Unofficial SJG Archive

The Unofficial Stephen Jay Gould Archive

Unofficial SJG Archive

Marihuana, The Forbidden Medicine (excerpt)

by Stephen Jay Gould

 am a member of a very small, very fortunate, and very select group—the first survivors of the previously incurable cancer, abdominal mesothelioma. Our treatment involved a carefully balanced mixture of all three standard modalities—surgery, radiation, and chemotherapy. Not pleasant, to be sure, but consider the alternative.

Any cancer survivor of such intensive treatment—indeed, anyone who has endured aggressive medical battles against any disease—knows firsthand the enormous importance of the "psychological factor." Now I am an old-fashioned rationalist of the most unreconstructed sort. I brook no mysticism, no romantic Southern California nonsense about the power of mind and spirit. I assume that positive attitudes and optimism have salutary effects because mental states can feed back upon the body through the immune system. In any case, I think that everyone would grant an important role to the maintenance of spirit through adversity; when the mind gives up, the body too often follows. (And if cure is not the ultimate outcome, quality of remaining life becomes, if anything, even more important.)

Nothing is more discouraging, more destructive of the possibility of such a positive attitude—and I do speak from personal experience here—than the serious side effects induced by so many treatments. Radiation and chemotherapy are often accompanied by long periods of intense and uncontrollable nausea. The mind begins to associate the agent of potential cure with the very worst aspect of the disease—for the pain and suffering of the side effects is often worse than the distress induced by the tumor itself. Once this happens, the possibility for an essential psychological boost and comfort may disappear—for the treatment seems worse than the disease itself. In other words, I am trying to say that the control of severe and long-lasting side effects in cancer treatment is not merely a question of comfort (though Lord only knows that comfort to the suffering is enough of a rationale), but an absolutely essential ingredient in the possibility of cure.

I had surgery, followed by a month of radiation, chemotherapy, more surgery, and a subsequent year of additional chemotherapy. I found that I could control the less severe nausea of radiation by conventional medicines. But when I started intravenous chemotherapy (Adriamycin), absolutely nothing in the available arsenal of antiemetics worked at all. I was miserable and came to dread the frequent treatments with an almost perverse intensity.

I had heard that marihuana often worked well against nausea. I was reluctant to try it because I have never smoked any substance habitually (and didn't even know how to inhale). Moreover, I had tried marihuana twice (in the usual context of growing up in the sixties) and had hated it. (I am something of a Puritan on the subject of substances that, in any way, dull or alter mental states—for I value my rational mind with an academician's over-weening arrogance. I do not drink alcohol at all, and have never used drugs in any "recreational" sense.) But anything to avoid nausea and the perverse wish it induces for an end of treatment.

The rest of the story is short and sweet. Marihuana worked like a charm. I disliked the "side effect" of mental blurring (the "main effect" for recreational users), but the sheer bliss of not experiencing nausea—and then not having to fear it for all the days intervening between treatments—was the greatest boost I received in all my year of treatment, and surely had a most important effect upon my eventual cure. It is beyond my comprehension—and I fancy I am able to comprehend a lot, including much nonsense—that any humane person would withhold such a beneficial substance from people in such great need simply because others use it for different purposes.

[ Stephen Jay Gould, In Lester Grinspoon, ed., Marihuana, The Forbidden Medicine, New Haven: Yale University Press, 1993, 39-41. ]

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