ONCE A HERO

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If what Najarian was doing was so wrong, his supporters ask, why did the FDA and the university wait so long to act? "The paper work [required by the FDA] didn't get done," observes transplant surgeon David Sutherland, Najarian's longtime colleague. "But the paper work hadn't been getting done for more than 20 years." Moreover, the sale and success of alg were never a secret. From the beginning, says University of Minnesota medical historian Leonard Wilson, Najarian told the FDA that he intended to produce the drug for more than his own use. Says Wilson: "The FDA would have to be deaf and blind not to know what was going on."

Fellow transplant surgeons speculate that the FDA crackdown may have been triggered by complaints from commercial drug companies. These companies, the thinking goes, were annoyed that their university-based competitor was selling an experimental drug as if it had been approved for full marketing. Or it may be that regulators, who sent letters to Najarian complaining of infractions, were unwilling to cut off the supply of a drug that filled such a desperate need. Whatever the reason, by the time the fda barred ALG production in 1992, two drugs capable of taking its place had come on the market. "We're using the alternatives now," says Sutherland, "and it's a good thing they're there."

As long as ALG remained the central issue, Najarian's defenders could claim he had done nothing more immoral than run afoul of federal bureaucrats. But earlier this year, university officials disclosed irregularities in the surgery department's handling of federal grant money, including apparent diversions of funds to support the ALG program. Investigators also released documents suggesting that Najarian sometimes cheated on his expense accounts. Seven years ago, for instance, he allegedly asked the corporate sponsor of a conference held in Stockholm to reimburse him for $4,122 in travel charges after submitting a bill to the university claiming a similar amount.

The surgeon's defenders argue that whatever mistakes he made, they were not the product of greed. Though Najarian earned as much as $600,000 a year and liked to fly first class, he shunned ostentatious cars and sent all his children to Minneapolis public schools. "My father could have made millions of dollars a year as a surgeon for the rich and famous," observes Jon Najarian, the eldest of four sons. "But it was never his goal to make millions of dollars. It was his goal to help people."

While Najarian may not have been greedy, he was certainly ambitious. He saw himself, says a former colleague, as a pacesetter who was moving the field of transplant surgery forward, someone who couldn't be bothered with the details of the rules because he was changing the rules. And while Najarian is a personable man who enjoys chatting with patients, he's also an opinionated, imposing figure who can intimidate friends and foes without even trying. University president Hasselmo sees Najarian's situation as "a tragedy in the classic sense. It's the story of a hero who is destroyed by arrogance."