[NYTr] The Frivolous Investigation of Dr. Sterner: Why San Diego Is Broke

[All the News That Doesn't Fit]

Counterpunch - Oct 29, 2007
http://www.counterpunch.org/gardner10292007.html

Why San Diego is Broke

The Frivolous Investigation of Dr. Sterner

By FRED GARDNER

Dog stories sell newspapers, they say. As the winds were fanning the
flames towards San Diego last Sunday, the Union Tribune ran one
purporting to describe how a pro-cannabis doctor authorized an
undercover police officer to buy some pot for his Labrador Retriever.
This is writer David Hasemyer's lead:

    "When an undercover police officer asked Dr. Robert Sterner to
prescribe marijuana for his dog, the doctor joked that only two-legged
patients were covered by the state's medical marijuana law. So the
officer suggested Sterner appoint him caregiver for the dog, a
designation that would allow him to obtain marijuana in the animal's
name, according to a Medical Board of California accusation. While a
hidden camera rolled, Sterner said, 'There you go. That's being
creative,' according to the accusation. The police officer walked out
of the doctor's office with signed authorizations that allowed him to
buy marijuana for his dog, as well as for himself."

But Sterner hadn't "joked" about the medical marijuana law applying to
people, not dogs; he had politely denied the detective's reiterated
request. Nor did he provide a caregiver form allowing the detective to
buy marijuana for his dog. The Union Tribune story, even more than the
police report published in the medical board accusation, falsified the
doctor-patient dialog and misrepresented the law itself.

According to the accusation, Detective C. DeCastro, posing as R. Cruz,
showed up at Sterner's San Diego office May 17, 2006, claiming to be a
migraine sufferer with a prescription for Relpax (Pfizer's drug for
migraine relief; it has many contra-indications and is not a
preventative). DeCastro/Cruz was told by Sterner's receptionist that he
needed to bring his prescription. DeCastro/Cruz tried to skirt this
requirement and had to be told again that Dr. Sterner requires proof of
an existing diagnosis.

DeCastro/Cruz returned June 9 with a written migraine diagnosis from
another doctor, fraudulently claiming to have made an appointment. (Why
couldn't he have really made one? Too much effort?) He pressured the
receptionist until she got Sterner to agree to see him instead of
taking a lunch break. The detective surreptitiously taped the visit,
aware that his performance would be chortled over by his buddies back
at the station house, incorporated into a report for the medical board,
and possibly reviewed by the media.

DeCastro/Cruz told Dr. Sterner (a dog lover who keeps his ancient
Miniature Pinscher close at hand) that he had an arthritic Lab whose
nocturnal whining could only be stopped by marijuana. DeCastro/Cruz
requested "a marijuana recommendation for his dog," which Sterner said
he could not provide. "Respondent [Sterner] replied he was not sure if
Proposition 215 applies to dogs as well as people, even though it makes
sense to also be compassionate toward animals because cannabis is very
safe. The detective responded he did not give his dog the good stuff
because he needed it for himself. Respondent replied that the detective
was not abusing his dog by giving it marijuana. Respondent then began a
discussion about how cannabis is effective for migraines."

In other words, Dr. Sterner declined to honor the
unusual-but-not-absurd request and tried to direct the conversation
back to DeCastro/Cruz's alleged medical problem. "Respondent then
discussed with the detective headaches and the use of cannabis,
recommending that it was better to keep the levels of cannabis up in
attempting to control the headaches." Sterner recommended ingestion by
butter for preventative effect, and better yet, by coconut oil.

"The detective then renewed his request for Respondent to provide a
medical marijuana recommendation for his dog, Storm. Respondent stated
the detective could share some of his 'medicine' with the dog, to which
the detective stated that if he could be designated his dog's
'caregiver,' the detective could get twice as much marijuana." Sterner
humors him -"There you go, that's being creative, yes you are right."
And then, according to the report, "Respondent reiterated his belief
that Proposition 215 applies to only two-legged creatures, not
four-legged creatures."

In context, it's obvious that Sterner refused to grant the detective's
request -but the Union-Tribune's cut-and-pasted dialog makes it appear
otherwise. David Hasemyer's story is the textual equivalent of a
crudely doctored photo.

Before the visit ends Sterner recommends vaporization, discusses the
safety profile of cannabis, and suggests discretion in discussing its
use with doctors who might disapprove. The detective asks where he can
take his recommendation in order to get cannabis. "Respondent stated
that he was not allowed to recommend or suggest any place." (Federal
law allows doctors to approve marijuana use but not advise where to buy
it.) Sterner adds a warning: some dispensaries will unnecessarily copy
patients' records. Although prodded, Sterner refuses to name any
establishment where marijuana can be obtained. He mentions the risk of
getting detained at a dispensary during a raid. "They hold people like
for six hours for no good reason," he warns. Lastly Sterner advises
DeCastro/Cruz that he has a right under state law but not under federal
law to cultivate his own cannabis -"indoors under lock and key" the
doctor advises.

Back in the reception area DeCastro/Cruz was given a letter of approval
and a "Designation of Primary Caregiver" certificate signed by Sterner.
These forms are typically provided by patients who don't grow their own
cannabis to people who are growing for them to confer some protection
under state law. On June 21 DeCastro/Cruz copied the caregiver form
"and completed it as directed by Respondent's office staff, but with
the name of his dog 'Storm Cruz.' He presented this completed
certificate to a medical marijuana dispensary and he was dispensed
cannabis as well as marijuana-laced edibles."

If there was any laxity in this scenario, it was not on the part of Dr.
Sterner or his office staff. The dispensary should have checked
DeCastro/Cruz's ID and not admitted him. Or did he also have ID as
"Storm?" Under any name, Detective C. DeCastro is a man who doesn't
accept "no" without trying to bluff and bully his way through.

Hasemyer misstated the year that California's medical marijuana law
took effect (it was 1996). He got the letter and spirit wrong, too,
when he described the detectives "posing as patients complaining of
insomnia and migraines, ills far less serious than those contemplated
by the framers of the marijuana law."

"Migraines" is one of seven medical conditions named in the first
sentence of the law as treatable by cannabis. The list of seven is
followed by "...or any other illness for which marijuana provides
relief." That clause reveals exactly what the drafters of the
initiative were "contemplating" -widespread use for a wide range of
problems.

Zenia Gilg, Sterner's attorney, says, "I made it very clear to this
reporter that the primary-caregiver document Dr. Sterner provided did
not authorize the cop to obtain marijuana for his dog. When the cop
filled it out with the dog's name, it authorized the dog to buy
marijuana for him. Which clearly didn't happen."

Gilg is planning a suit on Sterner's behalf against the San Diego
Police Department and other government agencies involved in the
investigation of his practice. She expects Sterner to prevail when the
medical board eventually hears the case based on the report of DeCastro
and another SDPD officer who feigned illness in order to get an
approval. (Your correspondent does not share her confidence.) Meanwhile
Sterner continues to see patients and to authorize the use of marijuana
in treating migraines and any other condition for which marijuana
provides relief.

As the world has learned since last Sunday, San Diego firefighters are
stretched thin, they didn't have enough "spotters" to direct the
bombers dropping fire-retardant, they haven't received a raise in three
years, the city needs new stationhouses... "San Diego has been mired in
a financial crisis stemming from a pension-fund deficient," the Wall
St. Journal explained 10/24, "...financial challenges affect all
departments, including the fire department." Yet the police have enough
to spend on frivolous "investigations" of pro-cannabis doctors by crude
publicity hounds. Will anyone who suffered in the fire put two and two
together and work for regime change?


The Seriousness of Migraines

Belittling the significance of migraines per se and the utility of
cannabis in treating them is an old and dishonorable tradition among
the Drug Warriors and their flacks. "Migranes" (sic) was on the list of
conditions that Barry McCaffrey cited to prove that medical marijuana
was a "Cheech and Chong show..." Soon thereafter Charles Krauthammer
wrote in the LA Times, "As Hanna Rosin reports in the current issue of
the New Republic, the clubs are peopled not by the desperate terminally
ill but by a classic cross-section of California potheads, all
conveniently citing some diagnosis or other -migraines, insomnia,
stress- as their tickets to Letheland."

Here's Dr. David Bearman's comment on the Union-Tribute piece: "To say
migraines aren't a serious pain problem is to never have had one. What
is the specific objection to Sterner's physical? Did they think he
should have done a rectal exam or a pelvic exam? Maybe they didn't care
for his banter or are opposed to a doctor trying to establish rapport
with the patient. Other than the stuff about the dog, which is kind of
confusing, it is unclear from the story exactly what the medical
quality issue is here.

"I for one am very concerned at this kind of intrusive behavior by the
police. Under what authority are they doing this? It smacks of the
intrusiveness of Nazi Germany. As someone whose job for 14 years
involved quality of care, it's hard to understand from the newspaper
story what rises to the level of requiring a medical board
investigation. What does the way in which this care was rendered have
to do with quality of care? And to the extent it does, how does it
differ from the many doctors who do less for prescription medication?
The medical board is making it up as they go along."

Tom O'Connell, MD, also noted the double standard involved in the
medical board's case against Sterner: "I wonder how the California
Medical Association would respond if orthopedists were visited by phony
patients claiming to have disc disease. or psychiatrists were visited
by people with alleged bipolar disorder?"

[Fred Gardner can be reached at fred at plebesite.com ]