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Monday, April 28, 2008

UW Doctors Leaving Man to Die for Using Medical Marijuana

posted by on April 28 at 12:45 PM

This story came out over the weekend, but as of late this morning, Timothy Garon was still barely hanging on—in his hospice bed at Bailey-Boushay House. “He’s going to be dead here in a couple days,” says his attorney Douglas Hiatt. Garon needs a liver transplant to survive.

Timothy Garon’s face and arms are hauntingly skeletal, but the fluid building up in his abdomen makes the 56-year-old musician look eight months pregnant.

His liver, ravaged by hepatitis C, is failing. Without a new one, his doctors tell him, he will be dead in days.

But Garon’s been refused a spot on the transplant list, largely because he has used marijuana, even though it was legally approved for medical reasons.

Garon, who has been hospitalized or in hospice care for two months straight, said he turned to the university hospital after Seattle’s Harborview Medical Center told him he needed six months of abstinence.

The university also denied him, but said it would reconsider if he enrolled in a 60-day drug-treatment program. This week, at the urging of Garon’s lawyer, the university’s transplant team reconsidered anyway, but it stuck to its decision.

Dr. Jorge Reyes, a liver transplant surgeon at the UW Medical Center, said that while medical marijuana use isn’t in itself a sign of substance abuse, it must be evaluated in the context of each patient.

The concern is that patients who have been using it will not be able to stop,” Reyes said. Reyes and other UW officials declined to discuss Garon’s case.

Dr. Reyes’s voicemail box is full at the UW Medical Center. My calls to the transplant division this morning haven’t been returned. Their lips are apparently zipped and they don’t want to reveal who is on the transplant committee. But you can still contact the UW transplant division and try to get answers.

Below is the main number and individual email addresses. Call and write. Ask who made this decision, what their names are and can you speak to them. Ask how Mr. Garon’s past marijuana use—as recommended by his physician and completely legal under state law—means he wouldn’t benefit from a liver transplant from the state hospital.

UW Division of Transplant: (206) 598-6700

The fax number: (206) 598-0628

The chief of the division is Jorge D. Reyes:

The director is Kay Wicks:

The full directory for transplant staff is over here.

The committee that made the decision knows full well that the marijuana Mr. Garon smoked hasn’t caused liver damage. Instead, Dr. Reyes justifies the decisions in the AP article by saying marijuana can be habit-forming, and he’s worried that Mr. Garon would continue to use marijuana.

Excuse me, but what sort of backward logic concludes it’s best to let a man to die because he used the very medication that helped him live? Hep-C is explicitly covered under Washington’s Medical Use of Marijuana Act for helping curb the nausea caused by the disease’s viral load. In the article, another doc grasps at straws by saying that a form of mold that can be found on marijuana could cause his body to reject the new organ—if Mr. Garon smokes pot—but he wouldn’t smoke pot if doctors told him not to, because he’s not addicted to it like a crack addict. It’s marijuana, one of the least habit-forming of all psychoactive drugs. So he’s being denied the transplant for something that hasn’t happened. I know I’ve gotten my ranties in a bunch, but the UW’s decision is a death sentence for Mr. Garon.

One more time:

The number to call: (206) 598-6700

The email address to write:

RSS icon Comments


What. The. Fuck.

Posted by Greg | April 28, 2008 1:01 PM

I wouldnt want to give a healthy organ to someone that intentionally harms their body with any substance either.

Posted by Bellevue Ave | April 28, 2008 1:18 PM

and if we could sell organs on a somewhat open market this wouldnt be as much of an issue. instead of bureaucrats making the decision the patient would be.

as it is now, you wait in a que for the organ and if you don't fit the criteria for transplantation as determined by someone else completely youre screwed. or if mickey mantle passes you despite being a late stage alcoholic with a liver he poisoned on purpose, too bad. yankees great > poor person in line.

Posted by Bellevue Ave | April 28, 2008 1:21 PM

Sometimes I just want to opt out of the human race.

Posted by AMB | April 28, 2008 1:22 PM

Bellevue Ave: He was using medical marijuana under a physician's care to manage the viral load of Hep-C. The drug was used to make him healthier, not harm his body.

All drugs prescribed by docs has some potential for harm, but the key is that the doctor believes the potential benefit outweighs risk, as was the case for Mr. Garon and pot.

Posted by Dominic Holden | April 28, 2008 1:26 PM

@3 - If organs were sold on an open market, wouldn't that make it more likely for rich people to cut ahead of poor in line? Not sure I understand your logic.

Posted by Levislade | April 28, 2008 1:31 PM

Emails sent. These people are disgusting.

Posted by Fnarf | April 28, 2008 1:42 PM

Rich people already cut in line through personal connections with the bureaucrats in charge. A system that relies on ques to dole out goods is always ineffcient in delivering the maximum amount of goods to the market and always has corruption that serves to usurp the queing system. Do you deny that in queing systems that bribery by people that can afford to pay bribes doesnt happen?

Dominic, I understand that one doctor's decision to prescribe pot may be valid but that isn't why he was denied the organ. He was denied the organ because someone else held exactly what I said in #2 to be true and thusly denied him the organ.

Posted by Bellevue Ave | April 28, 2008 1:42 PM

sorry, do you deny that bribery by rich folks happens in queing happens?

also in a somewhat open market there would be many more organs out there and the cost would be reduced.

Posted by Bellevue Ave | April 28, 2008 1:44 PM

@5 - Marijuana can't make you "healthier" if you have Hep C, it can only relieve some of the symptoms of it. It doesn't have any effect on viral load. People that meet the criteria for treatment with interferon and ribavirin, may find that marijuana helps them to complete the entire 6-12 month course of treatment because it lessens the bad side-effects of the medication. It sounds like this particular individual was using it to lessen the nausea that his HCV causes (I doubt he was on interferon/ribavirin with that amount of liver damage) but it wouldn't have any effect on his viral load.

Posted by DanFan | April 28, 2008 1:50 PM

SO..., just to be perfectly clear, who do you think should not get the liver that you think that this guy should get?

Posted by You_Gotta_Be_Kidding_Me | April 28, 2008 1:55 PM

i'm so fucked if i need a transplant. i don't have a doctor's note. all i have is the ability to lie through my teeth.

Posted by max solomon | April 28, 2008 1:56 PM

and seriously what incentive is there in today's world to donate organs? theres not enough altruists in the world to supply the demand for organs. if the goal is providing the maximum amount of organs to the most amount of people we should implement a solution that creates more organ donation.

even now, poor people can't afford the pay for organs nor can they afford the long term care waiting for an organ. most bankruptcies in the united states are due to medical costs. allowing the free flow of sellers and buyers of organs to exist would reduce the medical cost of obtaining organs, the waiting time of getting organs and thusly the care costs of waiting for an organ.

would there be some horror stories? yes. would there be the need for recourse on bad organs? yes. would there need to be complete information on who the organ is from and where it is going? yes. the government should do its job and enforce regulations like that.

also there is the concept that so many of the liberal hold so dear when it comes ot abortion that it's "my body and I choose what to do with it". if we can allow women to make an informed decision about abortions certainly we can allow people to make an informed decision about the pros and cons of selling their organs to other people.

Posted by Bellevue Ave | April 28, 2008 2:01 PM

@11: I don't think Mr. Garon should automatically get a liver. I think he should get the same chance at a liver as everyone else. That's why they have a waiting list. I want Mr. Garon to be put on it, in the normal spot he would take if he hadn't been prescribed marijuana.

Posted by Fnarf | April 28, 2008 2:09 PM

If he's got Hep C that bad, won't the virus just destroy the new liver, too? Especially if he has to take immune suppressants so his body doesn't reject the liver? I wouldn't think he could take the drugs to combat the HCV with a newly-transplanted liver.
I'm seriously asking this. I don't know that much about Hep C.

Posted by Rebecca | April 28, 2008 2:19 PM

email sent.

but the sad thing is that if he's just getting on the list now, it seems doubtful that he would get an organ in time anyway...

Posted by shena lee | April 28, 2008 2:23 PM

If folks feel like browbeating staff members at UW, they can certainly call. All someone on the other end of the line will be able to do is listen; Even if a patient's story has been in the paper, staff can't discuss the case.

I suspect, because of privacy legislation, that the quote Dr. Reyes gave is a general one in response to general questions about why someone might be denied a transplant if they smoke marijuana. While the reasoning may still be suspect, something taken out of context can easily be misleading.

There are 17000 people in the U.S. waiting for liver transplants; there are a little more than 5000 available and performed in a given year. It sucks that he might die, it sucks that there are questions about why he's low on the list. There are other unanswered questions, too:

When did he apply? Where would he be on the list absent the denial? How is priority determined? Are there other factors (age, stage of disease, likelihood of recovery) that are coming into consideration? How long is the list, and how long have other potential recipients been waiting?

Posted by bohica | April 28, 2008 2:53 PM

Totally fucking cruel. What is wrong with these people? Are they completely clueless or is there some ulterior motive?

Posted by Cale | April 28, 2008 3:02 PM

Another factor probably at play here but which they would never admit to is that the DEA is all over doctors prescribing pain medications and medical marijuana. They may have threatened the doctors' licenses or Federal Research Grants to the Medical School if they let this poor fellow into the line.

Posted by ratcityreprobate | April 28, 2008 3:04 PM

For fuck's sake.. there is no medical rationale for denying a transplant. This is moral prejudice pure and simple.

In 2002 the National Institutes of Health held a consensus panel on treatment of hepatitis C and in their conference statement argues that even active injection drug use not be a barrier to receiving appropriate care for treatment of HCV.

Posted by gnossos | April 28, 2008 3:28 PM

I've had the organ donor stamp on my driver's license for a couple of decades. I always thought it was the right thing to do. If I have a stroke or get hit by a bus and die, I have no problem with someone else making use of whatever salvageable organs remain.

But if this is the kind of lame ass criteria they have, I have serious reservations about the entire concept of organ donation. I will be watching the outcome of this. Regardless of this particular patient, I want to hear if legal prescribed use of medical marijuana is truly a disqualifier for organ transplant. If it is, I'm taking my name off the list.

Posted by Reverse Polarity | April 28, 2008 3:34 PM

Who gives a flipping flying super fuck if he is "addicted" to marijuana. It's totally frivilous anyways. I think it has more to do with the hospital not wanting to get stuck with the bill.

Honestly, the ethics of it are total bull shit, he's a musician (assumingly uninsured), hospital doesn't want to pay for transplant. And they tried to find some bull shit loop hole are sticking to their guns.

It reminds me of the death row inmate who got the heart transplate (later died for not taking his meds). But it's still besides the point. He had government health insurance, and when the time came for his surgury, the only people to ask why was the governemnt.

Posted by OR Matt | April 28, 2008 4:00 PM

The point: he's being denied for the reason that he used medical marijuana. Medical marijuana was recommended to him by his physician. As Dominic points out, this was "completely legal under state law", which is was. Logic has this to offer: the dude doesn't have time to jack off with proving he isn't addicted to the "highly addictive" substance that is marijuana.

Organ transplants have a number of flaws and problems to begin with, even with entirely healthy patients. To "optimize" selection to have these organs find the best home is in no way anything but medical discrimination.

Or at least that's what I've got out of this whole thing.

Posted by Mr. Poe | April 28, 2008 4:13 PM

I wouldnt want to give a healthy organ to someone that intentionally harms their body with any substance either.

Neither would I. But that has absolutely nothing to do with this case.

Posted by thehim | April 28, 2008 4:25 PM

Seriously, if I had to put money on why he isn't getting a transplant, and why they are being hush hush about it ... it's that they don't want to PAY for it.

It's not Canada, they don't just GIVE life saving surgury away around here.

Posted by OR Matt | April 28, 2008 4:34 PM

Matt (23 and 25). A little research would show you that the UW hospitals--Harborview (UW-managed) and the Medical Center--have given away hundreds of millions of dollars in charity care per year for many years. They give away most of the charity care provided in this state. Move on to a valid point.

Posted by lopez | April 28, 2008 4:44 PM

Of course, if the program that would pay for it is a federal program, it's not like they have any choice in the matter ...

Posted by Will in Seattle | April 28, 2008 4:59 PM

@26. I still don't buy, something is fishy. Possibly threats from the feds threatening funding, liscencing, etc ...

No serious physicican is going to deny a transplant based on "lifestyle chioces"

Insurance companies, feds, and hospitals will pull funding for a drug addicted patient AND sight privacy laws to justify their claim.

Posted by OR Matt | April 28, 2008 5:35 PM

As for charity, he's not an orphan in need of apendectomy if you know what I mean ...

he's a most likely sexually active illicit substace user ... slight differnce

Posted by OR Matt | April 28, 2008 5:38 PM

Re: Rebecca-
It's a crapshoot. Sometimes the virus will recur, and the new liver will also become cirrhotic and fail. But sometimes the virus will, with proper management, go into remission and the patient will experience near-full recovery. But either way, with end-stage liver failure due to HCV, a transplant represents the best chance that the patient will survive with decent quality of life.
Hepatitis C is an awful way to die. This March I watched it kill my father, and reading the description of Mr. Garon brings back awful memories. I recognize that transplantation involves complicated and heartbreaking decisions. But if the facts truly stand as stated in the article, then denying him this chance based on prescription marijuana use, for God's sake, is just beyond reprihensible.

Posted by Pandora | April 28, 2008 6:17 PM

I always thought Bellevue Ave was a douche but I never quite realize to what extent.

Posted by monkey | April 28, 2008 6:20 PM

And yes, I did send in my letter to Dr. Reyes.

Posted by Pandora | April 28, 2008 6:43 PM


Some people with Hep C got it from blood transfusions, not from drug use or sexual activity.

Posted by keshmeshi | April 28, 2008 7:55 PM

@33 ... yeah, it doesn't so much matter HOW he got it, I'm not morally judging him.

Yes, he might have gotten it from a blood transfussion or hell ... some random act where the virus entered a scratch on his wrist (apparently hep can survive outside the body).

But he could flaming starving artist homosexual for all we know, who has documented evidence for pot use ... and sadly, that might be enough.

To think if he aquired his pot (more)illegally he wouldn't be having this problem?


Posted by OR Matt | April 28, 2008 8:03 PM

@ 28

From everything i learned from "House", that is the one of the ONLY ways to determine who gets donor organs from large pools of viable candidates.

It's like elite college institutions and their admissions "criteria". They reject kids because they had too many "opportunities" and obviously, they should have had 4.9 GPAs.

Posted by el | April 28, 2008 9:06 PM


And then there is David Crosby, heaven forbid the middle aged white doctors be denied another David Crosby live with B. B. King blues album

Posted by OR Matt | April 29, 2008 9:42 AM


Hezode C, et al. Daily cannabis smoking as a risk factor for
progression of fibrosis in chronic hepatitis C. Hepatology

Hezode C, et al. Daily cannabis use: a novel risk factor of steatosis
severity in patients with chronic hepatitis C. Gastroenterology

Posted by Mike Bunyard | April 29, 2008 12:34 PM

So, Mike (#37), are you only into posting studies that support an anti-marijuana, pro-right wing point of view, or what?

Links advising against marijuana use by Hep C patients are pretty easy to find since the new study, but there are also studies less than two years old which show marijuana actually increases the success rate of interferon/ribivarin therapy.

Cannabis use improves outcomes in patients being treated for Hep C:

Posted by Steve Elliott | April 29, 2008 11:38 PM

All I could think about after reading this story, is "What does David Crosby think about all of this?" Both guys are musicians....however Crosby is wildly rich and famous. In spite of smoking crack (addictive! hello!) like a chimney for over 20 years, nobody bothered to deny HIS chance at getting a liver transplant! This is a MORAL JUDGEMENT by doctors, period. To not even let him on the list is absurd! This is akin to telling a black person at a deli counter that "You're not allowed to take a number...we don't like your kind here."

Posted by UW medi-nazis | May 5, 2008 10:41 AM

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