From personal first-hand experience and extensive research, I concluded that Dr. First had many inadvertent “accomplices” that could have stopped or slowed his 20-year transformation from respected oral surgeon to madman. I also learned that many doctors are operating in similar shadows – not just in Florida but across the country – due to the programs that can over-protect impaired physicians and their licenses while keeping patients in the dark.

To put it another way, you never really know who’s behind that medical license or scalpel about to make an incision. Doing your homework on doctors you’re considering or seeing is naturally advisable, but some frightening “blemishes” on their records may never be apparent or publicly disclosed. Ben’s deranged behavior reached epic proportions yet none of it stopped him from returning to operating on people’s faces.

The state’s PRN program is designed to give doctors a confidential way to “self-report” drug and alcohol addictions or other impairments. It also translates into effectively distancing those problematic doctors from those who decide – a medical board largely consisting of doctors – whether they are fit to continue practicing. In one sense, it’s a way for physicians to “pay” to get their fix.

Some push back and feel they are unjustifiably forced into PRN-type programs, which are now in almost every state. A lot of the related media coverage reflects this perceived injustice, with physicians often complaining about extortion and paying what they consider exorbitant participation fees. Numerous law firms also tout these alleged downsides while offering their services to protect doctors from the programs created to help them combat addiction and mental health issues.

Interestingly, it’s not unusual for state authorities to cite license retention statistics of physicians in the programs as evidence of effectiveness. As a result of Dr. First’s participation in Florida’s PRN program, he was able to retain a medical license the entire time he practiced, which theoretically categorized him among the thousands of success stories.

Administrators apparently recognize the need for more definitive insights and statistics over the many years of existence for these programs. Florida’s program for impaired physicians began in 1985, and the takeaways from a somewhat recent annual PRN conference underscored the importance of better data collection and analysis. Tracking is difficult, particularly considering that the individual physician recovery plans and monitoring are administered independently through qualified contractors approved by the state.

It’s not that these programs don’t do any good. It’s just that they can do way too much good for physicians who are questionable for far too long.

I reached out to the communications contacts for Florida Health and other state agencies to specifically learn why someone like Dr. First wasn’t prohibited from practicing, considering all the damning publicly available information about him. After first being told my inquiry got lost in an inter-departmental shuffle of my emails and phone calls, I eventually learned that no one wanted to – or would – comment. I eventually contacted Governor DeSantis’ office to explain that all the other communications contacts stonewalled me. Not surprisingly, they did, too.

My emphasis was on whether any effort was being made to improve PRN because of misfit examples like Dr. First. Oversights by law enforcement and the criminal justice system further enabled his vicious side.

When I didn’t know or didn’t believe my friend was brutalizing women and destined to do even worse, I was set on helping him. I felt he deserved companionship and an ear willing to listen. No one else was doing much of that as he went to jail and drifted around, while always returning to shuck teeth.

I didn’t blame friends or family for keeping their distance from Ben, nor did I encourage anyone to engage or take pity on him when I thought he was at his worst. I hate to even say how well we normally got along. I felt confident that I was doing the right thing, especially since authorities were continuously letting Dr. First slide – or slip through cracks the state should seal.

More can and should be done to prevent such travesties. I’m sure other physicians with similar dysfunctions are already out there practicing, perhaps even worse now or yet to come. State programs nationwide often enable doctors to preserve their medical licenses while providing resources that can support their recovery from severe issues such as drug, alcohol and sex addictions. Unfortunately, these programs can come up woefully short regarding their other purpose: to protect patients and public safety.

Determined to make a difference
In November 2021, I sold my stake in a tech marketing communications and media relations company I co-founded and operated for 15 years – to return to my journalism roots. It was time to delve into all that went wrong with and around my friend Ben, who would occasionally end phone conversations with words like, “I love you, Chuck. No one has ever been a better friend.”

A couple of days prior to learning the news about Ben’s murder-suicide, I had left a voicemail asking him when we could get together again. As always, I left a cheerful message. We hadn’t spoken for a couple of weeks, which was unusual. I assumed his renewed maxillofacial runway remained intact and that his live-in relationship was working out. He’d been together with Laurese a few months by then. Ben was divorced after 17 years of devotion-less union, and she was separated and in the process of divorce from an even longer marriage.

I was sickened by the early-morning call from Mary, Ben’s wife, on June 5, 2019, notifying me of Ben’s death and murder victim. Since Mary was no longer married to him, she had to deal with the police coming to her house and asking to speak with the three now-adult sons living there. “I thought I’d someday hear he died of a drug overdose,” their eldest son, Jared, said. “The murder part was what shocked me. She was a nice lady.”

Laurese had been a patient of Dr. First’s several years before seeking treatment in 2018 for daughter Jess, one of her five adult children. I don’t think Dr. First remembered Laurese from hundreds of others he’d operated on, as she and Jess met him for consultation at his New Port Richey office.  

“He listened thoroughly and pointed out some important things on x-rays that other surgeons had missed,” Jess recently recalled about that initial visit. “He exuded confidence, making me as well as my mom feel comfortable – and promised to give us a good deal, which he did.”

They didn’t know the destitute doctor slept nights in the dental chair in an adjacent room.

It was also surprising to Jess when she ran into Dr. First at her mother’s condo a couple of weeks later, cracking a joke upon seeing him: “Hey, dude, what’s up? Are you telling me you make house calls?!”

Ringing in a year of tragedy
Soon after Ben introduced my wife and I to Laurese, we picked them up the evening of December 31, 2018, for a New Year’s Eve party nearby. They were waiting outside the East Lake Woodlands condo she leased from her mother. It’s where my friend would kill her six months later.

Laurese was hugging Ben when we arrived and throughout the night. I felt things were progressing too rapidly between them. My friend didn’t typically attach himself emotionally or physically. He also wasn’t normally into public displays of affection. After a few drinks, he seemed comfortable and happy enough, dancing the night away.

Ben moved in with Laurese a couple of weeks later. Among other unsettling actions, he soon changed the door locks on the condo belonging to her mother.

Uncharacteristically, I questioned my friend’s motives for accepting Laurese’s invitation to live with her. I felt an underlying sense of wanting to protect this kind woman’s affections from Dr. First, because I didn’t think he could care enough about any woman, let alone such a new acquaintance. At 52, she was also a year older than Ben, and I knew he typically sought much younger companions.

I accused Ben of taking advantage of Laurese, saying he “didn’t want to sleep in dental chairs anymore.” My friend, furious, argued that I didn’t know how he felt – and that it was none of my business. While Ben’s moods could instantly turn from jovial to combative, we usually ended evenings on a good note. It wasn’t possible that night.

By this time, Dr. First was independently practicing again with a staff of several assistants and an office manager, yet still unable to afford his own place to live. The bankrupt doctor’s credit history was god-awful yet trivial compared to his record of felony domestic violence charges.