Uncertain Pathology with Many Symptoms

James Markes

The patient who presents his account here apparently suffers from collagenous colitis and other pathologies, although his diagnosis is uncertain. His case illustrates the versatility of cannabis as a medicine and shows how the means of ingestion can be adapted to individual needs.

I am a thirty-five year old male veteran, disabled since 1986 and homebound for the last few years. My medical problems prevent me from working, and I am forced to spend most of my time resting or recuperating from the minimal exertions my disabilities will allow. Buying groceries, washing a glass, getting into bed or even simply bathing are agonies I endure on an everyday basis.

While in the service, I was trained as an electronics technician and a nuclear reactor operator. I was medically discharged from the Navy in 1987. I later enrolled in the local university, but was forced to withdraw in late 1994 as my health rapidly declined due to excessive weight loss. I weighed 200 pounds in August of 1993; by the time I withdrew in September 1994, despite the efforts of my physicians, my weight had plummeted to a mere 150 pounds.

During this period, I received care at a VA Hospital for severe diarrhea, anorexia, nausea, and unbearable stomach pains from merely a sip of water. Some of the pain was alleviated when the doctors cured a series of infections (E. coli, Hafnia alvei, and a yeast infection). But I still had no appetite, and the severe nausea and diarrhea continued. After I had lost more than 50 pounds, one of my doctors informed me that they had exhausted their options in drugs that might help. Then he mentioned marihuana, suggesting that I go to the medical library in the hospital and look it up for myself. I discovered an amazing amount of information about this stereotypically "bad" drug. In fact, it was the only thing listed in the Merck Manual (at that time) for weight gain. Two months later, I had lost 20 more pounds and was faced with a difficult decision: whether to try the only medication that might help or rely on the failing treatments the doctors were providing. After much prayer and thought, I procured some of the herb and smoked it. After the first several times I tried it, I noticed the pain and nausea disappear and developed a classic case of the "munchies"-a truly unusual experience for someone who typically has no appetite at all (a rather strange interaction between the medicine doctors had prescribed for my fibrosis, monoamine oxidase inhibitors, caused me to have "heightened experiences" for nearly four months, which disappeared after I discontinued the use of the monoamine oxidase inhibitor).

A few weeks later, 26 pounds heavier and healthier, I informed my doctors of my use of marihuana. The doctors, amazed at my recovery, replied that I should continue. Within two years I was 194 pounds healthier, thanks to the miraculous properties of the marihuana. I was able to exercise and eat healthy at last. However, in 1997, my home was searched by the police and I was arrested. A court cased ensued. The combined Gastroenterology Departments at the VA Medical Center and a local University Medical Center jointly evaluated my situation and initially wanted to put me in the hospital for two months and try other drugs. But they feared that if I began to lose weight again, they might not be able to stop it this time. Eventually they told me that they would not let me try any other drugs or treatment, and that marihuana was my only option. I inquired about Marinol, but was told that was not an option either.

Because of two lung infections and subsequent allergies, I have had to experiment with a variety of ingestion methods besides smoking the typical joint. I have tried brownies and muffins, but was forced to smoke some marihuana to keep the food down. Even though the relief of pain, nausea, and diarrhea brought on by eating the brownies and muffins lasted far longer than when I just smoked it, I do not enjoy the prolonged feelings of disorientation and muddled thinking. Also, although eating marihuana did help with the nausea and diarrhea, it did little for the anorexia. Unfortunately, I can no longer afford the luxury of experimentation. I smoke from a pipe, a small concession in my (seemingly) never-ending fight with my allergic reactions to cigarette paper.

My current legal costs are a year of probation, six months suspended driver’s license, and a $475.00 fine. Marihuana is far more expensive than the VA medications (which cost nothing), but at least it works. One-fifth of my income is spent on purchasing this life-sustaining medicine. I am now petitioning the VA to provide me with both medical marihuana and a vaporizer as a medical device. My current problem is best summarized this way: the doctors say ‘Use it’ and the State says ‘Don’t you dare!’

I have asked Dr. Grinspoon to help my case with his knowledge and expertise. Both the doctors and the Court should receive a letter from him supporting my use of marihuana. Meanwhile, my struggle to enjoy a pain- and nausea-free existence continues.