Betty Hiatt's morning wake-up call comes with the purr and persistent kneading of the cat atop her bedspread. Under suburban Seattle's drizzly predawn gray, Hiatt blinks awake. It is 6 a.m., and Kato, an opinionated Siamese, wants to be fed. Reaching for a cane, the frail and unsteady grandmother gingerly rises to start her morning routine. With uncertain steps she pads to the tiny alcove kitchen in the tidy two-room granny flat, past the photos of two beaming granddaughters still asleep in the adjacent house. Her feline alarm clock gets his grub, then Hiatt turns to her own needs.

At 81, Hiatt is at once a medical train wreck and a miracle. Diagnosed with breast cancer a few years ago, she survived chemotherapy and a double mastectomy. Crohn's disease has left her digestive system bedeviled at every meal and her diminutive frame twig thin. She has high blood pressure and has suffered a series of small strokes. Doctors recently delivered more bad news; Hiatt has the onset of Parkinson's disease.

Inside an upper cabinet, just below the china plates, a horde of prescription drugs crowd the shelf. Hiatt takes a dozen pills every morning. But first she turns to a non-prescription drug on the shelf. Inside one of the translucent orange pill bottles are a half-dozen marijuana cigarettes. Peering through owlish glasses, Hiatt plucks out a joint, nearly as fat as a child's crayon. She fires it up with a wood-stem match, and sucks the cannabis smoke deep into her lungs. After a few contemplative seconds, she blows out a cumulus of unmistakable fragrance. The little apartment - a cozy, grandmotherly place of knickknacks and needlepoint - begins to smell like a rock concert.

A native of Chattanooga Tennessee, Hiatt spent her adult life rearing two sons and following her husband, a mass transit designer, around the nation and the globe. A self-described straight arrow whose most serious intoxicant was a rare cocktail, she never envisioned turning to pot for any reason, never gave it a thought. When her oncologist recommended marijuana, legal for medical purposes in the state of Washington, "I thought he was a little off track," she recalls. "I had never done anything like that." The first time she tried it, "I was very uneasy," Hiatt says. But it quelled the nauseating effects of chemotherapy and her prescription drugs, relaxed her stomach and restored her appetite.

Hiatt's oldest son, Doug, whose family she lives with, serves as her legal caregiver, picking up the medical pot every few weeks from a couple of dispensaries that serve patients in Seattle. But while Doug, a criminal defense attorney, endorses his mother's use of cannabis, Hiatt's other son, Dan an assistant district attorney in Atlanta, doesn't approve of her treatment. When he first learned about it, he was shocked to discover that she was seeking relief from a drug that has landed many a dealer and doper behind bars. (Dan Hiatt declined to be interviewed for this article.)

Still, Dan has never tried to talk her out of smoking medical pot. "He knows I wouldn.t be doing it for fun." She gazes over at Kato the cat, skulking nearby. "I don't know that I'd be alive without it."

Betty Hiatt is far from alone. Long an emblem of the counterculture '60s, marijuana remains an illegal recreational drug in all 50 states. But the leafy herb has sprouted a new face in recent years - as a natural remedy that, if its advocates are to be believed, is good for much of what ails us - and thousands of Americans have embraced pot at their doctor.s recommendation in hopes of overcoming an array of ailments, among them many of the serious afflictions that accompany growing older.

Doctors recommend marijuana to blunt the nausea of cancer chemotherapy, to ease the pain and spasms accompanying multiple sclerosis, to relieve the blinding eye pressure caused by glaucoma. Pot is also used to treat arthritis pain and migraine headaches. In AIDS paitents, the drug helps restore appetite and combat the nausea of HIV drugs. Though the jury is still out, a few researchers believe pot shows promise for lupus, Parkinson's, Huntington's and Lou Gehrig's disease.

Meanwhile, popular support for legalizing medical marijuana continues to grow. This past November, voters made Montana the tenth state to legalize medical marijuana, joining Alaska, California, Colorado, Hawaii, Maine, Nevada, Oregon, Vermont, and Washington. Arizona and several others already have symbolic medical marijuana laws. (In Arizona.s case, the law is symbolic inasmuch as it allows physicians to prescribe marijuana, not "recommend" it as in other states with legal medical marijuana. Since federal law prohibits prescribing marijuana, doctors in Arizona do not bother to do so out of fear of professional repercussions.) Maryland limits the penalty for patients who can establish that their marijuana use is a medical necessity to a $100 fine. The New England Journal of Medicine published an editorial in favor of allowing medical marijuana for the seriously ill. The American Academy of Family Physicians and the American Nurses Association support a doctor.s right to recommend it, while the American Medical Associations backs aggressive research into its uses. Several national church groups - including the United Methodist Church, the Presbyterian Church and the United Church of Christ - support pot for serious illnesses.

Advocates include TV talk show host Montel Williams, who uses cannabis to assuage the effects of MS, as well as such eminent conservatives as William F. Buckley Jr., George Shultz and economist Milton Friedman. And apparently a bit percent of the nation agrees: in an exclusive AARP The Magazine poll, 72% of respondents agreed that adults should be allowed to legally use medical marijuana if a physician recommends it.

But despite the pressure, U.S. officials refuse to back off a firm federal ban. Marijuana remains categorized, along with heroin and LSD, as a Schedule I drug deemed dangerous, with a high potential for abuse and bereft of medicinal value. And in the years since California approved medial marijuana, the federal response has been uncompromising. Drug agents have conducted raids and made arrests, shut down dispensaries and cooperatives that distributed the drug and put professed medicinal growers behind bars.

After years of jousting, the legal war between medicinal backers and their federal foes is being fought in the Supreme Court. The nation.s highest court has already let stand a lower court ruling (Conant v. Walters) that allows physicians to discuss medical marijuana with patients. (Doctors don't prescribe cannabis because they risk losing their federal licenses to administer prescription drugs). And last November, the court heard oral arguments on a landmark case (Ashcroft v. Raich) that challenges the very constitutionality of the federal government's actions. A decision is expected by July.

For their part, federal drug warriors drub the movement as Cheech and Chong medicine, a Trojan horse for broader drug legalization. "The standard of simply feeling different or feeling better" does not make pot "a safe and efficacious medicine," said John Walters, director of the White House Office of National Drug Control Policy. People who use illegal drugs like crack and methamphetamine might feel better, he noted, "but that doesn't make crack medicine."

Merely feeling better isn't Hal Margolin's aim. He needs marijuana to make it through the day.

Margolin, 72, had a successful career as an entrepreneur, at one time running a firm that sold soft leather goods to Ann Taylor, Macy's and Bloomingdale's. A resident of the California beach town of Santa Cruz, he has served on the county grand jury, volunteered to teach English to migrant laborers and was a board member for a nonprofit community counseling center that runs drug treatment programs.

Margolin and his wife, Marcia, live in an upscale townhouse next to a leafy coastal creek. The only telltale signs that Margolin has a small but pivotal role in America's medical marijuana war: Two medicinal cannabis plants growing on an upstairs balcony, and his habit of pulling out a small pot pipe every hour or so in the afternoon.

Pain drove him to the drug. It began eight years ago, as the cervical vertebrae at the top of Margolin's back calcified, strangling a bundle of nerves and producing a searing sensation in his extremities. His feet, Margolin says, feel scalded by boiling water. Margolin tried to address the unrelenting agony the standard way, buying maxi-packs of Advil and Aleve. He was prescribed Neruontin for the pain, but couldn.t handle the side effects. An operation made things worse. He lost the feeling in his fingers and soles of his feet, and at times was reduced to crawling to the bathroom. Despite a prosperous retirement, a good marriage and two happy grown children, he contemplated suicide.

Margolin tried pot at the urging of a friend with AIDS. A few puffs and the pain seemed to recede to the background. "I felt I was no longer obsessing about it," he says. Eventually he heard about WAMM. A collective of about 250 patients who jointly harvest their own cannabis, the Wo/Men's Alliance for Medical Marijuana is regarded by local and state elected officials as perhaps California's most credible medical marijuana dispensary. It became Margolin's source.

One recent Saturday found him volunteering there, stuffing capsules with leafy cannabis. Patients consume the capsules, cook marijuana into foods, or drink it in a grainy mixture they dub mother's milk. Some, like Margolin, smoke it. Others vaporize the pot's active ingredients with a heat gun, saving their lungs from the worst of the carcinogenic smoke produced by burning the woody leaf.

A wall behind Margolin displays a sweeping collection of photographs . WAMM members who.ve died. Margolin scans the sea of faces, points to a couple dozen new additions just in the past year or so. These are people he got to know well, men and women who turned to cannabis to help them through life's final months. "Oh my," he murmurs.

His firm belief in the medicinal value of the plant nudged Margolin into the legal effort to alter the nation's pharmaceutical landscape.

On September 5, 2002, a couple dozen camouflage-garbed DEA agents with carbines raided WAMM's farm, ripped up 167 plants and arrested the collective's founders, Valerie and Mike Corral. Within days, WAMM made national headlines by ceremoniously distributing medical marijuana on the steps of City Hall to protest the raid. The hubbub of publicity seemed to help. Neither the Corrals, who were quickly released, nor any of WAMM.s bevy of elderly cancer survivors, MS patients, wheel-chair-bound paraplegics and other sick was charged with anything.

But the collective's members remained discontent over what all considered a federal intrusion into their lives and health. Joined by the city and county of Santa Cruz, the collective filed a lawsuit against Attorney General John Ashcroft and the U.S. government, seeking to block any future raids. Margolin is one of seven patients named as plaintiffs. Last April, the collective got a temporary ruling to grow its 2004 crop. But the legal battle remains far from over. The Justice Department has appealed, and the case might well end up before the U.S. Supreme Court.

Hal Margolin makes not secret how he sees it: This is not the government.s business. To him, marijuana is a Godsend, and the government ought to leave patients alone. "For me, personally, it's been the difference between clinical depression from the pain, and carrying on with my life."

John Walters, the president's point man for the war on drugs, is sympathetic to the suffering of people like Margolin. But as he beats the drum for psychotropic abstinence, the drug czar doesn't mince words about marijuana. He sees the whole movement as a misguided charade intended to legalize recreational marijuana.

Choreographing the charade, Walters maintains, are deep-pocketed advocates bent on liberalizing America's drug laws. "I don't think we should play dumb here," he says, referring to a trio of wealthy benefactors - billionaire New York financier George Soros, Ohio insurance magnate Peter Lewis, and John Sperling, founder of the University of Phoenix private school chain. They are "the real money behind campaigns for smoked marijuana," Walters says, and their largess has fueled a vanguard of pot activists who are cynically using "the suffering of others" to push a broader agenda. "This is not like growing a rose bush in your yard," Walters says. "This is a plant the products of which are used for serious and expensive abuse among illegal drugs."

In the highly regulated world of modern medicine, you simply don't smoke a medicine, he and other pot foes say. They claim there's no solid scientific proof - the sort of unassailable findings derived from intensive clinical studies - qualifying pot as medicine. Walters says he.s all for research: Any beneficial compounds that do exist in the leafy plant should be synthesized, sent through the rigors of the FDA-approval process and packaged as a pharmaceutical, not smoked like a recreational drug. Indeed, just such a legal medicine exists in Marinol, a synthetic pill form of marijuana's psychoactive ingredient, Delta-9 tetrahydrocannabinol or THC.

Advocates of medical marijuana recoil at any suggestion they're cynically manipulating the ill. While many believe marijuana should be fully legalized for all purposes, others oppose relaxing laws against recreational use. What they agree on is that America needs a saner drug policy, a more humane approach to medicinal relief for the sick and dying. If marijuana works, they say, let patients have it. Soros, the movement's deepest pocket, came to the medicinal cause out of a humanitarian belief, says Ethan Nadelmann, executive director of the Drug policy Alliance, a Soros-backed advocacy group. The billionaire's stance evolved over time, Nadelmann says, and Soros now supports making marijuana legal, but "subject to high taxation, tough regulations, and put off limits to minors." In medical marijuana, Soros sees "an intersection of sensible drug policy reform on one hand and a humanitarian approach to death and dying on the other."

Nadlemann and other advocates say federal prohibitionists conveniently ignore scores of studies that show pot's beneficial effects for the ill. They contend it represents a milder medicinal alternative to prescription drugs like OxyContin, the painkiller that talk-radio host Rush Limbaugh in drug rehab. Marinol, though legal, doesn't do the trick for some patients. The prescription synthetic leaves them in a stoned haze, whereas they can control pot's intoxicating effects by smoking it. In the joust over medical marijuana, the elderly have come to play a potent role on the public stage. "There's this sense that when you get old enough, you've earned the right to live your own life," Nadelmann says. "The mantra of the drug war has been to protect our kids. But the notion of a drug war to protect the elderly? That.s ludicrous."

Irvin Rosenfeld knows what keeps him out of pain - the copious amounts of marijuana he smokes each and every day. But his is the rare case where the federal government grudgingly goes along. For a quarter century the U.S. has provided marijuana grown on a University of Mississippi farm to Rosenfeld and a tiny sampling of other seriously ill people participating in an FDA Investigational new drug program. The effort was shut to new entries in the early 1990s, just as a flood of AIDS paitents sought entry. Rosenfeld and a half dozen others are all that remain on the rolls. It is, he jokes, the nation's most exclusive club aside from living ex-presidents.

A 52 year-old stockbroker in Fort Lauderdale, Florida, Rosenfeld smokes a dozen marijuana cigarettes a day to ease searing pain from a rare bone disorder called multiple congenital cartilaginous exostosis. The disease, diagnosed when he was 10, causes bony protrusions to grow like cattle prods into his muscles. To blunt the pain, Rosenfeld in the early years would take a bevy of prescription drugs - morphine, Valium and other painkillers. But they left him zonked and unproductive. Doctors told Rosenfeld he might not live beyond his teens. Tortured by pain, he had to be home-schooled and give up sports. He discovered marijuana's medicinal benefits by accident. Zealously opposed to drugs, he caved in to peer pressure and tried it at age 18. He didn't get high like everyone else. But the merciless agony, the constant companion each day of his life, was eased.

It took him a decade of fighting - including a lawsuit against the U.S. Food and Drug Administration and an impassioned presentation before a panel of 20 physicians - to win federal permission in 1982 to smoke pot. Cannabis is now almost exclusively his only medication. The government marijuana, 300 freeze-dried cannabis cigarettes packed in a tin container, is shipped every 25 days to a local pharmacy where Rosenfeld picks it up. He gets no euphoric effect, he says. An exhaustive study at the University of Montana a few years ago determined that all the cannabis smoke hasn't compromised his overall health. Ant the pot doesn't hamper his brainpower or gumption. "I wish I had 50 of him," says Charles Brown, Rosenfeld's former manager.

Rosenfeld often hits the road in his dogged push to crack federal resistance to medical marijuana for the masses. Like a Johnny Appleseed of medicinal pot, he travels to Washington and talks up members of Congress. With short hair, tailored suits and a feisty but friendly pitch, the stockbroker is hard for lawmakers to dismiss. This is not some misguided stoner. Capitol police, informed that Rosenfeld's joints are U.S. approved, look the other way.

But not everyone is so accommodating. Rosenfeld has filed lawsuits against two U.S. airlines: one refused to let him board with his stock of marijuana cigarettes; another required a letter from his doctor stating that he was coherent enough to follow instructions before they'd let him fly. It is the sort of skirmish he accepts, but wishes would disappear. "The DEA should not be the ones deciding medicine in this country," Rosenfeld concludes, "just like doctors shouldn't be deciding criminal laws."

Philip Denney, M.D., lives in fear that his abiding belief in the curative power of medical marijuana is going to cost him dearly. A physician in Southern California's suburban Orange County, Denney specializes in cannabis medicine, making recommendations to a parade of the chronically ill. His office, tucked in an otherwise innocuous strip mall beside a beauty parlor, belies the risk he has assumed, even in cannabis-friendly California.

Denney is one of as many as twenty doctors in California who specialize in making medical marijuana recommendations. That focus on a single controversial drug has made these physicians a target of the state Medical Board of California. Denney is one of the few "pot docs," as critics call them, who hasn't had investigators come calling. To date, the Medical Board has investigated eleven cannabis specialists, and several have seen their licenses threatened amid allegations they failed to properly screen patients and keep adequate records. Three physicians have been put on probation or seen their licenses temporarily suspended. Denney doesn't want that risk, and practices "as if every patient in my chair is a DEA agent." On average, he rejects on out of four patients who don't pass muster as legitimate cannabis patients. "I've gotten good at telling who is lying to me," he says.

Downsized by a Northern California hospital in 1999, he opted to focus on medical marijuana after a quarter century in traditional medicine - stints in family practice, the emergency room and occupational medicine. Marijuana's medical potential had long been a fascination, says Denney. And like other cannabis physicians, he can cite chapter and verse on the drug's tangled history.

Accounts of cannabis as medicine date to 2,700 BC and the reign of Shennong, the Chinese emperor also reputed to have brought the world tea. In the 1840s, Irish physician William B. O'Shaughnessy introduced cannabis to western medicine after witnessing its use in Calcutta. Queen Victoria turned to it for menstrual cramps at the suggestion of the court physician, and several pharmaceutical companies in the U.S. marketed 19th Century cannabis tinctures. But its role as a mainstream medicine faded with the 20th Century. In the 1930s the director of the Federal Bureau of Narcotics (the predecessor of the DEA) began railing against the perils of pot. Fears of "Reefer Madness" resonated, and by 1942 cannabis had been dropped from the U.S. list of approved drugs.

Despite the decision of the San Francisco-based Ninth Circuit Court of Appeals in the case of Conant v. Walters that guarded a physician's right to recommend pot to patients (let stand by the Supreme Court in October, 2003), many doctors shy away from the drug - even in states that legalized medicinal marijuana. Some physicians feel prescription drugs are better. Uncertainty lingers over key medical decisions like how to standardize dosages and ensure quality and gauge potency. Many are unfamiliar with pot's reputed benefits. Others simply don't believe it has any. And many retain a nagging fear that state medical regulators or the federal government, which hasn't been shy about cracking down on doctors who abuse pain prescriptions, might still swoop in.

So in places like California, the hottest front in the medpot war, patients end up flooding the offices of specialists like Denney. "There's this huge cadre of patients who would benefit from cannabis," Denney says, "yet their treating physician won.t talk to them about it."

Denney doesn't dispense marijuana, but he will direct patients to web sites that list cooperatives that do. His abiding advice: Find the most potent marijuana you can and smoke as little as possible to reduce your symptoms. The drug itself, he says, is remarkably safe. It is the delivery method - the carcinogenic burning cellulose of the leafy matter - that poses the potential for long-term harm.

To that end, he and many other true believers are eager for the arrival of new marijuana-based prescription drugs on the horizon. One such drug has been developed by GW Pharmaceuticals in Great Britain. Sativex, a liquid extract from marijuana, is sprayed under the tongue. The firm has seen encouraging results in clinical trials of MS patients and those with neuropathic pain using the spray, which is up for licensing approval in the UK and Canada.

U.S. officials, meanwhile, have quietly suggested they would welcome cannabis pharmaceuticals like Sativex, if they clear regulatory hurdles for safety and efficacy. Walters, the drug czar, said the cannabis spray is "promising". Aside form providing prescription relief, it could draw a line in the sand between true patients and those simply trying to get high. Drug activists counter that it will prove the larger point: That the plant itself is a legitimate medicine. Either way, it could make life easier for cops and patients. "I would hope to be one of the first to write a prescription for Sativex," Denney said. "All of a sudden cannabis will be divorced from dope-smoking hippies."

Keith Vines, 54, has dealt with marijuana from the perspective of both prosecutor and patient. As an assistant district attorney in San Francisco, he proudly handled one of the city.s largest marijuana busts. But as a gay man with AIDS, he has turned to the very same substance to provide relief from the insidious wasting effects of the virus.

Vines grew up in Groton, Connecticut, one of five siblings in a Roman Catholic family. A squared away guy, he took the straight road to become a captain in the Air Force. He married and fathered a son. But in the early 1980s Vines finally came to realize he was gay. After divorce, he left the military and moved to San Francisco (Vines remains close to his grown son). AIDS invaded his life in 1986. He lost his first partner to the disease and lived with what he calls "the shackle of shame" that can engulf those with the disease.

Vines talks about medical marijuana as another coming out, another step in confronting the truths in his life. He almost died in 1993, dropping 60 pounds to AIDS wasting form a 6-foot frame that normally carries close to 200. His doctor prescribed Marinol, but the synthetic THC knocked Vines into a haze for hours at a time. As an alternative, the physician suggested marijuana, noting that it offered the advantage of "titration," being able to draw the drug into the body a few puffs at a time. Vines, who didn't smoke the stuff, had no source. So he screwed up his courage and paid a visit to the San Francisco cannabis buyer's club, the birthplace of the medical marijuana movement, where he felt like "a fish out of water." Vines bought a small amount and got out as fast as he could. But the cannabis worked for him. His appetite increased, the nausea from his medications ebbed. He has smoked it now for a decade. Two or three puffs are usually enough, and only a few nights a week. He compares the "high" to a glass of wine, except it "gives me the munchies, the famous munchies," keeping weight on him.

With his square jaw and prosecutor resume, Vines was gobbled up as a perfect plaintiff in the lawsuit (Conant v. Walters) brought by doctors to ensure that their right to make recommendation. In 1999, he testified before Congress, spending 20 minutes in a House sub-committee inquiring about medical marijuana. When he was done, one of the Republican members approached and shook his hand, Vine recalls. "He said 'I'm really sorry about your situation.' He said, 'Sometimes it's just politics.'"

Now, Vines says he would love "to sit down with [drug czar] John Walters or the president, just close the door and talk to them."

Vines would tell them his pot smoking isn't about recreational pleasure. He would tell them about losing friends and losing weight until his ribs jutted out, about feeling fatigue and nausea and despair. He'd tell them about the latest chapter in his life: In early 2004, Vines went out on a catastrophic leave from the DA's office. Doctors concluded that AIDS had compromised his short-term memory. He hasn't been back to court since. He doesn't expect to ever return.

"For people sick like me, it's struggle enough," Vines says. His voice is wistful. It seems almost a lament. But then the tone turns. The old DA is back, the man with a purpose. "It's so unfortunate," he concludes, "that our own government has to spend so much on this drug war against the sick."