CHRONIC PAIN SUFFERERS LEFT 'HIGH AND DRY'

Shrinking Pool of Specialists Decline New Patients

Like many former patients of Dr. Martin Gillen, chronic pain sufferer
Debora Bertrand pulls no punches about what will happen if anything
comes between her and the powerful drugs that temporarily tame her
full-body agony.

"I'm going to become suicidal," says the 52-year-old former postal
worker, one of many patients and doctors who told the Citizen an
already alarming shortage of pain specialists has hit the boiling
point since Dr. Gillen was forced to surrender his licence in June.

Ottawa has a small and shrinking pool of pain specialists and they are
not taking new patients, generating waiting lists of up to two years.
The pain clinics at the Civic and General campuses of the Ottawa
Hospital are so overwhelmed they have scrapped waiting lists
altogether and are turning away all non-cancer referrals -- hundreds
of people.

"It's very difficult to say no. It's very disheartening. That isn't
what I got into this business to do," said Dr. John Watson, a pain
specialist at the Civic, adding there's a "spot of hope" because his
clinic recently hired a third physician.

Dr. Ellen Thompson, a prominent pain specialist who, like most in her
field, is also an anesthetist, has closed her Ottawa pain clinic and
now sees only a fraction of her former patients at an office in her
home.

"I've been burned out for so long. I cannot honestly do anything for
all the desperate people who have been left high and dry," she said.

"Those of us who are left are just struggling. It's desperate."

Both doctors say Ottawa needs a well-funded pain clinic with
sufficient doctors, nurses and other staff, like ones in Toronto,
Hamilton, Halifax and many other Canadian cities.

The relatively new and somewhat controversial chronic pain specialty
employs drugs -- including morphine-like opioids, as well as
nerve-blocking injections and psychological techniques -- to try to
give sufferers as normal a life as possible.

Family doctors can and do treat ongoing pain. However, many are afraid
to prescribe opioids regularly because the drugs are powerful and
addictive and improper treatment with them can lead to severe
penalties from the College of Physicians and Surgeons of Ontario.

The shortage of specialists is so acute -- and Dr. Gillen so
well-liked -- that many ex-patients say they would gladly continue
seeing him although he admitted to sexual misconduct involving a
female patient. They're furious at Ontario's medical watchdog for not
allowing him to continue seeing patients under strict
supervision.

"I personally call us the living dead. If we had cancer we'd get more
attention. Nobody wants to take us," said Nikki Samuels, who has
periodically felt like a blowtorch is being aimed at her throat and
face since pain spontaneously erupted after a 2002 dental visit.

"Dr. Gillen saved my life. Perhaps the college's policies or practices
need to be reviewed. We're in a crisis situation."

Wendy Miller, another ex-patient of Dr. Gillen, has shed one-third of
her weight since 1993, when the first of two car accidents left her
with a rail-thin body wracked with arthritis-like aches, ending her
career as a craft maker.

"Without him, we've all been suffering. Dr. Gillen is the best," she
said.

In fact, many of them do see Dr. Gillen, but not as a physician. He's
now a receptionist in the Innes Road office of Dr. Marcel Guilmet, who
himself suffers from fibromyalgia, a pain and fatigue disorder, and
who took on hundreds of Dr. Gillen's patients.

Dr. Gillen wasn't the first Eastern Ontario pain specialist to become
acquainted with the college.

In April 2001, Dr. Frank Adams, a leader in the field, moved his
practice from Kingston to Texas after the college found him guilty of
professional misconduct and incompetence for prescribing large doses
of opioids without conducting what college officials believed to be
proper diagnoses, examinations and monitoring.

Some physicians accused the college of reacting to a new specialty by
organizing a witch hunt that would make all doctors afraid of
prescribing the drugs. Dr. Adams's patients scrambled for treatment,
some ending up with Dr. Gillen as well as Ottawa's Dr. Dan Sweet.

Then, in August 2002, the college stripped Dr. Sweet of his right to
prescribe drugs after he admitted giving addicts access to narcotics
as part of a program of "harm reduction" aimed at letting them live as
normal a life as possible with their habit.

Some of his pain patients went to Dr. Gillen and then, when he lost
his licence, to Dr. Guilmet.

Dr. Thompson, who has in the past been scathingly critical of the
college and its effect on the practise of pain management, said
yesterday the college has made strides by issuing guidelines on
opioids to help family doctors prescribe them properly and without
fear.

"What we're trying to deal with now is the hangover effect," from the
past, she said.