Pubdate: Sun, 21 Sep 2003
Source: Roanoke Times (VA)
Copyright: 2003 Roanoke Times
Contact:  http://www.roanoke.com/roatimes/
Details: http://www.mapinc.org/media/368
Author: Jen McCaffery
Bookmark: http://www.mapinc.org/find?232 (Chronic Pain)
Bookmark: http://www.mapinc.org/people/Cecil+Knox

CASE SHOWS ATYPICAL PRACTICE RUN BY ATYPICAL PAIN DOCTOR

According to testimony at his trial, Cecil Byron Knox did not run your usual
doctor's office.

Maybe it was the wooden throne, the whispers about the dead squirrel under the
couch, or the story that those noises in the basement were courtesy of beings
known only as Beetle and Spider.

There's no argument that Roanoke pain specialist Cecil Byron Knox's practice,
Southwest Virginia Physical Medicine and Rehabilitation, was not the typical
doctor's office.

The one thing federal prosecutors and defense attorneys in the case against
Knox and three of his associates at the practice do seem to agree about is that
Cecil Byron Knox was not a typical doctor.

The trial, which continues Monday, is focused in part on what went on in the
converted home, teal with purple trim, at 1130 Second Street Southwest.

Donna Stone, a former employee of the practice, testified for the prosecution
last week that the office was a cluttered place where patients' files were
sometimes stacked in piles around, on top of, or under Knox's stately throne.
Or they were impossible to find because Knox had taken them out to his truck or
home. She also testified that Knox smoked marijuana with his patients.

Stone said other things also concerned her about the practice.

Patients used to whisper that there was a dead squirrel under the couch in
Knox's office, Stone testified. Stone also asked questions about noises she
heard in the basement of the practice. Other employees told her that people
named Beetle and Spider were living there.

But Stone said office manager Beverly Boone, who is also facing federal
charges, did not appreciate her questions.

"Bev would tell me I need to learn to ignore things," Stone testified.

Defense attorneys pointed out that Stone worked at the practice for only about
two months in 1999 and that she was fired, according to court testimony.

John Lichtenstein, who is representing the practice, described Southwest
Physical Medicine and Rehabilitation as a "house of healing" in his opening
statement. Knox's office was the "knot at the end of the rope " for chronic
pain sufferers who had already been through the medical wringer, Lichtenstein
argued.

"All of the sudden, many of the people who had no hope began to feel like a
human being," Lichtenstein said. Defense attorneys have estimated Knox has
treated more than 2,000 patients since he opened his practice.

The office seems to have been a reflection of Knox's personality. Knox's
defense attorney, Tony Anderson, has described as him as "contrarian" who
became a "thorn in the side" of benefit programs to get what he thought was
right for his patients.

"Dr. Knox became one of the strongest patient advocates that any patient could
have," Anderson argued.

Knox was born in west Texas, Anderson said. His father was the only doctor in
an 80-mile radius, and Knox would travel with his father to see patients.

Knox eventually graduated from the University of Texas with a degree in
engineering. He brought that mechanical point of view to his medical practice
later, designing braces for patients, Anderson said.

During his medical training in Boston, Knox met the woman who would become his
wife, Donna Knox. They discovered that they each had relatives who had been
prisoners of war.

Concern for veterans was important to Knox. After he opened his practice,
veterans were treated with special respect at Southwest Virginia Physical
Medicine and Rehabilitation, Anderson said. Former employees have testified
that even if there was a roomful of patients who had waited for hours to see
Knox, the rule was that veterans always got to see him first.

When Knox first came to Roanoke, he worked for Lewis-Gale Medical Center. His
unconventional long ponytail and cowboy boots stood out in the medical
community, Anderson said. Then in the mid-1990s, Knox opened Southwest Physical
Medicine and Rehabilitation.

Another former employee of the practice, Cindy Conner , also testified last
week that she was concerned with some of the responsibilities that were
expected of her at the practice.

Conner was asked to fill out prescriptions for patients based on previous
dosages found in the medical files. Knox would then check over the
prescriptions and sign them, Conner said.

But Conner said she was never trained on how to write prescriptions. Sometimes
she made mistakes and ordered prescriptions filled early or in the wrong
amounts, Conner testified. When she made mistakes, Tiffany Durham, Knox's
medical assistant, would sometimes yell at her, Conner testified.

Conner said she could recall only one time when Knox handed her a prescription
that was blank, except for his signature. She testified that she did not feel
comfortable filling out the dosage with Knox's signature already on the
prescription.

She said she ripped the prescription up.
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