Politics in the exam room

By Jenifer Valley of Happy Valley, Oregon. Jenifer is a 32-year cancer survivor and describes herself as "an internationally-known cannabis breeder."

Two months after I turned 25, my new doctor - Dr. William Fletcher, Head of Surgical Oncology at OHSU - told me I had a 50% chance of surviving the next 6 months and that if I was lucky, I might get a whole year... but probably not.

And I was so relieved to finally have a chance to get treatment.

You see, for the previous four years, my 'doctor' had been denying me access to medical treatment because she was mad that I used marijuana.I knew something was seriously wrong, but she just wouldn't do anything. Despite reporting symptoms like an egg-sized tumor under my chin that was choking me and low appetite and chronic nausea every month, none of those symptoms made it into my chart: she charted "drug-seeking behavior". Instead of running thyroid tests, she ran marijuana screens and insisted that she would not treat any ailment I had until I stopped smoking marijuana. In January of 1993, I actually had to threaten her with assault to force her to chart the lumps.

But that drug-seeking behavior haunted me for years. Even though I was diagnosed with Stage 4 thyroid cancer, I was given ibuprofen for pain for the first two years of treatment. I finally got pain treatment after I pointed out to the Head of the Endocrinology Department that he was basing his treatment of HIS patient on the opinion of the moron who missed the most advanced case of thyroid cancer his hospital had ever seen - for over four years.

Last year I was involved in a Harvard study of doctor/patient relationships and I made the point that my doctor was too busy practicing drug war politics to have time to practice medicine in my exam room. Because of her drug warrior position, she violated my basic human right to access to medical care. She was my doctor, but she was my primary barrier to care. When you deny a little girl with cancer access to medical care because she smokes pot, you have officially lost the moral high-ground. It made it into the study.

I hope that Oregon will vote yes on Measure 80 this November and take a new look at our policy.

Many patients face the same barriers I faced back then. We need to really examine the effect the War on Drugs is having on the doctor-patient relationship and on patient care and outcomes. Not being able to trust your doctor will drive up the cost of care, as will having doctors not treat serious diseases in a timely manner.

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    Your story is sad and chilling; I am glad it did not do you more harm. However, I wonder if Measure 80 really will change anything. Your doctor was not as far as I can tell acting in any official capacity that would be affected by the law, and the drugs you were allegedly seeking for putative reasons of abuse were not marijuana.

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    The issue is that she felt that it was ok to violate my basic human rights because marijuana was illegal: I never used any other drugs and never asked for any kind of medication while under her care, only for tests to determine what the lumps in my neck were. But because of the label she charted instead of symptoms, I suffered a lot of unnecessary pain, and my already late-stage cancer was allowed to continue to grow for 4 years. When I was diagnosed, my X-ray looked like somone had dumped a bag of rice on the lungs: there were hundreds of thousands of tumors in my lungs that formed a skin of cancer that completely encapsulated both lungs. They did experimental surgery and radiation treatments on me. We beat back a lot of the cancer, but from 2000-2007 the remaining 1-2,000 1-2mil sized tumors neither grew nor shrank and I was declared "stabilized" and told that "more treatment would probably not be helpful." And I agreed, becausethe last treatment had left me bedridden for almost 4 years. How many puffs off of a joint should it take to eliminate all of your Constitutional, Civil and Human Rights? And why should it matter that much if someone smokes pot?

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    Medical cannabis patients unfortunately suffer discrimination, even though they are using a medicine sanctioned by their state's voters. Medical boards, hospitals and insurance companies still have policies that frown upon the use of medical cannabis and patients are often forced to choose between pain pills or cannabis (even though cannabis often helps patients use less pain medication.) Patients can even be kicked off of transplant lists even when there isn't any evidence that cannabis use hinders their chance of success.

    Only when cannabis prohibition has ended for all adults, will patients have an opportunity to not suffer harmful consequences because they choose to utilize a relatively nontoxic medicine that is less harmful and addictive than pharmaceutical narcotics. While Measure 80 won't immediately end the discrimination that Jen and other patients face, it will be a start. Further, if Oregon joins Washington and Colorado in ending cannabis prohibition this November, the wasteful and harmful federal policy of cannabis prohibition will certainly see its days numbered. Recent polling certainly demonstrates that more and more voters realize that our tax dollars and law enforcement resources should be spend on other priorities.

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    That sucks, and it's not fair. But it's not going to change for even one more patient after you, unless you fight a little harder than a post on Blue Oregon.

    For example, you have a new physician. Does he agree with the course of treatment you were 'provided' by your former doctor? He can put a note in the professional file of the former doctor if he doesn't, and that stuff matters. He probably should. Silence is agreement.

    That's what the Chief of Surgery at Tampa General did to the ER physician who 'treated' one of my family by not even cleaning his wounds after he'd lost three fingers in an accident. It didn't matter that he committed finger-losing behavior, or whatever crap. And that doctor's mistake wasn't even willful - it was more like careless/negligent.

    But I digress. Does anybody get to know her name, so she can be avoided? Maybe even the name of the clinic? I think that's only fair.

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      Avoided? After 4 years of non-treatment! I think sanctions at a minimum are more appropriate, because it sounds like malpractice to me.

      Back to the basic topic, my wife has severe pain problems, and ran into the drug paranoia when she tried a "pain clinic" in Salem. The clinic goal seemed to be to reduce drug use more than to treat the pain. We gave up on them after one of the pee-tests they insist on had a false-positive for opiates (probably because she had eaten a poppy-seed muffin the day before), and they refused to prescribe painkillers. She's back with her regular physician, and much less miserable than before.

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    I think it is more about the culture of care we have created under our Drug War.

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    This is a horrible example of abuse of medical powers, don't ya' think? Where is the honor in allowing more suffering? Ms. Valley, I am so sorry. Thanks to you and a few posters here for voicing your support for Measure 80.

    I want my cops busting meth heads and heroine junkies, not people who use cannabis. It is low hanging fruit for law enforcement and a waste of their valuable time. I think many in the law enforcement community will get that, or already do.

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