more drugs than the pills missing from her own prescription vials. Certainly, he was working very hard, and he had a lot on his mind—far more than she realized. He had to do some fancy time-planning to keep enlarging his practice, to preserve his sacred Wednesdays for research and invention, and to allow ample time to court the elusive Moira. Often, he came home only to sit in his recliner and drink until he fell asleep.
Debbie, who had weighed 110 pounds when they were married, had gradually put on about 40 pounds. It didn’t seem to matter whether she dieted or not; Anthony would always find something to ridicule about the way she looked.
When Debbie was recovering after one of her neck surgeries, she was given steroids that made her face puffy. Anthony stared at her and said, “Look at you. Who would want you?”
Little by little, he wore down her belief in herself. Even so, she kept trying harder to please him and make his life more comfortable.
Things got worse in the spring of 1996. They could both see that Anthony’s father wasn’t well. As Anthony himself wrote—back in his third-person voice: “The doctor’s world began to crumble.”
Dr. Ralph Pignataro had always been brilliant and sharp, Anthony’s example and hero, the one person whom Anthony continually tried to impress. He was the man who had never had time for his son until Anthony, too, was a physician. In a sense, he defined Anthony’s world. While Anthony’s mother had pampered him, his father was the god he never quite lived up to. But given enough time, he was sure that his father would be astounded by what he could do. His father was the audience Anthony played to, and it was Dr. Ralph’s ultimate approval that would assure Anthony that he was finally a man and a doctor of great excellence.
That was not to be. Gradually, the family had to acknowledge that Dr. Ralph was often confused, fumbling for words, and forgetting things that had been second nature to him. He had always possessed a mind fully capable of handling myriad details. Now, they realized that he was trying to hide his symptoms, which had become so profound that they could no longer be concealed. An MRI scan showed what Anthony had feared: his father had a large tumor in the frontal lobe of his brain. Always a very heavy smoker, Dr. Ralph also had many tumors in his lungs and liver. Buffalo area specialists gave him six months to live.
Anthony researched all the advanced treatments for the type of cancer from which his father suffered. He took charge and strongly recommended that his father travel at once to Houston for treatment. Dr. Ralph refused. He knew that he had only months to live, and he wanted to spend them in Buffalo with his family, doing the things he loved best.
In Anthony’s view of an idyllic world, he had always planned to return to Buffalo as a physician and to work side by side with his father for decades. Now, he blamed a cruel fate that would rob him of his father only four years after his homecoming. He hadn’t let the imminent death of Debbie’s father disturb his first day of hunting season, but now he beat his breast and cried, “Why me?”
And it was “Why me?” and not “Why my father?” In Anthony’s narcissistic world, every event was important only as it affected him. For Anthony saw himself as the center of the world, with other people spinning around him, ready to answer his needs. Any human consumed with such raging self-love is difficult to deal with; a physician who thinks only of himself is a disaster on the way to happen.
A month after his father was diagnosed, Anthony inserted breast implants into a patient and told her she would need Demerol for postoperative pain. He wrote a prescription for a hundred 50-milligram tablets and sent her husband to a drugstore to get it filled. The worried husband rushed to get the painkiller and gave it to Anthony. But the patient never got any of the Demerol. Anthony kept it, apparently for his own use.
Dr. Ralph Pignataro died on November 23, 1996. There was no Thanksgiving for the Pignataros that year. Dr. Ralph was only 62. He left behind his family and the patients he had served well over the preceding thirty-five years. Anthony announced that a piece of himself had died along with his father. But he added that his father had taught him to be strong and accept the reality of life, often advising him, “The dead are best left in the past. One can never forget, but one must move on.”
Anthony moved on.
After conducting a year-long campaign to convince Moira to go away with him, Anthony finally persuaded her to join him on a trip to Puerto Rico. He planned to set up a hair clinic there. The wealthy and the bald could get bolts and snaps in their heads or hair transplants in an exotic setting, combining recovery with a vacation. Labor would be cheaper for Anthony, too.
The Friday night before he left, Anthony was an uncharacteristically attentive father. He took Debbie, Ralph, and Lauren to the Erie County Fair. They all had a good time. It was the kind of family occasion that Debbie had always longed for. They had so much fun that she wondered whether things could work out for them.
The next morning, she drove Anthony to the airport and kissed him goodbye as he headed to New York City to catch his plane to Puerto Rico. He gave her the number of the hotel where he would be staying as he worked out the details on the new hair clinic. But Anthony wasn’t alone as he boarded the Puerto Rico flight. He and Moira flew south together.
Debbie stayed home, unaware that her husband’s trip was anything more than a business venture.
Debbie was faithful and supportive. She wasn’t particularly assertive, and she was long-suffering, living with a man who could be totally charming to his patients and potential patients and mean and critical at home. Now, he often compared her unfavorably with other women they saw.
Long-suffering, yes, but Debbie was not saintly, and she certainly wasn’t stupid. She placed a call to the hotel in Puerto Rico where Anthony was staying to ask about his flight. She was startled when a woman’s voice came on the line.
“Who is this?” Debbie asked.
“Moira.”
At first, Debbie thought she might have the wrong room, but she asked for Anthony anyway, and the woman didn’t think very fast.
“He’s not here right now—”
“Who are you and what are you doing in my husband’s room?” Debbie pressed.
“I’m…er…a model. Dr. Pignataro did my breasts.”
> But Anthony wasn’t in Puerto Rico for a breast clinic; he was supposed to be there for a hair clinic. A familiar sick feeling rolled over Debbie. She remembered the woman who had left evidence in their car in Maryland. She reacted like a mother tiger whose young are threatened, shocking herself with her vehemence.
Debbie’s voice had an edge of steel. “Well, tell him his wife called,” she began. “And I don’t know who you are, but if you ever come near him or my family, I’ll fucking kill you! Now get out of my husband’s room!”
A long time later, Debbie recalled that Moira packed her suitcase and literally ran from the Puerto Rican hotel.
“I went to Anthony’s office in West Seneca, and I asked his secretary if she knew anything about some woman named Moira,” Debbie said. “She knew, all right. She knew all about her.”
Panicked when he heard that Debbie knew about Moira, Anthony tried to get Debbie on the phone all day. When he finally succeeded, he begged her to fly down to Puerto Rico. “Please come down, Deb,” he pleaded, “so we can try to save our marriage.”
Debbie booked a flight to Puerto Rico. Once again, Anthony was chastened and frightened by her anger. He rushed out and bought her an expensive pair of diamond earrings, thinking that he could smooth over his infidelity with money.
But this time, Frank Rago was gone and so was Dr. RalPh. Debbie had taken her father’s advice the first time, and she had forgiven Anthony once, but that was all her father made her promise to do. This time, it wouldn’t be easy to forgive—or forget.
Debbie didn’t leave Anthony. She would honestly admit that she still loved him, even though she would never again really trust him. They’d been together for almost twenty years, and she had two children who deserved a good life with two parents.