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And then in the Netherlands, one of Lotsof's patients, a young woman, died. Though ibogaine wasn't proved to have caused her death, it has never been ruled out.
Today Lotsof and Mash disagree about what happened next, but both say it marked a change in their relationship. Lotsof maintains he had tried for years, unsuccessfully, to obtain permission to administer his ibogaine treatments in Dutch hospitals, where, he says, 24-hour medical supervision and emergency care would have been available. After the young woman died, he made the decision to move his treatment to a country where he could admit his patients to hospitals.
Mash, however, insists that she suggested the move. At the time, she explains, a Panamanian doctor doing research in South Florida heard about her ibogaine research and offered to assist and supervise treatments in his country so that information about patient doses, vital signs, and medical well-being could be carefully controlled. She says she instructed Lotsof on how the Panamanian medical authorities should proceed with the treatment protocol. Patients began to arrive in Panama in 1994, paying up to $15,500 for a three-day treatment course under medical supervision.
Even though Mash helped establish Lotsof in Panama, she says today that she began publicly to distance herself from him as much as possible by not asking him to speak on her behalf in NIDA hearings or other government meetings. She knew that the death of Lotsof's ibogaine patient would heighten other scientists' disapproval of the psychedelic research project and threaten her standing as a responsible investigator.
And she had standing to lose.
As a 31-year-old doctoral student at UM in 1984, she'd received national recognition both for herself and the university when she discovered a chemical pathway in the brain that would be a key to formulating medicines that counteract Alzheimer's disease. "I remember I was at a meeting of the Society of Neuroscience [in Minneapolis], and I was sitting in, listening to a presentation on Alzheimer's -- and that's when the light bulbs went off in my brain," says Mash. "I said, 'Oh my God, I know what I've got.'" When she returned to Miami, she approached one of the UM faculty members who was working on Alzheimer's and asked, "Do you have any Alzheimer's subjects? If you do and they die, can I have the brain?"
Her discovery helped her win a Harvard fellowship, and after two years she accepted a UM tenure-track position, one of the first offered to a female scientist. "She very rapidly took off as a scientist, on her own," says Robert Rubin, a former vice provost at the university who had extensive knowledge of her ibogaine work and in fact signed the first university contract with Lotsof. "She was a woman in pretty much a man's world. She was coming out of an environment that required a lot of aggression. It was very competitive. [Yet] as she finished her postdoctoral training, she was able to get funding on her own from the government, and that was rather unusual. She again and again proved she was ahead of the game -- her science was always a bit more unusual than the national average."
Mash harbors few illusions about what motivates her to succeed in science: "I'm addicted to achievement," she admits. When the university hired her as an associate professor of neurology in 1986, she decided that she needed more "live" material to study, so she proposed creating a brain bank in the hopes of persuading people to pledge their brains to science. (The bank, which she still manages, now has 750 donors, making it one of the largest in the nation.)
Mash never intended to study addiction, she says. But her attitude changed during the late Eighties in Miami, and she felt compelled to examine the cresting cocaine epidemic. "People were dropping like flies from cocaine," she recounts. "You'd see young people in autopsy who didn't belong there." During that period Lee Hearn, one of Mash's colleagues from graduate school, was in charge of the toxicology lab at the Dade County Medical Examiner's Office, where as a UM researcher he could do much of his toxicology work on the human brain. Hearn called Mash in 1989 to tell her of a discovery he'd just made: While examining the blood of cocaine users who had died of apparent overdoses, he'd found a chemical called coca-ethylene, which forms in the body through the combination of cocaine and alcohol. Before Hearn's discovery, scientists had thought it a byproduct of cocaine and alcohol that was simply discarded in urine, rather than being active in the blood and brain.
Hearn and Mash began to examine coca-ethylene and were able to prove that the chemical prolonged the sensation users experienced. The team also found that coca-ethylene was more potent than cocaine and that the body could not tolerate it at the same levels as cocaine. In 1990 the university obtained a grant from NIDA to study its properties.
"Again we get a wave of national recognition," Mash says, adding that they had beaten out a Yale research team that eventually came to the same conclusion. "Home run number two. The timing of that was pretty spectacular. Under the Anti-Drug Abuse Act of 1988 [which sets penalties for crack cocaine use and funds programs to combat it], Congress had appropriated money, particularly to recruit new investigators. I didn't have a track record in drug abuse -- I was doing degenerative diseases. And I go to this Society for Neuroscience to do a national press conference."