Ignorance Marches On

Of all the men in the world, the one who happens to be best suited to our daughter lives in Bristol, England. This afternoon we were in the nearby town of Wells, drinking Guiness at a pub in front of which the Quaker leader William Penn used to address thousands of people and was once arrested for doing so. “Must remember to tell Tod about that,” I thought (Tod Mikuriya, MD, being a Quaker from Pennsylvania who ran afoul of law enforcement himself). But of course Tod won’t be there to tell about Penn when we get back.

For many years I would get a morning phone call from him critically remarking a new political, legal, or scientific development in the medical marijuana movement. Tod was not self-aggrandizing and I doubt he would have been grateful for the size and prominent placement of his obituaries. The ones that ran in the San Francisco Chronicle, the LA Times, the New York Times, and Time Magazine all failed to describe his work accurately. This is not the fault of the individual reporters but of the top editors (operating in what they take to be the interests of their bosses, the corporate owners) who never made the medical marijuana movement a beat, i.e., never assigned a reporter to make a thorough study of the subject. Ever since California’s Prop 215 campaign in 1996, the occasional mmj story has been given to whoever was available in the newsroom. Thus in 2007 writing Tod’s obits fell to journalists who were, at best, only superficially conversant with the subject. Each obit writer had a file full of relevant clippings (once known as “the morgue” and now known as “Google”) and a few hours in which to recount the course and assess the significance of Tod’s career. To repeat: superficial treatment was guaranteed by the top editors’s decision not to make medical marijuana a beat. This was/is a self-fulfilling prophecy ensuring that the discovery of the endocannabinoid system remains a “minor” story and that the ignorance on which prohibition depends will drag on and on and on and on. The editors choose to ignore and the readers remain in ignorance.

The point the obits failed to convey was that the very thing Drug Czar Barry McCaffrey mocked Tod for in 1996 -his observation that cannabis is helpful to people suffering a wide range of ailments- ITAL has been confirmed and explained in recent years by scientists studying the body’s own cannabinoid messenger system. END ITAL More than a thousand studies of the endocannabinoid system have been published in scientific journals. An excellent summary of what researchers know appeared in Scientific American in December 2004, “The Body’s Own Marijuana” by Nicoll and Angier. The endocannabinoid system functions as a master modulator, a “retrograde messenger” setting the tone and tempo at which other neurotransmitters fire. It inhibits neurons firing too intensely and disinhibits neurons firing too sluggishly. Cannabinoids promote homeostasis (an even keel) in systems that regulate appetite, movement, learning and forgetting, perception of pain, immune response and inflammation, neuroprotection and other vital processes. That’s why smoking or otherwise ingesting cannabis affects such a wide range of symptoms. The editors should have known this and the obit writers should have been reminded of it and conveyed it to their readers.

The San Francisco Chronicle obit by Henry Lee didn’t even make reference to McCaffrey’s infamous mockery of Mikuriya’s findings. Lee focused on Tod’s subsequent prosecution by the Medical Board of California, which he had reported on for the Chronicle after briefly looking in on the hearing in Oakland. “In 2003,” Lee wrote in his obit, “Dr. Mikuriya was investigated by the Medical Board of California on allegations of unprofessional conduct and negligence in his handling of 16 cases since 1998. Supporters said the case was politically motivated and payback for his vocal support of medical marijuana.” In fact, the investigation began in 1999 and hung like a sword of Damocles over Mikuriya’s head for many years before the board decided to plunge it into his practice. Tod’s allies had provided the Chronicle with specific, meaningful facts: that all the allegations of unprofessional conduct and negligence had come from law enforcement, none from patients. Nor had there ever been an allegation of harm to a patient by Mikuriya. Reporting those verifiable FACTS would have conveyed a lot more than “said the case was politically motivated,” which is vague and whiney-sounding.

Lee redeemed himself by including interesting info from Tod’s sisters. “His interests were varied, said his family, who called him a ‘modern man for all seasons.’ He enjoyed racing cars, flying airplanes, singing and playing traditional folk music, and singing choral music and Elizabethan materials. He collected tools, electronic gadgets, political newspaper cartoons and marijuana T-shirts and posters.

“‘People didn’t really appreciate that Tod was not just all about pot,'” his sister, Beverly Mikuriya, 61, of Bucks County, Pa., said Monday. ‘He was really a very eclectic person who had lots of other interests and abilities.'”

Valerie Nelson of the LA Times correctly reported that Tod “helped draft Proposition 215,” and had approved marijuana use by some 9,000 patients. Nelson credited Tod with founding the Society of Cannabis Clinicians, but misleadingly added “to educate colleagues about the plant’s medical uses.” Although Tod had been monitoring its use for longer than his SCC colleagues, and he had many original insights to share about how cannabis worked, he never acted as if his understanding was superior to the other doctors’s. He was an educator indeed, but his goal in organizing the SCC was not to enlighten disciples but to have a forum wherein medical specialists could share observations and findings. He considered it unfortunate that the SCC, which met quarterly, had to devote so much time and attention to legal problems stemming from harassment by the medical board. At one point nine of 15 SCC members had been investigated by the board -a costly, frightening process in itself whether or not it results in prosecution.

Nelson wrote that Tod “kept a list of conditions that had been eased by cannabis” -which makes it sound like a personal rather than a collective project. The list of conditions was originally culled by Tod from journal articles in the pre-prohibition medical literature. In the early ’90s it was expanded based on reports from patients at Dennis Peron’s San Francisco Cannabis Buyers’ Club. After Prop 215 passed in ’96, other doctors gradually began monitoring cannabis use by their patients and adding to the list, which Tod kept according to the numbering system used by insurance companies. He was a by-the-book doctor in many ways and delighted in employing ICD-9 numbers and other trappings of establishment medicine. He used Latin words where English words would do. He submitted papers to the International Cannabinoid Research Society and attended several of their annual meetings. He referred to the ICRS as “the lab wonks,” although he liked and respected many individual members. He called himself “a townie, not a gownie,” but once when a professor invited us to lunch at the UC Berkeley faculty club he seemed especially pleased. Tod had his contradictions; he was a a perfect example of a human being.

Getting back to the LA Times: “When then-White House drug czar Barry McCaffrey saw a version of the list at a 1996 press conference, it included ‘recovering forgotten memories’ and ‘writer’s cramp.’ It moved him to assail Mikuriya’s brand of medicine as a ‘Cheech and Chong show.'” This is way too kind to McCaffrey (who is not just a liar but a murderer, having ordered retreating Iraqi soldiers shot in the back in ’91). It implies that McCaffrey was thinking on his feet at the press conference in ’96. In fact, It was McCaffrey who brought the blow-up of the list to the event, attributed it solely to Mikuriya, and proceeded to ridicule it with carefully rehearsed sound bites. The list had been found on the internet and edited by a McCaffrey aide named Dave Des Roches. McCaffrey’s comments had been prepared in consultation with assistant drug czar Robert Maginnes, another militarist brute who went on to become Jeb Bush’s drug czar in Florida. (Incidentally, cannabis as a treatment for “writer’s cramp” had been described in a pre-1937 journal article. Tod said it was a common problem when clerks and copyists had to wield fountain pens for 10 hours a day.)

Nelson of the LA Times also included some input from Tod’s family. “‘He was eclectic and had an adventurer’s spirit and was very, very curious,’ said his sister Mary Jane Mikuriya. That spirit could extend to traveling, piloting his own plane, racing cars or experimenting with cooking. He once turned a meal blue with food coloring ‘just to see what it would be like psychologically,’ his sister said.

“Dr. Tod, as his patients called him, had a gentle manner and wore a white lab coat with an embroidered logo that revealed his specialty. It showed the snake and staff of Asclepius, the Greek god of medicine, atop a marijuana leaf.”

Margalit Fox of the New York Times wrote that Tod was “widely regarded as the grandfather of the medical marijuana movement in the United States” -a term I never ever heard applied to him. Does it make him Dennis Peron’s father? Allen Ginsberg’s brother-in-law? Tod once wrote an article for the SCC journal entitled “Grandfather It In,” arguing that the Food and Drug Administration shouldn’t require clinical trials of cannabis because its safety and efficacy had been established prior to prohibition in 1937. Maybe that’s where Fox, doing fast research, picked up the “grandfather” bit.

“Elsewhere, however,” Fox’s piece goes on, “Dr. Mikuriya’s work found little favor. In 1996, for instance, Gen. Barry R. McCaffrey, director of the Office of National Drug Control Policy under President Bill Clinton, publicly derided the doctor’s medical philosophy as ‘the Cheech and Chong show.'”

Give Fox credit for reminding readers that the Clinton Administration began the rollback of Prop 215 immediately after it passed; but like the other obit writers, she omitted the salient fact that Mikuriya has been proven right. It’s not a matter of “Mikuriya said this, the prohibitionists said that.” Mikuriya’s observation has been substantiated! Science is all about proving and disproving theories and findings. It is the responsibility of the editors of the major metropolitan dailies to understand the state of the science and to incorporate it into their coverage of events when relevant. It’s true that political and legal controversies still surround the medical use of cannabis, but there is no scientific controversy regarding the existence of the endocannabinoid system. It is an established FACT that the active ingredients in cannabis modulate many systems within the body and therefore alleviate seemingly disparate kinds of symptoms. It has been PROVEN. More will be learned about the mechanism of action, of course, and our present understanding will be refined and revised; but there is such a thing as “what scientists now know,” and responsible journalists should refer to it when applicable.
Time’s Inept Copycat

Does Doris Kearns Goodwin write for Time Magazine? Time’s terse Mikuriya obit, which reads like a self-parody, was lifted, crudely, from Margalit Fox’s piece in the New York Times. Its sole paragraph contains at least six errors of varying maginitude–four in one sentence.

“MILESTONES. DIED. Like a lot of people who support marijuana use, psychiatrist Tod Mikuriya had detractors. (His work was called “the Cheech and Chong show” by Bill Clinton’s drug czar, General Barry McCaffrey.) The longtime Republican (1) believed in (2) the therapeutic effects of the drug on more than 200 ailments (3) and in 1996 saw a bill he crafted (4), Proposition 215, pass in California, legalizing the use of pot for the seriously ill. The “grandfather” (5) of the medicinal-marijuana movement said his fight to “restore cannabis” stemmed from a backlash against its medical use following the late-’30s film Reefer Madness. (6) He was 73 and had cancer.”

1. Fox’s NYT obit had mentioned Tod’s Republican affiliation, but it was only nominal after Wallace Johnson’s tenure as mayor of Berkeley ended in 1971. Mikuriya despised Ronald Reagan and the George Bushes.

2. “Believed in” applies to matters of faith. “Observed and recorded” would have been accurate.

3. Drugs don’t exert effects on ailments, they exert effects on people.

4. THM didn’t “craft” Prop 215 and any implication that he was the prime mover is wrong. Tod supported the primary author, Dennis Peron, who wanted a law that would protect people who were using cannabis to treat any condition for which it provided relief and not just a finite list of fatal or extremely grave illnesses. Dennis, with Tod’s help, prevailed over others who thought the open-ended wording would offend the voters.

5. By putting “grandfather” in quotes, Time presents it as Tod’s well known sobriquette, which it certainly wasn’t. If journalism is the first draft of history, the obituary is the draft that gets submitted. Expect Tod’s biography (if the book publishing industry ever overcomes its ignor-ance) to be subtitled “Grandfather of America’s Medical Marijuana Movement.”

6. Fox of the NYT had written, “Dr. Mikuriya saw his work, he often said, as a means of righting a historical wrong, namely the backlash against medical marijuana that began in the ‘Reefer Madness’ era of the late 1930s.” Time’s inept copycat makes it seem as if the film established marijuana prohibition when in fact the prohibition was established in 1937 by an act of Congress orchestrated by the U.S. Treasury Department. The film “Reefer Madness” was just one element in a long p.r. campaign that included numerous articles in the print media. It didn’t have much of an impact or attract an audience until the early 1970s when pot-smokers decided to laugh at its lurid, false depictions.

There might be a seventh gaffe in Time’s ‘graf about Tod. I recall McCaffrey using the term “Cheech and Chong medicine,” not “…show.” Tod taped the ominous press conference and gave me a dub, which I’ll check when we get home… Maybe the Guiness Book of World Records lists most errors per paragraph in a published news story. Maybe Tod’s obit will qualify, which would be fitting in a retrograde sense.

FRED GARDNER edits O’Shaughnessy’s, the Journal of Cannabis in Clinical Practice. He can be reached at fred@plebesite.com




Fred Gardner is the managing editor of O’Shaughnessy’s. He can be reached at fred@plebesite.com