T
The420Guy
Guest
To refute the state Medical Board's Accusation against Tod Mikuriya, MD,
the defense has called to the witness stand nine of the patients who
allegedly received substandard care from him. Each patient described
Mikuriya as a thorough, empathetic, and helpful consultant who never passed
himself off as a primary care provider.
Each confirmed that s/he had been self-medicating with cannabis before
seeking Mikuriya's approval to do so.
The prosecution's expert, Laura Duskin, MD, had claimed that reading
Mikuriya's files enabled her to detect "extreme departures from the
standard of care" in his treatment of 16 patients.
She felt no need to get input from the patients themselves. "We're taught
from day one in medical school that if you didn't write it down, it didn't
happen," Duskin testified in all seriousness. But it became obvious, as the
patients recalled their encounters with Mikuriya, that a great deal had
happened between them that Duskin failed to discern.
First to testify was D.K., a middle-aged woman from Humboldt County who
walked and spoke slowly and with obvious effort.
At 21 she'd suffered a stroke brought on by the combination of smoking
cigarettes and taking birth-control pills. ("The pill" was originally
approved by the FDA in a dosage many orders of magnitude greater than
required for efficacy.
A safer formulation was introduced quickly in the U.S., less quickly in
South America.)
D.K.'s enunciation may not have been crisp, but what she had to say was
eloquent. "None of you have ever had a cerebral hemorrhage. I'm always the
wrong one, the one who doesn't get the joke... I get feeling like I'm up
against a wall. A couple of puffs and I can come back to myself, I can grip
reality again." D.K. said she first consulted Mikuriya in June, 1998. "He
had been recommended to me as a compassionate doctor... I was totally
honest with him. I had discovered for myself that marijuana helped more
than anything.
And I don't need more and more -the same amount works!"
In response to questions from attorney Susan Lea, D.K. testified that
Mikuriya had written her a prescription for a neuropsychiatric evaluation,
but it had been confiscated along with other papers in her husband's
possession when he was busted for cultivation. Mikuriya had also urged her
to quit or reduce her cigarette smoking, and had suggested that she
substitute cannabis leaf for tobacco. "And it worked," D.K. reported.
She mimed hand-rolling a joint and drawing on it as she explained "You get
to do the same thing with your hands, and with your mouth..."
Assistant A.G. Jane Zack Simon asked, on cross-examination, if D.K. had
obtained from Mikuriya a second prescription for a neuropsych eval. D.K.
replied as if Simon was the slow one and had missed the key point: "It got
taken by the cops when they took our marijuana." D.K. also testified that
she'd had four follow-up visits with Mikuriya over the years, and that he'd
billed her on a sliding scale.
Prior to the next swearing in, Administrative Law Judge Jonathan Lew
commented that he'd never had a case in which patients's names had been
kept from him. Simon said, "We often have cases where patients names aren't
used -but of course they never testify." Which shows how far removed from
reality the Medical Board's procedures have become.
Why shouldn't patients be testifying about mistreatment by physicians? The
Mikuriya case is highly unusual in that no patients contend they were
victimized. Quite the contrary -the alleged victims are coming forward to
say "Thank you, doctor."
D.H., another middle-aged woman who didn't look as if life had been a bed
of roses, testified that she'd found on her own that cannabis provided
relief for severe itching and stress headaches "so bad I can't even
function." Tests couldn't determine the causes of her problems.
Other doctors had given her "medicines that didn't help. They put me out
and deprived me of feeling in control." She'd brought Mikuriya records from
her previous doctors and told him that when she smoked cannabis, "the
itching is less and I don't go to sleep with headaches." Mikuriya gave her
an approval for cannabis and taught her a method of rolling the shoulders
to reduce headache-inducing tension. She said she couldn't see him again
"money-wise."
On cross, Simon asked D.H., "Did you ask Dr. Mikuriya if there was anything
you should do about the itching?" -ignoring the woman's testimony that
cannabis had been an effective treatment.
The prosecution apparently hopes to show that Mikuriya provided substandard
care by not pushing the available corporate products!
It so happens that California doctors who are monitoring their patients's
cannabis use are hearing reports of efficacy in the treatment of pruritis
(itching)! Because the cannabis specialists are collecting data to which
the medical establishment has been unreceptive, it is the establishment
docs who are, in many instances, providing outdated, substandard care. As
noted before, the Mikuriya case takes us through the looking glass.
R.B. a man of about 30 with black hair and Buddy Holly specs, had been
incapacitated by nausea, vomiting and dizziness.
His Kaiser doctor conducted tests and diagnosed severe acid reflux, but
couldn't come up with a cause or a cure. R.B. testified, "I lost my job
because I was sick all the time, and then I lost my health insurance
because I was unemployed... I spent a lot of time just rolled in a ball...
I was ready to off myself." He first sensed the medical potential of
marijuana after using it socially.
He learned more via the Internet, he said, but was concerned about its
addictive potential. Mikuriya spent more time with him than any doctor
he'd seen. "When you call Kaiser, a nurse takes your info and they call you
back and you pick up some medicines," said R.B., accurately describing the
REAL standard of care provided by the medical establishment.
E.K., a middle-aged Christian Scientist, listed his problems as insomnia,
high blood pressure, hypertension, and back pain when he saw Mikuriya in
February, 1997. Except for the Army doctors who'd declared him 4F, he
hadn't visited a doctor since childhood.
He had self-medicated with cannabis for years. He'd sought a letter of
approval from Mikuriya so that he could ingest THC without violating the
terms of probation.
E.K. (who also has cognitive problems) said Mikuriya had spent an entire
morning with him and wound up prescribing Marinol.
Assistant A.G. Larry Mercer tried to make something of the fact that E.K.
had no other doctor -as if that made Mikuriya his primary-care
physician. E.K. patiently explained that it was his choice not to see
doctors, and he only consulted Mikuriya to legalize his use of THC. Mercer
asked if E.K. ever tested his blood sugar "by pricking your finger." E.K.
looked confused. "Did you ever prick your finger to measure your blood
sugar?" Mercer repeated.
E.K. looked at the red-faced prosecutor carefully and asked, "Are you a
doctor?"
Next came R.H., your basic American alcoholic working man in his 60s, beat
to shit physically but far-gone enough to stand up to the Inquisition. In
1997 he was on probation (for cultivating three plants) and couldn't sleep.
"I must have slept 100 hours in those eight months," is how he put it.
"Nothin' worked.
Cannabis worked.
It ain't no miracle but it sure helps.
It just makes things a little better and I can sleep at night."
One day in late October, 2001, I drove out to Georgetown, in El Dorado
County, about 40 miles east of Sacramento, to attend the funeral of Ferris
Fain, who had played first base for the Philadelphia A's in the post-WWII
era. Fain, who died at 80, had been "an Oakland product," as the
sportscasters used to say... He was the American League batting champ in
'51 and '52 and part of a record-setting double-play combo (Joost to Suder
to Fain).
In 1988 the Chronicle had carried a small story about Fain being arrested
for marijuana cultivation. He was subsequently tried and did 18 months in
state prison (Vacaville). I figured Fain had been a medical user -most old
jocks have aches and pains that the herb can soothe.
But this hypothesis proved wrong.
From the woman who'd been his caretaker (and who spoke of him with
affection) I learned that Fain had settled in Georgetown in 1961, soon
after retiring from baseball. He'd become a contractor and built his own
house and eight others in a tract of 13. He had an Alaska mill and milled
his own lumber.
He had a garden with 12 raised beds, and he put up preserves. (Good hands
off the diamond, too.)
The funeral was held in Georgetown's Pioneer Cemetery at 2 in the
afternoon. The VFW did the honors (Fain had played on an Armed Services
team with Joe DiMaggio). Five silver-haired vets provided a three-gun
salute and taps played on a boombox tape deck. An old friend named Ray
Malgradi gave a short eulogy.
He and Fain had grown up in the same Oakland neighborhood and they had
played on the same local teams.
Fain's family had been very poor, Malgradi recalled. "Nobody ever played
the bunt better than Ferris Fain," he declared.
A gent named Dan Maloney, who had come down from Weaverville, also spoke
briefly. Fain had hired him as batboy when the Bob Feller All-Stars came
through the Bay Area in 1949 (barnstorming against the Kansas City Royals
of the still extant Negro League)... Fain's granddaughter Nicole sang
"Peace in the Valley," then the family and friends headed for a reception
at the VFW Hall.
Somebody said that Ray Malgradi was trying to get Fain's marijuana
conviction expunged, but he left before I could ask: on what grounds?
John Fain, then 52, had flown in from Thailand, where he lives as an
expatriate, for his father's funeral and to see daughter Nicole. "All
anybody said about him was about baseball," was John's comment on the
funeral. He revealed that his dad never smoked marijuana and didn't
approve of its use; he'd been growing it to supplement his income.
At one time, according to John, his father had kicked him out of the house
- -"when I had a wife and a one-year-old baby, and it was really my house"-
because John had been into marijuana!
Ol'Ferris was also something of a racist.
The woman who'd been his caretaker said he expressed contempt for the
current players' skills. "He called it 'Z-league baseball,'" she said. "You
know: Martinez, Rodriguez, Fernandez..."
Good to be heading back to the cool, gray, overpriced city of tolerance.
The foothills look like they'll never recover from the original
over-logging... They catch the smog from the valley and hold it against Auburn.
Pubdate: Wed, 17 Sep 2003
Source: Anderson Valley Advertiser (CA)
Column: Cannabinotes
Copyright: 2003 Anderson Valley Advertiser
Contact: ava@pacific.net
the defense has called to the witness stand nine of the patients who
allegedly received substandard care from him. Each patient described
Mikuriya as a thorough, empathetic, and helpful consultant who never passed
himself off as a primary care provider.
Each confirmed that s/he had been self-medicating with cannabis before
seeking Mikuriya's approval to do so.
The prosecution's expert, Laura Duskin, MD, had claimed that reading
Mikuriya's files enabled her to detect "extreme departures from the
standard of care" in his treatment of 16 patients.
She felt no need to get input from the patients themselves. "We're taught
from day one in medical school that if you didn't write it down, it didn't
happen," Duskin testified in all seriousness. But it became obvious, as the
patients recalled their encounters with Mikuriya, that a great deal had
happened between them that Duskin failed to discern.
First to testify was D.K., a middle-aged woman from Humboldt County who
walked and spoke slowly and with obvious effort.
At 21 she'd suffered a stroke brought on by the combination of smoking
cigarettes and taking birth-control pills. ("The pill" was originally
approved by the FDA in a dosage many orders of magnitude greater than
required for efficacy.
A safer formulation was introduced quickly in the U.S., less quickly in
South America.)
D.K.'s enunciation may not have been crisp, but what she had to say was
eloquent. "None of you have ever had a cerebral hemorrhage. I'm always the
wrong one, the one who doesn't get the joke... I get feeling like I'm up
against a wall. A couple of puffs and I can come back to myself, I can grip
reality again." D.K. said she first consulted Mikuriya in June, 1998. "He
had been recommended to me as a compassionate doctor... I was totally
honest with him. I had discovered for myself that marijuana helped more
than anything.
And I don't need more and more -the same amount works!"
In response to questions from attorney Susan Lea, D.K. testified that
Mikuriya had written her a prescription for a neuropsychiatric evaluation,
but it had been confiscated along with other papers in her husband's
possession when he was busted for cultivation. Mikuriya had also urged her
to quit or reduce her cigarette smoking, and had suggested that she
substitute cannabis leaf for tobacco. "And it worked," D.K. reported.
She mimed hand-rolling a joint and drawing on it as she explained "You get
to do the same thing with your hands, and with your mouth..."
Assistant A.G. Jane Zack Simon asked, on cross-examination, if D.K. had
obtained from Mikuriya a second prescription for a neuropsych eval. D.K.
replied as if Simon was the slow one and had missed the key point: "It got
taken by the cops when they took our marijuana." D.K. also testified that
she'd had four follow-up visits with Mikuriya over the years, and that he'd
billed her on a sliding scale.
Prior to the next swearing in, Administrative Law Judge Jonathan Lew
commented that he'd never had a case in which patients's names had been
kept from him. Simon said, "We often have cases where patients names aren't
used -but of course they never testify." Which shows how far removed from
reality the Medical Board's procedures have become.
Why shouldn't patients be testifying about mistreatment by physicians? The
Mikuriya case is highly unusual in that no patients contend they were
victimized. Quite the contrary -the alleged victims are coming forward to
say "Thank you, doctor."
D.H., another middle-aged woman who didn't look as if life had been a bed
of roses, testified that she'd found on her own that cannabis provided
relief for severe itching and stress headaches "so bad I can't even
function." Tests couldn't determine the causes of her problems.
Other doctors had given her "medicines that didn't help. They put me out
and deprived me of feeling in control." She'd brought Mikuriya records from
her previous doctors and told him that when she smoked cannabis, "the
itching is less and I don't go to sleep with headaches." Mikuriya gave her
an approval for cannabis and taught her a method of rolling the shoulders
to reduce headache-inducing tension. She said she couldn't see him again
"money-wise."
On cross, Simon asked D.H., "Did you ask Dr. Mikuriya if there was anything
you should do about the itching?" -ignoring the woman's testimony that
cannabis had been an effective treatment.
The prosecution apparently hopes to show that Mikuriya provided substandard
care by not pushing the available corporate products!
It so happens that California doctors who are monitoring their patients's
cannabis use are hearing reports of efficacy in the treatment of pruritis
(itching)! Because the cannabis specialists are collecting data to which
the medical establishment has been unreceptive, it is the establishment
docs who are, in many instances, providing outdated, substandard care. As
noted before, the Mikuriya case takes us through the looking glass.
R.B. a man of about 30 with black hair and Buddy Holly specs, had been
incapacitated by nausea, vomiting and dizziness.
His Kaiser doctor conducted tests and diagnosed severe acid reflux, but
couldn't come up with a cause or a cure. R.B. testified, "I lost my job
because I was sick all the time, and then I lost my health insurance
because I was unemployed... I spent a lot of time just rolled in a ball...
I was ready to off myself." He first sensed the medical potential of
marijuana after using it socially.
He learned more via the Internet, he said, but was concerned about its
addictive potential. Mikuriya spent more time with him than any doctor
he'd seen. "When you call Kaiser, a nurse takes your info and they call you
back and you pick up some medicines," said R.B., accurately describing the
REAL standard of care provided by the medical establishment.
E.K., a middle-aged Christian Scientist, listed his problems as insomnia,
high blood pressure, hypertension, and back pain when he saw Mikuriya in
February, 1997. Except for the Army doctors who'd declared him 4F, he
hadn't visited a doctor since childhood.
He had self-medicated with cannabis for years. He'd sought a letter of
approval from Mikuriya so that he could ingest THC without violating the
terms of probation.
E.K. (who also has cognitive problems) said Mikuriya had spent an entire
morning with him and wound up prescribing Marinol.
Assistant A.G. Larry Mercer tried to make something of the fact that E.K.
had no other doctor -as if that made Mikuriya his primary-care
physician. E.K. patiently explained that it was his choice not to see
doctors, and he only consulted Mikuriya to legalize his use of THC. Mercer
asked if E.K. ever tested his blood sugar "by pricking your finger." E.K.
looked confused. "Did you ever prick your finger to measure your blood
sugar?" Mercer repeated.
E.K. looked at the red-faced prosecutor carefully and asked, "Are you a
doctor?"
Next came R.H., your basic American alcoholic working man in his 60s, beat
to shit physically but far-gone enough to stand up to the Inquisition. In
1997 he was on probation (for cultivating three plants) and couldn't sleep.
"I must have slept 100 hours in those eight months," is how he put it.
"Nothin' worked.
Cannabis worked.
It ain't no miracle but it sure helps.
It just makes things a little better and I can sleep at night."
One day in late October, 2001, I drove out to Georgetown, in El Dorado
County, about 40 miles east of Sacramento, to attend the funeral of Ferris
Fain, who had played first base for the Philadelphia A's in the post-WWII
era. Fain, who died at 80, had been "an Oakland product," as the
sportscasters used to say... He was the American League batting champ in
'51 and '52 and part of a record-setting double-play combo (Joost to Suder
to Fain).
In 1988 the Chronicle had carried a small story about Fain being arrested
for marijuana cultivation. He was subsequently tried and did 18 months in
state prison (Vacaville). I figured Fain had been a medical user -most old
jocks have aches and pains that the herb can soothe.
But this hypothesis proved wrong.
From the woman who'd been his caretaker (and who spoke of him with
affection) I learned that Fain had settled in Georgetown in 1961, soon
after retiring from baseball. He'd become a contractor and built his own
house and eight others in a tract of 13. He had an Alaska mill and milled
his own lumber.
He had a garden with 12 raised beds, and he put up preserves. (Good hands
off the diamond, too.)
The funeral was held in Georgetown's Pioneer Cemetery at 2 in the
afternoon. The VFW did the honors (Fain had played on an Armed Services
team with Joe DiMaggio). Five silver-haired vets provided a three-gun
salute and taps played on a boombox tape deck. An old friend named Ray
Malgradi gave a short eulogy.
He and Fain had grown up in the same Oakland neighborhood and they had
played on the same local teams.
Fain's family had been very poor, Malgradi recalled. "Nobody ever played
the bunt better than Ferris Fain," he declared.
A gent named Dan Maloney, who had come down from Weaverville, also spoke
briefly. Fain had hired him as batboy when the Bob Feller All-Stars came
through the Bay Area in 1949 (barnstorming against the Kansas City Royals
of the still extant Negro League)... Fain's granddaughter Nicole sang
"Peace in the Valley," then the family and friends headed for a reception
at the VFW Hall.
Somebody said that Ray Malgradi was trying to get Fain's marijuana
conviction expunged, but he left before I could ask: on what grounds?
John Fain, then 52, had flown in from Thailand, where he lives as an
expatriate, for his father's funeral and to see daughter Nicole. "All
anybody said about him was about baseball," was John's comment on the
funeral. He revealed that his dad never smoked marijuana and didn't
approve of its use; he'd been growing it to supplement his income.
At one time, according to John, his father had kicked him out of the house
- -"when I had a wife and a one-year-old baby, and it was really my house"-
because John had been into marijuana!
Ol'Ferris was also something of a racist.
The woman who'd been his caretaker said he expressed contempt for the
current players' skills. "He called it 'Z-league baseball,'" she said. "You
know: Martinez, Rodriguez, Fernandez..."
Good to be heading back to the cool, gray, overpriced city of tolerance.
The foothills look like they'll never recover from the original
over-logging... They catch the smog from the valley and hold it against Auburn.
Pubdate: Wed, 17 Sep 2003
Source: Anderson Valley Advertiser (CA)
Column: Cannabinotes
Copyright: 2003 Anderson Valley Advertiser
Contact: ava@pacific.net
