When Harvey Daniels, trim and broad-shouldered in a V-neck tee, walks into the one-room office with views of Biscayne Bay, the IV bag is already waiting for him. Its liquid a shade of amber, the bag dangles from a chain hooked to the ceiling.
Dr. Ivan Rusilko stands from behind a silver desk. Instead of a white lab coat, he wears sneakers, jeans, and a tight-fitting shirt that shows off his muscular build and tattooed forearms.
Doctor and patient chat while Daniels settles into a swiveling leather chair below the IV bag, and Rusilko pokes his arm in search of a vein. Finding one, he inserts a needle. Daniels doesn't flinch.
Soon the concoction begins to drip down a tube into Daniels' arm while Rusilko ticks off the ingredients: vitamin C, magnesium, vitamin B12.
"Bring it on," Daniels says, chuckling. "The more, the better."
Fresh off a jaunt to Mykonos, the vice president at Sotheby's International Realty had opted for Rusilko's biggest bag. It had been weeks since he'd last had an IV, and without them, he was feeling tired and rundown.
Now, sitting in Rusilko's black-, white-, and red-accented office in Sunset Harbour, he says he can actually taste the vitamins in the back of his throat. He already feels better.
Long a symbol of serious illness and hated hospital stays, IV drips in recent years have become a kind of status symbol. Celebrities and wealthy partiers spend small fortunes curing hangovers, fighting colds, and boosting energy with needles in their arms.
"We got nufffffin but love and vittys in our veinzzzz #vitaminpush," Miley Cyrus wrote below an April 2015 Instagram photo of herself making a face at the camera while an IV fed vitamins into her arm. Sofia Vergara reportedly had an "IV station" at her three-day wedding bash at the Breakers in Palm Beach in November 2015. "I thought somebody had had a heart attack because there was this first-aid truck set up outside of the pool area where all the bungalows are," Vergara's Modern Family costar Julie Bowen told Ellen DeGeneres. "And there were people sipping espresso getting IV rehydration... Apparently, there's nothing you can do in three days that can't be undone by some IV hydration!"
In South Florida, more than a dozen companies now offer IV therapy. For some, like the luxe MIAMI Institute inside the Four Seasons hotel, it's part of a menu of aesthetic medical treatments. For others, such as Hydrate Medical, a mobile clinic that deploys nurses to homes and hotels across the region, IVs are the only thing on the menu. They cost anywhere from $99 to $300 apiece.
At the forefront of the craze is Rusilko. An osteopathic doctor, bodybuilder, and former model who pens erotic novels about himself, the 32-year-old Miami Beach transplant has built a business on the belief that good looks and good health go together. From his office in "the sexiest city in the world," the fast-talking doctor administers IV therapy alongside booster shots and hormone replacement — controversial treatments he believes really work. He says he can mix IVs for just about anything you need: anti-aging, better sex, higher energy, thicker hair, fat loss, and reduced anxiety. "You come in, you tell me what you want," Rusilko says, "and I make it for you."
Yet others in the medical community say IV vitamin infusions are a scam. They typically are not covered by insurance. Few regulations govern their use, and no scientific evidence backs claims they boost energy or extend youth. There's no reason to undergo such an expensive, medically invasive procedure, critics say.
"It's the latest snake oil off the huckster's cart," says Dr. David Katz, director of Yale University's Prevention Research Center. "It's not the first; it won't be the last — something else will replace it soon. But it slices, it dices, you can leap tall buildings in a single bound. It's terrific, except that we know none of this, and we just made it all up."
The elderly woman was in the throes of cholera, severely dehydrated and near death. Dr. Thomas Latta worried he was too late. "Indeed," the young general practitioner later wrote, "so entirely was she reduced that I feared I should be unable to get my apparatus ready, ere she expire."
Still, he inserted a tube into a vein in her arm and injected "ounce after ounce" of saline fluid. At first nothing happened. But then her breathing became easier, her face began to glow, and her pulse returned. Soon she "became jocular and fancied that all she needed was a little sleep," Latta wrote.
The year was 1832, and the British physician had just performed the first-ever intravenous injection of saline fluids, which he described in a letter to London's Central Board of Health. Though Latta's first patient later died (because the treatment was not repeated, he surmised), his second survived and "in forty-eight hours, she smoked her pipe free from distemper."
The first documented intravenous infusion dates to 1492, according to a paper in Acta Anæsthesiologica Belgica. A doctor caring for Pope Innocent VIII, who was comatose after suffering a stroke, provided an infusion of blood from three healthy boys. All four died.
In the 1660s, doctors injected the blood of "quiet" lambs into the bloodstreams of troubled patients. A French physician named Jean Baptiste Denis successfully transferred nine ounces of lamb's blood into a teenage boy in 1667, but subsequent treatments caused a reaction. Other patients died after being injected with animal blood, prompting the French parliament to ban the practice in 1687.
It was the cholera epidemic of 1831, which claimed thousands of lives in cities across Europe, that ultimately led to advances in IV therapy. Latta's treatment was the forerunner to normal saline, which would become commonplace in hospitals more than a century later.
Hospitals used IV therapy for transfusions, hydration, and delivering nutrients to those unable to take them orally. But a Baltimore physician thought it could do more. In the early 1960s, John Myers began giving patients vitamins and minerals intravenously as part of treatment plans for a host of medical problems.
A mix of magnesium chloride, vitamins B6 and B12, vitamin C, and other ingredients, the treatment was dubbed the Myers cocktail. After Myers died in 1984, Dr. Alan Gaby began administering the cocktails to the late physician's patients. In 2002, he praised it in a paper for the Alternate Medical Review.
"Chronic problems such as fatigue, depression, chest pain, or palpitation were well controlled by these treatments; however, the problems would recur if the patients went too long without an injection," Gaby wrote.
At the time, he estimated, around 1,000 U.S. doctors were giving patients infusions of vitamins and minerals. That number was about to grow. An emergency-room physician in Arizona, Dr. Johnny Parvani, claims to have noticed some patients who came to the ER could benefit from just an IV — and not necessarily in a hospital setting. "You see people doing this day in and day out in the medical field," he says. "There was always the thought of, Why can't we offer this to the general public?"
In summer 2012, Parvani and three other ER docs opened Reviv, offering a menu of $99-plus IV treatments in a spa-like setting complete with massage chairs and iPads. They chose South Beach for the company's first location, believing the city's party crowd would flock to the hangover fix. But they were surprised to discover that their "wellness" IVs — designed to flush out toxins, replenish minerals and vitamins, and boost the immune system — had a wider appeal.
"It really helps hydrate people, keep people healthy, and help them be more productive," says Parvani, who runs the business from Arizona and has branches around the world. "And so what we are seeing is that a lot of people are incorporating this into their lifestyle, almost like a set routine, just as you would go to a gym."
Around the same time, Dr. Jason Burke, an anesthesiologist, launched Hangover Heaven and began roving the streets of Las Vegas in a tricked-out bus, plying burnt-out partiers with intravenous vitamins.
The New York Times reported in July 2013: "Celebrities — particularly touring rock stars like Rihanna and Madonna, reportedly — have long ducked into private medical offices for IV fluids, B12, and glutathione shots, fed directly into the bloodstream, bypassing pesky digestion to rehydrate, dispel toxins, and balance the skin. Now, a smattering of IV 'bars' and 'cafes' are looking to render this once alternative medical treatment as de rigueur as a manicure."
Many in the medical field were skeptical. But for some with the cash to afford them, routine IVs were becoming part of staying healthy. (Insurance generally doesn't cover the expense.)
When nightlife impresario Chris Paciello opened Club Essentia, a "wellness retreat" in the penthouse atop the Delano hotel in winter 2013, custom-mixed infusions were among its offerings. Also available were hyperbaric chambers, hormone replacement, and "vampire lifts," which use plasma from a patient's blood. Well-dressed Miami Beachers mingled on the hotel's rooftop for the grand-opening party, clutching flutes of champagne. IV bags full of clear liquid hung beside the bar.
Paciello, who pleaded guilty to committing murder and armed robbery in 2000, grinned for photos with his partner in the venture: a young, tattooed osteopathic physician who had long thought traditional medicine focused too much on staving off death and too little on enhancing life.
The woman, blond and attractive in middle age, lies in a reclining chair. She wears a white robe that barely covers her shoulders and leaves her breasts exposed. Rusilko, wearing blue latex gloves, sits between her bent knees and asks if she is ready. She nods, peering down as he gives her an injection he promises will make her next orgasm 1,000 times better than the best she's ever had.
Earlier, when Rusilko asked about her orgasms, she'd quipped, "There's not much to describe, honestly," and laughed dryly. The treatment Rusilko had given her, the "O-shot," would increase vaginal blood flow and "engorgement," he said, making her feel 20 years old again.
"By the time I'm done with you," he told her, "you're going to come harder and harder... Fucking fireworks are going to be shooting out of your pussy."
The procedure was set up — and sexed up — for a film crew. The patient was actually an actress. It was created for the pilot of a potential television show about Rusilko, which he showed to a New Times reporter. As a sex scene flashed across the screen, he strummed his white guitar.
IV therapy has been a way for Rusilko to marry two longtime passions: personal aesthetics and medicine, which is the family business. For him, the controversial procedure pushes medical boundaries — and also gives him ready access to South Beach's beautiful people and celebrity culture.
"I think he knew he didn't want to be in a position where he was going to do the same thing every day in an office," says his mom, Susan Rusilko. "He likes to do new things and always be reading and researching. He really loves medicine, loves fitness, loves health, and, you know, wants to try to live the best possible life he can and encourage others."
So, soon after graduating from medical school, he ditched traditional medicine and developed his own take on the discipline, which he says centers on exercise and dieting, as well as "cutting-edge" treatments such as injections, hormone replacement, and IV therapy.
He calls it lifestyle medicine. "I tell everybody traditional medicine is more about the prolongation of death, whereas lifestyle medicine, or what I do, is more about the augmentation of your life," he says.
Rusilko jokes that he still doesn't know if he wants to be a doctor. He's vocal about his disdain for certain aspects of the profession: the "God complex" that can come with a white coat, and the overreliance on protocol and prescription medication.
But growing up, he pretty much always knew he'd do something in medicine. His dad was a chiropractor. His mom had a degree in psychology. Both are from Pennsylvania; they met in college and married a year after graduation.
Matthew Ivan Rusilko was the couple's second child, born four years after Paul and three years before Cathryn. They were raised in Meadville, Pennsylvania, a city of 13,000 about an hour-and-a-half north of Pittsburgh. Set at the foot of the Allegheny Mountains, Meadville is lush and green, and very small. Most teenagers occupy themselves with hunting and fishing. "I don't know a kid here that doesn't go out on the first day of deer season," his mother says.
Rusilko, who was shy as a child, was no exception. He loved being in the woods. He also found another way to pass the time: bodybuilding. His dad had always been into weightlifting and training and taught his son how to stay fit, and from a young age, Rusilko's hockey friends would hang out in the family's basement gym, where he would pass on what he'd learned from Dad.
"They'd come over and say, 'How many pushups? What should I do?'?" his mom recalls.
At Meadville Area Senior High School, both Rusilko and his brother were standout hockey players. At age 17, Rusilko says, he even considered a professional career. But when his dad told him he'd been accepted into an accelerated medical program at Mercyhurst University in nearby Erie, he went that route instead. "Your gut knows where to go," he says.
He graduated from Mercyhurst in 2005 and then started at Lake Erie College of Osteopathic Medicine. Along the way, he stumbled into modeling after an agency came across online photos of him from a bodybuilding competition.
That led to an invitation to participate in Mister USA ("I never tried to do this stuff," Rusilko says. "I just fell into it.") "He kind of laughed it off at first, then thought, You know what? Everything is an opportunity," Susan Rusilko says.
The fledgling competition was held in Boston and featured eight contestants who performed dance numbers, strutted down a stage in evening wear, flexed their muscles in skimpy swimsuits, and answered questions. (Rusilko on why it's important to stay in shape: "Why drive a Pinto when you could drive a Ferrari?") He ended up winning. "I was sitting there, I was like, 'Oh, really?' I fucking won."
He spent the next year jetting off to events around the world. Mr. International 2008 was held in Taiwan. Rusilko made the top 15, but Vietnam's Ngo Tien Doan was crowned the winner. It was back to school for Rusilko.
After graduating with his doctor of osteopathic medicine degree in 2010, Rusilko began a residency in Miami. But he left after six months when his dad had a health issue, he says. He won Mister USA a second time (losing the international title to a Brit) and then spent another six months in a rotating internship. He'd been thinking about something that had struck him during his pageant stints.
"When it came to a certain demographic of individuals, everybody had the same complaints," he recalls. "They were all running the world, yet they didn't feel good, their sex was off, their energy was low."
At Club Essentia, he set about fixing those things. One of the ways to do that, he decided, was intravenous therapy. Rusilko had begun poking himself with needles for IVs after graduating from medical school.
"The first couple were a mess," he says. Because nurses are usually the ones to administer IVs, medical students are usually given little instruction, Rusilko says. So he had to teach himself. Once, he tried injecting GABA, an amino acid that creates a calming sensation, and felt like he couldn't breathe for several seconds. "That was the only time I almost had to pull a needle out of my arm," he says.
But Rusilko says he was hooked after the first one. "The feeling was amazing."
A mutual friend introduced Rusilko to Paciello, who was released from prison in 2006, and together they set about opening Club Essentia. There, Rusilko charged $50,000 a year for an annual membership and used 77 ingredients for IVs, according to Ocean Drive. Clients could gaze out at the ocean while getting pumped with vitamins and nutrients — sometimes with a glass of champagne in hand.
Around that time, erotic-fiction writer Everly Drummond reached out to Rusilko on Facebook. One of her readers had shared a photo of him for "Man Candy Monday," and now she had an unusual request.
"I just saw him and I thought, You know, he's the stuff that romantic heroes are made out of," the Canadian writer recalls. "I was like, 'Wow, can I use you as a character in a book?'?"
Rusilko had a different idea: He wanted to help write it.
The Winemaker's Dinner was published in summer 2012. It told the love story of Jaden Thorne, the beautiful new head chef at a restaurant called the Bianca, and her "Mr. Oh So Sexy:" none other than Ivan Rusilko, pageant king and wellness doctor extraordinaire. Thorne assumed a guy like that — "the most stunning man she'd ever seen" — would never give her the time of day. Instead, they have a one-night stand on the balcony of a penthouse suite and then become South Beach's "It" couple.
Rusilko posed shirtless for the cover of the book and made "house calls" for its debut, reading excerpts during wine-soaked, ladies-only parties.
"We see all these women, and they drool over these fictional characters, you know?" Drummond says. "I mean, look at Fifty Shades of Grey — millions of women fell in love with Christian Grey, who does not even exist. So why not give them a book with a romantic hero who is real and just as swoon-worthy?"
Rusilko's mom says she thought the story would be a romance. "I was told I'm not allowed to read the whole book, and to this day, I haven't," she says with a laugh. "He would say, 'You should read Chapter 3 or Chapter 8.'?"
But Rusilko thought it was a natural fit. He believes sex and health are intertwined. Sometimes he even gives patients signed copies of the book.
"What this medicine boils down to, and what life, I think, personally, boils down to is sex," he says. "Everything is about the next orgasm."
There are now five Winemaker's Dinner books, and Rusilko is working on a sixth. The series is published by Los Angeles-based Omnific Publishing, which seeks out "romantic fiction that breaks the mold of traditional romance."
After a year at the Delano, Rusilko left to open his own practice, where he creates wellness plans for patients. Today he has his Sunset Harbour office, two employees, and about 30 to 40 regular patients, many of whom he considers friends. "[They] are my business cards," he says. He doesn't accept insurance and says it's "very expensive" to see him. (On the high end of Rusilko's infusion treatments is his "Aging Vaccine" program, 16 IVs meant to reverse the aging process over the course of two months. It costs $2,500, or $156 an IV.)
That's allowed him to work mostly short days — squeezing in morning and afternoon workouts — and to take frequent hunting trips around the world, often with his dad. Rusilko, who rents an apartment on Belle Isle, won't divulge exactly how much he makes but says it's on the high end for a physician and meets a salary goal he set years ago.
He says his unusual approach to medicine has made him the "black sheep" of his family. His brother is a urological reconstructive surgeon at the University of Pittsburgh Medical Center, and his sister is a physician's assistant at West Virginia University Healthcare Neurosurgery, Spine and Pain Center. In the beginning, they weren't sold on the unconventional approach.
"When he first started talking about it, I didn't know what he was talking about," his mother says. "When you hear 'IV,' it's because you're getting fluids in the hospital or need to be fed, so I really didn't understand. But it really does make great sense if you can take those vitamins and minerals right into the bloodstream. It makes, really, perfect sense."
She gets an IV or two every time she comes down to visit. They help with her chronic fatigue, she says, adding, "I wish he lived closer!"
And Rusilko truly believes in his treatments, going as far as to say that if he were diagnosed with cancer, he would skip chemo altogether in favor of vitamin C infusions. He gives himself daily IVs, mixing a formula based of whatever he thinks he needs.
"It's always nice to own the candy shop, you know what I mean?" he says, laughing.
Ginny Simon squeezes her eyes shut and looks away as Rusilko prepares to stick her with a needle. She lets out a small "Ah!" when it punctures her skin.
The petite, stylishly dressed businesswoman and mother of four thinks getting pricked for an IV hurts. Yet there she is, her arm upturned on a patterned pillow in Rusilko's office.
The doctor's plan for her includes a diet, a workout plan, hormone replacement therapy, and regular infusions. Two-and-a-half years in, she says she feels younger and more energized. That's important to Simon, CEO of the cookie company ginnybakes.
"Whenever I tell people about him," she says of Rusilko, "I say, 'He's a little bit of a cowboy. You have to really believe in it.'?"
Though true believers like Simon say IV treatments boost the immune system, reverse aging, improve workout performance, decrease stress, increase energy, and strengthen hair, there's scant scientific evidence of those benefits. (Some studies have pointed to intravenous vitamin C as having potential in treating cancer.) Until more research is done, Rusilko says the anecdotal evidence is enough for him: "The proof is in the pudding."
But some doctors say pumping vitamins and minerals directly into the bloodstream is medically unnecessary — and potentially risky.
"We have an entire organ system devoted to putting nutrients into the bloodstream," says Katz, the Yale doctor. "It's a major part of our anatomy. It's pretty silly and arrogant to bypass it without a damn good reason. Why don't we bypass the heart with an external pump?"
When Katz was considering offering IV vitamin therapy in his clinic, he couldn't find any research on it. So he conducted what he believes to be the first National Institutes of Health-funded trial. The conclusion: Chronic-pain patients given the Myers cocktail got better — but so did those who took a placebo. So Katz gives IVs only to patients who have certain conditions, such as dietary restrictions.
Some have complained that the treatment, when used to cure hangovers or for aesthetic reasons, wrongly takes IV components from those who need them most. IVs are the only way some patients — especially premature babies — can get nourishment. And the FDA last year reported a shortage of saline fluid. FDA spokeswoman Lyndsay Meyer did not respond to a request for comment on the issue.
It's also a lot cheaper to get vitamins the old-fashioned way. A bottle costs $15 or so, while an IV goes for $100 to $300. Then there's the potential for harm: Intravenous therapy always carries a small risk of clotting, bleeding, infection, and allergic reactions.
This past February, Australian public health officials shuttered a Sydney clinic called iv.me after a woman landed in the emergency room following a treatment. She suffered a fever, abdominal pain, and low blood pressure, the Sydney Morning Herald reported. The clinic's director, pharmacist Shadi Kazeme, is now under investigation.
But Rusilko's clients say they don't fear negative effects. "You do it with people who know what they're doing," says Daniels, the Sotheby's vice president. And Rusilko says he's made safety a priority. He does consultations and bloodwork before administering an IV and customizes each one for patients' needs.
Other South Florida providers say they too have taken steps to ensure safety. Parvani's clinics exclude risky customers such as those with heart or kidney disease or those who have suffered any kind of aneurysm. Hydrate Medical hires only registered nurses with at least five years of experience to administer IVs, and a physician is always available via phone, cofounder Dr. Jonathan Leake says. "Everybody is making sure that this is very safe," he explains. "The first mantra in medicine is 'Do no harm.'?"
But if an IV is administered incorrectly or by someone who's inexperienced, there's a potential for serious risks. "It's a dangerous industry if they do it wrong," Rusilko says. "You're basically cheating the patient."
Florida Department of Health rules state there must be a patient-doctor relationship, and the doctor must give an order for an IV to be administered, spokesman Brad Dalton says. And, he notes, a procedure safe for one person might not be safe for another.
Meyer, the FDA spokeswoman, says her agency does not regulate, nor has it approved "IV therapies used in this manner." She wouldn't comment further.
"What we've got is a situation where there's essentially no oversight," Yale's Katz says. "It'd be a bit like walking into the prescription side of the pharmacy and just being able to point out the vial of drugs you want to have. Obviously, there ought to be some filter... I think it's a mistake to treat this as a trivial thing."
Some proponents of IV therapy think the United States is simply slow to accept revolutionary treatments. Ginnybakes' Simon, a believer in nontraditional medicine, says the European system does the research and brings in new treatments, "whereas we go through so many hoops with the drug industry and lobbyists and all that. We are prevented from getting a lot of the things that I would like to have, so I think it's more of a barrier."
Another patient of Rusilko's, Alan Araujo, says he learned about the benefits of IVs though his sister, who offers the treatment in Brazil. "This is the real deal," he says. As vitamins drip from his IV bag, he adds, "You feel it; you can taste it. You just know that you're feeling better. Like, your body responds. You feel like a million dollars."
After his patients leave for the day, Rusilko heads into his office's storage room, where he pulls out about a half-dozen little bottles and a syringe. He draws liquid from the bottles one at a time, naming each as he goes. He starts with vitamin C, salinium, biotin, magnesium, taurine ("it's what's in Red Bull," he says), zinc, dexpanthenol, glutamine, and arginine.
Then he moves on to "the fun ones, which give it color." B complex quickly turns the concoction orange. A form of B12 adds a shade of red. And glutathione — an antioxidant and "what Michael Jackson was using to turn himself white" — turns it a little redder. "And that's all," Rusilko says.
He sits in the swiveling chair and plunges a needle into his right arm, then begins pushing the mixture from the syringe into his vein.
Despite critics' concerns, the IV-therapy industry doesn't show any signs of slowing. Neither the FDA nor the Florida Department of Health will say whether regulations are on the way. A panoply of clinics have begun mixing IV cocktails of their own within the past two years, though the lack of regulation makes it impossible to know exactly how many.
Paciello owns one of them, having decided to stay involved in the IV therapy industry after Club Essentia closed. His new company, VitaSquad, opened last year and has a mobile service, as well as a "lounge" inside Paciello's high-end gym in Sunset Harbour, called Anatomy at 1220. A second location is set to open in Ibiza, according to the company's website. (An Instagram post from VitaSquad claimed Paciello receives weekly IVs.)
"When we first started the business and we said, 'Hey, did you want to get an IV?' people were taken aback," Parvani recalls. "People were saying, 'Wait, you want me to pay money to get stuck with a needle?' The answer was pretty much universally no. It's taken education and time to get people to realize the benefits of these treatments."
He thinks it'll be like Botox: Within the next ten to 15 years, there will be an operation in every city.
As for Rusilko, he'll spend some of his time at a plastic surgery clinic beginning in November, giving patients pre- and postoperative IVs, which he says speed up recovery time. He also wants to expand his practice to more locations and write more books, including in nonfiction: He wants to write a sexual health manual, complete with tasteful nudes. Some day, Rusilko — who considers himself a Republican — thinks he'd like to get into politics. "It's kind of our place to carve out a piece of history," he says. "It's the ultimate marketing thing."
It takes about five minutes for him to pump the liquid from the syringe into his arm. Injections, whether by syringe or IV, are part of his daily routine. He thinks they'll help with another mission.
"I tell everybody my legit goal is to live 120 years," he says, "a hundred of which I feel I'll look like this."