Medical marijuana activists are tightening the joints on an underground distribution network.

A man who wants to remain anonymous is moving bag after bag of midgrade commercial marijuana out of a trendy cafe in Dupont Circle. For a mere $75, the big Irish-American carpenter, whom we’ll call O’Toole, dispenses one of dozens of ounces from a brown paper bag. With a street value of $200, it’s easily the best deal in town—but only if you have a note from your doctor recommending your use of marijuana for medicinal purposes.

“No note, no cannabis,” O’Toole says flatly—which means you mere recreational users have to hump it up to your neighborhood dealer or risk your ass at an open-air drug market.

If you’re sick, however, you can join the procession of lame and weak who flock to O’Toole’s hangout like penitents to a sacred shrine, linger for a while so as not to attract the heat, and exit quietly to inhale some respite. Marijuana, advocates argue, can help treat nausea, lack of appetite, and certain vascular problems, among other conditions.

Steam from espresso machines fills the cafe as the wizened Vietnam-era vet, who represents the supply side of the local medical-marijuana effort, slides just under an ounce to a middle-aged woman. Stricken several years ago with a debilitating illness, the woman has trouble pronouncing certain sounds and controlling stomach spasms. Weed, she says, calms her muscles. It’s a treatment she plans to use within minutes of entering the safety of her own home.

Technically, O’Toole has just committed a misdemeanor, a transaction he characterizes as an act of civil disobedience. “What I’m doing should not be illegal,” he gripes from a cafe stool amidst the clink of ice cubes landing in cocktail glasses.

When he isn’t banging nails or moving dope, O’Toole spends a good chunk of his time helping Patients Without Time President Steve Pardieck and ACT UP/DC co-founder Wayne Turner launch a grass-roots “medipot” movement. Pardieck runs the District’s nascent medical-marijuana cooperative. And Turner was the driving force behind the successful but ultimately quashed ballot initiative to legally sanction the distribution and use of medicinal marijuana for District residents. With ACT UP/DC co-founder Steve Michael, Turner and Pardieck gathered the 30,000 signatures required to place their medical-marijuana question, Initiative 59, on the ballot in November 1998. Michael died of AIDS before the vote. But he made Turner, his lover, promise to keep the initiative alive.

That task has not been easy. The medical-marijuana initiative got bottled up in Congress when conservative Rep. Bob Barr (R-Ga.), a former federal prosecutor, introduced an amendment to the 1999 federal appropriations bill that forbade the city from spending any money on the medical-marijuana referendum—even if only to count the votes—and negated the ballot initiative’s outcome. Congress passed Barr’s amendment as part of the national budget, and President Clinton signed it into law.

The Metropolitan Police Department was another vociferous opponent of the initiative—a pretty good sign that O’Toole’s Florence Nightingale pose might not save him if a cop were to walk into the cafe. The effort “not only endangers public health in the short term, it also sets a dangerous precedent,” said Police Chief Charles Ramsey, testifying against the ballot proposal in October 1998. “The measure provides adequate cover…for offenders whose real purpose is to manufacture, distribute, and abuse marijuana.”

Because the ballots had already been printed, residents were able to vote for Initiative 59 on Election Day despite Barr’s amendment. But in compliance with the new law, a software specialist for the election board programmed the computer not to print out the results.

Pardieck and Turner sued the D.C. Board of Elections and Ethics, which was responsible for tabulating the votes. Last year, Judge Richard W. Roberts of Federal District Court ruled on Sept. 17 that the ballot-counting restriction was illegal. The votes were counted that day, and District residents learned that they had approved the legal use of medicinal marijuana by 69 percent, “the widest margin of any ballot initiative in D.C. history,” Turner says proudly.

Still, the rider to the appropriations bill ensured that it remains a federal offense to do what O’Toole today does all over town: supply medicinal marijuana to patients in need of weed relief.

Inside the dimly lit second floor bar of the Velvet Lounge on U Street, 40 or so medical-marijuana and pro-legalization advocates mill about between a pool table and a small stage where men with guitars play old folk songs and New Age covers. A loose coalition has gathered on this March night to strategize about how to uphold the will of the people without getting nabbed by the law. Rising to the stage to speak, Turner preaches to the choir, reminding the assembled that the “medical-necessity” defense is their best hope for thwarting prosecutors.

Because Congress must pass appropriations bills each year, says Turner, the battle is not dead but on hold. “We now need to survive the budget fights on the Hill,” he says, telling the roomful of medipot activists that Barr is holding onto his congressional seat by a thread. “So is At-Large [D.C.] Councilmember Harold Brazil, who wants to heighten penalties for marijuana use in the District,” he adds.

Next to speak is Pardieck, a person with AIDS whose weight loss suggests that he may not have unlimited time to fight prohibitions on pot. He says that prospective patients will be screened at ACT UP/DC headquarters at 409 H St. NE and admitted only after presenting a note from a treating physician, their diagnosis duly noted on the Medicinal Cannabis User Initial Questionnaire.

Pardieck is hoping to gain “sanctuary” for his “distribution center,” he says, at a local church where he is deacon. He won’t divulge the name of the church but notes that he had hoped to use the Whitman-Walker Clinic, which treats AIDS patients, to provide safe access to medical cannabis before the effort was driven back underground by Congress.

Pardieck says he knows “nothing” about O’Toole’s informal “distribution system.” His organizational literature envisions a “multi-faceted facility, accessible to people with disabilities” and “a professional atmosphere for patients to obtain photo ID cards qualifying them under the Health and Safety Code” of the District, with “trained member advocates on hand to offer advice and assistance.” And, he says, he’ll have no truck with recreational users or black-marketeers who want to use his cooperative as a shield against legal prosecution.

A few days later, O’Toole braves the rain of a miserably cold evening for one of his weekly house calls to “patients” too ill to leave home. At a two-story town house off Rhode Island Avenue, O’Toole uses a homemade marijuana “vaporizer” to administer his medicine to a man with AIDS wasting syndrome. The vaporizer, afficionados believe, allows smokers to get a pure hit of marijuana’s active ingredient, tetrahydrocannabinol (THC), without excess smoke. The man is one of 77 people who have already been screened by Patients Without Time in the ACT UP/DC offices. (ACT UP/DC members are quick to point out that there’s no pot to be found in their offices, but, with a wink and a nod, the patients seem to find their way to O’Toole.)

For eight seconds, O’Toole pulls the trigger of the vaporizer—a 100-watt Radio Shack soldering gun with a makeshift pipe attached to it. The trigger lights the leaf until it reaches a temperature of 325 degrees Fahrenheit inside the chamber. “That’s the temperature you need to vaporize the Delta 9, or THC,” he says.

The patient takes a hit. Within minutes, he is eating solid food—and laughing. And the gray-haired O’Toole is off to visit another patient.

O’Toole’s belief in the medicinal use of marijuana is based on more than hearing anecdotes, he says: He found that marijuana eased the crushing pain from his own complex migraines. When he was hospitalized for a stroke in 1980, he says, the attending physician told him that smoking dope had been alleviating his symptoms. But once he stopped smoking, the physician explained, the vascular symptoms returned, triggering new migraines and the stroke. Encouraged by his doctor, O’Toole began medicating himself.

O’Toole still figures he might get busted—for use, distribution, or cultivation—but worries little about landing in jail once he mounts a “medical-necessity” defense. “Sixty-nine percent of the voters in the District approved our initiative,” he says. “There’s not a jury in the city that would convict me.” CP