Robert Randall 1948-2001

These are from my notes on Marihuana, the Forbidden Medicine by Lester Grinspoon and James B. Bakalar.

Robert Randall was told, in 1972, that he had at most three to five years of sight left. He had already lost sight in his right eye. By 1974, he discovered that marijuana, unlike all other medicines his doctor had tried, relieved his glaucoma symptoms: that is, it gave him his sight back. He started smoking pot regularly, and maintained his sight for nearly thirty years, still retaining some distance vision when he died in early June, 2001.

According to Grinspoon and Bakalar, “Marijuana reduces intraocular pressure. This discovery occured accidentally, when UCLA did some experiments for the LA police to determine if, as the police believed, marijuana use dilated the eyes. (Thus allowing ‘dilated eyes’ as probable cause for arrest.) It turns out the opposite: very slightly constricted. Glaucoma is the result of “an imbalance of pressure within the eye.” Robert Randall had reached that stage where “standard drugs are no longer effective, and blindness is iminent.” “If nothing further had been done, he would have gone blind.”

Robert’s Story

Excerpted from Marihuana, The Forbidden Medicine.

I smoked my first marihuana cigarette the day Richard Nixon was elected President. Jerry Ford was President when I smoked my first legal “research” joint. Jimmy Carter was elected days before I walked out of a Washington, D.C., hospital carrying the nation’s first modern prescription for medical marihuana. I legally toked through the Reagan years, unscathed by the mindless War on Drugs. George Bush is President now. I still legally smoke medicinal marihuana and, as a result, still enjoy my sight.

…

…when I smoked marihuana I saw more clearly. I’m not talking enlightenment. I’m talking sight. Seeing. Since my mid-teens my evenings had been haunted by minor visual problems—transient tricolored halos. On some evenings I would go white-blind, my vision snared in an impenetrable swirl of absolute illumination—the white void.

I knew these problems were minor because when I noted them to my physicians they told me if I was older it might be serious. But, since I was too young for it to be serious, it must be “eye strain.” All that diligent study. If they weren’t worried, why should I be? Particularly since marihuana relaxed my “eye strain.” Nothing special in that. Marihuana relaxes nearly everything: mind, body, soul. That chronic kink in the neck. So why not eye strain? Without marihuana to ease my “eye strain” I probably could not have completed my master’s.

Following graduation in 1971, I moved to Washington to write stirring speeches for powerful people and ended up driving a cab. I loved driving a cab. Most instructive. No boss. You set your own hours. I’d also stopped smoking marihuana. Being in a new city, surrounded by new people, I had few friends and no access—no dealer.

One evening in the summer of 1972, I closed my left eye and discovered I could not read with my right eye. Instead of clearly formed letters I saw a jumble of black ink splashed on a white page. No matter how close I drew the text, it remained indecipherable, incoherent, alien. Someone gave me the name of a good ophthalmologist. I saw him the following afternoon. I was twenty-four.

…

Said Dr. [Benjamin] Fine, “Son, you have a very serious condition called glaucoma. You have already suffered a lot of visual damage and …”

“How long?”

Thrown by my directness, he responded in kind: “At best you’ve got three, maybe five years of remaining sight. You’ve lost most of the vision in both eyes. Your right eye has no central vision—no reading vision—none. In your left eye you only have a small island of healthy tissue. That’s why you can read. Your pressure in both eyes is over forty. It should be under twenty. You are in very, very serious trouble. You are going to go blind.” Surgery was risky, especially in someone with my advanced level of damage. There was a good chance surgery would annihilate the small fragments of healthy optic tissue which remained.

“I’m sorry, son. We’ll do the best we can, but there’s not a lot we can do. You are going to go blind.” He looked worn out. Doctor Fine put pilocarpine in my eyes, gripped me by the shoulders, asked if I was all right, gave me a pat on the back, and sent me out the door with those most fateful words: “Just live life like you always have…” Patients know the end to this dreaded sentence, “because you won’t have it for long.”

…I wandered downstairs, got in my cab, and realized I could not see beyond the dashboard. Pilocarpine, a miotic, induces intense nearsightedness. I drove through D.C. rush-hour traffic guided by memory and the glare of sunlight off the cars in front of me.

I ignored this gaping invitation to debilitating depression. I could still see, still read, still softly fondle all nature’s hues and tones. Until, of course, I put in my newly prescribed Pilo [pilocarpine], which quickly reduced my sight to remnants of ill-defined shape. My introduction to the wonderfully twisted world of glaucoma pharmacology.

…

Glaucoma and its therapies introduced me to much larger, more disruptive realities. Pilo and driving don’t mix. Within a week of diagnosis, I was out of my cab and out of work. Deemed “disabled,” I landed on welfare, an unexpected ward of the state. This really was getting serious. Within weeks of diagnosis, my prescription for Pilo doubled, redoubled, tripled, quadrupled. Within months, epinephrine was added. … Then came Diamox [a carbonic anhydrase inhibitor], a pill, a diuretic. Crushing fatigue. The taste of everything changed. Finally, in desperation, phospholine iodide, an eyedrop developed from a World War II nerve gas, was added to the mix. This battering pharmaceutical assault left me blurry-eyed, dysfunctionally myopic, photophobic, extremely tired, with a chronic backache—calcification of my kidneys. Objective medical control over elevated intraocular pressures (IOP), however, remained elusive. My rapidly escalating intake of toxic prescriptions was outraced by the dynamic character of my glaucoma. Each visual field shrank. …my evenings were routinely visited by tricolored halos… On some nights the halos were muted. On other evenings they appeared as hard crystal rings emanating from every source of light. And then there were nights, not so rare, of white-blindness—the world rendered invisible by its brilliance.…

Then someone gave me a couple of joints. Sweet weed! That night I made and ate dinner, watched television. My tricolored halos arrived, which made watching TV less interesting. So I put on some good music, dimmed offending lights, and got into some serious toking. I happened to look out my window at a distant street lamp and noticed what was not there. No halos. That’s when I had the full blown, omni-dimensional technicolor cartoon light-bulb experience. In a transcendant instant the spheres spoke! So simple. Old messages—new context. You smoke pot, your eye strain goes away.

Ganja is good for you.

Sure was fun, but in the medicated haze of the next miotic morning I chided my raging rapture and began a baseline reality check. My well-educated, acutely dispassionate intellect was not kind. “Let us,” my left sphere said, “be analytical.”… This poor, super-stressed soul, unwilling to accept the cumulative horror of what has become “real life,” gets his hands on some really good pot.… In despair and desperation, he imagines marihuana is going to “save his sight.”

Are we crazy? The answer is obvious, right? Given these facts, who would not want to believe something mystical, magical, mysterious, and forbidden is going to rescue them from the pit of eternal darkness? The idea that a legally prohibited, medically unavailable weed—a plant smoked for sheer delight, for fun—is going to “save your sight” is madcap and reckless; as farfetched, improbable, and pathetic a notion as someone insane could imagine.

So began six months of cynical observation. Six months of simple trial and error. At the end, the conclusion was unavoidable. Without marihuana there were halos and white-blind nights. When I smoked marihuana there were no halos.… If I watched very closely I could actually observe the halos depart. The cumulative evidence of a reproducible benefit was inescapable.

… What now? Do I rush to introduce nice, middle-aged, middle-of-the-road, prestigious ocular pathologist and genuinely swell fellow, Dr. Ben Fine, to my pot-driven revelation, which is, of course, of potential benefit to millions of similarly afflicted humans? Yeah, right! No way! He’s a good doctor. I like him. He’s honest. But he would not appreciate my news. There are medical questions. And, of course, legal concerns. Like malpractice, or worse. If Dr. Fine knows but does not tell the police, does he become my criminal accomplice? A co-conspirator? “Pot Doc arrested!” His career in ruins.

If not my trusted doctor, then whom? I could tell the drug bureaucrats? Sure! “Marihuana Can Be Good For You!” This is just the sort of good news rabid antidrug zealots are longing to hear. In this very unsubtle way, fear—prohibition-induced fear—pervades any dialogue on marihuana’s medical use, separating patients from physicians, from other patients, from government. You are isolated. In the best of times, under the best of circumstances, this is not something to be wished for. When you are young and going blind, the inability to share such vital information with the physician treating you or with others who might be helped becomes downright scary. It became a time of simple goals. Keep smoking, keep your mouth shut, and stay sighted. Seeing is real. Everything else is politics.

Doctor Fine, though mystified by the sudden change in my condition, was greatly pleased by the results. My ever-eroding visual fields stabilized. My slide into darkness slowed, then halted. As my glaucoma came under medical management, other aspects of life began to right themselves. I escaped welfare and took a part-time job at a local college.

… To cope with the uncertainty of adequate supply I did what many patients still do. I grew some pot.

…By midsummer we were blessed by beautiful six-foot pot plants. Things were going swell. My vision was stable. I was employed. I’d rediscovered loose change. Alice had come to live with me. Swell. These were the last quiet days of my life.

While we were vacationing in Indiana, the local vice cops raided my house and seized my six-foot marihuana plants. I returned to find a warrant on the kitchen table with a note scribbled on the back requesting that I surrender myself for arrest. I could not know at the time, but being arrested was about the best thing that could have happened to me. Being arrested “saved my sight.”

When I told my attorneys I was smoking marihuana to treat my glaucoma, they thought it was hysterical. When they realized I was not joking, they stopped laughing only long enough to tell me to prove it. I spoke with Keith Stroup, head of the National Organization for the Reform of Marihuana Laws. Keith didn’t laugh. Instead, he carefully explained that I didn’t have a prayer. But he gave me a few phone numbers and suggested I phone around. So I phoned around the federal bureaucracy. Needless to say, I was startled when at least three bureaucrats point-blank told me, “Oh, we know marihuana helps glaucoma. We have lots of data which shows…” They knew! They knew and hadn’t bothered to tell me. They knew, but did not want anyone else to know. Remember, this is 1975, not yesterday.

…

Eventually I underwent two highly controlled medical experiments. The first, conducted at the Jules Stein Eye Institute, UCLA, required my incarceration in a mental ward for thirteen days of round-the-clock observation. I arrived in the middle of an ongoing research project involving six “routine” research subjects who were being tested on pure synthetic THC—a man-made copy of marihuana’s most mind-altering chemical. The UCLA researchers did more than simply confirm that marihuana lowered my ocular tension. They discovered that my disease could not be controlled using conventional glaucoma medicines. Left on these drugs I would go blind, just as Dr. Fine predicted. I was also tested on synthetic THC [Marinol]. What a lousy, marginal drug! The ‘high” is anxiety-provoking. The therapeutic effects, if any, are minimal, transient, unpredictable. But THC comes in a pill. The bureaucrats, the research scientists and doctors can relate to pills. Besides, we all know you shouldn’t smoke. In the end, UCLA determined marihuana was not merely beneficial; it was critical to the medical maintenance of my vision.

OK. It’s proved. Let’s go to court. I was ready, but my anxious attorneys conspired with an even more anxiety-ridden Dr. Fine to compel me into a second, confirmatory evaluation. On the Ides of March, 1976, a second, much less fun experiment was undertaken at the Wilmer Eye Institute, Johns Hopkins University, where I was institutionalized for six of the most miserable days of my existence. The Wilmer physicians were under strict instructions from Dr. Fine to find a conventional solution. He didn’t want to testify in court.

So they threw every glaucoma drug in the book at my condition.… I got to know my roomie, a fifty-three-year-old West Virginia factory worker named Vince. We had just met, barely exchanged hellos, when Vince asked, “You tried any good marihuana?” Blown away?! You bet. Seems ole Vince had taken a break with a couple of his night shift buddies and smoked weed for the first time in his life. Bingo! Vince noticed his halos went away. “If I could get my hands on enough marihuana, I sure as hell wouldn’t be in here,” Vince convincingly said. Two days later I watched the guys in white wheel Vince into cryosurgery, a ghastly, painful procedure which freezes, kills, a part of the eye in an effort to reduce ocular pressure. That night Vince groaned in agony; his toes curled in torment. After leaving Wilmer I followed Vince’s progress for quite some time. The mutilating surgery had not helped him.

Eventually, unable to “get enough marihuana,” Vince went blind.

I had been in glaucoma therapy for nearly four years, and Vince was the first glaucoma patient I’d ever met. And Vince knew! How many others knew? At the conclusion of their pharmaceutical torment, the Wilmer doctors grudgingly conceded failure. UCLA’s evaluation was correct: in the absence of marihuana my ocular tension was beyond medical control. Ignoring the UCLA data on marihuana, the Wilmer surgeons recommended immediate surgical intervention.

What a surprise! Without marihuana I would go blind. Everyone agreed on that. The Wilmer physicians, in their zeal to evade this fact, had recommended surgical procedures Dr. Fine knew would result in blindness. He finally agreed to testify in my defense. He took the very highest ground; given the facts, it would be medically unethical to withhold marihuana. The rest, as they say, is history. Briefly summarized:

• In May 1976, I petitioned federal drug agencies for immediate access to government supplies of marihuana.
• In July, at my trial, we raised the untried legal defense of “medical necessity.” Essentially, a simple argument that any sane soul who is going blind would break the law to save his sight.
• In November 1976, the bureaucrats cracked. They delivered a tin of three hundred pre-rolled marihuana cigarettes to my new doctor, John Merritt at Howard University. In this way I became the first American to gain legal, medically supervised access to marihuana.
• In the same month, the D.C. Superior Court ruled my use of marihuana was not criminal, but an act of “medical necessity.” It was the first successful articulation of the “medical necessity” defense in the history of English Common Law.