Punyamurtula S. Kishore is the medical director of Addiction Medicine Associates (Brookline, Massachusetts). Kishore has been a practicing public health scientist for over 30 years. He began his medical career as a primary care/family practice physician and then moved into a position as the Medical Director of the Washingtonian Center for Addictions, the first organization in the U.S. to recognize… Read more at Wikipedia
Date of Birth: 03-Jun-1950
Zodiac Sign: Gemini
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Massachusetts Completes Its Takedown of Addiction Pioneer Dr. Punyamurtula S. Kishore
Massachusetts Completes Its Takedown of Addiction Pioneer Dr. Punyamurtula S. Kishore
This is the eighth in the ongoing series of articles about Dr. Punyamurtula S. Kishore, the Christian doctor who pioneered a non-narcotic, sobriety-centric approach to addiction that proved to be clinically superior to conventional treatment protocols.
While governments and pharmaceutical companies continue to promote methadone and Suboxone® (substitute narcotics labeled as “medical treatment”), the Massachusetts Model developed by Dr. Kishore rejected all such “hair of the dog, one size fits all” solutions to the complexity of drug and alcohol addiction (see the first two articles in this series). After a year of the conventional treatments, only 1% to 5% of patients have not relapsed, while 37% to 60% of Dr. Kishore’s patients have not relapsed after the same period of time. Dr. Kishore’s results are supported by hard data (actual urine tests), while the “best” statistics for conventional methods (that miserable 5%) involve unreliable self-reporting by the addicts.
In short, Dr. Kishore’s success rate in treating addicts and returning them to society as productive, healthy individuals isat least 750% better than the success rate of the big name treatment programs, and may actually run as high as 6,000% higher than the entrenched methods. At the time the Commonwealth of Massachusetts destroyed his clinics in September, 2011, if you stacked Dr. Kishore’s lowest clinically-documented success rate (which had risen to 50% from the 37% he had reached in 1994) against the highest success rate claimed by conventional programs, his Massachusetts Model was still ten times more successful in treating addiction. For every one person delivered from addiction by conventional treatments, Dr. Kishore was delivering at least ten people. A dollar spent in Dr. Kishore’s clinics was worth ten dollars spent elsewhere. We will return to this crucial point later in this article.
But it was Dr. Kishore’s expanding base of clinics that was destroyed, neutralizing the existential threat to Big Pharma and state medical doctrine. This left the inferior conventional treatment programs to work their magic on a populace doomed to wallow in a snowballing addiction crisis that remains one of the worst in the nation. By all measures, this crisis was a manufactured one.
Accordingly, the state had a pressing interest in preemptively covering up its actions in favor of Big Pharma (see the fifth, sixth, and seventh articles in this series). Shameless pressure (e.g., driving Dr. Kishore’s wife and daughter to tear-filled hysteria in front of him) was designed to strong-arm a guilty plea out of the innocent doctor (a plea needed to justify the state’s malicious actions against the most successful addiction treatment developed).
The breaking point was reached on April 6, 2015. Blocked from pleading no contest in the state’s tightly-engineered deal, the doctor offered himself up to the state and was jailed fifteen hours later. The media vultures slurped up the Attorney General’s gloating one-sided press releases without a scintilla of critical inspection, reaffirming their role as handmaidens of half-truths. Not surprisingly, they remain oblivious of the fact that the fight is not, in fact, over.
Vultures Seen and Unseen
The office of the attorney general repeated the talking points that they used in 2011 to depict Dr. Kishore as a monster who preyed upon the unsuspecting drug addicts of Massachusetts, deemed the “most vulnerable residents” of the state. Attorney General Maura Healey explicitly positioned her office as protecting “the integrity of our health care system”by overseeing the ultimate incarceration of Dr. Kishore. George Orwell’s Newspeak was alive and well in the aftermath of the toxic plea deal (the cup of hemlock the doctor was offered to drink or else). The factual errors riddling the story rushed out by The Patriot Ledger are legion, but they got what they wanted: a juicy headline that made for great click-bait.
The media story exposes the state’s willful cover-up of the pivotal role that urine drug testing played in Dr. Kishore’s record-shattering success rates (see the second article in this series). By suppressing the truth of the addiction revolution that Dr. Kishore had wrought, the state brought him down to the same level as the massively failed substitute narcotic programs still destroying lives in Massachusetts. The media, reinforcing its codependency with the office of the Attorney General, also adopted the same mantra. See no medical miracle, hear no medical miracle, speak no medical miracle. Once Dr. Kishore’s hard-won achievement is buried in obscurity and kept off the public’s radar screen, the state could act with impunity.
Whereas the state’s original actions against Dr. Kishore were mindlessly engineered by Nancy Maroney and then-Attorney General Martha Coakley for apparent political advantage (see the previous articles in the series), recent prosecution was handled by a different team that inherited the case from the departing figures. Independent legal observers close to the case were careful to distinguish the motives of the earlier prosecutors (described with pejoratives) with those of the current prosecutors (“people just doing their job”). There is no reason to reject this charitable assessment, but that concession cannot change the heinous outcome arising from the continued failure to put the factsback into their medical context.
The current prosecutors surely inherited a mess from their predecessors but didn’t know to clean it up. They were given a hammer and readily saw every problem as a nail. Successor AG Maura Healey’s parroting of the state’s misbegotten case against Dr. Kishore reveals the total absence of introspection, the continued refusal to admit the existence of the blatantly obvious. When you compare actual outcomes in human lives, one fact quickly rises to the surface: if there’s truly fraud being committed with the money Massachusetts keeps sinking into addiction treatment, it would rest on the shoulders of the mainstream treatment programs which deliver a miserable 95% to 99% recidivism rate for its “most vulnerable residents.” But the symbiotic relationship of state to Big Pharma prevents the commonwealth from admitting error or malfeasance or backing off from its deadly course.
The “vultures we see,” then, are the media outlets crowded around the corpse of a man brought to ruin in his bid to deliver as many citizens of his state from the grip of addictive substance as he possibly could. Throughout the course of this case, the visible vultures have adopted the state’s talking points and emulated the state’s blind eye to Dr. Kishore’s singular achievements in addiction medicine.
But the invisible vultures are the bigger concern. These are the vultures no one will see, but they will be all too busy as a result of the disastrous plea deal forced upon the embattled doctor. We are speaking of the rising mortality rates in Massachusetts that Dr. Kishore’s Sobriety Maintenance treatment program would have reined in had the state not continued its mindless actions against him. Neither state nor media refuse to debunk the falsehood that all addiction doctors are the same. They appear to have an interest in fostering this deadly mistake (there being no evidence of any interest in reversing the mounting death toll). Business as usual: death as usual. There are no better solutions if the state and media refuse to publicize such an inconvenient truth. Nonetheless, what the citizens don’t know can indeed hurt them. It is, in fact, killing them.
After his first week of incarceration, Dr. Kishore contacted me by phone. You will want to know what he had to say.
The Defense Bolts
There are many factors that conspired to drive Dr. Kishore, who was heading into the April 6 trial with every intention of pleading not guilty and proactively asserting his innocence, to finally accept the plea deal. When “the wicked frame mischief using the law” (Psalm 94:20), it is natural to despair of acquiring justice at the hands of the court (and in this case, of a jury). Following tactics described in Harvey Silverglate’s must-read book, Three Felonies a Day, the state (with essentially unlimited resources and time) simply put up 80+ charges against Dr. Kishore and his practices. The charges would be thrown against the wall to see what sticks. The state had merely to prevail on one of the charges (sixteen to be heard on April 6, another twenty to be heard in July, etc.). Even if Dr. Kishore prevailed on every other charge, a guilty verdict on just one would be enough to imprison him for five years and then deport him.
In short, the state would get many chances to convince a jury to throw Dr. Kishore under the bus. Dr. Kishore and his defense team would have to score a perfect 100% on all the charges: failure on even one would spell personal disaster for the doctor.
With a robust, committed defense firing on all cylinders, the case was winnable. Even advisors looking at the case with a justifiable pessimism (and awareness of some pesky elements in the prosecution evidence) asserted that the case was winnable. But that rosy outlook evaporated. Dr. Kishore’s faith in his attorneys (who were being forced by the court to continue to defend Dr. Kishore when his money ran out in 2013) continued to weaken. If his attorneys were only doing the legal minimum not to be sued in a malpractice complaint, that would not be sufficient to win the case.
One of my legal observers (an independent attorney involved in the most recent developments) was of the opinion that the doctor’s attorneys had denigrated him to the judge. A couple of weeks before trial they presented a heavily redacted letter of Dr. Kishore’s to Judge Janet Sanders and argued that a lone out-of-context sentence could be read as some kind of threat against them. Judge Sanders evidently saw this as a ploy to withdraw from the case rather than to spend four to six unpaid weeks defending Dr. Kishore. Such defense attempts to be rid of the case after having burned through $1.6 million dollars had come up repeatedly. Dr. Kishore had valid reasons to question what kind of defense he would get.
My legal observer attempted to mediate the relationship between Dr. Kishore and his attorneys. Skeptical before that point, he came to believe that the attorneys were prepared for trial and familiar with all the exhibits and witnesses. Some outstanding issues remained, however, beginning with the absence of expert witnesses in the trial.
For reasons that remain baffling, neither the prosecution nor the defense offered to present any expert witnesses in the trial. Dr. Kishore could easily have been accredited by the court as an expert witness in his own case; a professor at Harvard Medical School was also willing to testify on Dr. Kishore’s behalf as an expert witness; the different government auditors who had scrutinized Dr. Kishore’s practices and found nothing amiss could have been called as expert witnesses. (N.b. A court-approved expert witness is someone entitled to enter his opinion into testimony. Without expert status, a witness can only testify to carefully delimited facts and nothing more. A factual witness can only say, “We took three urine samples.” An expert witness can say, “Those samples were medically necessary.”) Most critically, only an expert witness could rule on the value of Dr. Kishore’s protocols. The opportunity to have that happen was squandered.
The prosecutors informed the judge that they had interviewed the defense witnesses. They then pointed out that “a lot of these witnesses don’t seem to have specific knowledge of the facts of the case that’s being tried.” At this point, the defense should have challenged that assertion, countering that they knew those witnesses had “relevant knowledge,” but instead said nothing. A legal observer characterized this silence as “tacit acknowledgment that the defense had not interviewed the witnesses.” If true, that would be very troubling, especially that late in the game.
Witnesses That Can’t Be Cross-Examined
My legal observer explained one of the more disturbing aspects of what “witnesses” were being admitted into Dr. Kishore’s trial:
Some of the recorded testimony was done at a grand jury hearing (with only prosecutors present). Several of these defendants testified under oath to the grand jury. The Commonwealth wants to take that sworn testimony and insert it into the case without calling the witness. There is a rule against hearsay, but hearsay is defined as an out-of-court statement structured to prove the truth of a proposition. But the Commonwealth is saying, “We’re not using it to prove the truth of the matter asserted. We think they lied. We’re trying to prove that these people lied and tried to cover up for Dr. Kishore.” This allows otherwise disallowed hearsay testimony into evidence using this artifice.
Such testimony amounts to disembodied witnesses—mere pieces of paper.
My legal observer pointed out how the Commonwealth used the same techniques disclosed in Silverglate’s landmark expose, to striking effect:
What the prosecutors do is that they get a small fish so that they can bargain to get the bigger fish. They indicted them, leaned on them very heavily, and tried to get them to give information about Dr. Kishore so that they could have a more effective case against him, in return for which they got much lighter sentences than they would have had had they gone to trial.
Those defendants said one thing to the grand jury and another thing when they pled. Are they lying now, or were they lying back then? They testified to two different things under oath at two different times. Having them present in the courtroom would neutralize the effectiveness of such prosecution “witnesses” by proving they were liars. Otherwise, you’re facing a disembodied transcript. It hurts Dr. Kishore badly if he can’t cross-examine his accusers. All his attorneys had to do was subpoena those witnesses. The state certainly wants to deprive him of his rights, but his attorneys need to step up to the plate and act in his best interest.
My legal observer came to believe that taking the plea deal made the most sense given what he learned from Dr. Kishore’s attorneys and the contours of the prosecution’s case.
When both sides recognize the possibility of winning or losing in a close case, and the defendant’s downside ishuge if he loses (whereas the state has no huge downside), that is generally when both sides try to settle.
Because the Commonwealth agreed to a plea, they also realizedthat their case was not a slam-dunk either.
We note here that, while the state has no downside in losing the case, the citizens of the state are suffering a huge downside as a result of the prosecution’s successful bid to take Dr. Kishore out of the picture.
An Ugly Shift in Tactics
When Dr. Kishore contacted me on Easter Sunday, the situation had worsened considerably. He had been planning to proactively assert his innocence and go through the trial, but the mounting deficiencies and stepped up pressures were reaching a breaking point. Since the original indictment, his family life has been on hold. With the imminent prospect of a failed defense, he would be imprisoned during the wedding of his daughter. Then the state sent audit notices to his wife, who runs a very simple, uncomplicated medical practice. In the doctor’s own words, the intent of that audit of his wife was crystal clear: “They want to put more pressure on Kishore.”
This became even more evident at the courtroom, when the emotional manipulation and threats of long jail sentences and deportation were mixed in with the urgency of this being the doctor’s last chance to avoid that possibility. As one of his advisors told him, “the train is leaving the station.” It was do or die.
Financial resources to underwrite a more robust defense simply did not exist. The man who had helped so many thousands was reduced to having those who believe in his work cover the costs of his gasoline for a prolonged period. One Christian minister recently paid to have Dr. Kishore’s transmission repaired, while another provided him with a $1,000 honorarium for speaking to his congregation. During the time these articles were being published, some incoming queries were directed through me to him, and he freely responded with valuable counsel and referrals in a spirit of genuine concern. He cannot help speaking and thinking as the physician, the healer, that he is. But the communities he helps are not rich. No war chests for his own defense could be rapidly assembled from those whom he has touched.
As a concomitant of his recently treated kidney condition, he had become the victim of serious dental conditions requiring over $30,000 of very recent treatment (I have the receipts to prove it). Bone loss in his lower jaw resulted in the loss of multiple teeth. In the wake of these extensive oral surgeries, it became even more difficult for him to be understood when speaking. His already strong accent became exacerbated. I’ve been speaking to him regularly for nearly two years and eventually caught on to the rhythms of his British Indian speech patterns, but now I had to strain to understand him. To make your case before a jury that couldn’t understand you added another layer of liability.
Dr. Kishore provided me an extensive daily chronology covering the weeks before his current imprisonment. Of particular interest are the heartbreaking final three days when the brutally-inserted straws broke the camel’s back, especially as regards his wife Sheela:
4.4.2015: Bishop Hogan and the Faith Community votes against Plea Deal.
4.5.2015: Sheela caves in. Feels 6 week trial and subsequent uncertainty if there is negative verdict too traumatic. I disagree. Hal Shurtleff from JBS calls me and refers me to Attorney David Grossack—a courageous attorney—to demolish the case. Call placed.
4.6.2015: I send email to [attorney] not to bring up the Plea Deal anymore and go for trial. I arrive at court. [Three defense attorneys] corner me in a room outside the court room and ask me to call in Sheela. They called it the “train is leaving the station.” Sheela arrives from her work. They work on her. I resist. They keep bringing up 2nd trial and further drain and strain. Sheela wants it all to end. I reach out to you [and two others] to see if we can develop a plan for appeal as the way this case was going a negative outcome was predictable. Nothing concrete develops. Mounting pressure. With no further resources and to avoid 6 weeks of news TV barrage, a decision has to be made.
Dr. Kishore’s account doesn’t even mention the expert witness issue. Should he testify “this was the right amount of urine testing,” the prosecutors would object that he’s not an expert witness and have the claim struck from evidence, despite the fact that the doctor has treated 250,000 patients for drug addiction more successfully than anyone in the entire state. As my legal observer noted, “it is simply mind-boggling” that the prosecution would be empowered to block Dr. Kishore’s testimony in this way.
The chronology ends with a listing of fifteen factors he had to consider when evaluating his prospects at this critical juncture in the case. The cumulative weight of these factors (pressures from without, pressures from within his own family, pressures from poverty, pressure from his own attorneys) comes to a head. Certainly the prosecution never expected him to last this long. The process of grinding him down has been fully documented beginning with the first article in this series. His chronology terminates abruptly with a clipped but poignant conclusion: “I needed to offer myself to stem the tide. Resulted in the decision.”
The Devil That You Know
The perennial problem with “choosing the devil you know rather than the devil you don’t know” is that you’re still choosing a devil. Dr. Kishore was required to assert something on the record that he knows is not true. Some might even argue that he was following a command in the Sermon on the Mount, in a passage some scholars believe was written to a captive, oppressive people unable to secure justice from Roman occupying forces: “Agree with thine adversary quickly, whiles thou art in the way with him; lest at any time the adversary deliver you to the judge, and the judge deliver thee to the officer, and thou be cast into prison” (Matt 5:25). The New Testament surely has its share of men cast unjustly into prison, whether or not this passage applies to Dr. Kishore. But was justice done for either side with a plea deal, one secured under duress and threat as the state insisted that no plea but “guilty” would avert its forward march against Dr. Kishore?
My legal observer explains why Dr. Kishore was not permitted to plead “no contest” (which doesn’t involve an admission of guilt yet still results in the same punishment upon the accused):
He can’t plead “no contest” because the “deal” required that he accept a specific list of facts and conditions, in return for dismissing all eighty charges, and pleading to one reduced charge. It had to be done in the structured manner offered by the state.
In other words, the state needs to keep its desired narrative intact. This has nothing to do with justice and everything to do with political perception. How this differs from the brainwashing of prisoners of war is not evident. The “structured manner offered by the state” is the narrative, and the state wants the dissident to repent, apologize, and support the state’s attack against him. Having secured such capitulation to its own narrative, the state can hold the damning documents in reserve should the upstart revive a counter-narrative upon release.
The irony should not escape the reader that if the accused later repudiates the “facts” the state made him “accept,” the state’s recourse would be of accusing the defendant of perjury for having originally said he was guilty. But if he’s guilty of perjury for having pleaded guilty to the original charges, that means he was innocent all along. How can you have your cake and eat it?
That is a bridge that Dr. Kishore will cross in five-and-a-half months, when he is released and continues a ten-year-long probation. He was also (of course) stripped of his medical license, and his clinics charged with $9.3 million of restitution (!) to MassHealth (see article seven in this series about why the state was desperate not to pay $4 million in restitution to Dr. Kishore for wrongfully-withheld Medicaid payments). The prosecution’s actions have guaranteed the unchallenged hegemony of methadone and Suboxone® treatments as the primary means of treating drug addiction in Massachusetts. The resulting preventable deaths statewide due to the destruction of Dr. Kishore’s clinics were essentially paid for with thirty pieces of silver.
Long ago, a literal bag of thirty pieces of silver also purchased a result that appeared to be absolutely final, closing the door on another Life in an ignominious way. But in both cases, the story was far from over. The unexpected transition from Easter Sunday to a Monday courtroom where “judgment is turned away backward, and justice standeth afar off: for truth is fallen in the street, and equity cannot enter” (Isa. 59:14) was no meaningless accident, for a renewed fight is brewing, and a new hope looks to be rising.
From Frontal Assault to Rearguard Action
One April 13, 2015, on the seventh day of his incarceration, I received a phone call from Dr. Kishore. We couldn’t talk very long. The plea deal went into effect, he said, “because all the roads were blocked.” He had been willing to fight to the end a week earlier, so I expected this conversation to be a postmortem of sorts. I was very wrong.
“Help is coming,” he informed me. “It’s coming from those that Dr. Kishore has helped.” (Yes, he really did refer to himself in the third-person.) As I discovered much earlier in my personal visits with Dr. Kishore, his strongest credentials are the former addicts who got their lives back thanks to his selfless work on their behalf (see the first three articles in this series for further detail). They apparently are rallying to his aid, notwithstanding the state’s temporary success in sidelining him. The state’s actions have only served to galvanize his supporters even further. As he told me, “the light is not snuffed out.”
“We could not win in a frontal assault,” he pointed out, “but we can win with a rearguard action.” The idea of living to fight another day was embraced by his supporters. “But,” he added, “help must come from outside”—outside of jail. “All I have to read is a Bible given me by a visiting pastor. It’s the only reading material I’m allowed to have. Here we have a minimal life. A bare life.”
A “Free Kishore” movement designed to restore the doctor’s freedom and bring his clinical successes back to the people who so desperately need access to his care is in process of being launched. The more airplay the movement gets, the more obvious will become the state’s folly in destroying the best addiction treatment program in the nation. The funds the movement plans to collect will be used to bring back Dr. Kishore’s Sobriety Maintenance treatment program, permitting Dr. Kishore to continue to push his already industry-defying success rates past the 60% mark.
His former patients understand exactly how far ahead of his time Dr. Kishore is. No surprise that last month the prestigious Yale School of Medicine extolled a new pilot program they were developing that in virtually all respects is a stunning carbon-copy of what Dr. Kishore had put in place more than twenty years ago in Massachusetts (since dismantled thanks to your friendly neighborhood attorney general). The Yale researchers should be in dialogue with Dr. Kishore about the next steps they need to take. Unfortunately, there’s no way to make a phone call to the innovator locked in his bare cell.
“For the Lord heareth the poor, and despiseth not his prisoners” (Psalm 69:33). Comforts in jail are few and far between for Dr. Kishore. Not every reader of these articles is in a position to apply Matthew 25:36 and visit Dr. Kishore in person (and the limitations on such visitation are fairly severe). However, he is able to receive mail at the facility. He vibrantly affirmed to me that letters of support, encouragement, counsel, and comfort to him would be as uplifting as a physical visit. Please write him at the following address and include the doctor’s ID number as shown:
South Bay Correctional Center
Attn: Punyamurtula Kishore, ID 51500925
20 Bradston Street
Boston, MA 02118-2705
Most people have cordial relationships with their physicians, but there is a visceral component in those former patients of Dr. Kishore who have started to take up his cause anew (given the legal train wreck he was funneled into). Their gratitude to him is grounded in the circumstance that their lives had formerly been forfeited, but he brought them back from the edge of despair. He gave them their lives back.
Some of these former patients no doubt sense the irony in the fact that had Dr. Kishore not come into their lives, they may well have ended up in prison themselves. Now that their lives were put back on track with the doctor’s revolutionary treatment programs, they discover that the man to whom they owe their own freedom has himself been deprived of freedom for having helped them.
This is all the more remarkable when you consider how long this medical pioneer’s clinics have been shuttered (nearly four years). How profound an impact would you have to make to see a tangible outpouring of gratitude that many years later?
The state is protecting its contrived false narrative with casual brutality, leveraging what amounts to forced confessions to distract from its deadly policies. On the other side are those with humble means, men and women and young people that all were at the receiving end of Dr. Kishore’s work for the Commonwealth and her people. They are the ones who openly reject the state’s narrative, work to expose the state’s complicity in widening its drug crisis, and are fighting to restore what the state has brazenly stolen from its citizenry:
Hope. Deliverance. Life. Truth.
The First Seven Articles in This Series:
Ibid. No distinction is made between the charges made against Dr. Kishore and those leveled at his defunct clinics. Other media outlets fared slightly better in respect to these facts, acknowledging that the state is not requiring Dr. Kishore to pay back $9.3 million, contra this story. Those reading these articles know that only two of the nine postponements mentioned in this media outlet were Dr. Kishore’s doing (based on his recent kidney surgery, etc.) while the other seven were the prosecution’s doing. Expect no errata to be published by the Ledger: they already got what they wanted from the story.
Phone conversation with my legal observer, March 29, 2015.
Email to the author.
I did not at first recognize the incoming phone number, and so I checked to see if it was known to be one used for scamming or phishing. About 95% of those responding advised that I was dealing with a scammer, but 5% claimed the number was a real number for a company (SECURUS TECH) that provided phone service from inside jails. I asked an associate in Massachusetts to confirm if Dr. Kishore had been trying to reach me through this service and learned that he had.
Dr. Punyamurtula Kishore, 64, along with his company Preventive Medicine Associates, Inc. (PMA), pleaded …
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Apr 7, 2015 – Dr. Punyamurtula Kishore, 64, along with his company Preventive Medicine Associates, Inc. (PMA), pleaded guilty on Monday in Suffolk …
Visit Healthgrades for information on Dr. Punyamurtula Kishore, MD. Find Phone & Address information, medical practice history, affiliated hospitals and more.
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Apr 7, 2015 – Dr. Punyamurtula Kishore was the third person sentenced in connection with the scheme.
Sep 20, 2012 – The disciplinary action against Dr. Punyamurtula Kishore, as well as his ongoing criminal case involving a drug-testing lab that he founded, …
Sep 25, 2013 – Public Mention about Punyamurtula S. Kishore, MD.
Sep 20, 2012 – The disciplinary action against Dr. Punyamurtula Kishore—as well as his ongoing criminal case involving a drug-testing lab that he …