What Patients Said in the Clinic, December 31, 2012

     1.  "Thank you for giving me that can of chicken soup you had in the clinic, when I was sick.  It was 'soup for my soul' and I think it's because you gave it to me that I got well."
     2.  "It's because of you that I got pregnant when I did, at age forty, and it's because of my little boy that I was able to get through the mastectomy, radiation and chemotherapy at age 44.  If you hadn't told me to have a baby, I wouldn't have done it, and now--I can't have another child.  I am so grateful."
     3.  "Your receptionist told me what I needed to hear to quit smoking.  She knew you'd given me a prescription for bupropion, which is the same thing she used when you told your staff you'd pay each person $1,500 if he or she quit smoking.  She said, 'Take the medicine for two weeks...then don't be surprised if one morning you say to yourself that maybe you don't really need that first cigarette of the day, after all.  Then, don't smoke!'  So I took the bupropion, and one morning it happened--I realized I didn't have to have a cigarette, and I haven't smoked since!"
     4.  "We are so glad to announce the graduation of our daughter, who has struggled for ten years with a severe disability to complete her bachelor's program at University of Florida.  Please attend her graduation, because you have been a key element in her success!"
     5.  "Thank you for your kind and thoughtful condolence card, and for your prayers.  My husband liked you as a doctor, a friend, and a neighbor.  Although it's been a sad and stressful time since he died, I will always be grateful to you for introducing the two of us through your clinic matchmaking  program.  We had fourteen wonderful years together, thanks to you."
     6.  "Your housecalls have been a lifesaver.  I can't go to a clinic, because I get so nervous and am unable to walk.  Your visits have connected me to the world, and made a world of difference in my life."
     7.  "No doctor has ever taken so much interest in me, or cared enough to tell me how to get off all these medicines.  I was on eighteen different prescriptions, and now I'm only on three!"
     8.  "Thank you for taking away my car keys in the clinic, and making the police escort me home.  I know I said some nasty things to you back then, but I want you to know that I have quit drinking, and go to AA meetings every day.  What you did, well, it woke me up."
\    9.  "I've been looking at that mole for ten years, but you're the first one who said it should come off immediately, and did the surgery in this office.  Thanks to you we caught the melanoma in time."
   10.  "I've been in pain since March.  Then I came to see you last week on Christmas Eve, and you did that shot in my hip, and now nothing hurts at all any more.  Can I please give you a hug?"
   11.  "Thanks for all the good health you keep me in."

A Brady Motion

     Once upon a time, in 1963, there was a case, Brady v. Maryland, 373 U.S. 83, in which the prosecution was required to disclose, in criminal cases (like mine?) every bit of information that was:

      1) material,
      2) relevant to guilt or punishment,
      3) favorable to the accused,
      4) within the actual or constructive knowledge or possession of anyone acting on behalf of the state.

     Prior to this case it had been the habit of prosecutors, when required to produce all evidence during discovery in a case, to hide bits and pieces that might suggest, or even prove, the defendant's innocence.  A court order to reveal everything had made no difference.  Prosecutors were playing a game of win or lose, and they weren't showing their cards when it looked as though they might lose.  So much for seeking truth.  So much for the government endeavoring to protect its citizenry.
     The Brady case was important because, along with Kyles v. Whitley, 514, U.S. 419 in 1995 and Strickler v. Greene, 527, U.S. 263 in 1999, it set a precedent for requiring the prosecution to hand over all information, including discovery that might help the defendant and harm the prosecutor's case, to the defendant's counsel prior to trial.
     There arose in my mind the following questions, as I researched this precedent:
     Why would the government, which is, after all, comprised of the voting citizens of this country, wish to act against its own membership?  Isn't that a little like cutting off the hand that feeds you? 
     And:
     Why would the prosecutors for the government, whose paid job it is to find the truth, wish to conceal and even distort information vital to getting at the truth in a case?  Isn't that like turning in your own children, who may have done nothing wrong, by hiding information that might prove their innocence?
     The only real answer is that it is in the government's interest to attack its constituents, as though they were the enemy, rather than to defend and protect them when they need it most.
     How have we managed, in this country, to foster a judiciary whose prosecutorial agents have an avid interest--using immoral means, such as hiding evidence, making up lies, coaching witnesses, and conducting secret, one-sided trials--in destroying people who are innocent, people who go to work every day to pay taxes that end up, in part, as those very agents' paychecks?
     When is the government required, thanks to Brady, to turn over all its evidence in a case?
     Certainly, it must do so once a conviction is made, or when a defendant is going to trial--but what about when a case has been under investigation for two and a half years, like mine, and the evidence is  local and easily obtainable (meaning, it shouldn't have taken two and a half years), or has been confiscated in an all-out raid?
     At what point can I file a Brady motion?
     I asked my lawyers.
     They thought about it, and said that maybe, if I have reason to believe that false information was given to the prosecutors, I could file a motion, a la Brady, asking a judge to force the government to open the affidavits in my case, because I believe the reasons given for carrying out the raid on my clinic were faulty.  
     In addition, and more specifically related to Brady, I would ask for any evidence obtained by the prosecutors post-raid that might, in fact, point to my innocence.  This is evidence that, prior to Brady, was kept hidden in many criminal cases, perhaps because it might have made the government prosecutors look incompetent.
     There is one type of material that government prosecutors have tried to keep hidden, in the past, pre-Brady, and that's evidence that might be used to impeach a state witness, or otherwise cast doubt on a prosecution case.  Impeachment evidence must be turned over even if it has nothing to do with the defendant's guilt or innocence.
     This is called "exculpatory evidence," and there are five types of such evidence:  

          1.  Evidence that the criminal act never occurred;
          2.  Evidence that the criminal act occurred, but the defendant didn't do it;
          3.  Evidence that the criminal act occurred and the defendant did it, but it wasn't legally a crime;
          4.  Evidence that the criminal act occurred, the defendant did it, but it wasn't the crime being apprehended.
          5.  Evidence the criminal act occurred, the defendant committed it, but wasn't legally responsible.

     Not only are all the above considered examples of Brady material, but so is any material that is not consistent with the prosecutor's theory of the case.
     Moreover, in 1995 Kyles v. Whitley established that evidence must also be disclosed by the prosecution even if it attacks the reliability, thoroughness, and good faith of the police investigation, to impeach the credibility of the state's witnesses, or to bolster the defense case against prosecutorial attacks.
     This means that if I were able to file a Brady motion I could force the prosecutors to divulge information that might show they didn't have enough evidence to justify a raid on my office, information that might even prove my innocence, or impeach (i.e., ruin, or making a laughingstock of) their (so-called) case against me.
     "Let's do it!"  I said.  "Let's file a Brady motion!"
     "Whoa!" my lawyers said.
     "They don't have anything on me, so let's force them to show their cards.  They're bluffing!"
     "Yes, but you haven't been indicted."
     "So?"
     "The Brady case established the requirement for a prosecution to show all evidence after an arrest, and sometimes after sentencing.  You haven't even been indicted."
     "You act as though I should hope for an indictment, so I can force the evidence to come out."
     "Not at all.  You don't want to be indicted, rest assured of that."
     "Can I force the prosecutors to show cause via Brady prior to an indictment?"
     "That's debatable."
     "I may not have been indicted, but I've been punished, and my professional life is a mess."
     "You're still practicing medicine, aren't you?"
     "Yes," I said.
     "And you have enough patients?"
     "We're busier than ever."
     "So, what's the problem?"
     "I can't hire another doctor.  No one will come near me.  Would you want to work for someone who is 'under investigation by the federal government,' or 'might be convicted of fraud'?  Nobody wants to get entangled with someone like that.  And my office set-up assumes multiple providers, including two more doctors.  I can't do it alone--which is why I'm closing."
     "That makes sense," they said, shaking their heads, "but it's a real shame."
     "So, what about a Brady motion?"
     They spoke among themselves about other cases, and said a Brady motion might irritate the prosecutors, who could puff up their porcupine skin costumes and stick me in other ways.
     "It's probably best to lay low," they concurred.  "You always take a risk when you go after the government."
     "I'm disappointed," I said.
     "That's our best advice," they answered.  "Sorry."
     "What do you think should happen from hereon in?"
     "Let's let the prosecutors save face by allowing the statutes to run out."
     "Right," I said.  "That's boring."
     "Boring is good," they told me.  "Leave it alone."
     I shook their hands, thanked them, and walked out to my car.
     The meter had run out while I was in the lawyers' den.
     I scanned the street--no police and, thank goodness, no parking ticket.
     I felt lucky, somehow.




  
      

An Interrogatory

     An interrogatory is a list of questions that is presented to an opponent in a legal case.  The questions are usually part of the discovery process early in a federal or civil proceeding, and must be answered within thirty days.
     Rule 33 of the Federal Rules of Civil Procedures outlines the rules for interrogatories and limits the number of general questions to twenty-five.  Interrogatories are not filed with the court, but consist of formalized communications between lawyers.  Only if the answers are not received within the thirty-day deadline will a lawyer file a motion in court to compel a party to respond.
     I wonder if I can put together an interrogatory for my prosecutors?
     Rule 33, Part (b)(1) states that:  The interrogatories must be answered:  (A) by the party to whom they are directed; or (B) if that party is a public or private corporation, a partnership, an association, or a governmental agency, by any officer or agent, who must furnish the information available to the party.  Part (b)(3) says:  Each interrogatory must, to the extent it is not objected to, be answered separately and fully in writing under oath. 
     Wouldn't it be great if I could obtain information about my so-called case by using the vehicle of an interrogatory?  I'd ask:  What's going on?  Where did you get your information?  Who do you think I am?
     That part about being "objected to" bothers me.
     It seems that "objections" are the primary means employed by the party being asked questions for avoiding having to answer those questions.  Lawyers are taught ways to avoid answering interrogatories, for example via law journal articles, like "Effective Use of Objections in Responding to Interrogatories," in the Advocate Magazine, and reproduced in the CAALA website.  "Should I object to this question?  What objections are available?" the lawyer readers are coached. "There is almost no risk to stating an objection."
     Objecting to questions does, however, raise suspicions about the litigant having something to hide.  Why, for example, would the prosecutors object to my request, in a court hearing last year, that they open the affidavits used to raid and forfeit my business?  I had every reason to want to know what illegal actions I might have been committing, so I could stop committing them.  This wasn't a good enough reason, the court decided, for me to be given such top-secret information.  But the question remains:  if the prosecutors have evidence proving that I am a federal criminal, why not say so?
     The government's refusal to divulge the nature of my "crimes" and the prosecutors' objection to opening the affidavits are proof that they don't have a case against me.  Prosecutor Corey Smith told Magistrate Judge Jones that he couldn't open the affidavit because he needed to "protect the witnesses" raises the question, protect them from what?  Am I dangerous?  Have I ever given anyone cause to believe that I might pose a risk to witnesses, if I knew who they were?
     And really, come on, do the prosecutors think I don't know who the "witnesses" might be?  Do they think I might have forgotten the names of employees who quit, or Pat McCullough, who bought my medical clinic and promptly reported me to the feds so she'd be first in line for a whistleblower payoff once the inevitable civil lawsuit resulted in a settlement?
     I read through the Rule 33 very carefully, examining it for an opening, something I might be able to use to force the government to unravel its case.  It looked as though it might be helpful, asking the government some pointed questions, like, "What were your reasons for raiding my clinic?" from which might follow, "Were these reasons sufficient to allow the magistrate to issue warrants to raid and forfeit my business and bank accounts?"
     In a pre-indictment context I could go before Judge Jones and say the list of "reasons" in the affidavit are likely to be faulty.  Then, Judge Jones would need to do an in camera assessment in light of what I allege, and decide if I'm entitled to another hearing.  One important question might be:  What's a reasonable time for me to be expected to wait for information about the raid and wreckage of my professional life?
    Then I read Rule 26, "Duty to Disclose; General Provisions Governing Discovery," and found under (a)(1)(B) Proceedings Exempt from Initial Disclosure that one workable objection to answering questions posed by me in an interrogatory forcing the government to show cause for the harm it has done might be, (ii) a forfeiture action in rem arising from a federal statute.  The prosecutors would use this as an objection to my interrogatories, and thereby avoid having to expose their measly suspicions, and the even more measly evidence backing up those measly suspicions.
     In other words, they don't have to disclose their reasons for raiding my office, usurping my bank accounts, and ruining my professional life, as long as they say they're investigating me for violation of a federal statute, and have conducted a forfeiture action against me as a penalty for this violation.
    Therefore, I remain in the dark.  Or, I pretend to remain in the dark.  In fact, I'm shining a spotlight into every nook and corner of my life and businesses, past and present, and there's nothing, nothing at all, that an interrogatory would uncover.  It seems inevitable that the prosecutors, then, would raise objections to questions, in order not to expose nothingness. 
     

The Problem with America's Food

     The problem with America is that we have no good fast food.
     Ambitious people in every country need fast food in order to accomplish anything.  We can't all spend time cooking what we eat from scratch, every day.  In most areas of the United States eating a healthy diet would now have to entail growing our own food as well, because we have so few healthy choices at grocery stores--and nothing produced by mega-companies can be trusted.
     Industrial foods are bad, as Michael Pollen tells us, and our fast food outlets are narcotizing us with devitalized calories.  Buying microwavable and plasticized meals from the grocery store might be a little better, but something essential has been lost when it comes to eating in this country, and we all feel it.
     Every country in the world has fast food, and most of it is really good.
     Step into the street in China, and vendors are preparing fresh, satisfying, cheap meals from honest local ingredients for you to buy and eat on the run.  You might fill up on steamed dumplings with meat, vegetables and multiple savory sauces for a dollar--all wrapped up in biodegradable bamboo leaves.  Or buy freshly made yogurt in clay pots that can be returned for a deposit.  There are homemade noodles, fermented duck eggs, crepes filled with tofu and vegetables, just-cut watermelon and pineapple on skewers, fish and veggie shish kebabs.  This is real fast food.
     My son, Eli, described the fresh-baked bread he saw in Senegal:  it's taken by wheelbarrow or rickshaw every morning to the fast-food stalls where sandwiches with fresh-mayonnaise sauces, vegetables and hard-boiled eggs are sold to people in a hurry.  In southern France the stalls are piled high with open-face pastries called pissaladiere, topped with onions, thyme, olives, and anchovies, or la socca, a chickpea pancake that used to be a morning snack for laborers.  These foods are made from local beans, grains and herbs, and are quick, hot meals served in paper cones and eaten on the go.  France is the size of Texas, but the French are proud of their regional foods, especially cheeses, wine, bread and olives, many of which are featured in fast food stalls with blue-and-white striped canopies, and cater to people on their way to work.
     Tunisian street food might be local fish, eggs and spices wrapped in thin pastry and deep-fried, like bite-sized bouquets called briks, or quail eggs and mint tea.  In Iran you'd pick up a lunch of labu, a dish made of red beets roasted in coals and served in wedges of newspaper, or loubia, fava beans cooked whole and flavored with angelica.  Italy sells local peppers, onions, sardines and beans roasted in olive oil and served with crusty bread as take-out food, along with the ubiquitous paninis stuffed with cheese and salami, or bubbly individual pizzas covered with sliced San Marzano tomatoes and drizzled with regional olive oil.
     I am told that street food in Turkey is the best in the world.  Balik-Ekmik is cooked fish on a bun, made right next to the boat that caught the fish.  Steam carts carry midye dolma, mussels with rice, pine nuts, lemon and olive oil, or garlic meatballs, smoked tongue, baked potatoes with a variety of homemade stuffings.  There are stuffed grape leaves, creamy eggplant baba ghanoush, and cracked wheat salad.  Grilled kofte, a meatball made with lamb or beef and spices, topped with sauces and served between fresh layers of bread, is readily available, and so are candied fruits, yogurt, and falafel.
     When I visited Thailand I was impressed by all the carts selling very cheap meals--for fifty cents you could fill up on plates of rice and vegetables seasoned with fiery sauces, or fresh-cut fruit and coconut water on your way to the office.  Along country roads we ate roasted corn on the cob grown in fields right behind the roadside stands, and sticky rice flavored with spices and packed in hollow cuts of bamboo.  In Israel you can pick up a pita stuffed with eggplant, mango pickle, tahini and a hard-boiled egg, or buy borekas, a phyllo pastry filled with meat, caramelized onion and peppers.  When I lived in east Africa I found harissa, yogurt, chermoula, chapati, and papaya on the streets.
     Why don't we have fresh, nutritious fast food in this country, in every town?  My employees run out at lunch time to pick up a meal and invariably come back with fried chicken from Popeyes, or fast-food burgers, and large plastic containers of soda or sweet tea.  My patients are obese from eating these foods every day.  I don't blame them, because there aren't any good alternatives, and they eat because, in reality, they're starving.  Our foods are fat, artery-clogging stuff, without nutrition.
     Obese, and starving:  that's America.  Day after day I stare at lab results that tell me my patients' blood is full of fat and cholesterol, and deficient in vitamins, minerals and protein.  I think the problem is not that we have "fast food," but that we don't have good fast food.  Our manufactured diets are killing us.
     I know that we doctors can't hold back the gargantuan problem of obesity and malnutrition in this country--or the fatigue, depression and cognitive breakdowns associated with bad food--by talking to our patients about "diet and exercise" all day long.
     Hardly anyone cooks, and very few people have the interest or know-how to grow food and prepare it in delicious ways.  But this isn't the problem.  We need good fast food, sold from carts in every town and on every street corner.  We need cooks who take pride in what they grow and make, and health departments that don't forbid individuals from selling what they cook on the street.
     We can't boycott McFastFoods unless there are McHealthy food alternatives out there.  The United States may be the only country in the world that doesn't have healthy, delicious fast food available to sustain those of us who are hurrying to work, or need to pick up lunch for the kids, or need to stay late at the office, or are on the way to the subway.  I'd like my lunch today to be locally grown bok choy cooked in olive oil with onions and garlic, a quinoa burger with real, crock-fermented sauerkraut and freshly whipped mayonnaise, and grated carrot salad with ginger, raisins and lemon juice dressing.  Where is this food?  Why aren't people cooking and selling it?  Let's demand real food, now!  
     I vote for relaxing the FDA and health code restrictions on preparing and selling street food, so the rest of us can decide what we want to eat for lunch, not what fast-food mega-corporations want us to eat.  The way things currently stand, health departments and zoning officials are legislating our deaths by forbidding mom-and-pop food carts from offering fast food up and down the main thoroughfares of American towns, under the pretext of "protecting" us from food-borne illnesses.  In fact, the government is allowing the food industry to be monopolized by corporate-owned food chains whose government-subsidized, chemical-laden, agribusiness-grown, food-like substances are killing Americans by the thousands. 

Dog Fight

     My two dogs had a fight.
     The first one's ear was ripped apart, bleeding.  The second one had patches of skin where the fur had been yanked out.
     It happened because they were sleeping together in close quarters, on rugs in one of my bathrooms, after I learned that the weather was going to be freezing.  The weather man on the radio had said, "Bring your pets in," so I did.
     I woke at 2:38 am to the sound of ferocious barking and lunging attacks.  My dream had used the dog fight noises as a soundtrack for a theme of grizzly bears tracking me down.
     The face of one of my bathroom cabinets had been torn off in the scuffle, and the sharp ends of four wood screws poked out.
     Wouldn't you think that after a til-death-do-us-part fight like that the dogs would never want to speak to one another again?  Wouldn't you think the hatred would burn holes in their hearts?
     But an hour later, my nervous system still sparking, I checked on them and they were asleep together on one rug, back to back.  If they were two men, they'd be having beers together.
     Maybe I should ask my prosecutor out for a few beers.
     Corey, how about it?  Let's go out for a few beers.  We can figure this thing out.  No point in staying mad.  There are plenty of places to go sit down together.
     This isn't how things are done, is it?
      

The Sixth Amendment

     In all criminal prosecutions, the accused shall enjoy the right to a speedy and public trial, by an impartial jury of the State and district wherein the crime shall have been committed, which district shall have been previously ascertained by law, and to be informed of the nature and cause of the accusation;  to be confronted with the witnesses against him;  to have compulsory processes for obtaining witnesses in his favor, and to have the Assistance of Counsel for his defense.

     Have we thrown the Sixth Amendment out the window?
     I am an American citizen.  I can read the Constitution, which is very clear.
     I am "the accused," and I want to know what has happened to my rights?
     Is not an accusation to be inferred from the fact of a raid on my clinic by dozens of armed government agents, or from the forfeiture of $400,000 from my bank accounts, or from the prosecutor's insistence on keeping affidavits supporting such actions sealed, or from the refusal of the government's health insurance industry, Medicare, to pay me for my services?
     Where is my "speedy and public trial"?
     Why have I not been informed of "the nature and cause of the accusation"?
     I demand to be confronted with "the witnesses against" me.
     I demand to know the accusations, of which my lawyers tell me there may be hundreds!
     My lawyers also tell me that undoubtably a Grand Jury, or several Grand Juries, have been convened in secret, to hear my case.
     A Grand Jury is not an "impartial jury of the State"--in fact, it is highly partial, in that its members are all chosen by government agents, and are presented with only one side of any case, namely, the government's.
     Where is my "impartial jury"?
     Where is my right to obtain my own witnesses?
     Thomas Jefferson is on my side!  He would not approve!
     We need to resurrect the founding fathers, and hold our government accountable.
     Where is my trial?
     Where are the powers of my lawyers?
     Why am I being straitjacketed?
     Where are my rights?  Where are yours?
     What happened to the Constitution of the United States of America? 

Merry Christmas

     Merry Christmas to all my friends, estranged friends, strange friends, non-friends, and enemies.
     Merry Christmas to my patients and co-workers, with whom I am enmeshed, thankfully.
     Merry Christmas to my prosecutors, who don't know me and whom I don't know:  Corey Smith and Bobby Stinson.  Let's get together for a beer some time soon!
     Merry Christmas to all the FBI agents and GPD officers who might have thought they got to know me that day of the raid in my office.
     I am at home with my family today.  It is the one day I am fairly certain the government won't knock on my door (they only have to wait fifty seconds, by law, before breaking it down), haul me away in handcuffs, read my Miranda rights (surely, they'd do that much!), and pitchfork me like so much manure into a 6 x 9-foot cell.  For some reason or another.  I believe, at that point, they'd actually have to tell me what their charges are--but who knows?  Maybe there is a new leniency for the government I don't know about, a statute hiding undercover somewhere, another excuse to keep me in the dark, even in jail.  It happens.
     We are making Christmas cookies:  cut-outs of little trees, bells, snowmen.  We're having fruitcake and scrambled eggs for breakfast.  We're having a talk about the idea of renewal, as though my sons--who have been born into an acquisitive, barely-conscious, skating-on-the-surface-of-things generation--might be interested in the idea of inventing or reinventing themselves.  It's my theme, these days, anyway, and it's a Christmas theme.
     One of the great things about leaving your station in life and changing your identity--making new friends, taking a new job, or altering routines--is that you can withdraw from the projections stacked onto your persona like so many pallets perpetually loaded with stuff put there by other people.  Every interaction with others consists of projections, the ideas we have about one another--which are really images of ourselves that we can only acknowledge by seeing them in other people--and relating to them through others.
     Changing your life allows you to take on fresh projections, or decline to take them on.  In your new life, new people project different demeanors onto you, and you can become someone else by picking and choosing the personality traits that feel correct.
    At a time when many of the projections onto me are demonic (I'm a criminal, I'm a government suspect, I'm a liar, cheater, swindler, fraud...) or larger-than-life (I'm a healer, the hand of God, a philanthropist, an empathic presence, a skilled technician) I fantasize about escaping from all projections, because none of them is accurate, or me.  The projections are too many weighty overcoats piled on top of a somewhat fragile reality.
     Christmas, in the dead of winter, is the occasion for the birth of a new self-image.
     How can I bring out of the depths of my being that which has been neglected, over the years, in the interests of serving the exigencies of life and the needs of others?  Whatever that is, which has yet to emerge, can't be taken away by government agents, or jailers, or spectators.
     No one can take away my  possibilities, or yours.  Not really.    

LED Spiders

     Find a field which is overlain with shaggy grass.
     Go out for a walk two hours after sunset, when the dew has begun to settle like fat little soldiers along the the straight-edges of the grass-blades.  Perhaps the spiders come out to quench their thirst after hot, dry days, inserting their puckered mouths like straws through the surface tension of the dew-bubbles, draining them.
     You'll need a headlamp to keep from tripping over twisted limbs that may have fallen from trees that borders the field.  LED lights send out rays that boomerang back when they hit the pupils of spiders.
     (Do spiders have pupils?)
     Look forward, and you see nothing but sky.  That's what runners do, so intent are they to chalk up miles and finish the run.  But turn your head to the grass and your LED will spotlights thousands of spiders who seem to be staring straight back at you.  Their eyes are pinholes, like another Milky Way, into the universe.
     The first time I saw this glittery display I assumed it was the dew itself reflecting light.  But water doesn't sparkle in response to LED light.  My pond, for instance, is a black hole that soaks up the glow of my headlamp without revealing anything.
     Kneel down, following each pair of lit-up pupils and you'll see in the grass the spiders who own them.  These are known as wolf spiders, terrestrial predators with big eyes.  They don't move.  Maybe they trust you, or are deep in thought.  They wait at night for their prey to wander in front of them, then paralyze them with their venomous fangs.  They don't eat other insects whole, but liquify them by spraying them with enzymes, after which they drink the remains.
     Wolf spiders are found by the millions in gardens and fields, and are an important part of the ecosystem, controlling populations of other insects that destroy crops.  They don't build webs like other spiders, but travel around on the ground, carrying their egg sacs,  then their baby spiders, on their backs.  Wolf spiders don't eat plants--only other living creatures including, sometimes, their mates.  Except for the occasional honeybee or butterfly, their meals consist of insects we'd rather not have around--aphids, roaches, ants, termites.
      There are 38,000 species of spiders, but only four are poisonous:  black widow, brown recluse, hobo and yellow-sac spiders.  The black widows (southern black widow, northern black widow, red widow, and brown widow) and brown recluse are found in Florida.  They don't bite except in defense. They like to hide in dark, enclosed places, so I always shake out my gloves and boots before putting them on, avoiding the most common way to get bitten by a spider.
     Wolf spiders don't bite people.  They sit around on the grass at night, waiting for something to happen.  Sitting around and waiting is something I'm learning to do, too.  If I could also figure out how to paralyze my prey, and liquify it with enzymes, I'd have nothing to worry about.  I'm not sure I'd want to eat a liquified prosecutor, though.  Sounds awful.
     Go out and look for wolf spiders tonight.  If you don't have an LED headlamp, a flashlight works almost as well.   So many eyes, watching you.  It's not a lonely world, out there.   

Gator Catch

     I reported the nuisance alligators in my pond to the agency called Alachua County Animal Control, which says it "removes unwanted wildlife."
     I think of these alligators as representatives of the prosecutors who are presiding over the putative investigation of my clinic.   The alligators and the investigators are both making life inhospitable for the rest of us.  They're hanging out in the wrong places, doing surveillance work where there isn't anything suspicious going on, taking down innocent creatures.  They're big fish in a small pond, making commotion, gaining fame by baring their teeth around the rest of us, who don't have weapons.  Ducks, fish, frogs, cranes, patients, doctors and clinic staff are all pretty defenseless.
     "They've got real small brains," said the local guys who arrived with fishing poles and beef lung as bait for catching the gators.
     "They don't spend a whole lotta time thinking."
     The two men happened to be relatives of some of my patients.
     "We know you," said one.  "We just live a mile away."
     "Yeah, you've been my grand-mamma's doctor for fifteen years," the other added.
     I mentioned the government's investigation of my clinic.
     "You don't have to tell us those government guys don't know what they're doing," they said.  "We know you're innocent."
     Turns out they'd had a run-in with the federal government, too.  The IRS nabbed them, saying they owed a ton in back taxes.  Two years and $190,000 in legal expenses later, the IRS changed it's mind, informing them they didn't owe back taxes, after all.   Too late:  the men had closed their business and decided not to work or pay taxes ever again.
     If you don't have to work, why bother, after having faced regulatory agents who terrorize you, threaten to shut down your business, and don't have to be accountable in any substantive way?
     That's what they said.  "I don't blame you for closing your business," one gator guy told me, as he baited his line and sent out a series of high-pitched clucking calls to rouse one of the alligators, who surfaced long enough to look at him.
     I left the pond, and watched the activities from a window.
    Both alligators were caught, and hauled off the property.  I know it's not kind, but I thought they looked like government agents with their jaws tied shut, trapped in the back of the pick-up truck.
    I am told they were going to be relocated to Lochloosa Lake.
    Should I care whether they end up in someone else's frying pan or not?

Mince Pie

If you love mince pie, make it yourself.  Bottled mincemeat and pre-fab pies don't come close to the warm, succulent flavors of this pie one hour out of the oven.  I taught a non-culinary friend how to make this by describing the steps over the phone.  It turned out to be a big hit at Thanksgiving.  If he could do it, anyone can.  Top it with vanilla whipped cream, or ice cream.

Crust:
   4 cups flour
   1 cup sugar
   2 tsp salt
   6 Tbsp butter
   6 Tbsp shortening (Spectrum is best)
   ice water
   waxed paper

Filling:
   3 cups raisins
   8 apples, cored and chopped into 1/2-inch pieces
   rind from two oranges, grated
   juice of two oranges
   1 cup cider, orange juice, or apricot nectar (or more)
   1 1/2 cups sugar
   4 tsp cinnamon
   2 tsp ground cloves (or substitute cardamom)
   4-5 Tbsp finely crushed soda crackers
   1/4 cup brandy

Stir dry ingredients for pastry.  Cut in butter and shortening.  Sprinkle in ice water little by little while stirring with a fork, until the dough forms a ball.  Divide in half.  Roll out half between two sheets of waxed paper and line a deep-dish pie plate with the dough.  Roll out the other half and use it for the top, once the filling is in.

Put raisins, apples, orange rind, juice and cider into a large saute pan and cook until apples are soft.  Stir in sugar, spices and crackers.  Add a little more cider if the mixture is too dry.  Cook five more minutes,  until fragrant.  Turn off heat and stir in brandy.

Pour the filling into the pie shell.  Lay the second pastry on top, crimping the edges, and cut a few air vents in the pastry.  Brush the top with a little beaten egg, and sprinkle with sugar.

Bake in a preheated 350-degree oven about 45 minutes, or until crust is golden.  Allow to sit one hour before serving.




 
 

Things People Say to Doctors

     1.   I lost my prescription for Ritalin--can you just write another one?
     2.   Could you wait a minute, Doc, while I finish my text message?
     3.   My insurance doesn't cover the last three prescriptions you wrote.
     4.   You need prior authorization for an MRI on your patient with an abnormal x-ray.
     5.   We refuse to authorize the MRI.
     6.   I don't know why I'm gaining weight.  I never eat.
     7.   My cocaine test can't be positive.  Maybe someone put it in my drink.
     8.   I don't use weed--the test must be positive from breathing other people's smoke.
     9.   I can't have an STD.  I haven't had sex in three years.
    10.  I don't know what medicines I'm taking--don't you have them written in my chart?
    11.  Dr. C., what are you going to do about my anger problem?
    12.  It's your fault, for not giving me a prescription, that I have to buy my drugs on the street.
    13.  I don't need you.  I can get order what I need from India.
    14.  I read on the internet that gabbapoocha juice will improve my sex life.
    15.  I don't like taking medicine.  Can you give me something that's not medicine?
    16.  I believe in natural cures.
    17.  I can't exercise.  I don't like the discomfort.
    18.  I can't diet, because I get low blood sugar.
    19.  My last doctor was a quack.
    20.  I woke up and couldn't move my arms or legs.  Can you tell me why?
    21.  I know I can't diet.  So, can you get me a gastric bypass?
    22.  My sister gets $500 a month from Social Security, so I want a letter from you saying I'm disabled too.
    23.  Can you get gonorrhea from schooching?
    24.  If I have herpes I'm gonna kill myself.  Could you do a herpes test?
    25.  He broke my arm, but I'm not ready to leave him.
    26.  I'm reporting you to the medical board for doing a drug screen on me.
    27.  The police stole my pain pills.
    28.  There are bugs crawling all over me.
    29.  I brought a stool sample in this mayonnaise jar.  Look--see the worms?
    30.  There's definitely a rash there.  It's not my fault if you can't see it.
    31.  I haven't slept for ten days.
    32.  I went to the ER for a second opinion.
    33.  Could you give me a work excuse for the past two weeks?
    34.  Could you write a letter saying I failed this semester because of anxiety?
    35.  My smoking isn't a health problem, cuz I grow my own tobacco.
    36.  I want you to do a blood test for every kind of cancer.
    37.  Can't you give me the shot without a needle?
    38.  Are you a real doctor?
    39.  Are you gonna put that thing in my cootersnapper?
    40.  I hate doctors.  Just letting you know.
    
   

Nature

     I brought the chickens some wheat sprouts I'd been nursing for a week, rinsing them daily and setting them on the windowsill to soak up chlorophyll.  Chickens love sprouts.
     But not today.  They clamored more than usual to get out when I opened the chain-link gate to their coop, and my efforts to keep them in with a boot-block failed.  They rushed out to the yard to poke holes in the damp earth of my one-acre garden.
     Two days of rain had unroofed lots of insect tunnels and wormholes.  I bent down to watch the chickens at work, the scientist in me counting worms so tiny I could only glimpse them for a millisecond, beak-squirming, before they landed in the chickens' crops.  The chickens averaged fifteen worms every sixty seconds!  But one champ, Mabel, set a record of thirty-six a minute when she excavated a worm hatchery by clawing frantically in a thatch of leaves.
     Mabel and Tagalong are my favorite chickens because they run after me wherever I go, like paparazzi.  I feel famous around the chickens--but it's not me they like, so much as the bugs and beetles I coax out of hiding places with my winnowing footfall, like a movie star stirring up National Enquirer news in ordinary places.
     Free-range chickens are not vegetarians.  When they're allowed to roam around they prefer earthworms and potato-bugs, not seeds and grass.  Sometimes they find special snacks like tree frogs, maggots, moths, and big hopping bugs.
     Today there was a bonanza, gruesome to watch.  One of the Delawares (a seemingly gentle breed) caught a field mouse.  It raced across the yard alerting the rest of the hens, and a competition full of excitement and clucking ensued.
     Chickens can't eat their prey without dropping it, which provides an opportunity for the others to snatch it away.  The poor, writhing rodent went from beak to ground to beak, carried all over the garden.  I watched with morbid fascination--like a Coliseum-goer, or someone at a bullfight or beheading, against my conscious will, not sure how empathy might figure in.  I couldn't save the mouse, at least not without losing a finger.
     I hoped the little creature would go into shock, as happens in times of great stress, sparing it suffering.  At last, one hen prevailed and poked rude holes in the mouse's belly, snagging weird bits of entrails.  I watched the tiny feet of the mouse open and close like blossoms, signifying that it still lived.
     Then I ran to the house and called my brother, who also keeps chickens.
     "I have to tell you what's going on in my chicken yard!"
     I walked down to the pond with the phone.  A duck was wading on the water's smooth surface.
     "What is it?" my brother asked.  I'm sure he suspected the worst.
     Once, a long time ago, a fox found its way into the coop and decimated my entire flock, leaving feathers and bits of bone for me in the morning.  It was like a horrible fairy tale.
     "The chickens are all right.  But one caught a mouse!"
     "So?"
     "It's eating it, alive!"
     "That's nature," my brother said.
     "Aren't you horrified?"
     "I would be, if I had to watch it.  But chickens like meat."
     "How can I possibly eat an egg, tomorrow, that's made from a mouse?" I asked.
     "It'll probably be one of your better eggs," he chuckled.
     That's when I saw the duck racing across the pond.
     Only, it wasn't racing, it was being dragged--swiftly, helplessly, in the craw of an alligator.  Then it disappeared underwater.
     "The alligator just took down a duck," I told my brother.
     "This very minute?"
     "Yes," I said sadly.  "And it isn't resurfacing."
     "Are you sure it didn't just dip down to catch a fish?"
     "No.  It's gone."
     We were silent.  My brother is a pacifist, like me, but he isn't a vegetarian, and he accepts the cycle of life better than I do.
     "That's nature," he repeated.  "We've all got to eat."
     I went back to the coop and saw the guilty chicken's bloated crop, which looked like a warrior's breastplate.  I imagined the mouse wriggling, Jonah-like, inside.
     Overhead the eagles were cawing.
     The Florida Fish and Wildlife website lists thirty-seven eagles' nests within a five-mile radius of my house.  This year I lost three chickens to these raptors, after which I resolved to watch over my brood better.  I won't let them wander out in the open unless I'm with them.
     Wrapped in two sweaters, lying on the grass with a biography of William Golding--author of Lord of the Flies--I guarded the chickens until dusk, when they went inside to roost.
     Tomorrow, I'll probably eat the egg from the chicken who ate the mouse who was eating seeds in the compost heap that belongs to the worms.
     Worms, chickens, mice, eagles, eggs, prosecutors, whistleblowers, special agents, alligators, ducks--  that's nature.  We're all eating one another.

Who Wants This Job?

     Ads for doctor positions show up in my mailbox every day.  For example: 

     Get what you want as an IPC physician.  Be collaborative.  Be well-compensated.  Be in charge.  Join a winning team dedicated to making medicine more rewarding.

Or:
     Achieve excellent work/life balance with our flexible scheduling.  Lucrative pay, full malpractice coverage and extraordinary work environments with collegial and talented peers await you here.  Find what you're looking for in your career!

Or:
     We are looking for a primary care physician for our premier urgent care facility.  We are a longstanding private group with an excellent reputation.  High hourly rate plus percentage of collections, full benefits, paid vacation, hours:  M-F 8-8, Sat/Sun 8-5.

Or:
     You can have it all in this pristine location with on-call every fifth night, fully staffed clinic with x-ray and lab, and no administrative hassles!  Leave the headaches to us, while doing what you do best--practicing high-quality medicine with patients who appreciate it.

     These recruitment firms want to read the minds of doctors.  They're no different from other marketing experts:  find out what people want--even what they want but don't know they want--and offer it to them.
     There's one problem.  Doctors in my generation went to medical school so they could be independent.  We don't want marketing agents recruiting us with glossy trifold brochures, into megalithic organizations where the focus is on profits, not compassionate care, not intellectual curiosity, not relationships with our patients--not anything else, but profits.
    In my last year at Bryn Mawr College there were corporate recruiters on campus whenever they could get past the president's office.  They petitioned soon-to-be grads with jobs at big companies like Procter and Gamble, Cooper-Hewitt, Estee Lauder, and Dow.  They promised high salaries, glamorous positions, and a chance to rise up in the corporate hierarchy.
    That was my chance to live in a scripted world, where in exchange for money and benefits I would donate my brain and prestigious-college-coddled creativity for the purpose of increasing profits for a corporation's shareholders by bamboozling its clientele into buying things they really didn't need.
     I didn't want any such position, nor the glamour, nor the CFO-type paychecks.
     What I wanted, following the peace-march idealism of the age, was a chance to make a difference in the world on a one-to-one basis, using the puissance of human interaction.  I wanted to help others (an old-fashioned ideal).  As for my personal life, I hoped to homestead five acres like other back-to-the-landers and build a Scott-and-Helen-Nearing version of life, eating organic vegetables and sunflower seeds, and raising smudge-faced children who might figure out some of the world's problems in the primordial backwoods of our property.  Like other '60's flower children, I measured the hypocrisy of my parents' post-WWII generation in terms of the numbers of dead soldiers posted in photo spreadsheets in the Bethlehem Globe Times every week.  I wanted a different world.
     Accepting one of those cushy, Armani-clad jobs would have been a form of selling out.  Being a doctor, on the other hand, might allow me to do some good in the world without relinquishing my pay--reframed as profits--over to executives.
     Doctors should be allowed to give away their services for free, like priests and shaman, when patients can't pay, and this has been the American model for hundreds of years.  We ought to be able to navigate the rules of insurance companies without needing MBA's.  But these days, even an MBA isn't adequate to figure out what codes and documentation government entities like Medicare and private insurance companies need as proof that patients got their money's worth.  Moreover, if doctors give away services for free, or reduce co-pays for sick people who don't have cash in hand, they're accused of committing fraud.
     If you're a doctor and agree to work 76 hours a week, as per one of the job listings above, why not just work for yourself?  Some of these corporate employers require doctors to sign five-year employment contracts.  After signing, doctors are pressured to make medical decisions at a dangerous pace, or have to see new patients every six minutes (the Kaiser-Permanente's model).  These businesses own doctors, and they manage money by threatening patients with debt-notices, or refusing them access to medical care if they don't pay up front.  They coerce doctors into sacrificing good judgment and the doctor-patient relationship by working faster, churning out patients as though they were assembly-line commodities.
     No thanks.   This form of indentured servitude has never appealed to me.  I doubt if there are any doctors who really want to work for corporations or hospitals.  But they continue to accept positions as employees anyway, in unprecedented numbers, out of fear, or because they believe the promises on the glossy, kaolinite-coated-cardstock recruitment materials that show up, unsolicited, in the mail every day, or maybe just because they think that if they work for themselves they'll have to work too hard.
     The landscape of medicine has changed, being run, as it is, by government mega-bureaucracies and corporate monsters.  It's being "regulated" by police-agents who must be taking orders from on high to drive solo docs out of business--and they're doing a good job.
     That's why people like me no longer fit in.
      

An Update with My Lawyers

     My lawyers and I get together every once in a while to remind ourselves that there's a "case."
     There is a case, right?
     It's just that every day seems like every other.  Kind of ordinary.
     As though I'm living a normal life.
    Gilbert sat to my right and Mark to my left and once again we seemed to be a threesome of leprechauns in the great big wood-paneled room lined with books.  The august realm of law does that to people--it's great, and powerful, and we're small.  But, like magical creatures, we can plot and wriggle our way out of the giants' trickery and corruption, and even have a little fun with the game.  Giants may be big, but they're stupid, and they bumble.
     For my lawyers, this is a puzzle.  How should they work it?  What clues can I offer?  When did something like this happen to someone else, and how did it get resolved?
     "I just can't believe how long this thing has gone on," Mark said, shaking his head.
     Gilbert nodded.
     "We both thought for sure something would happen by now...didn't we, Gil?"
     "Happen?"  I asked, looking back and forth at them.  "What do you mean, happen?"
     "We thought there'd be some movement on this case.  I mean, heck, it's been what...?  Two years?"
     "I've been under investigation for two and a half years," I reminded them.
     "And when was it, exactly, that your office got raided?"
     "One and a half years ago."
     "That's just unbelievable!"  Mark blurted out.
     "It sure is," said Gil.  "I haven't heard a peep from Corey--hard to fathom what he's thinking."
     "I know you said he's busy," Mark ventured.  "But come on.  Don't you think if Corey's guys had something, Gil, they would've brought it forward by now?"
     "You would think so," Gil said.
     I wonder if they're getting bored with my case, I thought.
     So I brought out the main question on my mind.
     "Couldn't we file something like a Writ of Habeas Corpus, only not to demand the reason for being imprisoned, but to request a review of the case, or a review by a higher court of Magistrate Judge Jones' decision to keep the affidavits closed, or something to get the case moving?" I asked.
     Mark scratched his chin.  "Maybe an interrogatory..." he suggested.  "What do you think, Gil?"  Would it help?  Or could it do some harm?"
     "Let's think about what it would accomplish," Gil said.  "I can't see how it would benefit us."
     "Maybe it's better to let the statutes run out," Mark suggested.
     "What do you mean?" I asked.
     "According to the law, there are statutes of limitations for every potential charge.  And the clock starts ticking on them the moment the supposed criminal act was committed."
     "How long are the time-frames?"
     "The average statute of limitations is five years," Mark said.  "So that could mean some of them are already running out.  Maybe we ought to just wait it out."
     "How many statutes are there?" I asked.
     "That depends on how many charges they're entertaining.
     "You mean...such as charges of conspiracy, or money laundering, or racketeering?"
     "Exactly," he said.
     "That's three...so how many more can there possibly be?"
     "Oh, there could be hundreds," he said.
     "Hundreds?  They might have a list of hundreds of charges against me?"
     "That's pretty typical," he said.  "Remember, they're determined to find something, if they can."
     "What if they can't?" I asked.
     "I'm thinking that's what's going on," he answered.
     "If they had something," Gil stated firmly, "they would have moved quickly on it.  Otherwise it doesn't look good to Pam Marsh."
     "Who's Pam Marsh?"
     "Corey's boss.  Sooner or later she's going to say--'What's going on with the Colasante case?' and Corey will have to give her an answer."
     "Why should she care?"
     "They can't just sit on these cases forever.  They have to be accountable."
     "So, can prosecutors get in trouble for having lame cases?"
     "It doesn't look good," Gil said.  "But you have to understand, there are never any penalties for prosecutors and agents who misjudge cases."
     "It doesn't take a lot for a prosecutor to convince a judge to issue an affidavit for a raid, or bank forfeitures."
     "That's terrible," I said.  "Because it ruins people's lives--so they ought to have a lot of evidence."
     "They do need to have a lot of evidence, put together in an organized way, to get an indictment," he told me.
     What about the "ham sandwich," I wondered.  "It's so easy to get a grand jury to issue an indictment that you could get a ham sandwich indicted," the quip goes.
     "And they need to be able to convince a jury you're a criminal.  That's where they'll get stuck on your case, because there isn't anything."
     "But it takes almost nothing to get permission to raid an office."
     "No wonder they throw a big net over the country, and catch whatever fish they can," I said, somewhat resentfully.  "In medicine, we have to pay for misjudgments."
     Then Gil told me about a guy who was intercepted at the airport by federal agents who took him into custody for having $80,000 in cash on his person.  The fellow petitioned a lawyer to help get his money back, but the feds are holding onto it, even though they haven't said why.  That case is sealed, too--like mine.
     "What right do they have to take a guy's money, just because he has it?" I asked.
     "They want to know why he has it," Gil said.
     "But why should it be any of their business?"
     "They're suspicious."
     "But what grounds do they have for suspicion?  Did the guy have drugs?  Or guns?  Or was there some evidence of a plan to do harm to America?  Or clues that the money had been obtained illegally?"
     "No, none of that," said Gil.  "They don't need to prove anything, at least not until they issue an indictment."
     I turned to Mark, who used to be a state prosecutor who filed charges against doctors, and authorized raids.  He may be working for the other side now, but he knows how these guys think.
     "What would you do, Mark, if you were in Corey's place, and you realized--as he must--that he doesn't have a case, and can't even fabricate one?"
     "I know what I'd do..." he began.
     "I don't suppose it's possible for him, being a macho-policeman-lawyer type, to hand everything back to me and say, Sorry, I made a mistake."
     "Highly unlikely," Mark laughed, as though I had made a joke.
     "What, then?"
     "I'd turf the case as fast as I could to HHS, and let them handle it."
     "HHS?"
     "Yes, that's Medicare.  I'd let them take it on as a civil suit."
     "I don't want a civil suit," I said firmly.  "There isn't a civil suit.  Don't they have to prove something?"
     "They can usually find something, even if it's minor.  It allows everyone to save face."
     "But then I have to pay for trumped-up charges."
     "Believe me," Mark said.  "That would be an excellent outcome."
     "I don't want to pay for doing nothing wrong," I said.
     "Look," Gil interrupted.  "It sure beats federal charges, or an indictment."
     "That's like telling me I should be glad my plane wasn't hijacked, or my house blown up."
     "This is how things work," Mark said.  "Besides, there's a lot of horse trading that goes on at these things."
     "What?"
     "You can make deals, when the case has been reduced to something civil."
     "What about the interrogatory you mentioned, or a habeas corpus demand?"
     "We should probably leave things alone," Mark said.  "Don't you agree, Gil?"
     "Why rock the boat?" Gil answered.  "When nothing happens, that's good."
     "Wow," I said.  "That's crazy."
     "Remember, time is the defendant's friend." Mark looked at me squarely.  "I know it's difficult, but time is on your side.  These statutes may fizzle out, one by one."
     "Meanwhile," Gil nodded, "the prosecutor gets promoted, or goes into private practice, and everyone gets kind of bored, because your case is old.  Someone new may inherit it, and that's a hassle because who wants to pick up in the middle of a case?"
     "Let's leave it alone."
     "We don't need to irritate the prosecutor."
     "Maybe it will be forgotten."
     So, in a way, I paid for nothing at that lawyer meeting, because nothing was considered the best thing to do.


       

My Report to the DOJ

The Department of Justice (DOJ) website (www.doj.gov) has a mechanism for reporting complaints about DOJ employees.
Today, I filed a civil rights and civil liberties complaint on the website. I will also send a letter by snail mail with the same complaint, to the following address:

Office of Inspector General
Investigations Division
950 Pennsylvania Avenue, NW
Rm. 4706
Washington, DC 20530

You, too, can file a complaint at the web address above, using the simple email form provided.  
As an American citizen you have a right to demand an investigation into the actions of the government against other citizens. If you are one of my patients, you have a right to demand that your medical chart be released from the FBI office, after eighteen months of seizure (plenty of time to make copies). You also have a right to know why such expensive and overzealous methods were used to obtain documents or proceed with an investigation, since your tax dollars were used to cover the cost of importing FBI agents from long distances to conduct a SWAT-team raid on my solo clinic.  
Here's the text of my complaint to the DOJ.


     "On June 16, 2011 thirty to fifty DOJ employees, FBI agents, surrounded and raided my solo family practice medical clinic in Gainesville, FL. Without reading any of my employees their Miranda rights, the agents--armed with weapons in paramilitary style--detained my employees for many hours, refusing to allow them to leave without being interviewed first. They barred the exits and even put a gun to one nursing assistant's head. The FBI agents told the patients to leave the exam rooms and go home. They told patients driving up for appointments in the parking lot to "go home, find another doctor." When I arrived two hours later with a lawyer the FBI agents were enjoying dozens of pizzas in the waiting room.  
     "On August 6, 2011 my clinic and personal bank accounts were forfeited--$400,000 of working capital were seized, as well as funds representing personal assets including my disabled son's social security disability income. All the patients' medical records were removed from the office, making it difficult and even dangerous to manage serious patient problems in the following months. The "mechanism" for getting charts back was laborious, involving 16 steps, and never allowed us access to medical records at the time we needed them, when patients were sick and in my clinic for treatment.  
     "The affidavits remain closed, despite my attempt via court trial to get medical records (or copies) returned, working capital to make payroll and cover bills, or information about the "crime" supposedly being investigated.  
     "I have been "under investigation" for 29 months now, without a word from the prosecutors, Corey Smith and Bobby Stinson of Tallahassee, or the FBI agents (lead agents Robert Murphy and Carissa Bowling) as to the nature of my crime or the reason for the raid, forfeiture, and investigation. I have been harmed and demoralized by these incidents, and my rights to a fair trial and to elucidation of the allegations have been breached.  
     "Moreover, the gestapo-type tactics used during the raid were a waste of government money, when requesting records using a simple subpoena would have sufficed. I am closing my clinic voluntarily, at a time when America desperately needs competent family physicians, because I find it difficult to perform the duties associated with my professional title while under silent siege by government agents, who should be required to show cause for such drastic action."

Habeas Corpus

     The American understanding of habeas corpus goes back to English common law, and was first used in 1305.  The rationale was that the king had a right to know when and why one of his subjects had been detained by local authorities--who supposedly acted in the name of the king.  Any litigant who felt his case ought to be heard by the king could, as Winston Churchill explains it in The Birth of Britain, "remove his case out of the court of his lord into the court of the King, using a royal writ, in order to claim the King's justice."
     The decision of the king could overturn all lower court actions and free a subject who had, in the king's estimation, been treated unfairly.  The rights of American litigants under habeas corpus have been interpreted in terms of the same British practice, referencing the Habeas Corpus Act of 1679.
     There are, however, suspension clauses which deny people habeas corpus under extreme circumstances.  At such times government officials may incarcerate citizens without giving cause, and the option to file a habeas corpus writ--as a way of forcing government officials to explain their reasons for detention--is nullified.
     Lincoln exercised his power to suspend habeas corpus, for example, for two years during the Civil War when detained individuals were suspected of being traitors or spies.  President Ulysses Grant suspended the writ in South Carolina after the Civil Rights Act of 1871, when conspiracies against the federal government endangered the whole country.  Habeas corpus was also suspended after the attack on Pearl Harbor when martial law was declared in Hawaii, and in 1996 after the Oklahoma City bombing, when President Clinton signed the Antiterrorism and Effective Death Penalty Act (AEDPA) of 1996, intended to "deter terrorism, provide justice for victims, provide for an effective death penalty, and for other purposes."  Section 101 of the AEDPA allows the government to detain prisoners for one year before they have permission to seek an explanation for detention by filing a writ of habeas corpus.
     The Guantanamo Bay detention and interrogation camps in Cuba represent another example of the suspension of habeas corpus.  Detainees there have been held and tortured by American military personnel, who claimed that there was enough suspicion about the prisoners' involvement in Afghanistan terrorist activities to incarcerate them.  These individuals have been denied all the usual rights granted under the Geneva Convention, the U.S. Supreme Court, and habeas corpus.  It was George W. Bush who asserted, as part of his anti-terrorism rampage, that these prisoners were not entitled to any rights at all.  In 2009 President Obama signed an order asserting that these prisoners had "the constitutional privilege of the writ of habeas corpus."  In 2010, many of these prisoners filed habeas corpus challenges.  However, Obama then signed the Defense Authorization Bill of 2011, preventing closure of the Guantanamo Bay prison camps-- despite the United Nations' call for closure of the camps on the basis of human rights violations.
     Then, the U.S. Senate voted to reject an amendment prohibiting indefinite detention of U.S. citizens.  Afterward, the ACLU issued a statement saying that this decision threatened the legitimacy of habeas corpus.  In effect, the government had affirmed that it was okay for citizens to be imprisoned indefinitely, without charge or trial.  This is an extreme example of the federal government's power to forbid citizens the right to know why they are being imprisoned, punished, or tortured, despite public outcry against such a denial of civil rights, despite pressure exerted by Wikileaks, and regardless of the fact that the rest of the world has called on Americans to grant Guantanamo prisoners transparency and their civil rights, because it may be the case that they are innocent.  167 prisoners still remain in Guantanamo facilities, stripped of their rights, and denied habeas corpus..
     This does not bode well for me.  I am not incarcerated, nor would most people consider my treatment by the government an example of physical torture.  But it is an example of unfairness, and the government's actions against me have altered my life irreversibly.
     Ever since the Defense Act amendment was rejected--thereby giving the government power to hold citizens without showing cause--the rights of American citizens have been in jeopardy.  The right of Americans to know why government officials are investigating and punishing them is "ambiguous," according to The New York Times.
     If someone like me can be perceived as a "threat to the American people," and with this pathetic explanation be denied the facts about why federal agents raided my clinic at gunpoint, and took the clinic's working capital, and made it impossible for me to conduct business as usual, then every one of us is at risk.  The right to know is an inalienable right, isn't it?  That's what habeas corpus is all about.  Perhaps it no longer exists.
     Habeas corpus gives people the right to challenge their treatment, especially prison detainment, in a federal court.  The only time this right may be denied is when an individual is seen as "an enemy combatant," in which cases "such persons may be detained without charge or criminal proceedings for the duration of the relevant hostilities."
     Do I have the option of filing a writ of habeas corpus, thereby asking a federal court to review my case in an attempt to force the government to show cause for the way it has treated me and my clinic?\
    Today, I meet with my two lawyers to find out.  While I'm at it, I plan to ask them what they think about the idea of my acting as a lead plaintiff in a class action lawsuit against the federal government for using damaging and unnecessarily intimidating tactics to obtain information from businesses, including mine.
     I have a feeling I already know what my lawyers will say. 

Article 1, Section 9, of the American Constitution

     The Constitution takes the muscle and flab of human endeavor and impulse and arranges it, like a body, into systems that have both possibilities and limitations.
     Whereas the Constitution describes the overall structure and function of our shared governing body, the Articles give specificity to certain organ systems within that body.  They outline how much power these organs--especially the three branches of the federal government--should have, how breaches should be handled, and how the body itself should go about updating or otherwise amending laws for situations that, like DNA transpositions, could not have been foreseen.  Cases, and case law, offer real-life examples of how the general statements set forth in the Constitution operate in the lives of human beings, in an if-this-then-that formulation, and serve as mini-laws, or "precedents," against which new cases can be measured and decisions induced.    
     Article 1 is a description of the powers and limitations of the federal government.  Article 1 concerns me, because it is the federal government, via its agents, which may have overstepped its limits when my office and bank accounts were raided, and Medicare's representatives declined to pay me, without giving a reason.
     Section 1 of Article 1 describes the scope of the legislature, Section 2 that of the House of Representatives, and Section 3, that of the Senate.
     Section 4 outlines the procedures for electing members of Congress, Section 5 the rules of order for conducting congressional meetings, and Section 6 compensation of elected officials.  Section 6 also describes the degree of independence Congress may exercise apart from the executive branch.
     Section 7 gives the procedure for introducing a bill and moving it into law, as well as the uses of the president's veto.  Section 8 enumerates the powers of Congress, including that stipulation that Congress can do whatever is "necessary and proper" to carry out the powers with which it is vested.  Over the years, many such powers have been deduced, or "implied," sometimes by those with a vested interest in pushing through laws that would advance a partisan cause;  therefore the powers of Congress have become broader, perhaps, than our forefathers intended.
     Section 9 outlines the limits of Congress.  Mostly it is out of date, setting a minimum tax on the importation of slaves, and prohibiting taxes on one state over another when there is transport of goods across borders.
     The two paragraphs that may apply to my situation are the following:

     The Privilege of the Writ of Habeas Corpus shall not be suspended, unless when in Cases of Rebellion or Invasion the public Safety may require it.

   and

     No Bill of Attainder or ex post facto Law shall be passed.

     Article 1, Section 9 has been referenced by one of my attorneys and by occasional others, offhandedly, when they hear the general outlines of my clinic's raid, as a violation of my rights.  But as I understand it, no specific rights in this Section have been breached by the government.  Habeas corpus is a writ that allows a detained prisoner to come to court with a demand to know why he has been imprisoned.  If the detention is unlawful, the prisoner can be released by order of the court.  I have not been formally detained, therefore cannot insist on a right to know why I have been imprisoned.
     I have, however, been informally, or effectively detained, i.e.,  held hostage by the government's actions against me, and by the assumption of my criminality, made public via media coverage and underlined by the removal of $400,000 from my bank accounts--a fine, or punishment, that has been imposed before an allegation, or trial, or conviction have been tendered.
     Could a writ of habeas corpus be used to force my prosecutor to come forward with the charges against me, since I have already been ruined, in so many ways equivalent to the ruination of a citizen who has been thrown into jail without explanation, and whose public persona has been blackened?
      A "bill of attainder" is a law allowing for a person to be convicted without trial.  The stipulation that no bill of attainder shall be passed insists on the necessity for a citizen's right to a trial, before conviction.
     I have not been formally "convicted," therefore government officials may claim that I don't have a right to a trial under the circumstances.  But I have been effectively convicted, without being detained in jail, insofar as my clinic has been shackled by Medicare's unexplained refusal to pay for my services, and by the forfeiture of clinic and personal funds, rendering the clinic insolvent, and by an investigation hanging over my head like a guillotine blade for two and a half years thus far--and up to ten years, depending on the [concealed--for what reason?] charges being levied against me.
     Do I have any rights, under Article 1, Section 9?  I am going to have to review cases, going all the way back to Lincoln, of individuals who exercised their ability to issue a writ of habeas corpus, and could not be denied by the courts, as they insisted on knowing why public officials threw them in a holding tank--usually jail--but in my case a jail without bars.
     The right to know is what has been infringed.  Unless government officials can claim that we are in a state of national emergency, and that I pose an immediate threat to the public good, they are required to tell me why my clinic was raided, and why my public name has been slandered, and why I have been punished before being convicted. 
     Right?

Asparagus Salad

A bright, beautiful salad to serve at a dinner party.  Full of micronutrients.

2 bunches fresh asparagus, washed, drained and finely diced
1 medium red onion, finely diced
1/2 cup freshly grated Parmesan or Pecorino cheese
1/4 cup red wine vinegar
1/3 cup fragrant, first press olive oil
1 tsp kosher salt

Toss all ingredients together and serve in a glass bowl.

Fifteen Ducks

     I saw some specks on the water and walked down to the pond like an old Indian, without crunching leaves underfoot.
     There were fifteen ducks--fledglings, with green, black and white uniforms--paddling away as though on holiday.  Couldn't they smell the alligator just fifteen yards away, hugging the edge like a burglar in the bushes?
     I saw it up close, that alligator, last week.  It looked like a dead raccoon with its tail swirling in the current, its head quite still.  I felt the shock, almost primitive, that accompanies any encounter with wildlife, and stepped back, holding my breath, staring at the macabre thing--so completely other.  It was only three feet away.
     "Whatever you do, don't feed the alligator," I've been warned by self-appointed wildlife experts in Lochloosa so often that the order is now etched in my thought-bank.
     "What exactly would a person feed an alligator?" I ask.
     The thought of feeding an animal whose evolutionary roots can be traced to antiquity chain as though it were a pet wouldn't occur to me.  That would be like feeding the feds.  Feeding creatures means you identify with them, and want to nurture them.  You'd have to think of the alligator as having hunger like yours, and sophisticated needs.  You'd  have to imagine it has feelings.
     "People throw them potato chips, and burger buns, for instance," my experts say.  "Then they start getting friendly, the gators, and come out of the water and chase you down."
     In fact, there are on-line sites that tell you how to get away from an alligator who's chasing you.  Don't zigzag.  Don't try to trick a gator.  Don't wrestle with it.  Run as fast as possible in the opposite direction. 
     Alligators make good time on land, but they can't outrun you,
     These sites also describe tactics for getting out of the jaw-clutch of a gator in the water, though your chances of escape aren't much slimmer.
      First, scream, yell and thrash about.  Alligators don't like a lot of noise.  Second, poke your fingers straight into its eyes.  Third, once it starts the "death-roll," which is its primitive method for drowning you, stop moving and play dead.  When an alligator thinks you're dead, it may release you.  Maybe you can get to the safety of shore before it grabs you again.  Maybe...
     I don't expect to be partying with alligators, or sharing my potato chips with them, or my hamburger buns.  Friendship with an alligator is about as inviting as friendship with my federal prosecutors.  Having to call these guys "my" prosecutors is already too intimate--as though we actually know one another.  As though we could share a laugh together.
     Maybe the ducks are aware of the alligator, but have calculated their odds.  A three-footer like the one in my pond can't fit a duck in its crooked maw, can it?  Why deny themselves a little sport, those fun-loving ducks, on account of a little whippersnapper of a duck-eating reptile?
     "Reptile" means "to creep stealthily under cover of water."  Baby alligators eat insects, little fish, and snails, then graduate to rats, snakes, birds and raccoons.  A three-foot alligator has eighty razor-sharp teeth.  It might be able to eat a duck, but it would have to be very hungry.
     In dreams, alligators symbolizes a threat or conflict.  If real life is just another version of a dreamscape, the alligator in my pond represents an aspect of my current experience.  Alligators and crocodiles are also Western symbols of greed and treachery, so it's no small surprise that alligators appeared in my pond once the government enacted its raid on my clinic.  In many traditions alligators and crocodiles belong to the mythic forces of death and rebirth, falling into the water and reemerging like night swallowing day in an endless cycle.
    Among the Pueblos and Aztecs, a crocodile gave birth to the earth, and in Mayan tradition, a great crocodile carries the earth in a conch-shell on its back.  In many traditions, the alligator is an embodiment of the Underworld.  That's why I follow the movements of this alligator very closely.  And why I keep thinking about calling the game warden to have the creature "removed."
     Is there a game warden for federal agents?
     Those fifteen ducks have suggested a name for my pond:  Fifteen Duck Pond.  It's strange, I guess, and sort of oriental, but I need a name, and the usual ones--Green Pond, after the pond I sought out for respite on bike rides in my youth, as well as the beautiful color the gumbo clay sends up,  or Red Fox Pond, after the fox I saw at dusk last year, or Big Trouble Pond because of its temporal association with the government's troublesome interventions in my life, or Frog Hollow Pond, because the diminishing frog population has found a sanctuary here--don't seem apt.  The county requires that I give my pond a name, however, for it to list on its topographical maps.  So I'm waiting for the pond itself to suggest another.
     Meanwhile, I'll keep counting the ducks.  If the number stays the same, I know they're safe from the threat lurking below the surface--and the name, Fifteen Duck Pond, might be a charm.
     I