For Dennis Augustine, being named medical director of the Santa Clara Medical Marijuana Center in San Jose represents coming full circle from his youthful flirtation with crime and drug use in Hoboken, N.J.

He describes the city he grew up in as "a cross between `West Side Story' and `On the Waterfront.'" His words have a philosophical, sometimes whimsical bent. "I've come back to what I ran away from," he says.

The nonprofit SCCMCC dispenses marijuana — though it does not allow smoking on the premises — for patients whose doctors have prescribed it. Augustine says the center is the first in the nation to get a business license and special use permit since passage of California's Prop. 215, the compassionate use act, to grow, cultivate and operate a medicinal marijuana dispensary.

Affirming the use of marijuana to alleviate suffering is a healing experience for Augustine, a podiatric surgeon who admits to experimenting with marijuana use more than 16 years ago.

"I guess you could say my life has gone to pot again for more noble reasons than my previous self-indulgence." The fact that some of his old friends didn't live long enough to quit their drug use, he adds, deeply disturbed him. "I felt really impotent."

As a result, he got involved with the Aris Risk Reduction Project, a needle exchange program in the South Bay, and now, the SCCMMC.

Augustine connected with the center after reading a newspaper article about its founders, Peter Baez and Jesse Garcia, who both have life-threatening illnesses. Above the article, Augustine posted a note to himself: Help these guys.

Soon after, he was the fledgling center's medical director, a volunteer position. Baez and Garcia serve as the executive director and director, respectively.

Augustine, a former Catholic and now a Jew-by-choice, sees his commitment to volunteerism as his way of living out the Jewish commandment to do mitzvot.

He and wife Cecile, who is Jewish, are members of Congregation Shir Hadash in Los Gatos and are raising their three children as Jews. "I like the idea of being able to question everybody, even God," Augustine says. "In other traditions the answers were static."

Shir Hadash Rabbi Melanie Aron welcomes the medical community paying more attention to pain management. "I think nausea can be very debilitating and can very negatively influence people's feelings about themselves, their future and their ability to function in their families," she says. Marijuana is said to be helpful in controlling nausea from chemotherapy and preventing wasting syndrome for AIDS patients, as well as providing relief to those with glaucoma.

Jewish law on the issue of medical marijuana is very clear, according to Rabbi Yehaia Familant, leader of an interfaith community in Palo Alto. He says the concept of taking medicine to relieve pain has been accepted within Judaism, "as long as it isn't detrimental."

Familant says this ethic comes from the Talmud (Kiddushim, 21B), where the rabbis decided that it was OK to apply an anesthetic when piercing the ears of indentured servants. "Although there is the danger of abuse, the belief is it's better to err in that direction than withholding the medication and causing undue suffering," he says.

It was suffering of a different kind that led Augustine to quit his practice in 1989 at the age of 39. Already burdened by emotional stress and job burnout, his back went out in April 1987. When his hand was injured a year to the date later, he saw it as a message. "I looked at all of those things as a kind of symbolic language telling me I needed to re-evaluate my life."

Augustine's injuries gave him a profoundly different perspective. "As a doctor or a surgeon you keep a professional distance. If you're in the same shoes as another person it brings you to a whole new level of humanity."

Augustine pursued volunteering and creative endeavors like writing haiku poetry and playing the saxophone. "All the things that get snuffed out when we're chasing careers," he says. "We don't even stop for the Sabbath. People always ask me, `Don't you miss being a healer?' I'm a healer through volunteering, writing."

He has written about his spiritual experiences in an autobiography, "Gifts from Spirit: A Skeptic's Path." In it he drew a great deal from Jewish wisdom, including Martin Buber, Albert Einstein, Elie Wiesel, Rabbi Harold Kushner and Victor Frankl. Proceeds from book sales will benefit the marijuana center.

In "Gifts from Spirit" Augustine also has an imaginary dialogue between himself and Hippocrates, who, he says, would have prescribed marijuana. "The first tenet of the Hippocratic oath is `Do no harm.' There's never been any toxic overdose from marijuana. Prescribing medical marijuana is certainly a better alternative to a visit to Jack Kevorkian."