Graves Vows To Practice Again

PACE DOCTOR BELIEVES CONVICTION WILL BE OVERTURNED

Dr. James Graves, convicted of manslaughter for illegally prescribing
drugs, vows to work as a physician again.

"I could go back to practicing emergency medicine tomorrow if I need to and
make a very good living doing that," Graves said. "I don't have to go back
and do pain management right away."

The Pace doctor spoke for an hour Thursday from Santa Rosa County Jail. He
was convicted Feb. 19 of manslaughter, racketeering and unlawful delivery
of a controlled substance. He faces up to 165 years in prison when he is
sentenced March 22, a day after his lawyers argue for a new trial.

Graves believes his conviction will be overturned. Then, he will ask for a
new trial outside Santa Rosa County because there has been too much
negative, pretrial publicity.

One day, he said, he will be free.

"I serve and trust a fair and just God, and I believe that he will be fair
with me," Graves said.

Graves addressed a wide range of issues, from what his conviction means for
other pain-management doctors to how he spends his time in jail.

He is housed alone in a cell and is allowed out for one hour three times a
week. Visiting hours are for two hours on Monday nights. He has given jail
medical staff suggestions about his blood pressure medicine and has lost 12
pounds.

Graves was interviewed in the jail's training room. He wore a blue,
two-piece jail uniform, white socks and caramel-colored slippers. His
court-appointed attorneys, Ed Ellis and Mike Gibson, sat nearby.

He said he reads "anything I can get my hands on," and he writes. He has a
lot of time to think about his case, and he maintains his innocence.

"It's incredible to me that a physician can be found guilty of
manslaughter," Graves said. "I knew what I was prescribing was the right
thing in the correct dosage."

To the families of the four patients who overdosed and died between
November 1999 and June 2000, Graves said he is "deeply sorrowful."

"I understand their loss, and I wish that things could have been different
in each one of their circumstances," Graves said. "It bothers any physician
when a patient dies."

But, he takes no responsibility for their deaths.

"Looking back on it, I think if they had taken their medication the way it
had been prescribed, all four of them would still be alive today," he said.

Nancy Elliot, whose brother, Howard Rice, was a patient and fatally
overdosed, said Graves' remorse surprises her. She holds him accountable
for her brother's death.

"Our position still is: The drugs that were prescribed were excessive and
unnecessary, and there were no medical conditions that warranted them,"
said Elliot, who resides in Jacksonville.

Rice, 41, overdosed on April 12, 2000, a day before law enforcement
officers searched Graves' office.

Graves rejects the prosecution claims that his pain-management practice on
U.S. 90 in Milton had a carnival-like atmosphere, with patients waiting for
hours, fixing their cars and giving others the thumbs up when they left
with prescriptions.

Assistant State Attorney Russ Edgar called Graves' office a "prescription
mill" because the doctor wrote virtually the same prescription for dozens
of patients: OxyContin in two strengths, Lortab, Xanax and Soma. He
prescribed up to 12 pills a day.

Pharmacists, who eventually stopped filling the prescriptions, dubbed it
the "Graves cocktail."

Edgar suggested Graves' motive was to make money - about $500,000 a year -
much of it in cash.

But the doctor countered there was nothing criminal about his practice. The
office, which opened in September 1998 and closed in July 2000, was just
like any other doctor's office, he said.

"There were so many things that were just portrayed as evil and wrong,"
Graves said. "There was nothing evil or wrong about them at all. They were
done in good faith."

He said the combination of medications he prescribed had legitimate medical
purposes - OxyContin and Lortab for pain; Xanax for anxiety associated with
chronic pain; and Soma for muscle spasms.

He prescribed so much OxyContin because it is the "No. 1" time-released
medication on the market.

"It is absolutely safe if it's taken as prescribed correctly," he said.

He knew about the drug's abuse and saw needlemarks on some patients' arms.
He kept prescribing OxyContin, he said, because otherwise they would get
the drug on the street.

"What do they do in that case?" Graves said. "How safe is that?"

As a landmark case, Graves believes his conviction will have a chilling
effect on other pain-management doctors. He was the first doctor in the
United States convicted on charges his prescriptions led to patients' deaths.

"I would tell them: be courageous," Graves advised his colleagues.
"Continue to help your chronic-pain patients to the best of your ability.
It's going to be a high price some of them are going to pay if they're
going to do that.

"I just continue to believe someone has to care for these patients in
chronic pain."

He said pain-management doctors are in a "risky business" because there is
no objective way to measure pain. A physician must rely on his patients to
honestly disclose their pain level, and sometimes patients lie.

"If the patient's not shooting square, if they're not telling the truth,
then that decision the doctor makes is based on flawed information, and the
outcome can't possibly be a good one," he said.

He conceded he would have done some things differently, such as keeping
better records, being more vigilant about prescribing some patients
medication and ordering drug tests.

"No doctor is perfect, and some doctors are going to miss some things," he said.