Abrams didn’t know for sure if there was a medical benefit to the marijuana Henry used. The doctor also had no inkling when Henry passed away that, years later, he would become California’s most renowned researcher on medical marijuana, and that clinical trials in the Golden State would challenge the federal government and medical research orthodoxy by helping establish the medical efficacy of pot. But one thing that struck Abrams at the time was that Henry had outlived most every other AIDS patient—and he used cannabis “every freakin’ day.”
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By 1990, anguish over the unsolved epidemic of AIDS and HIV was exploding into rage in San Francisco. That year the city hosted the International Conference on AIDS, only to have the event disrupted by activists from ACT UP, the AIDS Coalition To Unleash Power. Wearing “Silence = Death” shirts, they blew piercing whistles, threw chairs, and directed shouts of “Shame!” at conference participants, including Donald Abrams and other AIDS doctors and researchers. According to the activists, people were dying because of a conspiracy of government obstruction, because of a heartless ban on immigration to the United States for people with AIDS and HIV, because of a lack of funding for AIDS treatments, and from the continued failure of researchers to find a cure.
By then, another movement was attaching itself to the cause of AIDS and gay rights—marijuana. That same year, narcotics officers raided the apartment of Dennis Peron, targeting the pot dealer who supplied weed to sick people in the gay community. Police roughed up Peron’s lover, lesion-wracked and skeletal-thin AIDS sufferer Jonathan West. An enraged Peron would later describe an officer putting a boot on West’s neck and taunting him: “Know what AIDS means? Asshole in Deep Shit.” In 1991, Peron marshaled his fury to win 80 percent voter support for San Francisco’s Measure P, an advisory measure calling on the state to legalize marijuana as medicine. It launched his political march toward passing the California medical marijuana initiative, Proposition 215, five years later. Peron also found an ally in Mary Jane Rathbun, an eccentric Irish Catholic septuagenarian with a passion for baking and for pot. She partnered with him to set up the San Francisco Cannabis Buyers Club, which went on to provide marijuana to thousands of gay men with AIDS. They would later cowrite a book, Brownie Mary’s Marijuana Cookbook and Dennis Peron’s Recipe for Social Change.
The people wanting in on that change would include the likes of Richard Lee and Steve DeAngelo, lured by Proposition 215 and the progressive pot politics and medical cannabis opportunities in Oakland. They would include suburban Chicago seeker Stephen Gasparas and other new marijuana migrants drawn to the north coast Emerald Triangle. But as the AIDS epidemic extended into the early 1990s, with antiretroviral treatments still evolving, the social movement around marijuana remained focused on pot as a still-forbidden alternative that could relieve suffering and perhaps instill hope for better days. So in the years before California voters legalized marijuana for medical use, profoundly ill people risked seeking fellowship and comfort in places such as the Santa Cruz garden of the Wo/Men’s Alliance for Medical Marijuana; many others turned to cannabis to soothe their nausea, loss of appetite, and pain and maybe extend their lives in the frightened landscape of San Francisco.
It was at San Francisco General Hospital where Donald Abrams and fellow AIDS doctors got to know Mary Rathbun as “Brownie Mary.” It was there where her presence would ultimately serve to inspire social change through the clinical research of marijuana. For years, Brownie Mary was an ever-present volunteer in an outpatient clinic in a converted pediatrics ward on the sixth floor of the hospital’s building number 80. “Ward 86” became America’s most famous AIDS clinic. There, Rathbun shuttled sick young men she dubbed her “kids” from the clinic to radiology. She also brought them fresh-baked goods infused with marijuana, becoming a media darling for her compassion for people destined to perish from the disease. Abrams and other doctors in Ward 86, most of them products of the sixties who had smoked a joint or more in college, welcomed Mary’s presence. They didn’t worry much about her medicinal brownies. They just appreciated that pot offered some relief despite patients’ overwhelming medical challenges.
In 1992, Abrams arrived in Amsterdam for another International AIDS Conference. He flipped on the television in his hotel room. CNN International was broadcasting a breaking story from the San Francisco Bay Area: Brownie Mary had been arrested with two and a half pounds of weed, raided by police as she was crafting her confections at a friend’s home in Sonoma County. Soon the City of San Francisco, which under the voter-approved Measure P now officially considered marijuana as a legitimate source of symptom relief for AIDS, cancer, and other illnesses, staged a “Brownie Mary Day.” The star of the show let loose with a stream of profanity unfit for airtime. “If the narcs think I’m going to stop baking pot brownies for my kids with AIDS, they can go fuck themselves in Macy’s window!” Brownie Mary let it be known. The Sonoma County district attorney later dropped the charges.
Brownie Mary’s message—even scrubbed of profanity—elevated AIDS and pot as an international story, not only affecting Abrams as he watched in Amsterdam but also reaching a frustrated medical marijuana research advocate named Rick Doblin in North Carolina. Doblin, a graduate of New College of Florida, was preparing to resume his doctorate studies in public policy at Harvard after completing his Harvard master’s degree with a thesis on medical marijuana. Doblin had founded a group called the Multidisciplinary Association for Psychedelic Studies, which advocated research on alternative medicines, including marijuana and the drug known as Ecstasy.
Doblin had no medical degree. But for two years he had shopped around a research protocol for studying marijuana’s effectiveness in reversing the nausea and loss of appetite that led to wasting syndrome and starved AIDS patients into hollow-eyed human forms. After Doblin saw Brownie Mary on television, he wrote a letter “to whom it may concern” at the AIDS program at San Francisco General Hospital. The letter, urging someone there to take on the research project, was routed to Donald Abrams. The doctor followed up, and Doblin made an instant impression. Doblin insisted that groundbreaking marijuana research “should come from Brownie Mary’s institution.” Abrams was bemused by the thought of becoming the Brownie Mary Research Institute. But he was inspired by the study idea. Doblin’s idea made him think of Henry. It reminded him of how pot had seemed to keep his lover alive and functioning for so long.
By 1992, Abrams was working with San Francisco’s Community Consortium, a group of physicians setting up community-based clinical trials to explore treatments with AIDS and HIV patients. Despite being intrigued, Abrams was skeptical of Doblin’s plan to investigate the medicinal effectiveness of marijuana brownies. He didn’t see a way to standardize cannabis doses in brownies, particularly over a multiweek clinical research trial. But Doblin insisted that some kind of study of marijuana’s effect on wasting syndrome needed to happen. Doblin contacted the Food and Drug Administration about supporting a clinical trial and got a positive response. He arranged with a Dutch medical marijuana firm to grow cannabis for the research.
The same year, the prescription drug Marinol, containing a synthetically produced version of marijuana’s psychoactive delta 9-tetrahydrocannabinol (THC) constituent, had been approved for treatment of people with HIV wasting syndrome. But patients of Community Consortium physicians reported that swallowing Marinol left them zoned out for hours. Many reported they preferred smoking pot because they could regulate their dose through the number and spacing of hits from a joint. The Community Consortium’s board decided to back a study to assess separate groups of wasting patients—who either smoked marijuana or took Marinol—for changes in HIV immune system levels, body weight, and body composition. Research review boards from UC San Francisco and the State of