|WOL: What is the genesis
of this case?
Fisher: The problem
goes back to the 1920s and the era of prohibition, when drug use was viewed
as a moral problem. If drugs were made illegal, then addiction would
vanish. From the beginning, right after the Harrison Act, federal
officials started busting doctors as if they were drug dealers, and that
has continued to this day. But recent pain research has indicated
that addiction among chronic pain patients is extremely rare, something
like one in 3,000, and then we started getting good legislation such as
the 1990 Chronic Intractable Pain Act here in California. Within
five years, the medical board had issues guidelines for pain treatment
and I started following them. That was unusual, though, because the
other doctors kept their heads down and their prescriptions low because
they didn't want to be noticed. They knew what would happen.
Then at the beginning of
1998 the Patients' Bill of Rights passed, and I saw this as a mandate to
stop under-treating my patients. I followed the guidelines to help
patients be the most functional they could be. I had already attracted
most of the serious pain cases into my practice because no one in Shasta
County would treat them. When I titrated [gradually increased the
dosages] up, the computers started spitting out numbers that looked like
I'd done something unusual.
I had already come to the
Attorney General's attention a couple of years earlier, because when pharmacies
notice a high rate of such prescriptions they call in the authorities,
and that's how the authorities decide to go after a given doctor.
They don't actually look at his practice, they send in a couple of agents
to do a sting, they write up an enormous list of charges to intimidate,
and the doctors end up taking a misdemeanor as a plea bargain. They
charged me with 99 fraud felonies, then offered to deal. I turned
it down, so a large element of this case is retaliation for that.
I bucked their system by prescribing the right amount of medication and
by not taking their deal, so they started looking around for bodies.
They charged me with three murders and a million dollars worth of medical
fraud, and they charged the Millers as well.
WOL: Mr. Miller, it
was your pharmacy that was handling Dr. Fisher's prescriptions?
Mr. Miller: We filled
more than other area pharmacists, maybe half of them. We took it
a step further and began giving the patients prescriptions before Medical
agreed to pay for them. We helped the patients file for fair hearings
to get Medical to pay for adequate medical care.
Mrs. Miller: We saw
how Medical was treating Medical patients, and they were breaking court
orders dating to 1990. All of a sudden, Medical started denying all
of the patient claims without notifying the patients that they are entitled
to appeal. During the time when the cases are on appeal, Medical
is supposed to give patients aid pending approval until they go before
the trial judge. The judge commended us for our efforts on behalf
Mr. Miller: Two weeks
after the judge's decision in the patient's favor came down in the first
of those hearings, we were all arrested.
Mrs. Miller: Medical
was being really nasty because no one had ever challenged them before.
We had a meeting with Medical and Sen. Leroy Greene [author of the Chronic
Intractable Pain Act], and Greene told the bureaucrats that they were breaking
the law by not approving the pain treatments. We were trying to educate
Medical and the Attorney General's office about the new laws.
We went the extra step for
our patients by helping them file and document appeals. We saw patients
improving with pain treatment and helped them in various ways. We
told the bureaucrats that they had forgotten that each little form they
denied represented a living, suffering person. They didn't like that,
but they weren't the ones looking at patients across the counter who were
ashamed or embarrassed because they couldn't afford their medicine.
It got to be a very personal thing for us.
Dr. Fisher: I'd like
to add that the Millers went so far as to pay out of their own pockets
for prescriptions for these patients, assuming they would win on appeal.
Mrs. Miller: This was
a case of retaliation. They were very angry that we challenged them.
We just wanted our tax dollars to be going where they should be going to
help poor people who needed medical care. What was going on was wrong.
WOL: Were you two also
arrested and charged with murder? Why?
Mr. Miller: Yes, even
though Madeline is not a pharmacist. She was the office manager.
WOL: How long had the
pharmacy been in business?
Mr. Miller: Since 1986,
and we never had any problems before we started fighting with Medical.
WOL: Tell us about
the day of the arrest.
Mr. Miller: About 15
cops came in dressed in riot gear and carrying automatic weapons.
The first thing I thought was we were getting robbed. I asked for
identification and they put a gun to my head and said, "this is all the
ID you need." They threw me on the floor like it was a raid on a
crack house. They questioned us before they arrested us, to evade
the Miranda warnings.
Mrs. Miller: I started
screaming at them that they were there to retaliate for our advocacy for
pain patients. They shoved me back and said, "yeah, we know all about
you, you're a pain in the ass."
WOL: Welcome to the
war on drugs. So, now that the murder charges have been dropped,
are all three of you still defendants on the manslaughter case?
Dr. Fisher: Yes, and
a million dollars worth of fraud charges. Madeline doesn't have any
manslaughter charges, but we're all charged with conspiracy to commit MediCal
WOL: How many years
are you looking at?
Mr. Miller: We don't
even think about it. They have offered us various plea bargains,
but our attorneys just laughed. They know they've done wrong, they
audited the pharmacy and we came out clean.
WOL: Are you getting
Mrs. Miller: From everywhere.
We've been part of the community for a long time. While we were in
jail, only the prosecution's side got heard. That is changing now.
WOL: Dr. Fisher, you
were arrested the same day?
Dr. Fisher: They detained
a dozen employees. This is a community health center. They
also raided my house and the Millers' house and three other employees'
Mrs. Miller: They had
a key to our house, but they still broke the door down, ransacked the house
and left it wide open. You feel so helpless in jail. They did
everything they could to hurt us. They seized our bank account again.
WOL: Who is responsible
for this? Is it the state or is it local authorities?
Mrs. Miller: The state
of California. Our Shasta County DA didn't have anything to do with
Dr. Fisher: They hit
five or six locations all at once and announced it was the biggest drug
bust in the history of Northern California.
WOL: Dr. Fisher, were
you working outside accepted medical practice?
Dr. Fisher: No, but
the medical board investigators don't seem to understand this. They
didn't know what the laws are or what the state of medical practice is.
WOL: Are you completely
confident that you will be exonerated?
Dr. Fisher: Absolutely.
Mrs. Miller: And we
will continue on. You know, people are suffering, why should people
have to suffer when they can have adequate pain treatment? But the
doctors are scared and the pharmacies are intimidated.
Dr. Fisher: The problem
is we've spent the better part of a century telling these cops that these
drugs are evil, and now they are having to adjust to new medical realities,
and they haven't come through that transition in very good shape.
WOL: Mr. Black, please
tell us about your wife and Dr. Fisher's
treatment of her.
Mr. Black: Her name
is Tony Briano. She has chronic back pain and other health problems.
Before she starting seeing Dr. Fisher she was bedridden. After seeing
Dr. Fisher, she got her life back. She was about to return to work.
WOL: So you saw real
observable functional changes in her?
Mr. Black: Oh, absolutely.
After he got arrested, I saw it turn back the other way, and she went right
back to bed when her pain meds ran out. For a time I had to take
her to Eugene, Oregon, a six-hour drive, to be treated, and that wore her
out. Because of the stigma of being a Dr. Fisher patient, no one
was willing to take her. They were all deadly afraid of the police.
It was financially draining on us. Now we have a local doctor, who
provides some pain control. She just had another back surgery, which
she probably wouldn't have needed if Dr. Fisher hadn't been taken down
by the [California] Department of Justice.
WOL: Dr. Fisher, you're
the doctor here. Is Mr. Black's description correct?
Dr. Fisher: Yes.
She was functioning just fine. Her back had her hunched forward.
She could have declined further surgery if she had access to adequate pain
Mr. Black: The state
was a real obstacle to getting her medical records after Dr. Fisher was
arrested. We got the run around from the state. Eventually
two agents of the Department of Justice came saying they were bringing
the medical records, but they didn't bring the records; instead they wanted
her to testify against Dr. Fisher. Three times, they told us "if
you do not testify against Dr. Fisher, you will get no help from the state."
That was agent John Dodson. It took us 18 months to get her records.
Mrs. Miller: The state
should have supplied every patient with copies of their medical records,
but they did not. This left the patients in a real bind. Patients
couldn't get proper treatment, and new doctors would have to redo all these
expensive tests, costing the state even more money. The state didn't
WOL: When is your trial,
and what do you think the state will do?
Dr. Fisher: October
17th. Our local prosecutor was elected after this occurred.
My lawyer, Patrick Hallinan, once described this as "a malignancy left
over from the Lungren administration, which a little radiation therapy
ought to cure." But it's hard to predict what will happen, because
this case in so bizarre. But we're ready to go to trial because we're
so confident and because the issue of pain control is so important to millions
of people. We're not backing down.
WOL: Why hasn't the
local prosecutor intervened?
Dr. Fisher: Why he
hasn't stopped this along the way, I can't say. They have also spent
millions of dollars already.
WOL: Anything else
you want to say?
Mrs. Miller: This is
all because of the war on drugs. If you were Dr. Fisher's patient,
you were seen as an addict. This is like something you'd see on TV.
It's absolutely frightening to see the government come in and charge you
with these baseless crimes. It's all because of the drug war, which
is really a war against people. What they do to people in jail and
prisons is a crime.
Dr. Fisher: There have
been other cases, but nothing as bizarre as this. And the tragedy
is that now patients are dying for lack of treatment. The judge has
tossed out the murder charges against us, but now patients are dying.
WOL: How has this affected
Dr. Fisher: It's been
devastating, we've all been wiped out. But it goes further than that,
there's the devastation of the patients' lives as well. There are
tens of millions of patients who are not getting adequate treatment because
of this situation. We are looking for funding; we owe Patrick Hallinan
about $125,000 for the defense, and if we don't get it, there's a chance
this will all go down the drain; we'll have to take a plea.