A case the law can't cure


OAKLAND, Calif -- The law says Brenda Marie Payton -- indigent, seriously ill and excessively uncooperative -- cannot force her doctor to treat her. So she now must wait until the brink of a coma to receive 'emergency' hospital treatment.

'I don't want to die; nobody should just have to die,' said the 35-year-old woman. 'I know it's in God's hands, but this can't be what he meant.'


Brenda's problem -- brought on by a 15-year addiction to heroin and pills -- is that she is an excessively abusive patient who needs kidney dialysis three times a week. Welfare programs pay the bills.

California Appeals Court Justice Joseph Grodin wrote: 'Occasionally a case will challenge the ability of the law, and society, to cope effectively and sensitively with the fundamental problems of human existence. This is such a case.'

Brenda went to Dr. John Weaver in 1975 after birth of twin daughters. Her drug use strained a year-old transplanted kidney and it ceased to function.

Weaver said she regularly arrived for treatment high on drugs, used foul language and pulled needles out of her leg, causing blood to spew around the treatment room, and, on occasion, exposed her genitals to other patients.


'Despite these difficulties,' Justice Grodin wrote, 'Brenda appears from the record to be a marvelously sympathetic and articulate individual who in her lucid moments possesses a great sense of dignity and is intent on preserving her independence and her integrity as a human being.'

In April 1979, Weaver said he would only treat Brenda if she would sign an agreement to stop using alcohol and drugs, arrive on time, stay on her diet and see a psychiatrist. After five years, Weaver decided he and his staff would no longer put up with her abuse.

In ensuing court cases, Brenda's attorney Joanne Casey, argued that Weaver should be required to treat her. The courts, however, ruled an individual doctor cannot be forced to treat a specific patient.

'Dr. Weaver is and was and still is the man between me and death ... other than God, I don't think of nobody higher than I do Dr. Weaver,' Brenda told the court.

In April, the appeal court agreed with Weaver and in June the California Supreme Court refused to review the case.

Weaver -- who one judge called 'one of the most sensitive and honest physicians that I have ever been exposed to' -- stopped treating her.


Wrapped in a dirty blanket and looking older than her years, Brenda said in an interview: 'I just don't understand. I've changed. I've realized that one day's high isn't worth it in the long run, but now look where I am?'

She sat in a ratty plastic chair in a dingy apartment where she spends her days. One leg was propped on a stool, badly mangled from a recent bus accident.

On July 4, toxins in Brenda's body sent her into a coma. California requires hospitals to treat an emergency patient, so Brenda got dialysis treatment.

'Evidently when it reached a coma stage they determined it was an emergency,' her attorney said.

Now, she waits each week for the toxins to rise in her blood and, nearing a coma, she goes to the hospital.

Psychiatrists who have examined her say Brenda is not insane and cannot be forced to obey a court-appointed conservator, who could force her to conform her behavior to an acceptable norm.

'Besides, I talked to those people and they say they can't do nothing that I can't do,' Brenda said. 'I can get to the hospital when I'm fading and they say they can't force a doctor to give me the treatment.


'I know I brought it all down on myself, but they just can't let me die, can they?'

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