The world is benefited by a variety of human beings. Almost everyone can contribute greatly to our societies, no matter what their personal drives. Even the selfish and hate-filled can give us people like Henry Ford, the antisemitic supporter of Hitler who had union organizers beaten, but also doubled the standard wage for his workers and gave us the assembly line, standardized production, and vertical integration. His closest parallel today would be Elon Musk, who, while accomplishing astounding feats of engineering art—from electric cars and massive rockets to androids and brain links that may let the blind see and the paralyzed walk—is rapidly becoming a perfect example of the bullies that tormented him as a child and is rapidly on his way to being just like his father. These two men prove that you can be objectively terrible on a personal level and still do great things for society in general, acquiring tremendous wealth for themselves in the process.
Others are not driven by the pursuit of personal power and wealth, giving greater value to how they live their lives and what they do for others. We all know the name of Socrates, though he was never wealthy or politically powerful in Athens, because of his wisdom and self-sacrifice, while few remember the name of Croesus, the richest man of that time. We also revere those like Mother Teresa, who dedicate themselves to the service of others. For those who do find such value in living a life of service, there are two main tracks. I’ll reduce these down to protecting and healing. The first covers those who risk their lives defending all of us, such as soldiers and police, and the second would be those who pursue the healing arts—doctors, nurses, psychologists, pharmacists, therapists, etc. It may seem that the military is a strange place for a humanitarian, but you would think quite differently if your country was invaded by a foreign army, led by a psychopath and bent on taking everything that is yours, even your life.
No one rescued from Birkenau doubts the value of those who, in service to others, wear a uniform and carry a rifle. I’m not suggesting that these people are angels or that they live perfect lives or are always led by those of outstanding morality. The evil are also drawn to positions of power and trust, and a few can always be found in the uniforms of soldiers and police, and not infrequently in the prosecutor’s office and hospital lounge. All that being said, what stands between us and tyranny or chaos are those who wear the uniform. My brother-in-law is one of those. When I met him, he was already serving in the U.S. Marine Corps. As a former Marine myself, we bonded quickly; not many doctors can break down an M16 or recite the cycle of operations, and he was interested in the medical field. We talked about online classes he could take during his upcoming deployment—the wars in Iraq and Afghanistan were going strong—and I encouraged him to seek these out.
I didn’t see him again for over a year. He would come back on leave, and we’d pick up where we left off, discussing the potential for him to be an EMT or perhaps a physician’s assistant. He completed several tours and finally, after years away from his family, came home. I encouraged him to finish college, which he did, and I gave him a job at my clinic as a toxicology technician. This meant that he ran the drug screening lab. Before him, I had depended on a tech supplied by a lab company; this is allowed if you aren’t making a profit off the labs, but either his attention to detail was insufficient or he was earning extra on the side, since drug screens might not arrive at the outside lab for the same patient two months in a row. When David took over, everything ran with extreme precision. He reorganized the lab, labeling everything, and developed procedures to make sure that every protocol I had created was adhered to.
If something went wrong, I would tell him, and he would say, “Yes, Sir,” and it would be rectified and procedures modified to prevent its recurrence. His precision and dedication impressed me more than any other quality. He graduated college and, when he saw that he could not support a family as an EMT, joined the Dallas police department. Not long after, the DEA raided my clinic, having decided that I was an “overprescriber” from PDMP data alone, never excluding the dosage units prescribed to those with cancer or on palliative care. David let me know that he was ready and willing to testify on my behalf. This is not a small statement for a new police officer to make. The American federal government can be vindictive and venal, and getting on their bad side can be the end of any career, in medicine or law enforcement. My attorneys didn’t seem to be interested in calling him or any other witness, however, and I couldn’t understand why until just before the trial.
Some attorneys think it is their job to work with the prosecution and reach what they consider to be a “good deal.” This deal will, of course, require you to please guilty, even if you are innocent. From the perspective of this type of attorney—let’s call them a Neville—you are facing an almost impossibly powerful adversary. The enemy owns the battlefield and all the ammunition. They are, in our best of all possible justice systems, allowed to control the evidence and withhold anything they choose. You could argue that something was supportive or even exculpatory if you had access to the evidence, but since you don’t, you have to trust those dedicated to your destruction to give your side what’s needed to disprove their case. Amazingly, this does not seem to happen very often, and many defense attorneys who practice in federal court have become completely defeatist.
A few days before my trial, my lawyers called me, and I could tell they were thrilled. The prosecutor had agreed that if I pleaded guilty to a single count of knowingly prescribing a Schedule V medication without a legitimate medical purpose—raised from a misdemeanor to a felony—I would only serve up to a year in prison. If not, the government would try to convict me of being responsible for a patient of mine who had died in police custody after they withheld all his medications and treatment. I was looking at a minimum of twenty years in prison and a maximum of life. My attorneys explained that the government had almost unlimited resources and that they could afford to scour the country finding some doctor somewhere who would be willing, for the right price of course, to convince a jury that whatever I did was not the “national standard of care”—something that does not actually exist. They warned me that these “experts,” though scientifically wrong, can be very persuasive.
They went on to warn me that former patients, threatened with criminal charges, could make false statements about me to protect themselves. I understood not just this risk but why someone put in such an impossible position might choose to protect themselves and their families over a physician they saw once a month. But I could not take the deal. I told them no. They threw a fit, literally screaming through the videocall, telling me what a fool I was and that I would die in prison. When I said, “So be it,” I thought they were going to have strokes. They tried to get my family to their side, not realizing that we had all discussed this eventuality, and they all understood why I simply could not raise my hand in court and lie under oath. They had not charged me with anything I could convince myself I had done. To plead guilty would obviate everything I had ever stood for, everything I had ever taught my children.
At this point, one of them became verbally abusive, causing my children to cry and me to hang up on them. I told the less abusive attorney that I did not want the worst one at trial, but he insisted it was too late to make changes. Just before I took the stand in my defense, the rude one asked, “What do you need for the direct?” “Everything I emailed you,” I said, “the PowerPoint presentation, the graphs, all of that.” “I didn’t have time to read all your emails!” he sneered, and I was called to the stand with no ammunition, no way to simplify complicated medical concepts so the jury could try to do what the prosecutor had done—skip four years of medical school and go right to deciding what is the proper diagnosis and treatment for a complicated patient. I’m not ashamed to say I cried. I sat there on the witness chair and sobbed for several minutes thinking to myself, “My patient is dead because the jail denied him proper medical care.”
The federal government, the only ones who could hold them to account, is helping the jailers cover up the crime by blaming me and I, sitting here at risk of losing my freedom for the rest of my life, am being defended by an attorney who spitefully sabotaged my defense because I wouldn’t take a plea deal. At some point, I quit blubbering and got down to educating the jury about beta-endorphins, mu-opiate receptor variations, and cytochrome P450 polymorphisms. Not surprisingly, I failed. The simple truth is that if your attorney does not ask the right questions on direct examination, you are probably doomed. If they then fail to call the witnesses you had lined up and ready to go, you are definitely doomed. I was acquitted for treating the paraplegic with a metal rod in his spine, probably because of how eloquently he defended me, and was found not responsible for the other patient’s death.
Probably because the coroner and medical examiner both said it was unlikely and impossible, respectively, for my patient to die of an overdose twenty hours after taking medication that peaked in three. Though the government had been able to pay a toxicologist to retroactively diagnose my patient
with sleep apnea and claim that, on the lowest dose of medication he had been on for a decade and over twenty hours since taking that, he had fallen so deeply asleep from its effects that he forgot to breathe. You could never make this argument in a state court when the death certificate said, “natural causes due to cardiac condition.” But this is not state court. This is federal, where they can say and do anything they want, and no one has the power to hold them to account. Despite this victory, I was still convicted for treating him at all, and for continuing the treatment of a veteran with spinal fractures.
The government’s paid witness told the jury that the radiologist had read the MRI wrong and that the VA doctors and specialists were all wrong to have started him on treatment in the first place. The expert said he could tell from the MRI how much pain the veteran truly had and that it was less than what he said. This overrode the veteran getting on the stand and saying that I was a good doctor that had helped him keep his job while teaching him to deal with his pain and improve his quality of life. The patient who died in jail was not able to speak in my defense, of course, and as I said, I was convicted for continuing his treatment after his PCP moved out of state. I knew, should have known, or was willfully blind, after all, that some doctor the government had dredged up in Florida would have an opinion different than mine. The expert also said that the neurologist had read the EMG wrong and that this patient really didn’t need the cervical surgery I had sent him to Dallas for.
It turned out that all the doctors and specialists were wrong except this one paid expert—persuasive, I suppose, to people with no training in medical science. I was also convicted of two misdemeanors for prescribing cough syrup because, hey, black people, always lying to get those sweet medications to sell on the street, don’t you know. Not that the government was able to provide any proof that this happened, of course. Who needs proof when you have persuasion? They simply argued that I had put the patients at “high risk” of diversion, and the jury nodded along, even the black ones. That’s the thing about implicit bias—no one is immune to it. But the science is clear, and I refuse to throw out science to embrace what is politically popular today. So while I was fighting and losing at trial, David was fighting his own battle in law enforcement. He had excelled in training, as I was sure he would, and everything went fine for a while.
Then he was arresting a much larger young man who simply would not stop fighting with the officers. Eventually, David did indeed impart a few choice words from the Marine lexicon and held a taser to the young man’s face, asking if he wanted it activated. The man decided he did not want it activated and calmed down, and no one was harmed, but a complaint was made, and David was suspended. During this time, I was waiting to be sentenced, and David was morose, fearing for me and that his career in law enforcement was over before it really started. We talked quite a bit over the next year and a half, meeting in person at family events when we could, waiting to learn our respective fates. David was finally taken off suspension and returned to duty, and not long after, in August of this year, 2024, I was sentenced to seven years in federal prison. This hit everyone in the family hard, but in fact, it was as much a victory as you can hope for in our current system—it was not life.
The DEA had told the Arkansas Pain Committee that they were going to make examples out of five doctors in the state if we all didn’t follow their mandates fast enough to please them. Dr. Robin Cox was before me, and while the prosecutor did not ask for prison time, the judge felt compelled to give it to her anyway—three years. Dr. Gaby came next, pleaded guilty, and got five. Then Dr. Hinderliter, an 81-year-old doctor and veteran, folded after the DEA kicked his door in—probably hoping that he would have at least a few years to spend with his family before he was gone. They told him the maximum would be five years if he pleaded guilty to a single count of wrongfully prescribing a Schedule IV benzodiazepine, but when it was time for sentencing, the prosecutor argued to the court that his sentence should be enhanced because some of his patients had died. Some of your patients always die—that’s kind of the definition of sick people; they die more often than healthy ones.
If a few more years with his family was Dr. Hinderliter’s hope, it was misplaced, as the judge doubled his sentence to ten years. You see, once you plead guilty, you don’t get to refute all the “relevant conduct,” which turns out to be anything the government decides to say about you. I was told the prosecutor was smirking as Dr. Hinderliter was led away to his fate. Medical care in federal prisons is not designed to keep you alive, and he died after only two years in some dark little cell, probably asking himself the same thing I do—how the hell did this happen in the United States of America? I have long given up on expecting divine intervention or having faith in an all-merciful, benevolent being with a great plan. My first walk through a pediatric cancer ward would have been enough to accomplish that, but this time, as I sit here enjoying my last few weeks of freedom before I self-surrender to my own fate behind bars, the universe surprised me.
David was not long back on duty and was on patrol when a strange call came over the radio. Dallas Police Officer Darron Burks, a young and well-liked patrolman, had parked his car at the For Oak Cliff Community Center at 10 PM on Thursday night, August 30th, when Corey Cobb-Bey, age 30, walked up to the car, pulled out a handgun, and unloaded it into the officer’s head and chest. Cobb-Bey had serious mental problems and had gone online with a mixture of unhinged, pseudo-religious rants, claiming to be immune from U.S. laws and predicting the apocalypse. It seemed clear that it was his intent that night to kill as many police as he could. The dispatcher had heard officer Burks’ dying cries over the radio and called for a response, but did not know what had happened. Two more cars arrived but were not ready for what they would face, as Cobb-Bey had also armed himself with a shotgun and an AR-type rifle.
He took one officer, Jamie Farmer, down with a shot to the leg and walked up on the other, a female officer named Karissa David, shooting her in the face until she was down also. They would both survive but were in no condition to stop the gunman as he got in his car and left. Someone, however, maybe Farmer, was able to call in the vehicle’s description, and that’s where the hand of fate—if sometimes cruel and uncaring—can also show mercy. When the description went out, a young police officer, not long returned to active duty, happened to be nearby. David was racing to the scene when he saw the wanted car fly by and gave chase, calling it in so that soon two other cars joined him as they sped through the streets of Dallas. The chase ended in a suburb called Lewisville, where the gunman, realizing he could not outrun the patrol cars, pulled over and held his guns up in the air. David pulled over behind him, pulling his M-4 from the patrol car.
By now, the other two police cars had caught up, and those officers had pulled their pistols, all yelling at Cobb-Bey to drop the gun. Instead, he swung the rifle down to point at the officers. The instinctive thing to do when someone points a rifle or shotgun at your face is to duck. This seems like the safest choice—keep your head down, stay safe—but if every Marine on the battlefield did that, we would lose every war, and it is, of course, futile and will get you killed anyway. When confronting evil, you must stand up and take your best shot. David had been trained by the Marines to do exactly this, and he did, bringing the murderer down with a precision only those trained for combat can when looking down the barrel of a gun. David came by last night as we all got together to say goodbye before I’m gone, and we talked about what had happened. I’ve also listened to the radio calls, heard the Chief speak to the media, and the bodycam will be released soon.
The death of any human being is a tragedy, and I wish that Mr. Cobb-Bey had been able to receive the mental health care he needed to calm his inner demons and keep him from taking the life of an innocent man—devastating all the families, both born and blue, and causing so much pain and suffering for the other injured officers and their loved ones also. But this world is not a perfect place. Doctors are being forced to choose between doing what they believe is most likely to keep their patients alive and give them some quality of life and doing what politicians and politically appointed attorneys think they should do, with the DEA there to arrest and incarcerate anyone willing to practice according to their education, training, and experience. But in the end, everyone’s time on this rock is limited, and the only thing that lives after us is the example we set. When that time comes and you are staring into the barrel of a gun, do you fall to the ground and beg for mercy?
Or do you take your best shot in the face of evil? Each of us must think about this and decide what we can live with and what we are willing to die for long before the question is asked. David showed courage and strength and made the right choice, and I am very proud of him. If we all follow his example, the world will be a safer place.
L. Joseph Parker is a research physician.
