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Autumn 2004
O'Shaughnessy's
Journal of the California Cannabis Research Medical Group

 

A Reluctant Martyr: Marian Fry, MD

O'Shaugnessy's News Service

Marian “Mollie” Fry, comes from a long line of doctors. She went to med school at UC Irvine (class of ’85), trained in psychiatry, then switched to family practice. Her office is in Cool, a small town in El Dorado County. She herself has had to deal with breast cancer and other major health problems in recent years, and has used cannabis as an easement for chemo-induced nausea, depression, PTSD, and insomnia.

She discovered its anti-depressant effects at age 13, soon after her mom —a research physician who’d stayed home to raise her kids— died at age 42.
Her husband Dale Schafer, grew up in Sacramento. He observed the medical utility of marijuana first-hand when, as a teenager assigned to Oak Knoll Naval Hospital in Oakland, he assisted the surgeons who tried to perfect the stumps of sailors whose limbs had been amputated en route from Vietnam. After the navy he worked in Kaiser ERs to put himself through college and law school. Fry and Schafer have three kids of their own —17, 14, and 12— and helped raise several others, including two from Schafer’s first marriage, now in their late 20s.
Mollie Fry graduated from Western Washington University in 1980 and from UC Irvine School of Medicine in 1985. After an internship at UC Davis she became a family practitioner in Lodi, where she supervised two physicians’ assistants. The Medical Board of California did not look askance on this approach, which maximizes the number of patients whose care a doctor can oversee.

In ’88 Dale accepted a lucrative job with a San Diego medical-malpractice-defense firm. Mollie decided that her own kids needed her; she stopped practicing in ‘89 and became a home-schooler.
Dale developed misgivings about his firm’s ethics and in ‘93 the family moved to El Dorado County where he entered the workers’ comp field.
In ’96 they bought a big, old house in Greenwood on 26 acres. After Prop 215 passed, Mollie realized she could be of service —having used cannabis herself for various purposes and understanding its range of effects— to the many Californians who would now be seeking professional guidance in using cannabis. She resumed seeing patients (employing a physician’s assistant to handle the initial interview) and Dale established an adjoining practice to advise them of their rights under California’s Health & Safety Code section 11362.5.

Prozac and Paxil put me in such a fog that I could hardly express myself properly.”

In this period Mollie became convinced that she herself had breast cancer, even though several specialists found nothing. “I told them that something was wrong —I actually knew I had breast cancer— and they said ‘You’re depressed’ and offered me Prozac and Paxil, which put me in such a fog that I could hardly express myself properly.” She stopped using the pharmaceuticals when she developed severe hypertension (a fairly common side-effect).

Mollie says if she’d stayed on conventional anti-depressants she would not have had the clarity or forcefulness to insist on an exploratory procedure which revealed a malignancy that had spread to three lymph nodes. Her breasts were removed Dec. 17, 1997.

Mollie Fry and Dale Schafer got their first visit from law enforcement —two uniformed El Dorado County Sheriff’s deputies— in the summer of ’99. At the time there were six plants in the garden. Mollie said she was willing to help the officers “identify those people who are truly ill from those people who belong in jail for dealing drugs.’ They said, ‘Dr. Fry, write notes.’ I shook their hands, they left my house.”

When I used to prescribe drugs to people out of the PDR I would always go over the side-effects and possible long-term complications because they could be so dangerous.”

Mollie feels her early paperwork may have been lax because she was so convinced of the benignity of cannabis. “I used common sense. When I used to prescribe drugs to people out of the PDR I would always go over the side-effects and possible long-term complications because they could be so dangerous. Cannabis is so much safer than Tylenol, which is sold over-the-counter… And most of my patients were using it to get off much more dangerous drugs, like Prozac and alcohol, or to cut down on opiates. I had spoken to Tod [Mikuriya], and really saw eye-to-eye with him.

“After I got called into court [to confirm and defend her recommendation of cannabis for a given patient] about four or five times, I figured out how to tighten my records. Now I have a procedure that is so locked-down…patients come in with their records, if possible; they fill out a complete questionnaire; they sign a release for me to use the information in research; and they confirm under penalty of perjury that they’re not lying. They watch a film in which Dale reads the elements of the statute and I speak about the right to determine the best course of treatment, which means the right to consider all the options… Then they see Dale for at least 20 minutes, then they come to me.

“I often find that pain patients are suffering from severe over- or under-medication. I tell them ‘You need to go back to your doctor, you need to talk to them about this, suggest that they reduce this or that. I see a lot of doube anti-depressants, people taking Wellbutrin and Paxil. A lot of people taking 10 to 12 Vicodin a day, which is too much Tylenol [acetomenaphine being a co-ingredient]… I focus on their health and their habits. And of course I touch the part that hurts and try to figure out why it does. And I document it in the charts.”

Fry only orders procedures such as blood tests and x-rays when a patient refuses to see a primary-care doctor. “There are some crusty old men who are making a conscious choice to die rather than be subjected to certain things. I don’t think they should go to jail. With them I ask ‘What hurts most?’ They’ll say, ‘Well, doc, it’s gotta be this right hip.’ I’ll ask, ‘Will you let me order an x-ray for just that hip? Because we know it’s gonna show arthritis.’ And they usually go ‘Sure.’ For people who refuse, I can document that I wanted them to get a doctor; and they qualify [for a cannabis approval] based on the x-ray, which will be read by a second physician.

“A lot of people say to me, ‘Dr. Fry, since I’ve been using marijuana, I don’t need those pills. I don’t want to go back to that stupid doctor.’ I say, ‘I’m sorry, that may be good medicine, but it’s not good legal practice. You need to go back to the doctor at least every couple of years and report that you’re still having…’ whatever problems they’re complaining of.”

By the start of ’00 Mollie and Dale were beginning to feel confident that their medical/legal practices were appropriate under Prop 215. (The sheriff’s deputies had returned before the ‘99 harvest and told Dale he was a good grower.) They leased space in Oakland and Lake Tahoe to conduct one-day-a-week clinics at which they would typically see 15-20 patients.
On one occasion Mollie approached Attorney General Bill Lockyer at a VFW fundraiser and told him what she was doing. “The people who could most benefit from the implementation of Prop 215 are veterans,” she noted, “Vets with purple hearts.” According to Mollie, ‘Bill Lockyer said ‘Okay, go for it, but be low-key.’ He said something to imply, not that I should hide but that I should be discreet. Maybe that was the word he used… But the problem was, by now I had staff and office rents, and how do you let patients know that you’re available without advertising?”

Fry was charging $100 an initial visit and $40 for a re-ceritifaction. Patients on social security or welfare received discounts. “A lot of money flowed through the business,” says Mollie, “but it all went out to staff.” Dale and physician’s assistant Rob Poseley employed a receptionist and a file clerk. Mollie had a personal secretary working with her on some book projects —one on medical marijuana, one on surviving cancer, and one for children. She also employed “a full-time medical-records officer dealing with paperwork. The clubs tend to be very demanding, which creates a whole ‘nother layer of paperwork that no other doctor has to pay for… Then I had a data-entry person putting all our patients’s records into the computer for research purposes. The government [DEA] got all our computers [in a subsequent raid].”

In the spring of ’00 the El Dorado county sheriff’s investigators returned to the Fry-Schafer residence asking questions on behalf of the DEA about a former employee named Paul Magge. “They left and it seemed like no big deal,” Mollie recalls. “We harvested, I had enough medicine, Dale was making concentrates for me, I was feeling better, we had a staff we could trust… We decided to contact Bill Lockyer again and confirm that we were on the right track.” Dale arranged a meeting with Dave De Alba, the senior assistant AG whom Lockyer had put in charge of Prop-215 matters. “Dave told us to stay the hell away from Tod. That Tod is targeted, and that Tod is a problem. We ignored that, of course, because we like and respect Tod…” De Alba also arranged a meeting at which representatives of the Medical Board provided Schafer with practice guidelines. Fry reviewed them and felt she already was abiding by them.

In July of 2001 Dale Schafer announced that he was running for District Attorney of El Dorado County, putting up signs and going to the local fairs. That September he and Mollie were raided by the DEA —a raid they think DA Gary Lacy may have initiated with a call to the feds. (Shafer would finish third with 15% of the vote.)
Mollie recalls the raid: “I was going to bed with a migraine headache and they came running up my driveway with their guns in their riot uniforms. I opened my arms and said, ‘I entirely submit. You are welcome in my home.’ And they still forced me to the ground and handcuffed me for two hours. My hands turned white. I was so cold, my hands were shaking… So they moved me into the trailer. Then I had to change our granddaughter’s shitty diaper while in handcuffs. I couldn’t quite wipe… I said to the agent, ‘It’s so hard having five children and a baby to take care of and cancer…’ And she looked at me and said, ‘You have cancer?’ And I go, ‘Of course I have cancer, why the hell do you think I’m doing this!

“Not even the staff that raided me and was abusing me knew the truth.”

The September 28, 2001 DEA raid on Mollie Fry and Dale Schafer’s house in rural El Dorado county could not have come at a worse time, says Dr. Fry. “Dale was trying to learn to grow indoors. It’s almost impossible. You have to spend three hours a day every day playing with the plants. Ours got covered with spider mites and died. I had put them under the deck, not under lights, figuring Dale would compost them. We had nine plants growing for me, maybe four feet tall, in full bloom, and three plants from a woman I knew, a legitimate patient, who was being evicted and had asked Dale to take care of her plants for her. So we had 12 viable plants, and two of them had toppled over in a windstorm so Dale brought them into my bedroom to trim. It must have looked like a Christmas tree farm.

“And the house! At the time of the raid there was a mother and four children living here, so things were a little disordered. We’ve had about 50 people living in our house over the years…. When they handcuffed me I put my hands above my head and said ‘Thank you, praise you, thank you for making my book a bestseller! Thank you, praise you for electing my husband district attorney of El Dorado County!’
“The El Dorado cops were there and the DEA. I must have prayed a 20-minute prayer. They would ask me a question and I would answer yes or no and go right back to praying. I needed help. And finally they went away. But I think [El Dorado County DA Gary] Lacy got the word that Dale was really running to win, and a few days after he was re-elected, we heard that he had gone to the grand jury to get Dale indicted.”
The DEA sent Fry an order-to-show-cause advising that her prescription-writing privileges would be revoked because “It is inconsistent with the public interest for a DEA registered practitioner to live in a residence wherein large quantities of a controlled substance are being stored, cultivated, manufactured and/or processed for distribution and/or sale. In addition, it is inconsistent with the public interest for a DEA registered practitioner to be engaged in the illegal sale of a Schedule I controlled substance such as marijuana at the practioner’s registered location.”

The DEA also facilitated the Medical Board’s investigation of Fry by turning over certain of her patients’ records.

Medical Board Got Records From DEA Illegally, Says Fry

California Assemblywoman Hannah-Beth Jackson and State Sen. John Vasconcellos moved Aug. 11 that the Joint Legislative Audit Committee determine whether the state medical board has been investigating doctors for no other reason than that they specialize in cannabis consultations. At least nine of the 15 cannabis consultant MDs have been investigated, and it’s a costly, time-consuming, stressful ordeal no matter what the outcome.
The request for an audit fell one vote short because Sen. Kevin Murray, a Southern California Democrat, didn’t show. A reliable source says he’s lazy and irresponsible. This was a costly screw-up, a missed opportunity to expose the criteria by which the Board’s Enforcement Division has been choosing which doctors to pursue.
That same week Marian Fry, MD, appeared before Administrative Law Judge Ruth Astle in Oakland to recommend dismissal of the Medical Board’s case against her on the grounds that her files had been obtained improperly via the DEA. Fry, who does cannabis consultations from an office in Cool, California, was represented by attorney Lawrence Lichter.
The Attorney General’s office, representing the Medical Board, accuses Fry of providing substandard care to five patients. “Every patient I’ve been asked about by the medical board has passed through the criminal justice system in either El Dorado or Sacramento County,” Fry says. “The complaints all came from district attorneys, not the patients themselves.”
The three patients named in the accusation with whom Fry is still in contact refused to release their files to the Board, and she assumes the others would have, too. Conveniently for the Board, the federal Drug Enforcement Agency had raided the home and offices of Fry and her husband, attorney Dale Schafer, in September, 2001, confiscating 24 file cabinets containing 6,000 patients’ records. The Board acknowledges that it obtained Fry’s records from the DEA.
Lichter was able to site a section of the California penal code listing the steps that have to be taken before law enforcement agencies can share medical information. Fry’s prosecutors downplayed the significance of code section, arguing that “law enforcement agencies share information all the time,” and that it had been done “pursuant to statute.” But the statute they cited was a federal law authorizing the DEA to release information, not authorizing a state agency to receive it.
Judge Astle expressed concern about the Medical Board obtaining records without patients’ consent, or a warrant, or a subpoena, or the involvement of a judge. She requested more briefing and continued the hearing on the motion to dismiss till October 1.
See story on this page for the background of Fry’s ordeal.

 

 

O'Shaughnessy's
O'Shaughnessy's is the journal of the CCRMG/SCC. Our primary goals are the same as the stated goals of any reputable scientific publication: to bring out findings that are accurate, duplicable, and useful to the community at large. But in order to do this, we have to pursue parallel goals such as removing the impediments to clinical research created by Prohibition, and educating our colleagues, co-workers and patients as we educate ourselves about the medical uses of cannabis.
 
SCC
The Society of Cannabis Clinicians (SCC) was formed in the Autumn of 2004 by the member physicians of CCRMG to aid in the promulgation of voluntary standards for clinicians engaged in the recommendation and approval of cannabis under California law (HSC §11362.5).

As the collaborative effort continues to move closer to issueing guidelines, this site serves as a public venue for airing and discussing these guidelines.

Visit the SCC Site for more information.