NC Medical Board Dr. Rashid A. Buttar Transcript - Page 7 of 16
WITNESS: If you only knew, but, yes, sir, he ‑-
DR. WALKER: Has he ‑- since he's improved to such a degree, have you had him retested to sort of see where ‑- where he's at right now?
WITNESS: Yes, sir. We ‑- we stay in touch and frequent a developmental pediatrician in Greenville, South Carolina and so, yes, sir.
DR. WALKER: Is it ‑- so he's ‑- he's come around in all those ‑- not only is he looking better to you, but he's looking better on the tests?
WITNESS: What tests are you referring to?
DR. WALKER: The ‑- the developmental tests, you know, where they ‑- they do the little studies. I don't know exactly what they might have done.
WITNESS: Yes, sir. I didn't know if you meant the specific lab tests or what have you.
He is ‑- he's got issues every day, but I'm of the opinion the mercury ‑- the levels did significant brain damage. I mean, they're a nerve toxin, so he's got issues that we have not ‑- he has not been able to overcome, but a lot of them he has been.
DR. WALKER: Thank you.
WITNESS: Sure.
PRESIDENT RHYNE: Did you call your public health in your area with these toxins, family public health to make sure it was not a problem in the area? Was that done?
WITNESS: I did not make a phone call to any public health official. I sought information from public health officials, but I didn't call asking that type of ‑- or nothing, I mean.
PRESIDENT RHYNE: And you said that he got hyperbaric oxygen and what else did he get? Did he get any other treatment?
WITNESS: Yes, ma'am, he did. We received two summers worth. We spent a summer in a hotel in Dustin, Florida, two summers back to back, '05 and '06 and ‑- in which he received the hyperbaric oxygen treatments administered by Dr. Eddie Zandt in Dustin, Florida. As well as we also tried and explored umbilical cord blood stem cell in Mexico. That proved to ‑- you know, there was no benefit to the stem cell, but the hyperbaric oxygen was just miraculous, just off the charts.
PRESIDENT RHYNE: Thank you, Mr. Hewitt.
MR. KNOX: May I ‑- excuse me, Your Honor.
FURTHER DIRECT EXAMINATION BY MR. KNOX:
QDid that include some chelation?
AHe did. The chelation was the first process. We couldn't get to the hyperbaric oxygen until we basically got him cleaned up.
PRESIDENT RHYNE: So he had chelation before he did hyperbaric?
WITNESS: That is correct.
PRESIDENT RHYNE: Thank you.
QIs his speech better?
AIt's ‑- yes, sir, it's ‑- and, yes, sometimes too much.
MR. KNOX: That's all I have.
FURTHER EXAMINATION BY THE PANEL MEMBERS:
DR. WALKER: Could I ask one more question?
WITNESS: Yes.
DR. WALKER: What are you doing now to keep him from re-accumulating more toxic metals?
WITNESS: That's a great question. He's on a maintenance program as Dr. Buttar, you know, his staff have ‑- you know, have him in place and he will use the drops, you know, topically and just monitor him, so it's just basically a maintenance program.
PRESIDENT RHYNE: So excuse me, he's done chelation, drops and hyperbaric oxygen?
WITNESS: Yes, ma'am, and stem cell.
PRESIDENT RHYNE: And stem cell. Thank you.
CROSS-EXAMINATION BY MR. JIMISON:
QDoes the maintenance program continue on indefinitely?
AI guess it could. I would think that ‑- I don't ‑- there's no reason for me to believe that if it's a genetic problem it's just going to go away, so I guess we're prepared for it to go on indefinitely, but we haven't discussed, you know, is that going to indeed be the case.
QIs it once a month or once a week?
ANo, weekly.
QSo ‑- so once a week for maintenance to keep the metal ‑-
ANo, we're able to do it at home.
QOkay.
AWe're able to do it at home.
QWith chelating agent that you get from Dr. Buttar?
AYes, sir.
FURTHER EXAMINATION BY THE PANEL MEMBERS:
DR. McCULLOCH: Mr. Hewitt, you mentioned you said you had your child evaluated by the developmental pediatrician.
WITNESS: Pediatrician, Dr. Nancy Powers.
DR. McCULLOCH: Is she an M.D.?
WITNESS: Yes, sir.
DR. McCULLOCH: He or she?
WITNESS: She.
DR. McCULLOCH: She. Is she aware of this other treatment?
WITNESS: She is aware of the chelation. She was not necessarily for it, but she didn't ‑- she ‑- she felt like there wasn't any harm if it was done properly, so she supported us doing it. She was ‑- I guess, she was very happy with the fact that she's the one that put him on the five medications and the fact that he was off the five medications through, you know, weaned him off and what have you, she thought that there would be some merit to trying, you know, the chelation process and supported that.
She supported the hyperbaric oxygen treatment therapy.
She did not support the umbilical cord blood stem cell therapy.
PRESIDENT RHYNE: Thank you, Mr. Hewitt. And we're all delighted your son is doing better.
WITNESS: Thank you very much.
PRESIDENT RHYNE: Is there anybody else you want to call that's from out of state? No?
MR. KNOX: No. To be honest with you, we were supposed to talk with Mr. Hewitt tonight and I've got some people I haven't had a chance to talk to who drove here, so if we start at 7:00 in the morning, I'll bet we'll be done and I appreciate that.
PRESIDENT RHYNE: Okay. All right. We'll adjourn until 7:00 in the morning.
(WHEREUPON, THE HEARING WAS ADJOURNED
ON APRIL 23, 2008 AT 6:14 P.M.
TO BE RECONVENED ON APRIL 24, 2008 AT 7:00 A.M.)
PRESIDENT RHYNE: Good morning.
MS. GODFREY: Good morning.
MR. JIMISON: Good morning.
MR. KNOX: Good morning.
PRESIDENT RHYNE: We will resume in the case of Dr. Buttar. And I wanted to just remind everyone to turn off their cell phones and pagers. I see ‑- see you doing that that made me think about it.
Ms. Godfrey and Mr. Knox, are you ready to proceed.
MR. KNOX: Dr. Rhyne, the first thing that we would offer is an Affidavit of Michelle Reed which she's on standby because Mr. Jimison has graciously agreed that we could just admit her affidavit to you. I think it's Exhibit 42, but this is the signed copy of it. If I could hand up to you a copy of it.
PRESIDENT RHYNE: Please do. Thank you.
MR. KNOX: You're welcome.
DR. WALKER: Thank you.
MR. JIMISON: Dr. Rhyne, while we're doing some housekeeping, here's the signed Stipulation and the Pre-hearing Conference for your copy.
PRESIDENT RHYNE: Thank you. I would ‑- I'd like to take just a minute or so to look at this.
Okay.
MR. JIMISON: And, Dr. Rhyne, if I may, I spoke to Mr. Knox about this, I mean just one point about the affidavit. You know, clearly, Ms. Reed is not here to be cross-examined and the Board is not able to ask questions of Ms. Reed. However, in the interest of moving things along, I agreed to just allow that affidavit to be submitted.
PRESIDENT RHYNE: Okay.
MR. JIMISON: I just wanted to make that point.
MR. KNOX: And you may ‑- that was his ‑- and he's correct, you don't have the right to cross-examine, but she's on standby at her office to be called. I just thought we would expedite.
This affidavit is made in rebuttal to what Patient B's wife had said about her conversation about Dr. Buttar's practices and how he charged people and so forth and that's what the rebuttal is about. Thank you.
PRESIDENT RHYNE: Okay. Thank you. Mr. Knox and Ms. Godfrey, do you have any more evidence you wish to present?
MS. GODFREY: We would call Dr. John Wilson.
PRESIDENT RHYNE: Okay.
MR. KNOX: Pull that mike toward you a little bit, so they can hear you.
WHEREUPON,
JOHN L. WILSON, JR., M.D.,
being first duly sworn,
was examined and testified
as follows:
DIRECT EXAMINATION BY MS. GODFREY:
QCould you state your name for the record, please?
AMy name is John Layton Wilson, Jr.
QAnd, Dr. Wilson, where do you reside?
AI reside in Fairview, North Carolina.
QOkay. And is that near Asheville?
AIt's a bedroom community.
QOkay. And do you have a copy of your CV there?
AI do not.
QThere is an exhibit book, I believe it's Exhibit 29, so that you could ‑- I know you know what's on your CV, but for the benefit of the Board and just for the benefit of being able to follow along. Is Exhibit 29 your CV?
AYes, ma'am.
QCould you tell the Board where you graduated from college?
AI graduated from college from the University of Minnesota at Duluth with a B.A. degree in zoology and chemistry.
QAnd after that did you go to medical school?
AI attended medical school. I was in a charter class at the University of Minnesota, Duluth, Minnesota which is a school that was developed by the legislature with the express purpose of educating rural family physicians. I graduated from the University of Minnesota in Minneapolis in 1976.
QWith an M.D. degree?
AYes, ma'am.
QAnd then you pursued a residency in family practice?
AYes.
QAnd you completed that residency in what year?
AI completed one year of the residency and went into practice following that.
QOkay. And did you practice for a period of time in Minnesota?
AI practiced for a period of 14 years in a small town in Minnesota.
QAnd after that did you move to North Carolina?
AI moved to Asheville, North Carolina in 1991.
QAnd ‑-
AAnd I've practiced there since.
QOkay. And you're licensed by the North Carolina Medical Board?
AYes, ma'am. And I'm also licensed in Minnesota.
QAside from your qualifications in family practice, do you also practice in integrative medicine?
AYes, ma'am.
QAnd could you explain to the Board what sparked your interest in integrative medicine and how many years you've been practicing?
AWell, I think throughout my medical school and early practice years, I had an abiding interest in holistic medicine and looking at the whole person. And in the process of dealing with some of the health challenges in my own family, I developed a greater interest in trying to find alternate ways to get ‑- to help my own family improve their health.
And when I applied ‑- and I traveled this country from coast to coast many times and have attended many hundreds of hours of meetings in learning other techniques. And when I started finding my own family members improved their health, I was able to learn that I had numerous patients who had similar problems and I started applying the same principles in their ‑- in my practice with them and they also improved.
QOkay.
AAnd that interest was really sparked probably in the mid 1980s in particular.
QOkay. So you've been ‑- been practicing integrative medicine for some 25 years or close to that?
AClose to that.
QOkay. And have you held any positions in society that promote integrative medicine?
AYes, I have.
QWhat positions are those?
AI have served on the Board of Directors of three organizations ‑- four organizations in integrative medicine. The American Academy of Environmental Medicine, I served on their Board of Directors for perhaps 10 years. I was on the Board of Directors of the formerly Great Lakes College of Clinical Medicine which changed its name to the International College of Integrative Medicine for several years. I have served on the Board of Directors of the North Carolina Integrative Medical Society and I'm currently a Board Member of the International Academy of Oral Medicine and Toxicology.
I have served as past president of the American Academy of Environmental Medicine and the Great Lakes College Clinical Medicine. And I served for five and a half years as the National Director of Continuing Medical Education for the American Academy of Environmental Medicine.
QOkay. And could you explain to the Board ‑-
MS. GODFREY: Well, first of all, let me tender Dr. Wilson as an expert in integrative medicine and family practice. Any objections?
MR. JIMISON: No.
QNow ‑-
(PANEL DISCUSSION BETWEEN
PRESIDENT RHYNE AND DR. McCULLOCH)
MS. GODFREY: I'm sorry, did you have a question for me?
PRESIDENT RHYNE: Well, we can go over it now or in the question period.
MS. GODFREY: Okay.
PRESIDENT RHYNE: But we just don't see where he completed a residency of family practice or is board certified in family practice.
MS. GODFREY: Okay.
WITNESS: I did not complete a residency in family practice, but I have earned the status of a fellow of the American Academy of Family Physicians.
PRESIDENT RHYNE: But you have not been certified?
WITNESS: Not in family practice.
PRESIDENT RHYNE: Okay. So we ‑- so therefore that's our issue of accepting him as an authority in family practice.
MS. GODFREY: Okay.
Q(By Ms. Godfrey) Dr. Wilson, in your current practice, do you use both conventional and alternative therapies on your patients?
AYes, I do.
QDirecting your attention to some of the therapies that are used commonly as alternative therapies, are you familiar with ‑- are you familiar with treating patients for toxic conditions?
AYes, ma'am.
QAnd what can you tell the Board about your experience treating patients with toxic conditions as it relates to heavy metals?
AI have had extensive experience doing chelation therapy with patients and depurating toxic metal of the patients, our clinic has administered -- I'm quite certain over a quarter of a million intravenous EDTA chelation infusions over many years and I'm proud to say without adverse reaction or serious complication with any of them.
QAnd in seeking to eliminate heavy metals from your patients, what conditions do you treat with that therapy?
AI think an important distinction to make with ‑- with the approach of integrative medicine is that we're treating the patient more than we're treating the condition, per se. Toxic metals have a huge impact on many different body systems and in depurating the body burden of heavy metals from patients, many ‑- many aspects have improved, anywhere from ‑- from malignance ‑- conditions with malignancy to chronic fatigue issues to just many different types of problems.
So it's really not ‑- I think it's very important to differentiate between integrative medicine and just conventional practices in that conventional medicine is more oriented toward identifying, you know, signs and symptoms and determining, based upon that, which treatments could be used.
And in much of conventional medicine is involving and treating symptoms the patients have in alleviating suffering which of course is completely admirable and desirable and we all do that.
But I think what we do in integrative medicine is a step beyond that is trying to look at what are the burdens on this person's biology by reducing or using the total load on people. It has been my observation and that of my colleagues that many conditions improve. And so by reducing that body burden through these chelations and removing heavy metals results in clinical improvement in a wide range of conditions.
QAre you familiar with nutritional therapies?
AYes, ma'am.
QCould you explain to the Board how they are used by integrative medicine doctors?
AWell, I think in the larger picture we see illness as a manifestation of overburden of different aspects of people's health. You know, I mean you look at ‑- go from trauma to pregnancy to infections, parasites to toxic substances to sensitivities, hypersensitivities, and allergies to essential factor deficits such as nutrients, micronutrients, macronutrients, and we look at the broad spectrum of those who need to address micronutrient deficiencies through both oral and intravenous therapy.
QAre you familiar with the treatment by ‑- that is abbreviated IRR?
AYes, ma'am.
QCan you tell the Board what that is and how you know that?
AIRR is a term coined by Dr. Harry Philbert. Dr. Philbert is a physician now in his eighties and he actually discovered this autonomic reflex back when he was in his twenties and he practices outside of New Orleans, Louisiana. And he coined the term infra ‑- infraspinatus respiratory reflex.
And at that ‑- back at that point in time, Dr. Philbert was and still is just a remarkable individual who has a photographic memory of anatomy. I don't think there's a nerve or a vein, or a muscle origin or insertion that he doesn't know where it's at. He can picture it immediately.
But he ‑- because of his interest in anatomy, he started doing a lot of work in his twenties looking at trigger point therapy and he identified a autonomic nerve reflex in the belly of the infraspinatus muscle. He actually went to the ‑- to the lab, the veterinary lab, at the University of Louisiana and ‑- and would do experiments with dogs and also with rabbits and he would inject the infraspinatus muscle trigger points in these animals with local anesthetics.
He would actually ‑- what he actually ‑- one of his really interesting experiments is where he ‑- he injected an irritant solution, a dilute phenol solution into the ‑- into the infraspinatus reflex region of dogs and the dogs went into congestive heart failure. And they actually ‑- they just ‑- they actually died following that irritation of that nerve reflex and this was confirmed by ‑- by the veterinary pathologist.
He went back to the lab and did the same experiment again and after he had irritated that reflex, he actually injected it with lidocaine and completely reversed the findings.
And he started doing it ‑- so patients who had asthma, for instance, he would treat that reflex and his asthma patients improved.
He actually showed this or kept good records over many years and treated over 4,000 asthmatic patients over many years and found that 80 percent of the patients with asthma would show improvement from the IRR injections and they would have ‑- it improved peak flow following the injections as compared to before.
And he also found that ‑- that half of those patients who responded were able to get off all of their asthmatic medications. And so he actually found that this injection helped a number of different conditions.
QNow, do you perform IRRs?
AI have performed IRRs since I spent three days training with Dr. Philbert perhaps 10 or 12 years ago.
QAnd what types of patients do you find this treatment helps?
AIRR therapy, as I mentioned, can be a tremendous benefit for ‑- for asthma. I have found ‑- I actually think it's one of the best kept secrets in medicine. I think it's unfortunate that medical students are not taught this technique. It's a dramatic and usually immediate benefit that patients ever -- incurred in the patient's improvement from that treatment.
I found it's also very useful for chronic pain conditions in the shoulder and the neck region.
And the theory is that, you know, we have sort of developed with this injection is that the ‑- that the autonomic ‑- when trigger points occur in that muscle ‑- in the belly of the infraspinatus muscle, an autonomic hypervigilant state is set up that puts the paraspinal autonomics into a state of sympathetic hypervigilance. The injection relaxes that entire ‑- that entire region.
We've seen shoulder pain and neck pain substantially improve from these injections, algias of the upper extremities, for instance.
It can be helpful for patients who have malignancy, particularly if they have malignancies in the lungs and Dr. Philbert has done that with a number of his ‑- I don't know his statistics, per se, but many patients he's seen that had lung cancer have had a substantial improvement in their breathing following the treatment.
QAnd would the same be true with patients that were ‑- had other cancers that have metastasized to the lung?
AOf course.
QYou were asked to be an expert witness in this case, correct?
AThat's correct.
QAnd I sent you a great deal of material to review. Do you ‑- did you review the Medical Board charges in this case?
AI did.
QAnd did you review the opinion of Dr. John Peterson?
AYes, I did.
QOkay. The sheets that he ‑- he provided to the Medical Board, correct?
AYes.
QAnd with regard to Patients A, B, C and D, did you review their medical records from Dr. Buttar's office?
AI did.
QDid you also review their billing statements?
AI did.
QAnd did you review the Medical Board investigative file on those patients?
AI did.
QOkay. Now, after review of all of that information, some, I think, a thousand pages that was sent to you on a CD, do you have an opinion within a reasonable degree of medical certainty of whether or not Dr. Buttar's diagnosis and treatment of Patient A was within the standard of care for a doctor practicing integrative medicine in North Carolina in 2006?
MR. JIMISON: Objection, just to note that it's an incorrect legal standard. I'll just note the objection.
Q(By Ms. Godfrey) You may answer the question, Doctor.
AI do have an opinion.
QAnd what is that opinion?
AI believe that Dr. Buttar's therapies and choice of therapies and treatments in these patients would fall within the usual framework of the types of treatments that integrative doctors that I know that have experience dealing with and treating that would indicate that was appropriate.
QOkay. And with regard to Patient A, did you review Dr. Peterson's critiques and opinions as they relate to Dr. Buttar's treatment of Patient A?
AYes, I did.
QAnd do you agree with Dr. Peterson?
AI do not.
QCould you tell the Board why?
AI believe one of the criticisms that has been levied against Dr. Buttar, really not just to Patient A, but all three of the cancer patients, is an unjust criticism and I think highlights the different yardstick by which integrative medicine is judged as compared to conventional standard.
The conventional standard for this patient ‑- for all three of these patients who had Stage IV terminal disease was to refer them to a hospice unit and let them be in the hospice unit until death.
Dr. Buttar was approached by all of these patients that were seeking these treatments and they ‑- they went into it with full knowledge, they knew what they wanted to get, they were fully informed about what the treatments would involve, what the costs would be and they chose to do that.
I think to without -- physicians who have something to offer to patients to improve their quality of life, to withhold that from them, I think is not correct. I think his position is ‑- if that's the conventional standard is to ‑- is to basically relegate people to the morgue, I think it's the incorrect standard and I think the standard should be expanded to allow people the freedom to make those choices.
So that was my major argument with Dr. Peterson's opinion of Dr. Buttar's supposed violation of the conventional standard.
The conventional therapies failed in all of these patients.
And I just ‑- I'm not comfortable sitting in a position of being ‑- playing God with any patient. If they want to make ‑- they have a right to make informed choices, I think they should have ‑- they should be given that right.
QOkay. With regard to Dr. Peterson's opinion as it relates to Dr. Buttar's practice with these patients and his physician contact with the patients, did you see documented in the chart that Dr. Buttar was, in fact, ‑- or did you see any documentation in the chart as to whether or not Dr. Peterson's opinion could be supported?
AWell, I'm puzzled by ‑- by Dr. Peterson's comments about Dr. Buttar, number one, not using SOAP notes and the charts are full of SOAP notes and ‑- and that Dr. Buttar never saw the patients.
You know, Dr. Buttar performed all of the IRR injections, for instance, on these patients. And I don't know how one could read those charts and not come to the conclusion that Dr. Buttar was very much involved with the patient and the care of these patients.
QOkay. Basically you covered my questions as they relate to Patients A, B and C. I originally asked you as to Patient A, but I think in your answers you went on and told us that you feel the same way about Patients B and C as regards to the standard of care.
I want to focus for just a minute on Patient D, the non-cancer patient. First of all, do you have an opinion to a reasonable degree of medical certainty as to whether or not Dr. Buttar's diagnosis and treatment of Patient D was within the standard of care for a doctor practicing integrative medicine in North Carolina in 2006?
AI believe it was.
QOkay. And do you ‑- can you explain why you hold that opinion?
AThe types of therapies that were brought to ‑- to her care, I don't have her ‑- her record in front of me or the summary but --
QOkay.
ASo I'd have to refresh my memory a bit with that specific case.
But as with the other cases, as well, the kinds of therapies that were utilized are kinds of therapies that are typically to be used in integrative medicine when you would see a patient and approaching a patient from the standpoint of not what are ‑- what is your disease and which ‑- what treatment are we going to use to specifically focus on your disease, but where ‑- but the kinds of treatments that we'll be looking at, what the body ‑- this person's body burden is and how can you reduce that.
You know, one point I'd like to make in that regard, you know, I think it was about four years ago that the environmental working group published a paper where they studied the cord blood of ten infants -- I don't know if any of you saw that paper -- but they identified in these infants that ‑- that there were over 200 toxic pollutants in the blood of these infants.
That's how people in our society start life and that number increases substantially as we go through ‑- as we go through life by simply the acts of eating, breathing, drinking and touching. We are living in a world full of pollutants and these things slowly and gradually and chronically accumulate in our system and the accumulation of the pollutants interferes with biologic function. If these pollutants are removed, biological function improves.
This is the basic premise of environmental medicine and of integrative medicine. That by reducing the burden of these, patient's physiology improves. Again, it's one of the numerous stressors on the human biology that, you know, I had mentioned earlier in the list of things including micronutrient deficiencies, trauma, stress, all these things that we look at.
And I think it's an important point to mention that, when you're ‑- when you're looking at somebody who comes in for the symptom of fatigue or if they come with a symptom ‑- whatever their symptoms may be, however the body makes -- expresses an illness, there's an underlying reason.
I think it's another very important differentiating point between conventional and alternative medicine. Conventional medicine is symptom focused and integrative medicine is really more looking at the bigger picture, you know, why do things happen the way they do in the body and how can we reduce the stressors on the body.
And it has been the experience of those of us who have done this for many years, that many people improve their physiology functioning. Are we curing disease? I don't think so. I think we're lessening the body burden and we're allowing people a better chance to operate and function in life with the remaining burdens that they have.
MS. GODFREY: I think that's all the questions I have.
Marcus, do you have any.
CROSS-EXAMINATION BY MR. JIMISON:
QGood morning, Dr. Wilson. Thank you for coming in so early.
AGood morning.
QDr. Wilson, you don't have any special training in oncology, correct?
AI do not.
QYou've never done the residency or fellowship or anything like that in oncology?
AI have not.
QAnd you're not an expert in cancer, are you?
ANot at all.
QAnd yet you treat patients with cancer, don't you?
AI treat patients and if they have ‑- if my patients develop cancer, I will do what I can to assist them with them fully understanding that I'm not an oncologist and that I insist actually that my patients be followed by an oncologist if I'm going to be continuing to provide any supportive therapy for them.
QSo when patients come to you, you treat them and you hope their cancer gets better, correct?
AOf course.
QOkay. But you don't treat their cancer directly?
ANo. I treat their underlying biology and hope that we'll see improvement in immune function from the treatments that we can offer and the body can better cope with the malignancy, that their body has expressed -- expressed in their situation.
QAnd so you told patients up front that you're not an expert in cancer and you're not treating their cancer clinically?
AOf course.
QAnd so is it achromatic that a doctor should only treat diseases for which he has training to treat?
APlease restate that question.
QIt is sort of an acumen of truth that doctors should only treat those diseases for which he has training to treat?
AI think the doctor should treat patients in a manner in which they are ‑- are trained and for which they have knowledge.
QFor instance ‑-
AAgain, another important concept in integrative medicine, I see, is on the marquis of the North Carolina Medical Board, the Primum Non Nocere, we take it very seriously, above all, do no harm.
QA doctor who's doing neurosurgery should probably be trained ‑- be trained in neurosurgery before he does neurosurgery?
AI would hope.
QColorectal surgery, a doctor should be trained in that before he does that?
AI would hope so.
QAll right. Infectious disease or anesthesiology?
AOf course.
QAnd so if a doctor is treating cancer, he should probably be trained in oncology, correct?
AIf a doctor is treating cancer, a doctor should be trained in oncology.
But if a doctor is treating patients and not the cancer primarily, even providing support of care, I think they should be trained in those fields as well, in those areas.
QIsn't it true that Dr. Buttar advertised and said he treats cancer?
AI am not familiar with Dr. Buttar's advertisements.
QAll right. Isn't it true that he holds himself out as a doctor who treats cancer?
AI'm not sure what Dr. Buttar holds himself out as. He holds ‑- to my knowledge, he holds himself out as an integrative doctor.
QAre you familiar with Dr. Buttar's seminar where he has a seminar called Innovative Protocols for Treating Chronic Disease, Cancer, Cardiovascular and Neurodegenerative Disease?
AI have seen that brochure.
QSo would this be an advertisement that he holds himself out as treating cancer?
AI think it would be an advertisement for ‑- for the integrative medicine that's presented in the seminar he's conducted.
QProtocols of treatment.
AWhatever the seminar is teaching. I have not taken that seminar.
QOkay. And cancer is a ‑- if you ‑- you weren't here for Dr. Peterson's testimony, correct?
AI was not.
QOkay. You had critiques of Dr. Peterson from his deposition, but you weren't here to listen to him testify?
AThat's correct.
QAnd he testified about the heterogenous characteristics of cancer. Is cancer a single disease or is it many diseases?
AIs it a single disease or what?
QIs it a single disease or is it many diseases?
AWhat's the adjective, I'm sorry?
QMany.
ACancer is an immune system dysfunction. Ultimately it boils down to that and it is ‑- it has many potential manifestations.
QSo cancer is a symptom of a bad immune system?
AYes. An immune system that is not functioning properly, if you want ‑- if that's how you term a bad immune system.
QSo under your understanding of cancer, it being a symptom of the immune system of a poor immune system, if the patient has brain cancer or liver cancer or lung cancer or ovarian cancer, cervical cancer, all those cancers can be treated with a single protocol?
AThat is not what I said.
QOkay. And on there -- are there therapies that can treat all different cancers no matter what type cancer it is?
AThere are many therapies that are used to provide immune support for patients.
QSo if you have a protocol that's just to increase the immune system, that can treat all cancers?
AIf you have a protocol that provides improvement of immune system communication, a patient who has cancer which is a manifestation of an impaired immune system communication, their situation would very likely improve.
QOkay. And you ‑-
AA properly functioning immune system will not allow ‑- will not allow the cancer to develop.
QSo hydrogen peroxide therapy would be a treatment for cancer or the immune system?
AHydrogen peroxide therapy has been used for treating immune disregulations that manifest as malignancy to my knowledge.
I do not hold myself as an expert in hydrogen peroxide therapy. I do not do it my practice.
QAnd ozone therapy, would that be a treatment for the immune system?
AOzone therapy is another oxidated therapy that I have no familiarity with other than what I've learned in seminars that I've attended, but I've never utilized it in my practice so I cannot even comment on that therapy.
QAnd hyperbaric chambers, would that be a therapy for cancer?
AI'm familiar with that. Familiar with the use of hyperbaric therapy in treating patients who have cancer.
QAnd these IRR injections, is that a therapy for cancer?
APatients who have cancer that have metastatic cancer that doesn't -- or a primary that involves the lung and results in immune ‑- in respiratory function compromise will benefit from an IRR injection, very likely.
QAnd these ‑- these therapies that you testified and when Ms. Godfrey asked you that when you reviewed the charts, Dr. Buttar was within integrative medicine standard, yet, you're not familiar with these therapies and you don't use them in your practice.
AI'm familiar with the therapies, but I don't use them in my practice and so I don't have patient experience with those therapies.
Again, I have served as National CME Director for ‑- for an American Medical Society and I have in that role have invited physicians into the academy to speak to -- on these issues. I've heard many presentations over the years and I think the ‑- in my opinion, these therapies have a lot ‑- a lot of potential value.
QYou don't have any firsthand experience with them, though?
AI have very limited firsthand experience.
QDo you have some experience? I mean, is it zero or some?
AWell, years ago. Many years ago. I probably haven't done hydrogen peroxide therapy in my practice for 15 years.
QAnd why not?
AIt is a therapy that has risen ‑- risen above the radar screen for many physicians in this ‑- in this country for political reasons and the medical boards have ‑- have found it a fairly favorite target of therapy to attack physicians for and I'm not ‑- I can get along without those therapies in my practice and help patients within the scope that are not as high profiled or politically dangerous is the word I used in my deposition, I believe.
QAnd have any of these therapies proven effective by any double-blind placebo-controlled studies?
AWhat are any of these therapies you are referring to on this?
QThe hydrogen peroxide, the ozone therapy, the hyperbaric chambers, fusion and minerals and vitamin C.
AWell, I don't have an encompassing view of all of the ‑- all of the studies that have been performed that are in voluminous literature volumes, so I really can't comment about that. I can say that I'm not familiar with the studies that are ‑- that are putting on with that regard.
I will mention that the NIH is currently in the middle of a $30 million clinical trial on a double-blind placebo-controlled trial for the use of EDTA chelation therapy for treating coronary artery disease and that trial is currently to be underway.
QThe thin notebook, if you could grab this thin notebook over here and turn to Tab 17. It's the Board's thin notebook, Tab 17. Okay. Do you recognize that entitled ‑-
AYes, I do.
QAnd this is your deposition?
AYes, it is.
QIf you could turn to page 36, it's on page 4 in the top right-hand corner. If you go to page 36.
AOkay.
QYou indicated that a double-blind placebo-controlled trial is the gold standard in medicine, correct?
AThat is generally the ‑- has been for years, what's considered the gold trial -- the gold standard for evaluating pharmaceutical agents.
QSo drug therapies is the gold standard for determining whether drug therapies work or not?
ACorrect.
QSo we're not talking about double-blind placebo- controlled studies for surgery or, you know, bypass or some sort of surgical procedure, we're talking about drug therapy, correct?
AWell, it has been performed on surgical procedures through the, you know, double-blind studies have been done on surgical procedures, for instance.
QIt mostly is, in fact, the gold standard for drug therapies and development of drug therapies?
ACorrect.
QAnd ‑- and then on page 37, I asked you: Did any of these therapies, hydrogen peroxide, ozone, the miscellaneous therapies that actually you were not familiar with, that you --
AI didn't say I'm not familiar with that.
QWell, let me just read the question down to line 16 on page 37. But the therapies that you listed for Patient A, the hydrogen peroxide, the ozone, the miscellaneous therapies with all the initials that you were not familiar with, have any of those therapies been subject to what you call the gold standard of medicine which is a double-blind placebo-controlled study?
And your answer was --
AI am not aware that they have, but my lack of awareness does not necessarily mean that they haven't.
QAnd I went to page 38 and I asked you whether these therapies ‑- and it says element, but I think I might have mispronounced the word "ailment". But I asked you if any of these therapies have been subjected to double-blind placebo-controlled studies for any other ailment except for cancer.
And your answer was the same, correct?
ACorrect.
QSo none of these therapies have been subjected to double-blind placebo-controlled studies to improve the immune system either, correct, to your knowledge?
ATo my knowledge. But I will also add that there are ‑- that the double-blind placebo-controlled model does not work as a waiver of evaluating all types of therapies that can be applied to human beings.
The therapy is not practical for a number of different reasons especially if you're looking more holistically at patients in terms of, you know, what's happening with them.
Now, I would like to add to that, that when we talked ‑- the purpose of the double-blind placebo- controlled study, to the best of my knowledge, is to ‑- is to separate the, quote, unquote, real effects of a particular therapy against the placebo effects of the therapy and however you may define placebo effects.
Placebo effect seems to me as a ‑- ultimately as the healing power of the mind and it would seem to me if we could find ways of harnessing the healing power of the mind, we would be enhancing the quality of health as well.
QSo Dr. Buttar is basically just practicing placebo therapies?
AI didn't say that. What I said ‑-
QBut ‑-
A-- what I said is that the patient ‑- is the double-blind placebo-controlled study is not the only model that can be used to study and evaluate the effectiveness of particular therapies.
Many ‑- many integrative therapies and this has been endorsed by the National Center for Complimentary Alternative Medicine, NIH, use the SF36, the Special Form 36 which is basically a way of evaluating a patient's symptom ‑- you know, as groups of patients symptoms respond to different therapies.
There are ‑- there are other models by which ‑- by which therapies can be studied. I'm not aware of all of the different studies that have been done. There are millions of studies that have been put into literature and no single physician could possibly have the encompassing view of all of that.
QAnd going back to the placebo, did you review anything regarding Dr. Ripoll's testimony or her testimony yesterday?
AI reviewed her testimony. I was --
QAre you familiar with her?
AYes, ma'am ‑- yes, sir.
QAnd from your understanding what is the amount of hydrogen peroxide that Dr. Buttar would use to treat patients?
AIt's a very small quantity. I mean, the standard therapy of that, from my knowledge of hydrogen peroxide therapy, even though I'm not doing it in my practice, is a very little dose. It's 1 cc of 3 ‑- 1 cc of three and a half percent solution of hydrogen peroxide. That is added to 100 cc of -- (inaudible) -- and that is what's used.
QAnd when hydrogen peroxide hits the blood it immediately dissipates, correct, into ‑- into hydrogen peroxide and oxygen?
AI am not prepared to testify about the physiology of hydrogen peroxide. I think I've already stated that I don't hold myself as an expert in this field.
QThe ‑- well, let's go to something you know about family practice. When you get a cut on your hand and you run into your house and get the hydrogen peroxide out of the medicine cabinet and you pour the hydrogen peroxide on the cut, what normally happens?
AIt has a fizzy and bubbling effect.
QIt bubbles up and that's because it's being immediately ‑- there's a chemical reaction as to basically transforming into just water, correct?
AAgain, I think I will ‑- I'll go back to my previous comments that I'm not holding myself as an expert in this piece. Hydrogen peroxide in dilute solutions that are used do not ‑- does not cause a bubbling effect in the blood ‑- in the blood stream.
I would quite concur with Dr. Ripoll's opinion of hydrogen peroxide that when normal cells encounter hydrogen peroxide, the catalasing enzyme that was present in normal cells can easily dissipate and eliminate it.
The hydrogen peroxide even in very dilute amounts that are used causes mischief with certain kinds of cells, infectious agents or, you know, viruses and bacteria and malignant cells will adversely be effected because they do not have the catalytic enzyme system to be able to destroy the hydroxolode free radicals.
QAre you familiar with the proceedings in the National Academy of Science?
AI reviewed it.
QDid you review the article about pharmacologic absorbic concentrations likely kills cancers cells? Did you review this article?
AI just saw this in the ‑- I never reviewed the article, I reviewed the abstract.
QWould you be familiar with any study from the abstract that ‑- that no matter how much hydrogen peroxide you put into the blood it immediately transforms to water and oxygen?
AIt's been some weeks since I've read that and I don't have ‑- I don't have a specific recollection of that. I think I established already that I'm not holding myself in any particular expert status of really evaluating this other than from what I had learned from reading this.
QSo from your understanding of reviewing the testimonies, when hydrogen peroxide, especially as a very, very low concentration that Dr. Buttar uses when it's infused into the blood system, which he's doing, he's infusing it into the blood stream, it is immediately turned into just basically nothing more than saline, correct?
MS. GODFREY: Objection. Objection. I mean, we've been over this about four times and it's sort of old and we object to ‑-
QWell, let me ‑- let me ask it ‑- well, let me ask it this way, Dr. Wilson.
If it is immediately turned into saline and the hydrogen peroxide is not finding its way to the cancer cells, essentially all that's being done is that saline is being injected and, at most, all you can have is a placebo effect ‑-
MS. GODFREY: Well, objection.
MR. JIMISON: That's a good question.
MS. GODFREY: He just ‑- he's just testified he's not an expert in hydrogen peroxide. He is an expert in other integrative therapies and in integrative medicine.
QBut I'm asking just from your experience as a doctor, if the hydrogen peroxide immediately goes into water and if that's all that's going into the body because it immediately catalases when it gets into the blood stream, at most, all you're hoping for is a placebo effect?
AI think you'll have better luck with this line of questioning with Dr. Biddle who I think has more knowledge about this field. I'm quite aware that the ‑- there are very many complex mechanisms that are in play when hydrogen peroxide is given and it effects the redox system in cells.
And I've heard this ‑- I heard this explained numerous times and I have not quite gotten my mind around all of the different intricacies of this, but it is not what you are trying to label it as which is a placebo effect.
I personally like the placebo effect. I'm interested in anything that could be used to help my patients heal and I will utilize the placebo effect if I can, but I'm unsure the interest of using it alone is something that's going to have a real biological effect.
PRESIDENT RHYNE: Mr. Jimison, I think you can move on.
MR. JIMISON: I will move on.
Q(By Mr. Jimison) With Patient D, did ‑-
APatient which?
QD, the non-cancer patient. Is it true that Dr. Buttar never saw this patient?
AThat's my understanding.
QNow, you're also a member of the North Carolina Integrative Medical Society?
ACorrect.
QAnd Dr. Buttar is a member of that organization?
AYes.
QDr. Biddle ‑-
AYes.
Q-- is a member of that organization.
In fact, all three of you know one another?
AYes.
QAnd you all go to conferences with one another?
AYes.
QYou're friends?
AYes.
MR. JIMISON: I have nothing further.
MS. GODFREY: I just have a few.
REDIRECT EXAMINATION BY MS. GODFREY:
QDr. Wilson, in your ‑- in your work with the North Carolina Integrative Medical Society, were you involved in the effort in 2003 to appear before the Legislature to change ‑-
MR. JIMISON: Objection, relevancy.
MS. GODFREY: Well ‑-
PRESIDENT RHYNE: No, go ahead.
MS. GODFREY: Can I finish the questions?
Q‑- change the law in North Carolina as it relates to the Medical Board and the recognition of integrative medicine?
AI was.
QOkay. And was Dr. Buttar also involved in that effort?
AYes.
QAnd as a result of your efforts, was the law in North Carolina changed in 2003?
AYes, it did.
QAnd is one of the changes that ‑- that integrative medicine is now recognized in the General Statutes as a separate type of medicine ‑-
MR. JIMISON: Objection, that's incorrect. That's way beyond the expertise of this witness. He's not an expert on law.
MS. GODFREY: Well, he was involved in the effort to change the law.
MR. JIMISON: But everybody ‑- there's lots of people that talk to the legislatures. I mean, the law speaks for itself. He's not an expert in the law.
PRESIDENT RHYNE: True. He's not held himself as an law expert.
MS. GODFREY: Okay.
Q(By Mr. Knox) Let me just phrase the question this way. As a result of your efforts and the efforts of Dr. Buttar, Dr. Wilson, was this definition of integrative medicine inserted into the Chapter 90 of the North Carolina General Statutes: Integrative medicine, a diagnostic or therapeutic treatment that may not be considered a conventionally accepted medical treatment and that a licensed physician in the physician's professional opinion believes may be of a potential benefit to the patient, so long as the treatment poses no greater risk of harm to the patient than the comparable conventional treatments.
Is that change in the law part of your efforts?
AYes. Yes, ma'am, it was. I think the purpose of the statute, but, yeah ‑-
MR. JIMISON: Well, objection. The law speaks for itself. He's not qualified to talk about the purpose of the statute.
AOur intention ‑-
PRESIDENT RHYNE: No, no, no.
MR. JIMISON: No.
PRESIDENT RHYNE: No, I think ‑- you're not a legal expert or a legislative expert.
MS. GODFREY: Thank you, Dr. Wilson.
WITNESS: All right.
PRESIDENT RHYNE: Any Board Members?
DR. McCULLOCH: I have a couple.
PRESIDENT RHYNE: Oh, excuse me, I'm sorry. Did you ‑-
MR. JIMISON: No, ma'am.
MS. GODFREY: Do you have any questions of Dr. Wilson?
MR. KNOX: Yes.
PRESIDENT RHYNE: Dr. McCulloch.
EXAMINATION BY THE PANEL MEMBERS:
DR. McCULLOCH: I'm just curious as far as your background. You did not complete a family practice residency. You went to one year of internship, correct?
WITNESS: Well, one year of family practice residency.
DR. McCULLOCH: And so how did you become a fellow in family practice? I'm just curious about that process.
WITNESS: I completed all of the educational requirements and there was a period of time before the residency required was ‑- requirement was imposed to achieve fellowship status and I got in before that deadline. I was accepted as a fellow before that deadline.
DR. McCULLOCH: So you were grandfathered in before it became an accepted ‑-
WITNESS: Before it was part of ‑- no, it was accepted ‑- it was accepted, but there was a grandfather period where those who had been in practice for a period of time that they could apply for it and receive fellowship status if they completed the educational requirements and I got in under that deadline. I think a year after I got my fellowship, a full completion of the family practice residency was required.
DR. McCULLOCH: All right. You're a diplomat of the International Board of Environmental Medicine?
WITNESS: Yes.
DR. McCULLOCH: How did you become that?
WITNESS: By having taken extensive course work in environmental medicine and having passed both written and oral examinations.
Dr. Buttar Truth Quotes
“Whoever undertakes to set himself up as a judge of Truth and Knowledge is shipwrecked by the laughter of the gods.”
—- Albert Einstein
“Truth is generally the best vindication against slander.”
—- Abraham Lincoln
"All truth passes through 3 phases: First, it is ridiculed. Second, it is violently opposed, and Third, it is accepted as self-evident."
—- Arthur Schopenhauer
"There is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success than to take the lead in the introduction of a new order of things because the innovator has for enemies all those who have done well under the old conditions and lukewarm defenders in those who may do well under the new."
—- Machiavelli, The Prince