PLENTY OF PAIN TO GO AROUND

McLean Pain Doctor, 59, Sentenced To 25 Years In Prison.

Some families will always consider Dr. William E. Hurwitz a healer. Elyssa
Gurganus, of North Carolina, says she had already picked out a plot in a
cemetery before she sought treatment from Dr. Hurwitz for chronic pain.
"After seeing him for months, I was back on my feet for the first time in
10 years," said Gurganus. "I thank God that he gave me my life, and I will
always be grateful.

He has saved so many lives." Other families will always consider Hurwitz a
killer. "My mother had two visits with Dr. Hurwitz and was brought home in
a container," said Jennifer Click, whose mother Linda Lalmond, 51, died in
2000 in a Falls Church hotel room after consulting Hurwitz for chronic
pain. "He can never restore what he has taken from us," Click told U.S.
District Court Judge Leonard D. Wexler, during Hurwitz's sentencing last
Thursday, April 14 in Alexandria. "I ask you to sentence him to life, which
is far less than he sentenced my mother to." Wexler sentenced Hurwitz, 59,
to 25-years in prison.

He also ordered Hurwitz, once considered a national leader for treating
chronic pain patients with aggressive doses of opioid medication such as
OxyContin and Dilaudid, to pay a $1 million fine. After a six week trial
last fall, featuring 76 witnesses - 63 for the prosecution - and thousands
of pages of exhibits, a jury convicted the McLean pain doctor of 50 of 62
counts against him, including conspiracy to traffic in controlled
substances, drug trafficking resulting in serious bodily injury and death,
and drug trafficking distributions. "I do not feel sorry for you. You were
one of the chosen people," Wexler said. "By your behavior, you put people
in jail. By your behavior, you seriously injured people.

By your behavior, you killed people." Hurwitz will file his formal intent
to appeal the case to the Fourth Circuit Court of Appeals within 10 days of
sentencing.

MORE THAN 135 people filled the 8th floor courtroom last Thursday. They
comprised two distinct groups - one of family, past patients and advocates
for patients with chronic pain who believe Hurwitz relieved pain and is a
victim of overzealous prosecution, and the other of those families who
wanted to see Hurwitz pay for the pain he's caused. Hurwitz's supporters
stood up to applaud him as he was led into the courtroom, wearing a green
prison jumpsuit.

At the same time, families of people who died under Hurwitz's care wept.
Defense attorney Marvin Miller said Hurwitz, a former volunteer medical
director for Peace Corps in Brazil, dedicated his life to serving people.
"All the good he's done has to account for something," Miller said,
requesting some leniency from Wexler. Assistant U.S. Attorneys Gene Rossi
and Mark D. Lytle asked Wexler to sentence Hurwitz to life. "Dr. Hurwitz
does not just deserve a tough sentence including life, he has arrogantly
earned it," Rossi said. "Despite incontrovertible evidence of his direct
knowledge of drug dealing and drug abusing by his patients, the defendant
continued to prescribe large quantities of potent narcotics," according to
Lytle. "His behavior not only damaged the very patients he claimed to care
about, but his criminal conduct has affected entire communities in rural
Appalachia where he fed the black market for drugs like OxyContin and
Dilaudid." Wexler limited both the prosecution and the defense to five
people to testify at the sentencing hearing, and those witnesses took turns
sharing contrasting views of the pain doctor. Paul Nye, of Prince William
County, said the large amounts of OxyContin prescribed by Hurwitz to his
wife became "more important to her than me, our children, herself." "I've
spent everyday of my life since my wife's death trying to repair my
family," Nye said. Finding Hurwitz's Web site on the Internet was "like
putting $20 in a slot machine, the bells were ringing," said Gerald Walker,
of Michigan. Walker spent $88,000 filling Hurwitz's prescriptions for pills
in two years. "Pills were the only thing I cared about," he said. "What I
want to know is how could anybody on earth justify 600 pills a day for knee
pain." But Camilo Andrade, another patient, said patients have
responsibility themselves. "I was terrified at the medication at first, and
I received a great deal of benefit from Dr. Hurwitz," said Andrade,
formerly of the CIA. "The man I saw on a monthly basis was a professional,
and very helpful and good and concerned."

HURWITZ REMAINED SILENT at his sentencing, even though Wexler asked twice
if he wanted to speak to the court and to victims. Hurwitz's ex-wife, Nilse
Quercia, and childhood friend, Jonathan Arac, gave a deeper glimpse into
Hurwitz's psyche and motivations. Quercia met Hurwitz when he worked from
1973-1975 with the Peace Corps in Brazil, her homeland. "Very soon, my
friends and I realized he was an incredible human being and he was a wealth
of humanity," she said, recalling how he would often go to the slums of
Brazil to offer medical care to people even though his job was to take care
of Peace Corps volunteers. "Billy was somebody who hoped to use his gifts
to help people," said Arac, chairman of the English Department at Columbia
University. "Billy has enormous capacity to understand the best human
qualities in every individual he encounters." After he set up his practice
in the Northern Virginia area, "his devotion was such that he made himself
available 24 hours a day," Quercia said. "Patients called him at all hours,
he always took the time to talk." She remembered when one of his patients,
an elderly woman, missed an appointment. When he drove to the patient's
house, he diagnosed her with pneumonia, picked her up and drove her to the
hospital. She recalled another time they were in a car accident with
another driver, who was at fault and had no insurance. Her husband didn't
press charges, he gave the driver, a dishwasher, a ride to work, she said.
"I loved him so much in that moment because we live in such a cruel world
and there was this person who was filled with kindness," Quercia said. But
one of her husband's greatest weaknesses, she said, was that he was "too
trusting of people.

When he was committed to a relationship, he could not conceive someone he
trusted could lie. "He only saw the best in people and always gave them the
benefit of the doubt. He thought with love and encouragement he could help
them. He was a constant source of love," Quercia said. "I am very saddened.

I believe that Billy thought what he was doing was the best for them," she
said. "He is not a criminal, he is a loving man, he is a pure soul. . He
doesn't belong in jail."

PROSECUTORS NEVER DISCOUNTED the care some of Hurwitz's patients received.
But the 1,879,677 pills prescribed by Hurwitz to just 24 of the 400-plus
patients he treated from 1998-2002 led to drug addiction, drug dependency
and death, according to Rossi and Lytle. "This case is about the egregious
and criminal conduct of one rogue doctor who simply refused to comply with
the basic tenets of good medical practice despite numerous sanctions from
medical and regulatory authorities and overwhelming evidence of patients
who were diverting and/or abusing the narcotics he prescribed," wrote Lytle
in court documents filed before sentencing. Throughout the six-week trial,
Rossi and Lytle emphasized that Hurwitz deliberately ignored obvious "red
flags" of abuse and distribution and continued to prescribed medication to
patients who: tested positive for illicit narcotics, requested numerous
early refills for medication, had track marks on their arms, cocaine rashes
on their skin, and even were arrested for distributing Hurwitz's
medications. As one example, prosecutors pointed to William "Curtis"
Mullins. Hurwitz continued to write prescriptions for Mullins even after a
family member wrote Hurwitz a letter in April of 2000. "We do not wish to
see him looking like a pin cushion up and down both arms. This young man is
out of control with his meds," wrote the family member. Another patient,
Bret McCarter, whose street name was "Mav," paid $15,000 to $20,000 a month
to fill prescriptions for OxyContin, Dilaudid and Methadone. Prosecutors
said that even though Hurwitz's waiting room had a sign warning patients
that they would be terminated if they tested positive for cocaine or
marijuana, Hurwitz continued to issue McCarter high doses even after he
tested positive for cocaine numerous times. Hurwitz failed to make use of
information authorities tried to provide to him, according to Lytle and
Rossi. Peter Grant, for example, was arrested on April 3, 2002 and had
needle marks up and down his arm. Even though a detective called Hurwitz to
let him know, Hurwitz continued to issue Grant narcotics, "the last thing
he should've received," Lytle wrote. On May 29, 2002, Grant was arrested
for the third time in a year, when he was found passed out in the parking
lot of a 7-Eleven. The arresting detective said he found the "engine
running, a full syringe of Dilaudid resting on [Grant's] leg, an
unconscious woman in the passenger seat and her four-year-old daughter
asleep in the rear, amidst used syringes littered throughout the backseat,"
according to court documents. More than 15 convicted felons testified
against Hurwitz during the trial. Some of them, including Cynthia Horn and
Robert Woodson, who wore a hidden tape recorder into Hurwitz's office, were
granted reduced jail time after their testimony and are now released.

Others, such as Timothy Urbani who was originally sentenced to 240 months
in jail, had his sentence reduced to 72 months. Prosecutors never claimed
that Hurwitz profited from the drug dealers' illegal sales of pills he had
prescribed.

ONE FALLACY of the case against Hurwitz, according to Miller, one of his
attorneys, is that the jury only got to see a small portion of his
practice. During the six-week trial last November and December, Wexler
limited Miller to five past patients who could testify during the trial.

Molly Shaw, William Fleischaker and Sylvester Boyd all testified that
Hurwitz saved their lives. "The jury made its finding, the government made
its case, but that wasn't the whole practice," Miller said last Thursday.
"There are all kinds of people you didn't get to see. . There are hundreds
of people who have a life because he gave it to them." Hurwitz's attorneys
maintain that he was duped by the small percentage of drug dealers of his
practice, estimated at about 10 percent of the 400-plus practice. "He's
academically brilliant, but he has no street smarts," Miller said.

HAVING HURWITZ BEHIND BARS makes Virginia's streets and American's streets
safer, said U.S. Attorney Paul J. McNulty, during a press conference
immediately after Hurwitz's sentencing in the Office of the U.S. Attorney
in Alexandria. Outside the courtroom, Quercia said it doesn't make sense
for her ex-husband to be behind bars. "I'm so disappointed in the American
justice system," Quercia said, after her husband was led back to jail. Her
husband often didn't charge patients for treatment if they couldn't pay,
she said during the hearing.

One time, when she and her ex-husband found out that the family he was
treating for free was wealthy, he didn't get upset. She said he simply
responded, "That's life.sometimes you win, sometimes you lose."

Sidebar

Dr. Hurwitz: Timeline "By your behavior, you put people in jail. By your
behavior, you seriously injured people.

By your behavior, you killed people." - Judge Leonard D. Wexler

"He is not a criminal, he is a loving man, he is a pure soul. He doesn't
belong in jail." - Nilse Quercia, Hurwitz's ex-wife

"All the good he's done has to account for something." - Marvin Miller,
defense attorney

Timeline: Dr. William E. Hurwitz 1945: Hurwitz born 1963: Graduates,
Roxbury Latin School (Boston) 1966: Receives B.A., Mathematics, Columbia
University 1971: Receives M.D., Stanford University 1971: Receives M.A.,
Sociology, Stanford University 1971-1972: Intern, Internal Medicine, Boston
Veterans Hospital 1973-75: Medical Director, Peace Corps Brazil 1975-76:
Resident in Internal Medicine, Washington Veterans Hospital 1976: Marries
Nilse Quercia 1976-77: Clinical Scholar, Robert Wood Johnson Program,
George Washington University 1977: Certified, American Board of Internal
Medicine 1977-96: Internist in private practice, Washington, D.C. 1978:
First treats patient with intractable pain 1978-91: Medical Director, The
Presbyterian Home of Washington, D.C. 1980: Oldest daughter Elisa born
1981: Youngest daughter Gabriela born 1991: Medical director, Arleigh Burke
Pavilion, McLean 1991: D.C. Board of Medicine suspends license 1992: D.C.
Board restores license 1992-96: Pain practice grows to more than 200
patients 1993-96: President, National Chronic Pain Outreach Association
1996: Receives J.D., George Mason University School of Law 1996: Virginia
Board of Medicine brings disciplinary charges against Hurwitz, alleging he
"indiscriminately and excessively" prescribed high dosages of opioid drugs
to 29 patients.

The Board orders 90-day suspension of his license followed by probation.
July 1998: Resumes practice, treating patients with intractable pain in
McLean 2000: DEA requests Hurwitz to provide more than 6,000 pages of
records regarding 32 patients Nov. 6, 2002: Hurwitz's office searched by
DEA Dec. 2002: Hurwitz shuts down his pain practice Summer 2003: Virginia
Board of Medicine places Hurwitz on indefinite probation. The Board rules
that Hurwitz believed he was practicing medicine in good faith, and for
recognized and accepted medicinal or therapeutic purposes. Nov. 2004:
Criminal trial begins, U.S. District Court, Alexandria Dec. 2004: Hurwitz
convicted of 50 of 62 counts against him April 14, 2004: Hurwitz sentenced
to 25 years in prison

Misled? National Implications Advocates for people who suffer with chronic,
severe pain say Hurwitz's trial has made it harder for pain patients to get
relief. "Physicians are understandably unwilling to run the risk of being
federally prosecuted and ending up in Hurwitz's position," according to
Siobhan Reynolds, of the Pain Relief Network, who wrote to President George
W. Bush on April 13, urging him to call for Congressional hearings on the
prosecution of pain doctors. "By announcing to the press at the time of
arrest that the physician has killed several of his patients, and indicting
him on dozens of felonies, the U.S. Attorneys use their official power to
give the court and the public the impression that they are bringing a
hardened criminal to justice," Reynolds wrote. "By the time the case
reaches the courtroom, however, what we find is a well-intentioned doctor
who has been duped by a tiny percentage of his patients, the government
arguing that he should have known better." But Hurwitz and his supporters
are the ones who have misled pain doctors across the country, according to
Assistant U.S. Attorney Mark Lytle. "Many pain practitioners across this
country are being misled by the defendant and his supporters about the type
of conduct that could bring about criminal charges against a pain
management physician," Lytle wrote, in a pre-sentence report. "The irony in
all of this is that the defendant, who has held himself out as a supposed
national leader in the treatment of chronic pain, has done more through his
own deceit to cause a chilling effect on legitimate physicians trying to
treat chronic pain sufferers than any other possible cause," Lytle wrote.
"Dr. Hurwitz was one of a very small number of doctors who grossly abused
his authority, recklessly exploiting the term 'pain treatment' to deal
street narcotics like a common drug dealer," according to Karen P. Tandy,
DEA administrator. The Drug Enforcement Agency "remains committed to
striking a balance between promoting pain relief for patients in need and
preventing abuse of pain medications," she said.