B.C. doctor urged to retire because of zealous approach to Lyme disease

A physician sought out by patients for his particular approach to treating Lyme disease is speaking out about a College of Physicians and Surgeons of B.C. investigation into his views and practices with regard to the disease.

Documents from the investigation show the licensing body encouraged him to retire after calling him a "zealot" during a review that began in 2005.

"It was a very frightening experience for the last three years," said Dr. Ernie Murakami. "I've helped a lot of people, saved their lives. I've taken a lot of people who are extremely ill and made them better, and yet they were investigating me."

Lyme disease is caused by a bite from an infected tick. It is a bacterial infection that, without antibiotic treatment, can cause serious, chronic, multi-symptom illness.

Murakami used an intensive form of antibiotic treatment to cure the disease that was more long-term than the usual 30-day dose used by most practitioners. 

He has been accused by some of his colleagues and those who track the disease of overestimating the incidence of Lyme disease in B.C. and possibly misdiagnosing patients as a result.

"I have to state that they [the College] found nothing wrong with my Lyme patients," Murakami said.

The College of Physicians and Surgeons of B.C. refused to comment on the case, citing confidentiality.

Murakami said he agreed to retire early in 2008 after months of scrutiny, because the pressure from the College was affecting his health.

200 patients sent abroad for treatment, doctor says

Murakami's retirement forced dozens of patients, some who had tested positive for Lyme disease in Canada and many who hadn't, to turn to the U.S. to get the type of treatment Murakami offered, he said, because there was no B.C. doctor to take over his practice.

"I was consequently forced to send about 200 patients across the border to California and Washington, some to New York and some to Europe," said Murakami.

In written testimonials, several of Murakami's patients say they believe testing and treatment for Lyme disease in Canada is substandard.

"I feel sorry for those people [who have to go abroad], and I do whatever I can for them — to get them directed," Murakami said. "I get choked up, and I want to continue, but I can't. I have to face the consequences of being a pioneer in this field."

Murakami is in his 70s and was a general practitioner in Hope, B.C., for decades. He holds a degree in bacteriology and taught at the University of British Columbia.

He said he became interested in Lyme disease several years ago after noticing many similarities with the symptoms and long-term effects of syphilis.

Dozens of letters from B.C. patients and doctors show Murakami built up a significant following by giving patients long-term antibiotic treatments not prescribed by most clinicians.

Many of his patients, he said, had been ill for a long time and had either not been diagnosed with Lyme or had tested positive but had insufficient treatment.

"There are two factions in the medical world," said Murakami. "Some [doctors] believe only a very short term of treatment — 30 days — is all you need. … Yet there's another group that feels many cases require longer periods of time. That's what I believe, and I have evidence for that."

Murakami lacked objectivity, review finds 

Minutes from a May 2005 meeting of the Medical Performance Committee of the College of Physicians and Surgeons of B.C., which reviewed Murakami's practice, referred to the doctor as a "zealot."

"It was the opinion of the committee that Dr. Murakami lacked critical thinking and objectivity in his management and approach to Lyme disease. Dr. Murakami appeared to be a zealot," the minutes said.

"Dr. Murakami told the committee that, if he could not find another organic diagnosis for patients presenting with what was, in his opinion, third-stage Lyme disease, then he offered them treatment for Lyme disease. The committee was very concerned with that."

In spite of his detractors, Murakami said he firmly believes Lyme disease is endemic in B.C. He predicts time will prove him right but fears the College investigation into his practice has made other B.C. doctors more reluctant than ever to prescribe long-term antibiotics.

"It really worries me that the doctors are now going to say, 'Nope, you're not going to be treated. You don't have Lyme disease. Goodbye.' And it's going to mean a lot of suffering," he said.

Dr. Muhammed Morshed of the B.C. Centre for Disease Control said the scientific data compiled on Lyme disease province-wide simply does not support Murakami's findings. He said he's tested 10,000 ticks over 10 years, more than have been tested in any other province, and has consistently found less than one per cent carry the disease.

"Your facts have to be based on some sort of data," said Morshed. "We have actually generated a huge amount of information on Lyme disease. Nothing suggests that the incidence is high in B.C." 

Murakami cited several treatment success stories, though, including a B.C. nurse who he said saw 30 doctors before she came to him. Before long-term antibiotic treatment, Murakami said, she was mentally and physically incapacitated and could not be left alone.

A few months afterward, he said, she was well enough to have her first baby.

"She was at my final retirement party, and this little girl — she is now three and a half — she said, 'Thanks for saving my mother's life,'" said Murakami.

"I've taken 21 people out of permanent wheelchairs," he added.

Documents show the College investigation was sparked by the death of a 20-year-old woman in Kelowna General Hospital. The woman was not Murakami's patient but her family doctor suspected she had Lyme disease and consulted with Murakami over the telephone.

Her doctor then referred her for antibiotic treatment. She had a severe allergic reaction. A nurse at the hospital then mistakenly gave her a dose of adrenaline, intravenously, which caused cardiac arrest.

"I had nothing to do with that," said Murakami of the case. "My involvement was just saying that it was suspicious for Lyme disease. It was a nursing error."

Patient 'heartbroken' by doctor's retirement

"Its just criminal that Dr. Murakami was forced into retirement," said Sheri Souch, a formerly fit and healthy teacher from Kaledon, B.C., who is now paying $3,000 every two months for Lyme disease treatment prescribed in the U.S.

Souch said that prior to beginning treatment, she was bedridden, couldn't think straight and had constant joint pain.

"I would go to my [B.C.] specialists and say, 'Look, I think I might have Lyme disease.' 'Oh, no,' they would say. 'Nope.' With some of them, I would get laughed out of the office."

Souch said she turned to the U.S. after speaking with Murakami, who she said finally pinpointed what was wrong. She said her health has improved dramatically. She can look after her children again and hopes to return to work soon.

"I would be skeptical, too, but I've lived it," she said. "Why on earth would I be paying out of pocket $3,000 every two months for something that is not working?"

Souch broke down in tears when talking about Murakami.

"I was so incredibly heartbroken that he couldn't help me, because he was retiring," she said tearfully. "I begged. I said, "Please, tell me somebody else who can help me.' And he said 'You have to go to the States'."

Patients like Souch are no doubt very ill, Morshed said, but must have another ailment.

"They definitely do have some sickness, but … do those people have Lyme, or do they have something else we don't know about yet?" asked Morshed.

"Antibiotics cure hundreds and hundreds of diseases with infectious causes."

Morshed and Murakami agree on one thing: that Lyme disease will increase in Canada as climate change allows ticks to thrive during the winter months, a time when they usually die off.

"With the warming effect of the world, they are now active all the time, " Murakami said.

Despite his forced retirement, Murakami said he will continue lecturing to doctor and patient groups. His hope now, he says, is to unite Canadian doctors to work together on Lyme disease for the sake of patients.

"Let's get together," he said. "We [doctors] have gotten together before for major diseases. Let's do it again."