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January 25, 2007

The 7th day of the hearing began with the panel hearing motions. The health department had requested that the father of the two children be permitted to testify by phone, to avoid the cost of the trip East. The health department attorney stated that it was a little bit embarrassing, but the department doesn't have the budget to bring him here. Attorney

Pollock countered, citing the irony, that this father, ¦who put [these proceedings] into motion, effectively placing in jeopardy the lives of so many people, is unwilling to come to testify unless the department pays the cost of his travel. (Note: It was this father's complaint to the medical board about his children's being treated for Lyme by Dr. Jones that led to the actions against Dr. Jones. Previous testimony had alleged that the father had intimidated and threatened other doctors who were treating his children, as well)

The panel denied the health department's request for telephonic testimony, stating that it is important to see the witness, in order to determine his credibility.

Cross-examination of Dr. Jones continued, from Day 5 of the hearing. Attorney Tillis, representing the health department, addressed information from the children's charts. Extensive questioning involved:

1/ the continuation of antibiotics, prescribed originally in Nevada for a serious persistent cough,
2/ history of symptoms,
3/ results of serological testing, and other details.

As the cross-examination of Dr. Jones continued, with questions regarding telephone conversations that took place, as well as communications during the examinations of both children, one could wonder why a physician might be asked to recall these events in such fine detail. Lost in this minutia is the fact that a brilliant and compassionate physician made careful use of his expertise and finely honed clinical skills to diagnose and treat these children. Lost in the minutia is the fact that two children who were very ill for many years, perhaps suffering from gestational Lyme, had become healthy under the care of this physician. Lost in this minutia was the fact that their mother, a highly trained and experienced registered nurse, had not found anything near adequate treatment for her children prior to contacting Dr. Jones, as her children's health declined, and in the case of her son, with dire consequences to his education.

In the cross-examination pertaining to research articles, Dr. Jones was questioned regarding details of the articles. Attorney Pollock objected, as he had on previous occasions, to the extensive questioning regarding Lyme disease treatment, given the health department's allegation that this action taken against Dr. Jones was not about Lyme. The panel, however, did not sustain the objection, allowing the questioning to continue. Questions included issues of sero-negative Lyme, why some tests had not been done (MRI, for example), whether these patients had had Jarisch Herxheimer reactions, with the implication that that might be diagnostic, serology regarding co-infections.

Attorney Pollock's questions to Dr. Jones clarified several issues: 1/ Dr. Jones has found amoxicillin to be effective in a large number of his patients, 2/ EM Rash seen in fewer than 50% of patients, per Dr. Joseph Burrascano in Conn's Current Therapies, 3/Dr. Jones experience has shown the EM rash in far fewer patients even than that, 4/ Dr. Patricia Coyle's research has indicated that Lyme is a disease of the central nervous system.

Panel questions included the questioning of Dr. Jones' reliance on input from the children's mother regarding the children's health issues. Prior testimony from both Dr. Jones and the mother attested to her high qualifications as a nurse, and one that is a trained observer, given her experience with trauma and ER patients. One panelist's questions regarding communications with the school appeared to be under the erroneous assumption that Dr. Jones involvement with the school led to the expulsion of the son, when the opposite had actually taken place.

Note: Overall, the morning questioning could appear to the observer to challenge a highly experienced physician's right and responsibility to use his/her best clinical judgment, when developing a diagnostic profile and treatment plan. This could be a dangerous direction for medicine to go in, severely limiting quality treatment not just for Lyme disease, but for other illnesses, as well.

Leo J. Shea, III, PhD, a neuropsychologist who has a wealth of experience, not only with Lyme disease patients, but with patients who have suffered other types of brain injuries, testified in the afternoon. Dr. Shea was accepted as an expert witness, after citing his extensive and impressive credentials, both regarding Lyme disease as a specialty, and in general, in the field of neuropsychology. Dr. Shea's expertise in making recommendations for school accommodations, based on neuropsychological evaluations also qualified him as an expert witness. Admitted into evidence was his article, The Role of Neuropsychological Testing in Children With Lyme Disease?..

Some questioning ensued regarding Munchausen's by Proxy. Dr. Shea defined it, and pointed out that it is not listed as a diagnosis in the DSM (Diagnostic and Statistical Manual), as a mental disorder. He also mentioned (as had Brian Fallon, MD, in his testimony) that Munchausen's by Proxy is brought into question, in his experience, when there is a contentious divorce or custody issues, with accusations made by one of the parents against the other. Attorney Pollock's motion to admit a report related to Munchausen's by Proxy was withdrawn when Attorney Tillis stated that Munchausen's by Proxy was not at issue here.

Focusing on Lyme disease, Dr. Shea discussed the various learning problems often seen in children with chronic Lyme disease, and their specialized needs in the school setting. When asked about Dr. Jones making recommendations to the school for a child who appeared to have learning problems consistent with Lyme disease, Dr. Shea stated Dr. Jones clearly understands the issues for accommodations. Regarding Dr. Jones' communication with the boy's school, and his input into school decisions, prior to seeing the child, Dr. Shea pointed out that both the school and the mother were in sync with Dr. Jones recommendations, and that the decision was necessary to benefit and protect the child.

Attorney Tillis cross-examined Dr. Shea regarding the school psychologist testing of the boy. Dr. Shea indicated that the school psychologists tests were normal for school testing, that it would give a general idea, but that the schools did not have the funds to do comprehensive evaluations. When asked by Attorney Tillis whether, if he were the school, he would seek the advice of a doctor 3,000 miles away, Dr. Shea indicated that it happened all the time [where Lyme was concerned] because of the lack of knowledge of tick-borne diseases [among physicians].

Attorney Pollock's redirect examination brought out the extensive amount of information contained in the school psychologist's evaluation that would have been of value to Dr. Jones in making his recommendations.

The hearing ended with no new dates set for Day #8.

Note: An observer who has witnessed all 7 days of the hearings would, I believe, be impressed with the quality of the expert witnesses that have been called in support of Dr. Jones. Drs. Phillips, Fallon, and Shea have an impressive collective knowledge of tick-borne illness, and their testimony demonstrated a depth of understanding of the plight of the patients, the paucity of available physicians who understand the illness in its chronic and complex stages, and the substantial body of medical literature that supports the treatment that patients of Dr. Jones receive. Under the weight of this evidence, in the face of the success of the treatment of these children, and given Dr. Jones demonstration of the incredible fund of knowledge upon which he based his clinical judgment, one has to wonder why these proceedings against Dr. Jones are continuing, when so many children continue to suffer from the lack of diagnosis and treatment from the vast majority of the medical community.

Sandy Berenbaum, LCSW, BCD
Family Connections Center for Counseling
Brewster, New York
(845) 259-9838

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