IT WAS in the three years between the Behrman case and Dr. Linder's vindication that the Narcotics Division commenced the unworthy practice, carried on by federal authorities ever since, of recruiting informers and agents provocateurs from the addict community for money rewards or, not infrequently, for immunity from prosecution and an assured supply of drugs. Drug-enforcement officials have always denied the charge that their "special employees" are provided with drugs, but the consensus of all nonintimidated reports from the addict community, plus staple common sense, provide evidence to the contrary. The addict-turncoat is of little use to his law-enforcement masters if he is suffering withdrawal symptoms, so he must have his periodic "fixes" regularly one way or the other, either with drugs from seized supplies or else by the criminal act of purchasing in virtual partnership with the enforcement agents.

In these years also, the Division commenced reporting its prowess in the dubiously relevant and slightly sadistic measure of how many years' imprisonment it had inflicted on lawbreakers; for example, for 1925-26, "6,797 years, 11 mos., 10 days," and for 1926-27, "7,088 years, 10 mos., 10 days."

This was the formative period in which patterns were set. Federal agents arrogated to themselves not only the image of gallant saviors holding evil forces at bay, but also that of the nation's only "experts" able to inform a timorous public about the nature of the problem, its severity, and how it should be dealt with. In 1924 the American Medical Association knuckled under again, establishing a special committee to repeat the 1921 finding that addicts could be treated only when they were locked up in total confinement ( the old distortion of "ambulatory"), and officially recording its "firm conviction" that any kind of treatment for drug users without compulsory isolation "begets deception, extends the abuse of habit-forming narcotic drugs, and causes an increase in crime." Medical authorities even began parroting the dogma that addiction itself was somehow connected with weakness of character and latent criminality.

But above all, the official campaign played into the hands of peddlers and the nascent drug rings. Whenever law-enforcement efforts were increased in a particular community, the black-market price of drugs—and the peddlers' profits—increased too. Thus patterns were set in this era in which more than a few corruptible individuals on the law-enforcement side joined forces directly with peddlers to share in the golden flow of cash generated by the traffic. A venal federal narcotics agent or local drug-squad officer could work wonders in protecting and immunizing his peddler-partners, arresting competitors who might turn up to challenge their arrangements, diverting seized drugs back into the traffic, and even making high-level contacts himself 'With notoriously shy smugglers and overlords of the traffic.

The Narcotics Division now began suggesting to its worried public that it was at last bringing the situation under control. Official estimates of the addict population dropped from the millions of 1919-20 and the manageable 200,000 of 1923 on downward to a stable range of 60,000 to 75,000 by 1925. Thereafter for four decades federal spokesmen allowed no serious tinkering with this total. Admittedly during World War II, when international shipping, and therefore smuggling, was drastically curtailed, the total dropped; but for the most part the T-men contented themselves all those years with talk of threatened increases, especially when they went periodically to Congress for larger appropriations to carry on their good work.

As has been related, the repudiation of the Behrman case and the denunciation of the government's repressive policies by the Supreme Court in Linder in 1925 had almost no effect, notwithstanding that the Linder case immediately became the supreme law of the land and has, for that matter, remained the final word on the meaning of the Harrison Act and the proper limits of drug-law enforcement until the revisions of 1970. The Narcotics Division and its successor, the Narcotics Bureau, never relented. If mere official misstatements in the guise of Treasury regulations did not always suffice, a menacing call from the federal agents, coupled if necessary with open threats of prosecution, would usually prevail when a doctor dared minister to an addict.

As practitioners of the healing arts moved into their Golden Age, emerging as one of the softest, most conservative, and richest groups in America, it is small wonder that few of them have chosen to stand up to this harassment or deigned to trouble themselves with the unpleasant and unrewarding task of treating the afflictions of drug addicts, although once again it must be conceded in fairness that there was a hard fist behind the verbal menace when agents warned doctors to stay in line. Not a few of the latter had been packed off to serve time in prison before Dr. Linder's victory. And to see how little the victory really meant, let us move forward a decade to the story of Dr. Thomas P. Ratigan, Jr.

If this were a work of fiction, I would present Dr. Ratigan very much as he played his part in real life—only I would substitute a victorious ending. I believe he was right, and had he emerged as conqueror instead of near-forgotten martyr, America might well have been turned back toward dictates of common sense in the 1930's, avoiding most of the errors and excesses of three succeeding decades.

The locale of the action was Seattle. Ratigan grew up there as one of eleven children in the family of an inconspicuous civil servant in the City Treasurer's office. Though crippled in a street accident while he was working as a downtown newsboy, he put himself through college and medical school, receiving his M.D. in 1925.

In 1931, after the usual residencies and service on the staff of a local medical clinic, Dr. Ratigan went into practice for himself, opening a clinic which he called the Public Health Institute. And here the tale might also bear modifying slightly, for even in mid-Depression Seattle and starting from humble antecedents, our doctor-hero should not have advertised his services. In those days Seattle boasted a dentist who had changed his Christian name to "Painless" so he could promote himself as "Painless Parker," and it was not unusual for West Coast practitioners to insert self-laudatory squibs in telephone directories, but even in this company Dr. Ratigan overreached. Local newspapers began carrying advertisements describing his Institute as "A Clinic for People of Moderate Means," assuring prospective patients that the quality of his services was unquestioned and consultations were free, and displaying competitive price lists, such as $1.00 for a blood test, forty cents for a urine test, $2.00 to treat varicose veins, and $2.00 for nonsurgical attention to hemorrhoids.

Possibly the general public did not respond to these attractive prices. We do not know his motives at the outset, but it was in this period that Dr. Ratigan began ministering to a large proportion of Seattle's addicts. Consistently with his expressed determination to provide medical attention for people who could not afford to patronize his more orthodox colleagues, he charged $1.00 for each clinic visit by an addict, although he subsequently claimed that more than half of his administrations were given gratis to those who were without funds.

Of vital importance, Dr. Ratigan scrupulously observed the cardinal distinction, confused by the medical profession and distorted by the Narcotics Division, between ambulatory in the sense of being afoot and at liberty, and ambulatory meaning provided with drugs for self-administration. Addicts who presented themselves at the Public Health Institute received an appropriated dosage by injection. At no time, except for patients whose addiction was genuinely related to pain associated with other illness, did Dr. Ratigan permit addicted persons to take drugs or prescriptions for drugs off the premises.

Reference has already been made to the way the Treasury Department picked and chose its test prosecutions. With the emphatic pronouncements of the Linder case standing as the law of the land, the Narcotics Division, reorganized in 1930 as a full-fledged Treasury bureau, had to be careful lest it expose itself to further judicial reprimand or give the courts a chance to put an end to its doctor-baiting altogether. Accordingly, in the period after 1925, cases where Treasury went all the way in prosecuting medical men involved only the most flagrant abuses. And even in some of these, when the convictions reached federal appellate courts the reviewing judges cited Linder and reversed, holding that the accused doctor was protected in the exercise of his medical discretion by the Harrison Act exemption.

So in a way the most impressive tribute to Dr. Ratigan's determination and good faith came from his arch-enemy and ultimate nemesis, the Narcotics Bureau itself. By early 1932 the Public Health Institute was well known in Seattle and was beginning to attract addicts from other areas. The Bureau, with its minute surveillance of drug and prescription records, not to mention its informant connections, must inevitably have known of this operation from its inception; yet for several years, apart from petty harassing tactics that came to light later, the authorities made no move to challenge Ratigan. The first blow fell in May 1934, by which time it must have been clear to the federal men that Ratigan was becoming a threat to the foundations of their empire, so that action could no longer be deferred.

The federal marshal who arrested Dr. Ratigan on this first occasion was more considerate than the crude gang of T-men who had taken Dr. Linder in Spokane under similar circumstances a decade earlier. He permitted the doctor to finish consultations with several patients before leading him away. The indictment charged illegal sales of morphine in seven counts. Bail was set at $2,500, then reduced to $1,500, and—since he was always accused of profiteering—it seems significant that the doctor remained behind bars several days before his family and friends could raise the latter amount. At the time of his arrest, local Bureau agents announced to the press that records in their possession showed Ratigan had, over the past two years, dispensed the equivalent of more than 100,000 standard doses of morphine (a suspicious way of presenting the matter because anyone really addicted, with a developed tolerance, would require several times whatever a "standard dose" might be).

Ratigan's attorney was one of Seattle's most eminent, John F. Dore, who had just completed a two-year term as mayor. A demurrer to the indictment, based on Dr. Linder's case, was held underadvisement for two months by the District Judge; when it was denied, Ratigan, who had been at liberty on bail and carrying on his operations, surrendered and pleaded not guilty, insisting that he had always acted in good faith and that whether a particular patient needed narcotics or not was purely a question of medical opinion.

The government's case against Ratigan was essentially that he had administered hypodermic injections to addicts "to satisft ,their craving." At his trial the key witness was one- '—r—lica•mas O'Malley, brought to testify from jail, where he was being held on a disorderly-conduct charge, and who discredited himself by admitting that he had been given a shot of morphine by a City Hospital physician that morning. His story was that prior to his arrest he had been receiving injections in Dr. Ratigan s anteroom twice daily over an extended period. The Bureau's district supervisor testified that according to Ratigan's purchase records ( and the fact that he had kept them accurately was not questioned) the clinic had purchased enough morphine between June 1932 and March 1934 to give 219,600 "normal doses" of the drug.

Ratigan admitted that he had been treating 7,000 addict patients per year, in all cases administering the drug by hypodermic on the premises. The government called investigators who testified that they had placed the clinic under surveillance and had observed "known narcotic addicts" entering and leaving repeatedly over a long period. Four leading physicians then paraded through the witness box, each affirming that in his opinion the amount of narcotic drugs used by Dr. Ratigan was "in excess of that used in the ordinary routine of medical practice." This was of course scarcely open to question: Ratigan's recorded purchases of morphine for the two-year period—without any distorting speculation about "dosages"—totaled 54,900 half-grain tablets.

The doctor took the stand again in rebuttal to insist that be had only administered morphine "to ease pain when the patient needed it to restore him to normal." The government countered with additional testimony from the chairman of the Narcotic Research Department of the Washington State Medical Society, who gave his opinion as an expert that no one need have any disease to be an addict, and that addiction was a condition which could be cured. Under cross-examination this witness admitted, nonetheless, that there was no place in the state where addicted persons could go for treatment or to "undergo cure."

On October 14, 1934, the jury found Ratigan not guilty, whereupon the prosecutor made an angry statement to the press charging that Ratigan received $10 per injection and was a mere drug peddler. The doctor's comment on the verdict was, "The jury decided that the doctor is the judge as to who should have morphine and who should not."

The harassment of Ratigan continued, of course. A fair application of the federal constitutional protection against double jeopardy might have suggested that once brought to trial and acquitted for administering drugs to addicts in a manner which was fully disclosed to the jury, Ratigan should not have been prosecuted again for the same offense arising out of the same facts. But a few months later, in April 1935, Ratigan was in jail again.

The complainant who put him there this time was a federal narcotics inspector, and the charge was assault arising out of a street fight which had allegedly taken place directly across from the clinic. Bail was set at the surprising figure of $10,000, and Ratigan was held "incommunicado."

While he was thus silenced and out of the way, the federal officers told their version: two of them had been patrolling the business district "in a search for narcotics addicts" and happened to find themselves near the clinic. Suddenly Ratigan appeared, coming toward them with a camera to take their picture. The agents said they protested, whereupon without further provocation Ratigan struck one of them with such force that the agent's wrist was fractured.

In due course lawyer Dore was reached, located his client, had the bond reduced to a more reasonable $1,000, and got him out. Dr. Ratigan's account of the incident for which he had been arrested was different. According to a contemporary news report:

Dr. Ratigan's release brought for the first time his story of the fight with two agents in front of his office, and disclosed a battle in the office yesterday when Miss Bernadette Ratigan, the physician's 91-pound sister, struck the wall after Warner [one of the city detectives] assertedly knocked Dr. Ratigan into a corner.

The federal agents and city officers who arrested Ratigan had descended on the clinic together, and when the doctor attempted to telephone his attorney, he was knocked down by Warner. The press stories noted that "Dr. Ratigan does not have full use of one leg."

Ratigan claimed that the federal agents had been shadowing him and watching his office continuously, and that on numerous occasions they had accosted his patients, threatening them with prison if they entered the clinic He wanted pictures of the agents,to support a proposed action to enjoin this interference, and said that his able-bodied younger brother had pursued the agents several times trying to photograph them. He claimed that on the occasion in question he had been rushed and knocked prostrate on the street.

The assault case was finally dropped because Ratigan found an impressive witness to give the Bureau's agents the lie: a nurse at City Hospital, where the factured wrist had been treated, was willing to testify that the injured complainant had told her he had been hurt in a fall which had nothing to do with the alleged assault.

But a heavier blow was struck in October 1935. Federal agents again appeared at the clinic, arrested Ratigan and three patients who were with him, and then arrested twelve more as they arrived. All the patients were arrested "for questioning." Ratigan was allowed to summon his attorney this time, but when the lawyer arrived he was told to keep still; when the attorney protested he too was arrested—for disorderly conduct.

The bond was $2,500. Ratigan was indicted in thirteen counts for administering narcotics to one George Morey, a forty-four-year-old "government informer" who had been to the clinic approximately thirty times. When bond was posted, the doctor told the press: "I give seven or eight addicts daily treatments. I am not ashamed of it. It is in the course of my regular practice. The present enforcement of laws by narcotics agents is wrong. It tends not only to create more addicts, but also creates criminality among them."

During preliminary legal maneuverings Ratigan kept his clinic operating, but now the Bureau opened a new line of attack, trying to cut off his supply of drugs by threatening the pharmaceutical houses from which he bought. And in this connection he was arrested again on another charge—refusing to turn over his purchase records to Bureau officers.

Ratigan's trial on the Morey indictment began a week after this later arrest and its accompanying new blast of damaging publicity. Three addict-informers bore the burden of the government's case: Morey, who told of receiving injections and also claimed that he had once bought a small phial of a narcotic solution from the doctor for $3.00; a Mrs. Sowers, who said she had received treatments merely by asking for them and paying the price of $1.00 each; and her husband, a third-offender burglar, brought in from an Oregon jail to give his testimony.

The agents claimed the doctor had purchased 134,100 half-grain tablets of morphine in the year ending October 8, 1935. Seattle physicians again testified that they used far smaller amounts than this in the course of their practices. The prison doctor from McNeil Island Penitentiary said that the only workable cure for addiction was compulsory withdrawal, although he admitted on cross-examination that he had never seen an addict cured by this method whose cure could be described as permanent. On Ratigan's behalf, other addict-witnesses testified that he had given them injections only after a thorough initial physical examination and that in addition he had required each of them to sign an affidavit affirming their addiction.

In his own defense, Ratigan insisted that the informers who had testified against him had obviously been given drugs just before taking the stand. He admitted that he had treated addicts who came to him for narcotics, providing they were suffering from withdrawal symptoms or other physical symptoms, and avowed that he would continue to do so. He also admitted that he charged $1.00 per treatment, whereas other physicians in the community charged $3.00 or $5.00 for similar administrations.

He explained that he was treating a large number of addicts by giving them morphine in his office each morning before they went to work and again in the evening after they had fulfilled the obligations of their jobs. Asked about his refusal to let the federal agents examine his files, he responded:

Narcotics agents used to come to my office and look over my records, taking down the names of addicts. Then they went to the places where addicts worked, called them from their tasks, and interviewed them. After that, the employers would say to the addicts: "We don't want you around here anymore," and the addicts would be thrown into the street to shift for themselves.

Countering the charge that he was making large profits, Ratigan claimed that only half his patients could afford to pay anything. Ninety-nine per cent of all addicts, he told the court, are poor people who cannot afford $2.00 per prescription at drugstores. The maximum injection he gave patients was worth $3.00 at current legitimate prices, whereas the same amount of morphine on the black market would cost at least $30.00.

He was adamant about never having permitted addicts to take drugs out of the clinic premises:

The only logical way of preventing more persons from becoming addicts is for physicians to administer to the addicts and not permit the patients to receive any morphine for self administration. The addicts who have morphine in their possession are the ones who create more addicts. The number of addicts will increase greatly year after year until some definite system of treating them is adopted by the entire medical profession.

Dr. Ratigan estimated that he had treated as many as thirty to forty addicts per day, admitted that he had bought a total of 194,000 half-grain tablets during the preceding year, and said he had administered all but the 5,000 tablets seized by the agents at the time of his arrest. The drugs cost him $15.50 per thousand half-grain tablets in bulk, and he explained that he charged $1.00 per treatment regardless of the amount of drug administered, and that depending on the degree of addiction he would give one, two, or three injections per day and administer from one to as much as five and a half grains of morphine per treatment.

The press made much of the prosecutor's summation, including an assertion that dope traffic was the largest single industry in the United States, supposedly amounting to $2 billion per year. Ratigan was described in a fist-pounding tirade as the biggest dope peddler in the city, "catering and pandering" to addicts' appetite for drugs, and not acting in good faith within the bounds of legitimate professional practice as a physician. The fact, probably true, that Ratigan had been dispensing more drugs than all the other physicians in Seattle and Portland combined was stressed. From somewhere the government came up with a figure of $77 per day as Ratigan's profit, and he was charged with "earning money on the misery and slavery of unfortunate ad- dicts."

This time, on August 20, 1936, the jury came back with a verdict of guilty on all counts. Ratigan, now thirty-nine, was still ready to fight. He announced that he would continue his work "until the Supreme Court says what I am doing is wrong." Referring to the maximum possible cumulative sentence, he jibed, "Sixty-five years in the penitentiary should satisfy the three years' craving of narcotic agents for a conviction. Conviction by twelve people means nothing to me as to what is good medical practice."

But the real sentence imposed on him was a harsh seven years, plus a fine of $10,000. The prosecutor begged the judge not to release him on bond until he had surrendered his narcotic license and turned over his supply of drugs to the federal adthorities, but the judge concluded reluctantly that he had no power to impose such a condition. In announcing the sentence he told the doctor that the crime of which he had been convicted was "one of the most, if not the most, hideous of crimes against society."

When released on bond pending his appeal, Ratigan told his friends: "I am not through, by a long way. I have the solution to the narcotics problem and I am carrying it out. I am proud of my conviction. If administering morphine to confirmed addicts is a crime, I am a criminal." During the appeal he sought to carry on, but now he was attacked from yet another quarter. The Washington State licensing authorities set a hearing to revoke his license to practice medicine, obliging him to bring an action in the local courts for an injunction to hold off the proposed revocation until his federal conviction had been finally disposed of.

Meanwhile the Bureau kept pressing its attack on Ratigan's suppliers, circulating official bulletins to every pharmaceutical house and drug dealer in the United States warning against selling drugs to him without first consulting the Bureau. Ratigan countered with a suit in the District of Columbia. By this time he must indeed have been tired of lawyers, and running low on resources even if he had made profits from the clinic.

He was summarily denied relief against the Bureau in the District of Columbia suit. In February 1937 the U.S. Circuit Court affirmed his conviction, and in June of the same year the Supreme Court—his final resort—denied review. His last effort was a petition for rehearing in the High Court, but this too was promptly denied.

In Seattle that summer mass meetings were held to support Ratigan's cause. Members of the Washington Legislature and, interestingly, officials from the State Narcotic Farm, where addicts were supposed to be sent for treatment, assailed the federal government and spoke in support of his position as "the only intelligent viewpoint." An investigator from the Narcotic Farm reported to one of these meetings that he had made a thorough review of all the clinic's work with drugs and had not found a single person for whose addiction Ratigan could in any way be held responsible. The main theme of Ratigan's supporters was that if drug addicts could get their supply of drugs at cost there would be no illegal peddlers, and that since there would then be no significant recruiting of new addicts the problem would tend to disappear in a single generation as the existing addict population died off. But the meetings came to little. No one seemed willing or able to continue the struggle on the local scene.

Ratigan surrendered in June 1937 and was sent to the McNeil Island penitentiary. In a final interview he described himself as "a martyr to the 100,000 suffering dope addicts in the United States . . . a pleasure I had not anticipated." But even at this juncture he stuck to his convictions: "My solution to the narcotics problem, by administering to addicts, is the only real solution and will be adopted in the future."

In May 1938 a blue-ribbon panel of medical doctors, specially appointed by the Governor, revoked Ratigan's medical license.
Ratigan was not considered for parole, and even after he had served his full term there were obstacles to his release. First, he could not pay the fine which had been imposed, and thus he was held an additional thirty days; then, reportedly, he refused to sign a pauper's oath upon discharge, so his good-behavior credits were revoked and he was sent back to McNeil Island and detained there for two more months.

In 1953 this tortured healer turns up again, suing the local Medical Service Bureau and the county and state medical societies; in 1954 he challenged the panel which had revoked his right to practice medicine, to have his license reinstated. His suits were dismissed, and reinstatement of his license was denied on the cruel ground that any right of court review he might have had at the time of the revocation was long forfeited because it had not been prosecuted earlier, while he was still in the penitentiary.

The story ends with a brief obituary in 1961. In his last decade Dr. Ratigan had survived as an unlicensed and ignored private tutor, occasionally lecturing on chemistry, nutrition, or the drug problem. But he was never forgotten in one quarter. As late as the mid-1950's his persecutor of twenty years, the Federal Narcotics Commissioner, was still assuring congressional committees that Ratigan's license would stay revoked: "He has taken the medical board into court several times. / am sure he will not get his license back."