Fornits

Treatment Abuse, Behavior Modification, Thought Reform => The Troubled Teen Industry => Topic started by: Deborah on July 01, 2005, 08:27:00 PM

Title: Who 'IS' Paul?
Post by: Deborah on July 01, 2005, 08:27:00 PM
Who IS Paul? Read on.

I learned this morning that while I was on vacation Paul moved his attack on me to several other forums including Straights, one I rarely read. He?s spread his venom around so much it?s hard to keep up with him. I would?ve appreciated a PM from someone!!  But, what the hell.

I had decided this morning to ignore the freak. I perceive him as a black hole. It had gotten to the point where he was sucking every moment of time and energy I had available to rebut the daily barrage of misquotes, misrepresentations, and erroneous assumptions. I?m so far behind on reading industry stuff it will take a week to catch up.

Who ?IS? Paul?

Has anyone else wondered why Paul has singled me out to burn at the stake? Why he is obsessed with convincing people I am a scientologist, and/or that ?all? the information I have shared in the past was from scientologist front groups? And that anyone who advocates for MH alternatives is ?influenced? by scientology?

Could it have to do with the fact that I am the most outspoken person at Fornits re: the psych industry? Over the past 5 years I have posted articles and opinions on the fraudulent nature of the industry, FDA, and research; the political ties; and the connections with the bm warehouse industry, etc. Paul couldn?t refute the information, so he initiated an organized attack on me in an attempt to discredit not only me, but all the information I have shared. I was the one here he needed to silence. Several times actually telling me to stop posting.

I don?t know why I didn?t think to do it sooner, but as soon as I wrote him off as a black hole, I had the thought to search his previous posts here. Discovered his name is Paul Cumming (so fitting?) and googled him. From what he?d shared I envisioned a mousey, self-professed ?mentally ill? guy taking calls for the SD Mental Health hotline, who had worked his way up to be a board member. That imagine just didn?t fit with the viciousness of his attack. Slamming me in multiple forums at Fornits. First blasting me for not posting articles from Safe Harbor. When I posted the links to a couple of articles I?d posted by them, he then exposes that the owner is a scientologist. Well fine, but then he goes on the tell that he refers people to their ?alternative? program and had tried to get them funding. So, I?m a scientologist for posting their articles. He refers people, and is not? He continues to claim that Ablechild (another independent group I had cited) is a front group, yet hasn?t proven it. I know his allegations are false, unless they lied in their response to another query.  I?ll contact them as time allows in the event that one of the ladies might want to respond to Paul?s accusations here.

This may not be of interest to anyone else, but it brought me peace of mind. It all makes sense now, and I can put the thing to rest. He is a mouthpiece for one of the biggest, greediest, power-hungry,  ?cults? in the nation.

Take a look at Pauly boy?s resume:

http://www.bcss.us/our_board_of_directors.htm (http://www.bcss.us/our_board_of_directors.htm)
Back Country Support Services
Incorp Sept 2002
Paul Cumming
9800 Oak Grove Drive, #7
Descanso, CA 91916
Long Term Back Country Resident
NAMI San Diego Board of Directors
    County of San Diego - Member
Mental Health Board
   County of San Diego - Member
Emergency Psychiatric Unit - Policies & Procedures Committee
   County of San Diego - Co-Chair Education Committee
SanDMAP - San Diego Medication Algorithm Project.
Treasurer for NAMI- 2003
http://64.233.187.104/search?q=cache:_Q ... iego&hl=en (http://64.233.187.104/search?q=cache:_QQ5rrKlSoUJ:www.namisandiego.org/docs/annualreport04.pdf+%22paul+cumming%22+%2B+san+diego&hl=en)

I imagine that Paul is privy to a hell of a lot more than he has lead people to believe about TMAP/SanDMap, MH screening in public schools, scientology (the industry?s biggest foe), the bm industry, etc. etc. etc.

WHAT IS SanDMap?
The San Diego Medication Algorithm Program (SanDMAP) is a national model for developing consumer/provider agreements around treatment adherence.
http://www.namisandiego.org/whatsnew.html (http://www.namisandiego.org/whatsnew.html)
http://64.233.187.104/search?q=cache:P9 ... DMap&hl=en (http://64.233.187.104/search?q=cache:P9HBh4ozTOoJ:www.chcs.org/usr_doc/bh_pharmacy.pdf+SanDMap&hl=en)

SDCAMH is piloting a medication management (known as the San Diego Medication Algorithm Project, or SanDMAP, adapted from the Texas Medication Algorithm Project) for persons diagnosed with schizophrenia in two county-operated clinics.
http://sandiego.networkofcare.org/mh/na ... y_2004.pdf (http://sandiego.networkofcare.org/mh/na_docs/PSR_REVIEW_May_2004.pdf)

TMAP, of course being Bush?s little project in Tx to ensure that tons of money go to selected drug companies (cohorts) when they initiated Teen Screen. They?ve been raping the Tx taxpayers via Medicare/Caid and the foster care system with their pilot program, now they want to take it national. Some recipients, even children, on multiple psych drugs. One child, if memory serves, was on 15 or so drugs. Search TMAP in the this forum for more.

While searching for SanDMap, found info on a conference advocating ?Evidence Based? protocol in 2003- which was a big debate in one of the THI threads:
http://www.cccmha.org/JUNE03.conf/CCCMH ... 8.2003.htm (http://www.cccmha.org/JUNE03.conf/CCCMHA.EBP.06.17and18.2003.htm)

I also found a post in the Elan forum in which he stated that he was friends with CEDU?s own Saul Rudman (nuf said) and that Saul had rejected him when he was depressed. Saul and Paul? has a biblical ring to it. Anyway, I imagine he knows more about the bm industry than he lets on as well.

He and a couple of cohorts put together a non-profit called Back Country Support Services, incorporated in 2002. Some of their projects:
teaching disadvantaged people how to survive in the back country,  organizing and facilitating drug and alcohol addiction recovery and support groups for both the addicted persons and for their families, counseling and referrals to other more specific recovery services, and
future plans to establish a Back Country TEEN CENTER where to facilitate inter-generational mentoring programs which will promote literacy and adult mentoring throughout the Back Country communities.

Their Mission? That page reads, ?Coming Soon?. Since 2002? A non-profit without a mission?

The ?Support Groups? page reads:
Due to lack of participation these groups are not on going. [So sorry Paul] If you are interested in participating in any of these groups please call us.
Every Monday @ 6:30 - 12 Step Study Meeting
Every Wednesday @6:30 - Depression/Bi-Polar Support Group
Every Thursday @ 6:30 - Al-Anon Family Support Group
Every Saturday @ 6:30 - Gamblers Anonymous

Who is Paul? Just another sappy, wanna-be 'helper' on a mission.

Hey Paul, is this a picture of you with the ?light therapy? machine? Why not just get out in the sunshine dude? You do live in ?Sunny California?.
http://www.csonline.com.cn/publish/gb/c ... 163407.htm (http://www.csonline.com.cn/publish/gb/content/2002-08/19/content_163407.htm)
Title: Who 'IS' Paul?
Post by: Paul on July 01, 2005, 08:40:00 PM
Like I said regarding another issue today, this is a comprehension problem, not a content problem.

Ask me about any of my endevours!
Title: Who 'IS' Paul?
Post by: Anonymous on July 01, 2005, 10:29:00 PM
Haha, nice try.  When you don't want to deal with the issue brought up, claim the other person has a "comprehension problem".  I'll have to remember that next time I want to act like a pompus ass.
Title: Who 'IS' Paul?
Post by: Anonymous on July 02, 2005, 01:18:00 AM
(http://http://www.csonline.com.cn/publish/img/2002-08/19/081903rl.jpg)

That light helping any?
Title: Who 'IS' Paul?
Post by: The Psychiatrist on July 02, 2005, 01:33:00 AM
YIKES, Paul.

Whenever we read the obscene stories, the voluptuous debaucheries, the cruel and tortuous executions, the unrelenting vindictiveness with which more than half the Bible is filled, it would be more consistent that we call it the word of a demon than the word of God. It is a history of wickedness that has served to corrupt and brutalize mankind.
--Thomas Paine, American revolutionary

Title: Who 'IS' Paul?
Post by: Paul on July 02, 2005, 02:27:00 AM
Quote
On 2005-07-01 19:29:00, Anonymous wrote:

"Haha, nice try.  When you don't want to deal with the issue brought up, claim the other person has a "comprehension problem".  I'll have to remember that next time I want to act like a pompus ass. "


What is the issue?
Title: Who 'IS' Paul?
Post by: Paul on July 02, 2005, 02:28:00 AM
Quote
On 2005-07-01 22:18:00, Anonymous wrote:

"(http://http://www.csonline.com.cn/publish/img/2002-08/19/081903rl.jpg)



That light helping any?"


Read the article!
Title: Who 'IS' Paul?
Post by: Paul on July 02, 2005, 02:32:00 AM
http://www.onelook.com/?loc=pub&w=comprehension (http://www.onelook.com/?loc=pub&w=comprehension)

Quick definitions (comprehension)

# noun:   an ability to understand the meaning or importance of something (or the knowledge acquired as a result) (Example: "How you can do that is beyond my comprehension")
Title: Who 'IS' Paul?
Post by: Anonymous on July 02, 2005, 03:40:00 AM
Quote
On 2005-07-01 23:27:00, Paul wrote:

"
Quote

On 2005-07-01 19:29:00, Anonymous wrote:


"Haha, nice try.  When you don't want to deal with the issue brought up, claim the other person has a "comprehension problem".  I'll have to remember that next time I want to act like a pompus ass. "




What is the issue?"


"Has anyone else wondered why Paul has singled me out to burn at the stake? Why he is obsessed with convincing people I am a scientologist, and/or that ?all? the information I have shared in the past was from scientologist front groups? And that anyone who advocates for MH alternatives is ?influenced? by scientology?"

I believe that paragraph sums up the issue Deborah brought up.  Do you frequently need help comprehending English and finding the main topic?
Title: Who 'IS' Paul?
Post by: Antigen on July 02, 2005, 08:25:00 AM
Quote
On 2005-07-01 17:27:00, Deborah wrote:

I would?ve appreciated a PM from someone!! But, what the hell.


Oh, sorry Deb. I didn't realize you were on vacation. I figured you were just ignoring an obvious troll. Hope you had a blast!

Anyway, he didn't fare too well in the Straight forum. Set off bullshit detectors all over the place.



God is inconceivable, immortality is unbelievable, but duty is peremptory and absolute.
--George Eliot, author

Title: Who 'IS' Paul?
Post by: Paul on July 02, 2005, 09:20:00 AM
Quote
On 2005-07-02 05:25:00, Antigen wrote:



Anyway, he didn't fare too well in the Straight forum. Set off bullshit detectors all over the place.




That is your opinion.
Title: Who 'IS' Paul?
Post by: 001010 on July 02, 2005, 12:01:00 PM
Well Deb, your information certainly does correlate well with this PM Paul sent me.   :eek:

(http://http://i20.photobucket.com/albums/b201/paulcumming/paulPM1.jpg)

It does me no injury for my neighbor to say there are 20 gods, or no God. It neither picks my pocket nor breaks my leg.
--Thomas Jefferson, U.S. President, author, scientist, architect, educator, and diplomat

Title: Who 'IS' Paul?
Post by: Anonymous on July 02, 2005, 12:03:00 PM
ECT, thats electric convulsive therapy, or something like that?

Shock treatment ?  Really?
Title: Who 'IS' Paul?
Post by: 001010 on July 02, 2005, 12:03:00 PM
Btw, Paul, I don't refer to myself as "mental."

Kthx...

The Constitution of the United States is a law for rulers and people equally in war and peace. And covers with the shield of it's protection all classes of men at all times and under all circumstances.
--US Supreme Court, Ex Parte Milligan



_________________
EST (Lifespring) '83
Salesmanship Club '84-'86
Straight, Inc. '86-'88
Title: Who 'IS' Paul?
Post by: 001010 on July 02, 2005, 12:09:00 PM
Quote
On 2005-07-02 09:03:00, Anonymous wrote:

"ECT, thats electric convulsive therapy, or something like that?



Shock treatment ?  Really?"


Apparently.

http://www.ect.org/ (http://www.ect.org/)

Our Bible reveals to us the character of our god with minute and remorseless exactness... It is perhaps the most damnatory biography that exists in print anywhere. It makes Nero an angel of light and leading by contrast.
--Samuel Clemens "Mark Twain", American author and humorist



_________________
EST (Lifespring) '83
Salesmanship Club '84-'86
Straight, Inc. '86-'88
Title: Who 'IS' Paul?
Post by: Anonymous on July 02, 2005, 12:10:00 PM
Whoahhh... that explains a lot now.

I've seen that done on people, it ain't pretty afterwards.
Title: Who 'IS' Paul?
Post by: Anonymous on July 02, 2005, 02:47:00 PM
bumpity bump!
Title: Who 'IS' Paul?
Post by: Paul on July 02, 2005, 03:02:00 PM
Quote
On 2005-07-02 09:01:00, 001010 wrote:

"Well Deb, your information certainly does correlate well with this PM Paul sent me.   :eek:


Of course my history correlates to my statements.

Sorry if you offended by the word mental. I don't know origin of the word, but it has been around a long time.

I think I also sent you another private message, hmmm, private message, what a concept, eh. Anyway
my other private message was that, for me, I reduce the power of the illness by making jokes about it, and episodes. That is why I was asking you about those various support groups. To see if they had the same positive effects on you.

If there is more mystery to my comments, you can ask me to clarify, rather than create some lame conspiracy.

Oh, I won't be posting your PM, out of courtesy and confidentiality, of course.
Title: Who 'IS' Paul?
Post by: Anonymous on July 02, 2005, 08:28:00 PM
So, as to the original issue, are you going to comment or keep acting like a coward?
Title: Who 'IS' Paul?
Post by: Antigen on July 02, 2005, 09:55:00 PM
Does it depend on what the definition of the word 'IS' is?

The first human who hurled an insult instead of a stone was the founder of civilization.
--Sigmund Freud

Title: Who 'IS' Paul?
Post by: Deborah on August 11, 2005, 03:37:00 PM
From Dr. Ty Colbert's book Broken Brains or Wounded Hearts: What Causes Mental Illness on Hemingway and depression.

"It is even more revealing, and tragic, to see how Ernest Hemingway, who suffered from extreme bouts of depression, wrote about the electric shock treatments he received, his 'brilliant cure':

'What these shock doctors don't know is about writers and such things as remorse and contrition and what they do to them.  They should make all psychiatrists take a course in creative writing so they'd know about writers...  Well, what is the sense of ruining my head and erasing my memory, which is my capital, and putting me out of business?  It was a brilliant cure but we lost the patient.  It's a bum turn, Hotch, terrible.'

Hemingway was quite aware that the shock may have rid him of his symptoms of depression by erasing his memory, but it did not produce a permanent cure.  What's worse, he found that his ability to write, the most important thing in his life, had been damaged.  In 1961, a few days after being released following a second ECT series, he killed himself with a shotgun.

Hemingway, who took his life because of his depression and the effects of shock treatment, perhaps said it best:  

'The world breaks everyone, and afterwards many are strong at the broken places.'

As human beings, we have a responsibility to each other, and we can't let the medical model circumvent that responsibility lest we lose the glue that holds our society together:  the healing of each other's wounded hearts."
**********

A friend of mine who teaches Intro to Psych said the textbook mentions Hemingway's depression but fails to mention ECT. I particularly appreciated his comment about them destroying his 'capital'.
Title: Who 'IS' Paul?
Post by: Anonymous on August 12, 2005, 12:40:00 PM
Paul, I'm sorry I've left you to face Deborah's pervasive, obnoxious ignorance alone.

You're right, she's wrong, she's a total flake, but I just flat could not take one more minute of the woman.  I've said what I think, and there's no point in belaboring it any further.

I break that silence only because I don't think you deserve to get crapped on without a word of support from someone else whose beliefs are also in the mainstream of mental health.

I won't be replying to any replies, I'm bored with her ignorant, fringe crap.  I just logged back on to catch up on any *real* news in the industry after reading about the lawyer who used to represent Brown(?) until they positionally asphyxiated his son and is now suing them.

But I don't have better things to do that give you this single message of support.

Hang in there.

Timoclea
(You know, after a certain amount of time trying to argue with someone who's obsessed with a conspiracy delusion, it becomes awfully tempting to just throw up your hands and trust to other people's bullshit detectors to sort it out.)
Title: Who 'IS' Paul?
Post by: Deborah on August 12, 2005, 02:21:00 PM
Unfortunately, the lawyer settled for an undisclosed amount of cash and moved to a farm in Tennessee. The settlement was thought to have been a significant factor in Brown filing bankruptcy.
Title: Who 'IS' Paul?
Post by: Troll Control on August 13, 2005, 09:11:00 AM
Quote
On 2005-08-12 09:40:00, Anonymous wrote:

"Paul, I'm sorry I've left you to face Deborah's pervasive, obnoxious ignorance alone.



You're right, she's wrong, she's a total flake, but I just flat could not take one more minute of the woman.  I've said what I think, and there's no point in belaboring it any further.



I break that silence only because I don't think you deserve to get crapped on without a word of support from someone else whose beliefs are also in the mainstream of mental health.



I won't be replying to any replies, I'm bored with her ignorant, fringe crap.  I just logged back on to catch up on any *real* news in the industry after reading about the lawyer who used to represent Brown(?) until they positionally asphyxiated his son and is now suing them.



But I don't have better things to do that give you this single message of support.



Hang in there.



Timoclea

(You know, after a certain amount of time trying to argue with someone who's obsessed with a conspiracy delusion, it becomes awfully tempting to just throw up your hands and trust to other people's bullshit detectors to sort it out.)"

Geez, Timochlea.  That's a bit harsh, isn't it?

She's not obsessed with a conspiracy delusion.  She was confronted with an actual conspiracy.  

The program in which her son was enrolled wields an amazing amount of de facto power in rural north Georgia.

The owner of the facility is a big cash cow political contributor.  The folks he supports outright circumvented the law regarding this facility and Deborah's parental rights as such.

How else can you explain an unlicensed, unaccredited facilty alternately billing itself as a treatment center and a boarding school, depending on the inquiry?

Do I think one can extrapolate this experience to the ENTIRE treatment industry?  No, I surely don't.  But it is a common modus operandi for the so-called "TBS" segment.  

You read this board.  How many parents in how many states have had nearly the EXACT same experience of having their parental and legal rights subjectively and extrajudicially extirpated at will by a non-governmental entity like a TBS for chrissake?

I think you need to reexamine your comments here and/or lighten up...
Title: Who 'IS' Paul?
Post by: Antigen on August 13, 2005, 11:59:00 AM
DJ, Timoclea's talking about a slightly different issue; rampant overprescription of psyche drugs for often bogus dx.

Tim and Paul seem convinced that there is no big problem in the psyche industry. Deb turns up a good deal of documentation to the contrary. Evidently, that meets their criteria for a free psyche dx.

Either cocaine and marijuana are terribly dangerous substances, and breaking the law by consuming them is a major offense that should be severely punished, or these are minor, personal matters that do not really count in the big picture of a man's life. If the latter is the case, then the rationale for a bloody, costly and futile war against drugs simply disappears.
--Jorge G. Castaneda, Newsweek International, September 6, 1999



_________________
Ginger Warbis ~ Antigen
Drug war POW
Seed Chicklett `71 - `80
Straight, Sarasota
   10/80 - 10/82
Anonymity Anonymous
return undef() if /coercion/i;
Title: Who 'IS' Paul?
Post by: Deborah on August 13, 2005, 01:59:00 PM
Ginger summed it up nicely, while I was off searching for some links. My take on it was that Tim, and later Paul, were threatened by the information (and ocassional opinion) I shared on the fraudulent nature of Psychiatry. Both stating at different times that they feared the 'anti moonbats' would take away their right to take drugs. When challenged, they could never produce proof of their claims, so instead resorted to attacking me personally. Paul went so far as to suggest I was a Scientologist, a mouth piece for the organization.

Culminated when I made this comment:
I was content to post information about the industry that people may not find otherwise, and pretty much as it pertains to young people. I made NO derogatory comments to you (or Tim) until you/she attacked me personally, rather than refuting the information I had posted.
Should I have ignored the personal attacks? Yeh, probably. But I?m not a saint. You and Tim both have used the 'bipolar' excuse for your rudeness. Having a psych dx sure hindered my nephew from learning the social skills he desperately needed- what I consider to be the crux of his 'problems'.
http://fornits.com/wwf/viewtopic.php?to ... 260#113981 (http://fornits.com/wwf/viewtopic.php?topic=3515&forum=9&start=260#113981)

Because I used 'excuse' rather than 'reason' Tim then decided that I was a Bigot, and posted a couple of lengthy rants before she departed suggesting, among other things that I 'fuck off and die':
http://fornits.com/wwf/viewtopic.php?to ... 280#117974 (http://fornits.com/wwf/viewtopic.php?topic=3515&forum=9&start=280#117974)

The 'disagreement' started with this interaction:
http://fornits.com/wwf/viewtopic.php?to ... =100#50900 (http://fornits.com/wwf/viewtopic.php?topic=3515&forum=9&start=100#50900)

Went downhill from there. In this thread I am labeled a paranoid flake, tinfoil hat moonbat, with fringe, conspiracy beliefs.
CABF
http://www.fornits.com/wwf/viewtopic.ph ... 38&forum=9 (http://www.fornits.com/wwf/viewtopic.php?topic=9138&forum=9)

Several other thread on MH/Drugs in which we had disagreements:
Bush plans to screen whole US population for mental illness
http://fornits.com/wwf/viewtopic.php?So ... =9&start=0 (http://fornits.com/wwf/viewtopic.php?Sort=&mode=viewtopic&topic=5804&forum=9&start=0)

Mental Health Screening in Schools Signals the End of Parental Rights
http://fornits.com/wwf/viewtopic.php?So ... =9&start=0 (http://fornits.com/wwf/viewtopic.php?Sort=&mode=viewtopic&topic=10271&forum=9&start=0)

Involuntary Commitment?Notice Any Similarities
http://fornits.com/wwf/viewtopic.php?mo ... rt=0&Sort= (http://fornits.com/wwf/viewtopic.php?mode=viewtopic&topic=9581&forum=9&start=0&Sort=)

FDA warning on SSRIs
http://fornits.com/wwf/viewtopic.php?So ... =9&start=0 (http://fornits.com/wwf/viewtopic.php?Sort=&mode=viewtopic&topic=3515&forum=9&start=0)

SSRI's and Depression in Children
http://www.fornits.com/wwf/viewtopic.ph ... 84&forum=9 (http://www.fornits.com/wwf/viewtopic.php?topic=4284&forum=9)

ADD/ADHD/Meds
http://www.fornits.com/wwf/viewtopic.ph ... 39&forum=9 (http://www.fornits.com/wwf/viewtopic.php?topic=2539&forum=9)

Dexedrine for 4 year-olds
http://fornits.com/wwf/viewtopic.php?So ... =9&start=0 (http://fornits.com/wwf/viewtopic.php?Sort=&mode=viewtopic&topic=3572&forum=9&start=0)
Title: Who 'IS' Paul?
Post by: Anonymous on August 14, 2005, 10:35:00 AM
(http://http://www.csonline.com.cn/publish/img/2002-08/19/081903rl.jpg)

Maybe T should join him under his light?

Seems VERY mainstream to me...  :roll:

Todays version of snake oil salespeople.
Title: Who 'IS' Paul?
Post by: Anonymous on August 14, 2005, 08:02:00 PM
Patients often have burden of deciding on treatment

By Jan Hoffman
NEW YORK TIMES NEWS SERVICE

August 14, 2005

Nothing Meg Gaines endured had prepared her for this moment. Not the six rounds of chemotherapy for ovarian cancer that had metastasized to her liver. Not the doctor who told her, after Gaines was prepped for surgery, that he could not operate: A last-minute scan revealed too many tumors.

"Go home and think about the quality, not the quantity, of your days," he said.

Just about out of options, the 39-year-old lawyer and mother of two toddlers faced an excruciating decision. Her last-ditch chemotherapy regimen seemed to be working. Three medical oncologists thought she should stick with it. But two surgical oncologists thought she should first try cryosurgery, injecting liquid nitrogen in the tumors to shrink as many as possible, and then following up with chemotherapy.

The catch? Gaines' chances of even surviving the procedure were uncertain.

"Who will decide?" she asked a surgeon from Los Angeles.

The doctor recited what has become the litany of medical correctness: "We're in the outer regions of medical knowledge," he said, "and none of us knows what you should do. So you have to make the decision based on your values."

This is the blessing and the burden of being a modern patient. A generation ago, patients argued for more information, more choice and more say about treatment. To a great extent, that is exactly what they have received: a superabundance of information, often several treatment options and the right to choose among them.

   Advertisement
As this new responsibility dawns on patients, some embrace it with a sense of pride and determination. But many find the job of being a modern patient, with its slog through medical uncertainty, to be lonely, frightening and overwhelming.

The job of being a modern patient includes not only decision-making, of course, but often coordinating doctors, medical records and procedures, as well as negotiating with insurance companies, who are often the ultimate arbiters over which treatment options will be covered.

Like many patients, Gaines did not turn to a primary care doctor to help coordinate her care or aid with decisions. Increasingly, that soul-healing, doctor-patient relationship has become harder to sustain. Whipsawed by insurance plans, patients frequently switch physicians. Pressed by diminishing reimbursements, those doctors are building ever larger, more unwieldy practices, with less time for each patient.

A generation ago, most of the diagnostic tests that monitored Gaines' cancer did not exist. Nor did the range of treatments. After the cancer had been found, most likely her primary care doctor or local oncologist would have told her what to do. And she would have obeyed.

Until the late 1960s, patients perceived doctors, then almost exclusively white men, as unassailable figures of authority. During the social and cultural upheaval that ushered in the women's rights, civil rights and consumers' rights movements, however, the paternalistic authority of the physician became deeply suspect.

And with the introduction of Medicaid and Medicare in 1965, health care began to be seen as a right, not a privilege. Patients repositioned themselves as consumers of health care, entitled to as much information as possible. Support groups sought to empower patients with booklets and questions for doctors.

In response, many patients became insatiable consumers of medical information.

The drive to become better informed has been fueled, in part, by the array of options that often accompanies diagnoses, many so new that gold-standard treatments, backed up by randomized trials, have yet to emerge.

But hope is a potent elixir. Patients with good insurance or other financial resources have quickly learned how to find medical centers that could offer them the latest procedures, like the cryosurgery Gaines sought out, which then had no long-term experience behind it.

A patient's research does not have to be any more extensive than turning on the TV. The eruption of pharmaceutical advertising has introduced millions to medical conditions that were once discussed only in the privacy of a consultation and to the promises of new approved treatments. And inevitably following these promises was the prompt: "Ask your doctor."

At the same time, medical science itself was widely perceived to be in a Renaissance period. Basic research in fields like biotechnology received deep bipartisan federal support. As the results continue to unfold, patients with major and minor health problems can choose from an array of options: some good, some bad, some redundant and some virtually miraculous.

Whether patients make a decision by themselves or at the behest of a doctor, the fact that the choice was theirs has become known among bioethicists as patient autonomy ? the right of governance over one's own body. The term is symbolic of the pendulum swing away from the paternalism common through the 1960s. Patients began seeking second and third opinions.

By the 1980s, opinion-seeking could even turn into doctor-shopping for specific procedures. Patients began suing doctors, an escalating conflict leading to, among other things, high malpractice premiums, congressional debates and, in the examining rooms, overcautious conversations between litigation-alert doctors and patients.

Within the past decade, the shift in the doctor-patient conversation ? from, "This is what's wrong with you, here's what to do," to "Here are your options, what do you want to do?" ? became all but complete. Baby boomers had gotten what they had asked for. And then some.

"People want to feel a part of their health care," said David Mechanic, a medical sociologist at Rutgers University. "But they don't want to be abandoned to making decisions all on their own. When a doctor says, "Here are your options,' without offering expert help and judgment, that is a form of abandonment."