Author: Ryan Mac

Part 2 in a series of 2

“Has everyone been to the bedside of someone who’s dying?” asked Judy, a clinical care nurse.

Eight new volunteers responded, thrusting their hands into the cold air of Room HO147. On a cold and rainy Monday night in October, these eight hopefuls convened in a converted break room in Stanford Hospital’s basement for a new volunteer orientation session for No One Dies Alone. Some had driven from work straight to the meeting, while others only had to make the short trip down the elevator from their jobs upstairs. They all listened intently to the revolving presentations of hospital chaplains and program organizers.

One by one, chaplains and nurses gave short talks, each speaker ending with a profuse outcry of thank yous directed at the hopefuls. After all, it was death they would be dealing with.

Among the new volunteers was David Bowman, a 70-year-old retiree with wispy white hair and an accompanying white beard. An ordained minister of 40 years with the United Church of Christ, Bowman had given his fair share of last rites. Still he jotted down every bit of advice from the chaplains.

“A dying person’s body temperature will get cooler, so you will need to feel for a pulse.” Quick scribbles of a pen.

“Wet their mouths with a small sponge if you see that their lips are dry or chapped.” Noted.

“You’re never alone in this process.” Word for word.

Across from Bowman was Jim Chan, 49, a single father who had come straight from his 9 to 5 at Sun Microsystems where he worked as a lead engineer. Jim regularly volunteered in the hospital’s E.R., working the Saturday shift from 10 p.m. to 1 a.m. every week.

Bill Strewby sat in a chair separated from the table, a self-inflicted punishment for arriving late.

“I asked like four people and none of them knew where this place was,” he said.

With a handlebar moustache and a purple and green windbreaker, he listened for 40 minutes before his restlessness succumbed to a bout of doodling on his volunteer worksheets. By meeting’s end, he had created his fair share of hieroglyphics — yin-yangs, stars and hearts.

It was a quiet group, according to Allison, a social worker who gave the first presentation. The room was often filled with awkward silence, broken only by Strewby’s crunching of trail mix, as presenters waited for questions. Surely, not everyone could be that confident in dealing with death.

Allison continued anyway, discussing the importance of the volunteers’ mental health, because in this business, “you can’t take care of someone until you can take care of yourself.” Yet, she struggled to find words to explain the need for distance between what’s inside the hospital walls and what’s outside. They had to realize the sensitivity and intensity of the matters they would deal with. She hazily explained the program’s support system for affected volunteers and waited for questions, which never came.

“I know that these things are nebulous,” she said. “It’s hard to recognize when these things are going to be relevant.”

Yet, in discussing the responsibilities of the program, Allison became resolute and clear: volunteers should not and could not take on grief because of their experiences. While their job required compassion, volunteers were expected to stem their emotions once they stepped out of the hospital room.

“The key is recognizing that you have a role in this end process and that your role is pretty confined,” Allison said. “You haven’t caused their death or their lack of family. These are problems that you can’t own.”

But for David Bowman, something wasn’t right. How could he be expected to show concern for a dying person, then forget about that person when he left the bedside or as soon as the person died? And what about the families who wanted to know more?

“What if a family that was around didn’t want to let the caregiver go?” he asked.

Susan Scott explained that neither the volunteers’ phone numbers nor their full names would be given out to relatives. No volunteer would be expected or encouraged to maintain ties to the family of the deceased. The program was about care within a strict standard protocol.

“You are scheduled for a shift,” Scott told them, “and when that shift ends, you have to leave.”

—–

Susan Scott had her reasons for the strict volunteer-patient relationship. She’s based her whole career on staying within the boundaries, and as decedent care chaplain, it’s the only way she can withstand the 40-hour workweek. In her current position at the hospital, Scott handles all death certificates, which average two or three a day. She talks with families whose relatives have died or are dying, and can refer them to the funeral home that’s best suited for their needs.

A self-described introvert, she is quiet but firm. She wears a charm on her necklace that reads, “Live With Grace.” Susan believes that her profession is one meant to provide comfort within a certain reality, describing it almost as a placeholder for grief. “I think you need a certain amount of patience with people and compassion for people,” she said. “And I think part of what I do is hold it for a while for people. I don’t ever try to say, ‘It’s going to be O.K.’ But I try to be with them . . . until they can kind of gather their resources and take care of themselves.”

After 23 years of being a reverend, she’s learned that she’s not there to keep their grief. It’s an understanding that she emphasizes every time a new volunteer joins No One Dies Alone, and the restrictions have been put in place as a constant reminder. For Scott, it’s the only way humans could have any chance of handling death, something she has learned from her own experiences.

_____

It was 1993 and Susan Scott had only been on the job a few months at Lucile Packard Children’s Hospital, when she was summoned to the neonatal intensive care unit to perform a baptism. Weaving her way through the buzzing incubators of the sterile ICU, she arrived to find a baby boy only a few weeks old, still lying on the operating table wired to a ventilator. Doctors rushed back and forth monitoring the baby’s vital signs and examining the aftermath of heart surgery.

“If you’re going to baptize this baby, you’re going to have to do it right away,” a nurse whispered.

Gathering herself between the whir of the machines and the newborn’s labored breathing, she glanced around the windowless room as the parents and grandparents stood silently around the surgery table. She was Lutheran and they were Roman Catholic, and the service would be in English, not their native Spanish. But it didn’t matter. This was an emergency, and any ordained Christian minister could perform the rite. Opening her Bible, she began the Lord’s Prayer:

“Our father who art in heaven, hallowed be thy name. Thy kingdom come, thy will be done . . . “

As family, nurses and doctors recited the prayer, the reverend concluded with the ceremonial dash of water upon the baby’s forehead. He died minutes later.

Scott retreated to a private hospital room with the family. The nurses brought in the baby’s body, clothed and wrapped in blankets. Picking up the baby from its basket, the mother wept; she passed the body to the grandmother, who began to cry as well. Unable to bear the sight, the family placed the baby back in the basket. Susan looked on, unable to comprehend the Spanish between the sobs, and was caught up in her own thoughts as she focused on the baby’s face. And in that moment, she was no longer in the room.

It was 1959, and she was a 9-year-old girl at a funeral home in Delaware. Her brother Michael had died before she had ever known him. He was seven months old.
Viewing the body in its casket only five feet away, Susan clung to her grandmother as she listened to the priest’s service. She could only understand the basics. She knew that her brother had been born with dysfunctional intestines while her family was living on a U.S. Army base in Rome. Her father, a sergeant, had spent the greater part of the year shuttling Michael and her mother back and forth from the hospital, sometimes having to fly to stations in Germany to find better doctors and treatment.

The oldest of four children, Susan had seen little of her baby brother and had often talked to a nun at her Catholic school about her troubles at home. There wasn’t much else she could do.

With Michael’s condition deteriorating, her parents decided it would be best that the family return to the States. Boarding a military plane with her father and the rest of her siblings, she arrived earlier than her mother and brother’s flight, and waited anxiously for their plane to land.

Her brother never made it. He died over the Atlantic.

Looking back, Susan often tells this flashback to new volunteers of No One Dies Alone to explain how the smallest things can trigger the memories of death or traumatic experiences. She tells her volunteers that death isn’t something that should be dwelled upon, but rather part of the process of life. In her line of work, it’s the only way to find closure.

Yet, in those long nights sitting next to the bedsides of her patients, she cannot help but think about Michael.

“For me, it’s also about accepting that death is a reality in life,” she said. “Sometimes, when I’m sitting with someone and they’re very quiet and I’m sort of in my own thoughts as I watch them, I will think about that someday when I will be the one in the bed.”
_____

It takes time for people to realize that death is just a part of life. Some people never come to this understanding. Others simply don’t want to. For Susan Scott, who has lost count of the number of sick and dying she’s sat with, it’s what has allowed her to shoulder the burden that comes with being at the hospital day after day of signing death certificates.

She’s hoped to establish this understanding with her volunteers, but it has never been that easy. Susan’s volunteers are normal people with normal jobs, who have dedicated two hours of their time to deal with something that defines her profession.

Heida’s attempts to reach this understanding are founded on her belief that death is just a transition. As a Catholic, she doesn’t view death as an end, and that’s what’s allowed her to step into the hospital room when she gets the call.

“It would be nice to think that you have loved ones waiting for you and a lot of people do believe that,” she said. “You will frequently hear people say ‘I get to go see Mom and Dad again. I’ll be with my brother again.’”

There is a fine line in handling religious matters in No One Dies Alone. The program prides itself on being non-religious and non-proselytizing, and its patients come from many different faiths. Volunteers are constantly advised to avoid religious conversation, unless prompted by the patient, and to defer any religious questions to the overseeing chaplains.

But religion still plays a large part in the lives of those involved. Susan Scott is not only the decedent care chaplain, but also a Lutheran reverend and handles patients for spiritual care specific to that faith. For Heida and Penny Barrett, religion has provided a means of processing their individual experiences in the program.

Heida frequently referred to her involvement with the program as “a calling,” spurred on by her Catholicism and the memory of her father’s death. Penny, a Christian Scientist, maintained that religion helped define her perception of patients. “From a doctor’s perspective, yes, they are sick,” she explained. “But from my perspective, it’s a hospital filled with God’s children, and I view that as my job to make sure that I maintain that. I don’t think I could have done this for eight years if I viewed them as sick, broken people.”

Not everyone can step into that hospital room. Even fewer can step out, accept what they’ve experienced and move on. It all comes down to the perception of death. While Heida has sat with four different patients in No One Dies Alone, she hasn’t yet fully made the connection that death is just a process of life. But every time she steps in the room, she’s getting a little closer to this realization. And it’s her religion that’s helping get her there.

“For me, to think that this is it,” she said. “It’s too unbearable . . . I think a lot of people, especially people of faith, spend their whole lives preparing themselves and behaving in ways so that there is something more.”

Do you think there is something there after death?

“I hope so; that would be wonderful.”
_____

Today, the No One Dies Alone Program has 70 active volunteers. Yet, there have been even more who signed up and attended the volunteer orientation sessions, before realizing that it’s just not for them.

“No, not everyone can become a volunteer,” said Sandra Clarke. “Everyone has to find their level of comfort. Volunteers wanted to get involved, but they couldn’t do it.”

Jim Chan still has yet to sign up for a shift, citing a lack of time and some communication problems. Jim Bowman, on the other hand, couldn’t come to terms with the religious restrictions put on volunteers. “The program is run by a chaplaincy, but it’s a very secular program,” he said. “I can’t even go in and say, ‘My name is David Bowman, and I’m here to be with you,’ and I can’t say I’m a retired clergyperson, and I can’t introduce myself as a minister.

“I wouldn’t want to impose, but I would like to be freer to use my own good judgment,” he added. “I want to emphasize that I think it’s a good program — it’s just not my cup of tea.”

Of course, many volunteers have stayed. Penny has had a lifetime of volunteering, and despite initial doubts about the program, she has cherished every session with patients. Heida, motivated by her own personal experience on her first shift with Peter Pan Lady, sees herself doing this for a very, very long time.

Heida dug around for the prayer book in her pre-packed program bag with one eye on Peter Pan Lady. With the harp player gone, she needed something appropriate to read to her patient. Locating the book at the bottom of the bag, she picked it up and began thumbing through it for Old Testament prayers. “Stick to the Psalms,” she was advised by the previous shift’s volunteer. “She’s Jewish.”

As 5 o’clock rolled around, she continued to read from the book, picking and choosing small passages. With the next volunteer, Repeka Iemeria, waiting outside, Heida finished Psalm 73 and bid Peter Pan Lady a warm farewell.

But she didn’t leave immediately. She helped get Repeka settled, explaining what could be read, what music should be played and how best to comfort the patient. Yet, looking back at Peter Pan Lady, she noticed something was different: The woman’s chest no longer rose as when she was softly breathing. “You know what — ,” Heida said, “I don’t think she’s alive anymore.”

Heida quickly retrieved a doctor and waited with Repeka as he searched for a heartbeat. When the doctor was sure, he turned to the women and looked at them sternly. “She’s not here anymore,” he said.

Despite the preparation and the knowledge that these people would die, Peter Pan Lady’s death still came as a shock to Heida. No training could completely shield her from the emotions of death. “It was disbelief, I think, because in my head, I had committed to being a part of the program for a long time,” she said reflecting on the experience. “I knew eventually that I would be with someone that would die. But I did not expect it to happen the first time.”

Leaving the hospital room with tears in her eyes, Heida made the long walk down to the hospital basement and the Spiritual Care Offices. Fittingly, in those moments after the death, Heida was never alone, accompanied by Repeka as she cried and held prayers. But these weren’t tears of sadness or grief.

This program is Heida’s calling, and she believes that she’ll be there for many other dying patients as they close their eyes for the last time. Hopefully those experiences will be as moving as her first.

“It was beautiful,” she said. “Everything went right.”

— Part one ran in yesterday’s issue of The Daily.

On a Sunday afternoon, Heida Earnest sank into her living room couch at her home in Mountain View, Calif., counting down the days when she would see her father again.

She remembered the last time she saw him, in April at Gulfside Regional Hospice in Florida, fixed to his hospital bed with his muscles eaten away. At 79 years old, he could barely speak, but he was still awake and alert.

It was late June now, and in two days, she would be back at his bedside. She and her husband, Ian, had already booked their plane tickets, and she had scheduled a few days off from work.

But Heida and her husband never boarded their Tuesday flight.

The shrill ring of the telephone pierced the afternoon silence. Heida picked up, and a nurse from her father’s hospice quickly identified herself.

“It’s your dad,” said the nurse. “He wants to talk to you.”

Heida was immediately concerned, wondering why this nurse was talking for her dad, especially after holding a seemingly normal conversation with him the day before.

“Hello, Dad?” she said.
No response.

“Dad, hang on,” Heida said. “Ian and I will be there on Tuesday.”

Again, nothing.

“Everything’s going to be O.K.,” she finished. “I love you.”

The rustling and crackling of the phone on the other side interrupted the conversation.

“Your father just passed,” the nurse said and hung up, leaving Heida to the monotonous dial tone.

She sat on her couch perplexed and, after waiting 10 minutes, called back.

“This is James Hall’s daughter,” Heida said calmly. “Did he just die?”

“Yes, he did, and he heard your voice,” the nurse responded. “Your voice was the last thing he heard.”

A year and a half later, sitting in the basement offices of Stanford Hospital’s Spiritual Care Services, Heida Earnest still finds that call hard to accept. She is a soft-spoken woman with large, bright eyes. As she speaks, her voice barely rises above a whisper, and she pauses occasionally to collect herself.

“It’s a funny kind of a thing, because in your mind you know it’s coming,” she said. “You know it’s coming, but when it happens, it’s always disbelief. It’s very strange.”

After she hung up the phone, it took a few hours for the pain to hit. Then it came in waves — an “unbelievably profound sadness.” Still, she is thankful she was able to talk to her father in his last moments and that he was not alone, but surrounded by nurses and doctors.

At Stanford Hospital, 600 to 700 people die every year. Of those, about five percent die alone — some 40 people left to face death in their hospital beds by themselves.

Sometimes, they are the sick and elderly who no longer have families. Other times, they are like Heida’s father — patients whose families are in some other part of the country and can’t make it to their loved ones in time. Whatever the reason, the patients are left in the care of the hospital, where the hustle and bustle of staff duties can prevent someone from being at their bedside at all times.

So, when Heida uncovered a binder with a new program in the Spiritual Care offices last February, she was immediately intrigued. “No One Dies Alone,” she read, flipping through the hodgepodge of papers on “the dying process” and “providing a caring presence.”

She asked the Reverend Susan Scott, the decedent care chaplain, what it was all about. No One Dies Alone would be a volunteer program launched by Spiritual Care Services in April, she was told, to provide company for patients who didn’t want to face the end of their lives alone. Heida joined immediately.

In the same binder that Heida found on Reverend Scott’s desk was “The Dying Person’s Bill of Rights.” Created by a Michigan nurse more than 30 years ago, it outlines 16 rights that an individual should be afforded while dying. Right #7, printed in bold, is the foundation of Stanford’s new volunteer program: “I have the right not to die alone.”

This idea sat in the back of Sandra Clarke’s mind for 16 years, after she left the side of a dying man as a nurse at Sacred Heart Hospital in Eugene, Ore. The man had asked her to sit with him in the Intensive Care Unit in his last moments, and she promised him that she would, just as soon as she finished checking on other patients. He died before she returned an hour and a half later.

Now retired, Sandra remembers the burden she carried after that night in 1986.

“He asked for dignity and respect . . . and the simple fact that a nurse on duty could not be there for him — I thought this was just wrong,” she said.“If he had needed machines or medication, that would have happened.”

She vowed to ensure that this same situation would never happen again, and in 2001, she launched the first No One Dies Alone program with Sacred Heart. From the start, Sandra never intended the program to provide medical attention to its patients. Instead, she focused on the basic human needs of individual patients, with care as simple as waiting at the bedside or providing a hand to hold.

After establishing the first No One Dies Alone organization, Sandra developed an extensive manual, teaching other hospital staffs how to start programs of their own. She did not copyright the material and name in order to allow for open dissemination, and she has shipped more than 1,500 copies around the world — from Alaska to France to Singapore.

Seven years later, a copy found its way into the hands of Susan Scott. After receiving approval and structuring a program around Clarke’s manual, Scott began Stanford Hospital’s No One Dies Alone program in April.

No One Dies Alone volunteers are strictly on call — they sign up for two-hour shifts in which they are available during the week and are only called if the program receives a patient. Heida signed up for any open 3 p.m. shift on weekdays, so that if she were called, she could make her way to the hospital quickly from her job at Stanford’s medical library. She didn’t expect that she would be phoned within weeks of signing up.

On a late April afternoon, she entered a first-floor hospital room to find a woman, eyes shut, propped up in a hospital bed. Light flowed in through an open window, basking her in a warm light as she lay peacefully. A woman singing and playing a Celtic harp accompanied the patient.

Heida placed down her things, including a program-provided bag filled with poetry books and a music player, and glanced at the patient with whom she would be spending the next two hours. Remembering her training, Heida introduced herself even though the patient kept her eyes closed — she never opened them in those two hours.

Penny Barrett, a long-time volunteer with Spiritual Care Services, had sat with the patient some eight hours before Heida on the inaugural shift of the program, and had given the woman a nickname.

“There was nothing scary about it, the patient had a great sense of peace and innocence and there was a childlike characteristic for a person in her 90s,” Barrett said. “Her hair was short and . . . I thought of Peter Pan.”

Gathering herself, Heida read through Peter Pan Lady’s files, reciting her name and diagnosis. There was nobody in the area to look after her because her family lived on the East Coast.

Heida sat in a bedside chair next to the woman and clasped the woman’s hand in her own. As doctors moved in an out of the room, and the Celtic harp player left for other duties, Heida remained the one constant.

Since Peter Pan Lady, Heida has sat with three other patients, each with a unique nickname and experience.  There was Mr. Verbal, a man transitioning to hospice care, who couldn’t stop talking — a rarity given that most of the patients in the program no longer have the capacity to speak.

An atheist, Mr. Verbal questioned Heida, a devout Catholic, about her religion. He wanted to know where she had traveled and what she did for a living. But their conversations were broken by bouts of sleep that overcame the patient.

“I don’t know why I keep falling asleep the way I do,” he said before nodding off.

Then there was Thirsty Woman, hospitalized in Stanford’s ICU. Heida spent two hours with her on a Saturday night holding a pink sponge that she used to soak in water and dab the mouth of the patient. Thirsty Woman could barely speak.

“For the whole time, I just gave her water,” Heida said. “She just drank and drank and drank.”

Her most recent patient was Big Man, an unresponsive man suffering from heart disease. She spent most of that time working with a new volunteer who had just joined the program.

It’s been a month since Heida sat with her last patient, and she doesn’t often think about any of the patients she’s been with. The volunteers are not expected to dwell on the subject of their previous patient’s conditions and are not usually notified if a patient they had been with has died on a later shift. Despite the intimate nature of the program, volunteers are expected to maintain a certain emotional distance from their patients, especially after leaving the room.

But by sitting with fellow human beings in their last moments of life, how could one not develop a personal connection to the dying? Isn’t there at least a sense of wanting to know? Heida only heard of Thirsty Woman’s death through Reverend Scott.

When asked if she knew whether Mr. Verbal or Big Man had died, she whispered, “I don’t know.”

— Part two will run in tomorrow’s issue of The Daily.

In a series of long and embittered fights in the Florida court system, a judge’s recent ruling may prove vital for smokers’ lawsuits against the tobacco industry. Yet for a Stanford professor who has been at the center of more than one case against big tobacco, the decision may have greater implications in preserving his work and academic freedom.

Last month, in the case of Castleman v. R.J. Reynolds Co., Judge Charles Mitchell of the Fourth Judicial Circuit Court in Duval County ruled that Prof. Robert Proctor, a key witness for the plaintiffs, did not have to turn over a manuscript of his unpublished book to R.J. Reynolds’ lawyers for the purpose of cross-examination. Proctor, who has appeared as an expert witness in lawsuits against tobacco companies since 1995, is only one of two historians to regularly testify against the industry.

However, this ruling reveals a number of legal disparities and uncertainties, as a judge presiding over an earlier case — Koballa v. Philip Morris U.S.A. — had come to the exact opposite conclusion: In October, Seventh District Court Judge William A. Parsons approved defense lawyers’ requests for a subpoena of the professor’s unfinished work, entitled “Golden Holocaust: A History of Global Tobacco.”

At the time of that decision, the plaintiffs immediately reacted, arguing that a court-backed seizure of any unpublished work was a direct violation of First Amendment rights. Developing an argument against a ruling that they believed would have a “chilling effect on academia,” Proctor and a team of lawyers filed a motion to block the subpoena.

The University also filed an amicus curae brief in support of Proctor’s motion, the first time it has ever done so to protect a professor’s unpublished research.

“For them to have access to notes before they are finished impairs ability to conduct research,” Proctor told The Daily for an earlier article.

The decision in Castleman, however, will give some support to the professor’s arguments. And while it is still uncertain how the recent Fourth Circuit decision will apply to other smoking lawsuits, Proctor and representatives of the plaintiffs claim it is a step forward in their cases against a multi-billion dollar industry.

“It is a big victory for academic freedom, but it remains to be seen how it will be applied in other counties… and how this argument is carried over in other cases,” Proctor said. “I’m hoping it will establish a certain protection for these manuscripts.”

Florida up in smoke

The case of Castleman v. R.J. Reynolds Co. is just one of hundreds of Florida smoker lawsuits that Prof. Proctor could become embroiled in. Even he has lost count.

“It’s all confused in my mind, with the same defendants in every case making this argument,” he said of the lawsuits he’s currently involved in. “It’s several [cases] — I don’t know how many.”

In the Sunshine State, these individual lawsuits brought against big tobacco are the result of a 1994 class action lawsuit, Engle v. R.J. Reynolds Tobacco Co.. Arguing that the industry had knowingly sold a product that caused injury to consumers, former smoker and pediatrician Howard Engle sued on behalf of more than 500,000 state smokers for punitive damages of nearly $145 billion.

While the case was originally decided in favor of the plaintiffs, higher state appeals courts later overturned the decision on the basis that the state smokers were too dissimilar to constitute a class for a class action lawsuit. The Florida Supreme Court, however, ruled that smokers could try their cases on an individual basis.

This has prompted the emergence of thousands of tobacco lawsuits, known as “Engle Progeny,” the first of which are coming to a head now.

“There are 8,000 potential plaintiffs that have to be tried one by one,” Proctor said. “I testified in the very first Engle case in December of 2008, and ever since then, I’ve been called in a couple of other cases.”

Since September, nine Engle cases have been tried with seven judgments in favor of smokers and their families, and the others ruled for the tobacco industry.

“We thank the jury for taking the time to consider all of the evidence presented and for making the right decision,” said J. Jeffery Raborn, vice president and assistant general counsel for R.J. Reynolds, in a statement following a March 2009 ruling for big tobacco. “Their verdict demonstrates that despite the flawed decision of the Florida Supreme Court to allow these cases to proceed in this fashion, we have strong defenses to them, and we will continue to defend ourselves vigorously.”

Proctor and the ‘Engle Progeny’

As Engle cases begin to materialize 15 years after the original lawsuit, Prof. Proctor can expect to be more heavily involved in tobacco lawsuits.

Attorney C.K. Hoffler, who represents the plaintiffs in Castleman, stated that her law firm will pursue 420 other smoking cases in the state. She hopes to use the professor’s statements in each of these lawsuits.

“Dr. Proctor is testifying as an expert,” she said. “He will be giving generic testimony that is not case-specific.”

Proctor and lawyers for the plaintiffs can take confidence in the Fourth District Court’s ruling in Castleman, which prevents the professor from turning over his work, and allows him to testify freely as a witness in the case.

“Hopefully [other counties] will follow suit and will deny the disingenuous attempts [of tobacco companies],” Hoffler said. “Other judges, if it comes up in other counties, may follow suit or may make their own ruling.”

Yet, as confirmed by Hoffler, the issue surrounding the subpoena is by no means settled, and, according to lawyer Bill Ogle, will remain a point of contention in Florida smoking cases.

“There are tobacco cases that are spread throughout the different counties, and the issue will probably come up again and again and again,” he said. “Tobacco companies could raise it again in another court system and could be decided by appellate courts, the Florida Supreme Court, then the U.S. Supreme Court. These are constitutional issues.”

It was a homecoming of sorts Sunday night for the men’s soccer team at UC-Irvine’s Anteater Stadium. Six of Stanford’s 11 starters—juniors Dominique Yahyavi, Garrett Gunther, Cameron Lamming, Ryan Thomas, Shaun Culver and senior goalkeeper John Moore—plied their trade on the soccer complex surrounding the stadium in the club leagues of Southern California before heading to the Farm.

With so many players familiar with the area, it was no surprise that plenty of Stanford fans made their way out to the second round NCAA tournament contest. Parents, relatives and curious spectators packed the north end of the stadium, as chants of “Go Stanford” overpowered any noise from UCI fans.

Despite the comforts of “home,” however, it took the individual brilliance of a player with ties closer to the Bay Area to settle the game. In the 35th minute, junior Daniel Leon received the ball, and after a few adept touches, rifled the ball into the top corner to take Stanford (11-5-2, 4-4-2 Pac-10, 1-0 NCAA) to the third round of the tournament.

For 16th seed UCI (15-6-0-, 6-4- Big West, 1-1 NCAA), the result will be a bitter loss to swallow after piling a great deal of pressure on the Cardinal defense in a particularly tense second half. Despite this, the away team proved particularly resilient holding on to preserve Moore’s second shutout of the tournament.

On a cold night in Orange County, the game was nervy from the start. With both teams employing a five-man midfield, the middle of the park was especially congested. UCI found some early joy with senior Irving Garcia pulling the strings to carve out two clear-cut chances on the left hand side for the Anteaters.

As Stanford struggled to keep the ball, UCI continued to run at the Cardinal defense from the left flank, forcing senior Michael Strickland to perform a particularly warm-blooded challenge, earning the midfielder the game’s first and only yellow in the 10th minute. The card, to the contrary, seemed to settle Cardinal nerves, and soon fans began to witness some of the slick passing that they had been accustomed to.

The first real chance for the away team came through forward Adam Jahn, as a cross skipped into his path after some quick exchange on the left wing. However, the freshman disappointingly screwed his shot over the bar as the chance went begging.

The introduction of Leon as well as freshman forward and Irvine native Dersu Abolfathi halfway through the first period seemed to breathe some much-needed creativity to the Stanford offense. Coach Bret Simon’s move paid dividends 10 minutes later, as Leon scored perhaps the most important goal of his career, which later proved to be the match winner. And despite a late scare off a long throw, the Cardinal went into the break with the one-goal advantage.

Following half-time, UCI came out with clear attacking intent immediately throwing on a second forward and pressing into Stanford’s half. Clearly on defensive orders, the away team were content to absorb pressure and hit on the counter, as centerbacks junior Bobby Warshaw and Culver marshaled the defense. As each Anteater attack was broken, the ball was hoofed up to Jahn, with one effort proving particularly fruitful as he was able to break free of his marker and force a save out of the UCI goalkeeper.

As the minutes ticked down, the home team threw everything at the Stanford goal. Opposing forward Amani Walker proved particularly menacing as he produced a series of towering headers toward goal and had a goal-bound volley saved by a full-stretch Moore. This proved to be UCI’s best chance, with the Cardinal sniffing out every threat to preserve the team’s ninth shutout of the year.

With cheers erupting from the boisterous away crowd as the referee’s watch hit 0:00, the players embraced and will not look forward to next Sunday’s date with number-one seed University of Akron, who are currently enjoying a perfect 21-0-0 season.

If the Cardinal is able to prove the spoilers to Akron’s undefeated season, they will face the winner of Tulsa and Northwestern in the tournament quarterfinals.