THE DOCTOR OF LAST RESORT

When the Medical Marijuana Patients Union held a symposium in Fort
Bragg in August, 2004, Sheriff Tony Craver asked an organizer to
please introduce him to Dr. Tod Mikuriya. It turned out that Mikuriya
had left after participating in a morning panel. "That's one man I've
always wanted to meet," said Craver, looking down in disappointment.
The sheriff knew there was something unique about Mikuriya, and so
did half the cops and prosecutors in California, who, unlike Tony
Craver, fiercely resented him for legitimizing people previously
considered criminals.

Mikuriya died Sunday at his home in the Berkeley Hills. He was 73.
The cause was complications of cancer.

In the final days he'd been in the care of his sisters, Beverly, an
MD from Bucks County, Pennsylvania, and Mary Jane of San Francisco,
and his longtime assistant, John Trapp. Cancer had been diagnosed
originally in his lungs, and as of last March it had been detected in
his liver, too. Dennis Peron and Dale Gieringer threw farewell
parties for him. He canceled a trip to Hungary where he was to
present a paper at the International Cannabinoid Research Society meeting.

His office began steering patients to other doctors.

And then his condition improved.

In late May 2006 Mikuriya attended his 50th reunion at Reed College
and sang rounds with his old madrigal group.

His office geared up again.

He wrote the lead section of an article recounting what California
doctors had learned in the 10 years since the passage of Prop 215
("Medical Marijuana in California, 1996-2006," O'Shaughnessy's,
Winter/Spring 2007). He met with a publisher about reissuing
"Marijuana Medical Papers," his 1973 anthology of pre-prohibition
medical literature -the new edition to include a CD containing eight
more articles that had come to his attention over the years.

He had many visits from his 12-year-old daughter, Hero, the apple of
his eye; they even went cross-country skiing one weekend.

As recently as March Mikuriya played a key role organizing a
symposium at which retired colonel James Ketchum, MD, discussed the
Army's secret search for a cannabinoid-based incapacitating agent.
Mikuriya had begun assembling the contents for a new anthology,
"Cannabis Clinical Papers," that would include studies by colleagues
and three major papers of his own: "Cannabis as a Substitute for
Alcohol;" "Cannabis as a First-Line Treatment for Mental Disorders;"
and "Cannabis Eases Post-Traumatic Stress." (The titles alone reflect
the relevance of Mikuriya's concerns.)

Even his historical studies related to our present time and place.

For example: "An 1873 survey by British tax officials in India
elicited a range of views on cannabis that seems strikingly
contemporary... 'the general opinion seems to be that the evil
effects of ganja have been exaggerated.'")

Mikuriya liked to use the slogans "Grandfather it in!" and "Back to
the future!" in discussing the legalization of cannabis for medical
use. The generations of Americans who discovered cannabis in social
settings in the 1960s and the decades that followed had no idea that
it had been widely used in this country between the Civil War and the
Great Depression, with tinctures manufactured by Eli Lilly, Parke,
Davis and other major pharmaceutical companies available by
prescription. For decades Mikuriya was the only MD among the small
group of activists and scholars who collected the bottles and labels
and sought to unearth and publicize the history that our educational
system had erased so systematically.

Mikuriya was given to creating polysyllabic phrases that forced one
to puzzle over their meaning.

For example, America's cultural preference for the modern he called
"temporal chauvinism." Cannabis clubs, he said, showed the efficacy
of "proactive structuralism;" by which he meant, "People can create
something and, by doing so, set a precedent."

Tod Hiro Mikuriya was born in Eastern Pennsylvania in 1933 to Anna
(Schwenk) and Tadafumi Mikuriya. His father was a Japanese Samurai
who converted to Christianity, his mother a German immigrant and
practicing Baha'i. Tod and his two younger sisters went to Quaker
schools. "The Quakers were proprietors of the underground railway,"
Tod noted. "The cannabis prohibition has the same dynamics as the
bigotry and racism my family and I experienced starting on December
7, 1941, when we were transformed from normal-but-different people
into war-criminal surrogates."

He graduated from Reed College in 1956, served as a medic in the U.S.
Army, and then attended Temple University School of Medicine. It was
at Temple that a reference in a pharmacology text to the medical
utility of marijuana triggered the interest that would define
Mikuriya's career.

After getting his medical degree, Mikuriya served an internship at
Southern Pacific General Hospital in San Francisco, specialized in
psychiatry at the Oregon State Hospital in Salem, and completed his
training at Mendocino State Hospital. In 1967 he became director of
non-classified marijuana research for the National Institute of
Mental Health Center for Narcotics and Drug Abuse. He left the
position after several months, he said, "When it became clear they
only wanted research into damaging effects, not helpful ones."

Mikuriya moved to Berkeley in 1970 and entered private practice.

He was active in Amorphia, a West Coast reform group that eventually
folded into NORML, and helped organize a 1972 marijuana legalization
initiative, working alongside Michael and Michelle Aldrich, Pebbles
Trippet, and others who stayed with the struggle through the ensuing
decades of cultural and political rollback.

"Western medicine has forgotten almost all it once knew about the
therapeutic properties of marijuana," Mikuriya lamented to a UCSF
medical student interviewing him in 1996. (I had the privilege of
sitting in.) "Hemp-based tinctures and preparations were prescribed
for myriad purposes(analgesic and hypnotic; appetite stimulant;
anti-epileptic and antispasmodic; for the prevention and treatment of
the neuralgias, including migraine and tic doloreux; antidepressant
and tranquilizer; oxytocic (to induce uterine contractions); topical
anesthetic; withdrawal agent for opiate, chloral and alcohol
addiction; introcular hypotensive; childbirth analgesic;
hypothermogenic." Cannabis is also an antiasthmatic and antitussive
(cough suppressant), Mikuriya told the med student.

It went out of favor with doctors in the early decades of the 20th
century 3not because it was deemed toxic or dangerous but because
alternatives came on the market -injectable opiates and synthetics
such as aspirin and barbiturates-that were quicker-acting and offered
more consistency in dosage and patient response.2

When Dennis Peron launched the San Francisco Cannabis Buyers Club at
the start of the '90s, Mikuriya saw "a unique research opportunity."
He began interviewing club members in an attempt to confirm or add to
descriptions in the pre-prohibition literature. When Prop 215 was
being drafted, Mikuriya contributed the all-important phrase in the
first sentence that allows doctors to approve marijuana use in
treating "any...condition for which marijuana provides relief."
(Eleven other states have since passed laws allowing marijuana use to
treat specific conditions. Mikuriya considered them all
intellectually dishonest compromises.)

Mikuriya's contention that marijuana alleviates an extremely wide
range of symptoms was ridiculed by Drug Czar Barry McCaffrey and
other federal officials at a press conference in December, 1996.
Reform advocates promptly sued the drug czar's office and obtained a
federal injunction confirming the Constitutional right of doctors and
patients to discuss marijuana as a treatment option.

Nevertheless, for several years following the passage of Prop 215,
almost no California MDs were willing to risk the wrath of the
government by putting in writing a recommendation for cannabis in the
treatment of say, depression, or lower back pain. People all over the
state were calling cannabis clubs to report that their doctors -many
of whom had expressed their approval of marijuana previously-would
not give them a written "letter of diagnosis" entitling them to join
a club. These people would very often be given the name and phone
number of Tod Mikuriya.

Thus Mikuriya became the doctor of last resort for thousands of
California patients.

He flew or drove with John Trapp to cities and towns around the state
to preside at ad hoc clinics. "It's one of the most satisfying
experiences for me as a psychiatrist to be able to remove the stigma
of criminality from an individual," he said after testifying for an
alcoholic Vietnam vet in 1998. "Not just the self-perceived stigma,
but removing the real danger of civil forfeiture and other kinds of
state viciousness."

Mikuriya was investigated by the California medical board on the
basis of complaints from law enforcement officers (none from
patients, and no allegations of harm to a patient). At a disciplinary
hearing in 2003 all the patients named in the accusation praised and
thanked Mikuriya. He was placed on probation by the board, but
continued to practice until two weeks ago. Then his decline was
rapid. He had issued some 9,000 approvals.

Mikuriya was the founder of the Society of Cannabis Clinicians, a
specialty group whose members have issued more than 160,000
approvals. "Tod was the mentor of every doctor working in the field,"
says SCC president Philip A. Denney, MD. "His observation that
cannabis alleviates so many seemingly disparate symptoms has been
explained by recent research showing that its active ingredients
modulate virtually every neurotransmission system in the body." In
other words, the finding the drug czar mocked as "a fraud" turned out
to be a most significant truth.

A Quaker service honoring our mutual friend will be held at 4:30 p.m.
Friday at the Berkeley Friends Church, 1600 Sacramento St., Berkeley.