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From: Frank B. Fisher, M.D. To: Alex DeLuca ; allynbeth@aol.com ; Bary Meier ; Billy Hurwitz ; caauction@earthlink.net ; Carl HALL ; Charles Hixson ; Cheryl Gaul ; Don Link ; Dorothy Bryant ; Doug Thorburn ; Gary Delsohn ; Gary Greenberg ; Kim Bolander ; Kurtis Ming ; Mary Baluss ; Mike Fisher ; Pain + Chemical Dependency ; Pain Issues ; Rich Willner ; Robin Goodfellow ; roy higgins ; Shannon Sullivan ; Skip Baker ; Tod Mikuriya ; Tom Grace ; Jeff Anderson
Sent: Thursday, June 27, 2002 11:27 PM
Subject: Another Pain Doctor Arrested
Friends, It has been a long day... here's why..
We Have To Stop the War on Doctors Who Treat Pain
Myrtle Beach, S.C. June 26, 2002.
The doctor is a pleasant-faced woman. She stands by her front door on a hot summer morning, her young son against her leg. Her husband stands in the doorway behind her, completing what should be an ordinary family moment. But the doctor?s wrists are cuffed behind her back. Her legs are shackled. The child is not leaning into her as he usually does, for closeness and support. He is crying, clinging, shrieking. The father?s face is gray as he steps into the sun and lifts the child away. The doctor-mother disappears into the back of one of three squad cars that had pulled up only minutes before. She is a doctor who has treated pain using Oxycontin and other medications. She will go to jail today for that. This is a pain that she can?t make go away.
Deborah Bordeaux, M.D., board-certified in family medicine will be arraigned today in Charleston, S.C.. She is my pro bono client. We had seen her indictment coming, but had not been prepared for the stark, brutal manner with which it was carried out. I am not a criminal lawyer; this is my first experience with the hard details of an arrest, as it is hers.
A week ago I flew down to meet with the US attorney for that part of South Carolina in a last effort to avoid indictment. ?Come on?, he said, ?but I?ll be hard to convince?. We worked the day before, packaging facts that disputed every element of her ?wrong-doing? that the DEA had given out. She had never even seen many of the patients they named. One she had seen, whose death was mentioned, had died over a year and eight doctors later than her two clinic visits with him. We brought the affidavits of patients whom she had treated with care, for whom she had been ?the first doctor who paid any attention to me?. We explained again that she had only worked at the clinic for 57 days. That she terminated patients who seemed to be abusing their pain medicine or faking their pain. That she kept a list of patients she would not see again even if they were accepted by other clinic doctors. The prosecuting attorney and the three DEA agents who heard us out were dismissive. ?You don?t understand? they said.? ?She isn?t going to be indicted on that evidence?. ?Oh,? we said, ?what evidence would you use?? ?We won?t tell you.?
We will find out when we see the indictment today. Sometime soon the government will have to give out the ?tons of evidence? they claim to have. She may, I suppose, even be convicted?mix media frenzy over ?Oxycontin, the hillbilly heroin? and the manipulable conservatism of a South Carolina jury and it could happen. But I do know this, Deborah Bordeaux will not plead guilty. She treated clinic patients in good faith and treated them well.
The investigation into the pain clinic where she worked briefly has been going on for a long time. She had met repeatedly with the DEA, the first time only days after she quit the clinic. Voluntarily, freely and frankly, without asking for promises or deals. Deals have been offered. Everyone advised her to take one. ?Just plead guilty to something small?. ?Get this behind you.?. ?Johnny?s too young.? ?(Husband) Ed?s too sick.? She says ?Show me how I have broken any law and I will plead.? She has a gentle, steel-hard determination not to tarnish herself or her son with a plea otherwise. Her husband agrees. He is sick enough to have received a settlement on his life insurance, but he still agrees. He knows who she is.
The War on Drugs has become a war on doctors who treat pain with opioids?Oxycontin, morphine, methadone (yes, it is a good pain medicine and cheap to boot). I am not talking about doctors who trade sex for drugs or sell scripts. I am talking about doctors who treat difficult patients who have difficult lives and severe, persistent pain. These target doctors are not protected by the academic medical centers. They have a lot to lose. For every Dr. Bordeaux there are probably dozens of doctors who simply stop prescribing these medications when the state medical board or the DEA come with questions or the pharmacist mutters about ?high doses?. I have talked with too many of these doctors. I hate it when they abandon their patients under pressure. At least, however, they acknowledge the pain. For every doctor who backs fearfully out of pain management, there are hundreds who refuse to start because they just don?t want to take the risk. That is why another of my clients is the son of a 74-year old man who suffered weeks of agony before his fast-moving cancer killed him. His oncologist refused to provide anything stronger than Tylenol. She said, ?I don?t want him to die an addict and I will not risk a pill bottle with my name on it turning up on the street.?
This has to stop. It is as simple as that.
On paper, at the top levels, in the cool of a Washington D.C. press conference, DEA Administrator Hutchinson uses all of the right buzz words to encourage pain management. http://www.deadiversion.usdoj.gov/pubs/pressrel/newsrel_102301.pdf In the field, the reality is starkly different. It will continue that way as long as the medical profession goes along, distancing themselves from doctors who are threatened and harassed. It will continue as long as the patients don?t know enough about their alternatives. All of us who advocate for good medicine have to make it stop. One of the ways to do that is to take a stand, to acknowlege that bad things happen to good doctors, and insist that the nice words mean something.
Mary Baluss, Esq.
The Pain Law Initiative
? Mary Baluss 2002
Mary Baluss-Pain Law Initiative2850 Arizona Terr. NWWashington, DC 20016202/244-0710 (phone)202/361-2775 (cell-preferred number)202/318-3027(fax)mbaluss@yahoo.com
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