Qing McGaha Sentencing Memo

1. UNITED STATES DISTRICT COURT
MIDDLE DISTRICT OF FLORIDA
TAMPA DIVISION
UNITED STATES OF AMERICA,
v.
QING MCGAHA,
Defendant.
8:22-cr-2-CEH-AEP
SENTENCING MEMORANDUM ON BEHALF OF QING MCGAHA
Dated: October 7, 2023
Spodek Law Group PC
By: /s/ Todd Spodek
Todd Spodek
Spodek Law Group PC
85 Broadway, 30th Floor
New York, NY 10004
(212) 300-5196
ts@spodeklawgroup.com
Attorneys for Defendant
Qing McGaha

2. 1
18 U.S.C. Section 3553(a) “requires a court to take account of
a defendant’s character in imposing sentence. And how could
it be otherwise, for on this day of judgment, must not one judge
the man as a whole?”1
I. PRELIMINARY STATEMENT
Defendant Qing McGaha respectfully submits this memorandum in
anticipation of her sentencing, unveiling a life narrative intricately woven with
silent, enduring struggles and a tumultuous past that has significantly shaped her
sensitivity to the pain of others. Qing's life journey is a tapestry of pain and
resilience, marked by a childhood fraught with severe abuse and unyielding
expectations, leading her to develop an acute sensitivity to the suffering of others.
This heightened sensitivity, while a testament to her empathetic nature,
inadvertently nudged her towards making the decisions she profoundly regrets
today.
Qing’s journey has been a relentless pursuit of healing and redemption
amidst life’s relentless pressures, from striving for academic excellence to
establishing a medical practice and shouldering the responsibilities of motherhood.
Each phase of her life subtly, yet inevitably, pushed her towards the edge, with the
burdens of untreated depression and the emotional turmoil of a failed marriage
further clouding her judgment.
1
United States v. Gupta, 904 F.Supp.2d 349, 354 (S.D.N.Y. 2012).

3. 2
As she stands before Your Honor, Qing represents a spirit that has navigated
through dark and shadowy valleys, seeking legal, emotional, and psychological
closure. Her plea extends beyond the call for leniency; it is a heartfelt request for
understanding and compassion, an acknowledgment of a life spent grappling with
invisible chains, and a beacon of hope for a future where she can positively impact
the lives of her family, her loving and dependent patients, and community.
Qing’s life narrative is a poignant tale marked by hardships and relentless
efforts to surmount them. Raised in a tumultuous household characterized by
domestic abuse and molestation, Qing battled untreated depression and trauma
from her early years. Despite these formidable challenges, she pursued academic
excellence and was engulfed in the demanding medical school environment.
Her journey through marriage and motherhood, coupled with a painful
divorce due to her husband's infidelity and further complicated by traumatic
litigation, added stress and despair to her already fragile mental state. Amidst
these personal battles, Qing endeavored to start an independent medical practice to
provide for her children, navigating the pressures and responsibilities
accompanying this venture.
Compounded by health issues, including diabetes, depression, and reliance
on alcohol as a coping mechanism, Qing’s struggles were manifold. Nevertheless,
she embarked on a journey of self-redemption and healing, gaining a new

4. 3
perspective on life and seeking to make amends for past mistakes. Today, Qing
stands before the court with a deep understanding of her faults and a commitment
to turning a new leaf, not just for her dependent patients and 85-year-old mother
under her care, but for herself, as she seeks to rebuild and contribute positively to
society.
Given the above, we implore the Court to consider Qing McGaha’s life
entirely, acknowledging her struggles, her efforts to change, and the people
dependent on her. We ask this Court to consider Dr Qing’s exceptional life of
service to others, described in detail in the more than 40 letters of support that have
been submitted along with this memorandum.2
We believe a significant downward
variance would serve the interests of justice and allow Qing to continue her
redemption and service to others.
On October 10, 2023, this Court will have the chance to end this tailspin by
giving Dr. Qing a significant downward variance. Dr. Qing comes before this
Court having been found guilty of a 21-count Superseding Indictment. Count One
of the Superseding Indictment charged conspiracy to distribute and dispense
oxycodone, hydromorphone, and hydrocodone, not for a legitimate medical
2
The compilation of letters is attached as Exhibit A. For the Court’s convenience, each letter is
individually numbered. Citations to specific letters in this memorandum are referred to as “Ex.
A-**.”

5. 4
purpose in the usual course of professional practice, in violation of 21 U.S.C. §§
846 and 841(b)(1)(C). Counts Two through Sixteen charged intentional
distribution and dispensation of Schedule II controlled substances, not for a
legitimate medical purpose in the usual course of professional practice, to
identified individuals, in violation of 21 U.S.C. §§ 841(a)(1) and 841(b)(1)(C), and
18 U.S.C. § 2. Counts Seventeen through Twenty charged engaging and
attempting to engage in monetary transactions of criminally derived property
valued over $10,000, derived from specified unlawful activity, in violation of 18
U.S.C. §§ 1957 and 2. Count Twenty-One charged willfully making and
subscribing a false U.S. Individual Income Tax Return for the calendar year 2020,
in violation of 26 U.S.C. § 7206(1) and 18 U.S.C. § 2. Her mistakes have only
ruined her life but have broken her heart as she has watched the damage her actions
have caused to the family she loves so dearly.
We ask Your Honor to give Dr. Qing a significant downward variance. We
submit that it is just and fair because it takes into account Dr. Qing's history and
characteristics, the facts and circumstances of the offense, and meets the statutory
requirement of 18 U.S.C. § 3553(a) that a court impose a sentence that is “not
greater than necessary” to achieve the goals of punishment.

6. 5
II. DR. MCGAHA’S PERSONAL HISTORY AND CHARACTERISTICS
A. Early Life and Childhood Trauma
Qing McGaha's early life was marked by a series of struggles and pain
deeply rooted in a troubled childhood that left indelible scars on her psyche. Born
on March 6, 1966, in Tianjin, China, Qing was the firstborn child of Zhenqiu Lu
and Iae Zhang. Despite coming from a family of accomplished individuals, her
arrival was met with disappointment rather than joy, as her parents had hoped for a
son, a preference deeply ingrained in the Chinese culture of the time.
She found sanctuary in her grandparents’ home, who, like her parents, wanted a
grandson rather than a granddaughter but at least spared her the beatings that she
received at home. At the tender age of 7, she rejoined her parents when the clouds
of physical and emotional abuse escalated, casting a long, dark shadow over her
formative years.
Upon her return to her parents' home, Qing was subjected to relentless
physical and mental torment. Her mother, a librarian by profession, would often
belittle her, using cruel words that chipped away at her self-esteem, while her
father, a university professor, engaged in physical abuse for minor transgressions,
such as eating noisily. On three separate occasions, people known to her family
molested her, yet neither of her parents stood up to protect her against such abuse.
The pain was not only physical; the emotional wounds ran deep, with her parents

7. 6
making it abundantly clear that she was unwanted and unloved, a sentiment that
haunted Qing throughout her life.
The abuse was not limited to the confines of their home. On one occasion,
Qing's father dragged her down flights of stairs and beat her in public, a
humiliating and painful experience for a seventeen-year-old girl. Despite being a
diligent student and obedient child, Qing could never earn the love and approval
she desperately sought from her parents, who favored her younger brother.
In Qing's words, the mental torment was even more excruciating than the
physical pain. “Although [her] father treated [her] badly, [her] mother treated [her]
worse. She would abuse and degrade [her], telling [her] that [she] was too ugly,
too dark to be her daughter. Routinely, she told [her] that [she] was ugly as “poop”
and she used the derogatory term “poop-making machine” when describing [her].
From childhood until adulthood, [her] mother humiliated [her]. She said that since
she gave birth to [her], she also had the right to kill [her] at any time.”3
Her parents
controlled every aspect of her life, stifling her dreams and aspirations. Qing
harbored ambitions of studying journalism or film direction, but these were
summarily dismissed, with her parents forcing her into the field of science. This
relentless control and lack of support plunged her into depression, a condition she
3
See Exhibit B - Remorse Letter by Qing McGaha.

8. 7
would struggle with for most of her life.
The pain of her childhood did not dissipate with time; it cast a long shadow
over Qing's adult life, affecting her relationships and mental health. The
depression that took root in those early years of abuse and neglect grew, fed by the
continuous mistreatment by her mother and the loss of her cultural connections and
support network in China. Despite the passage of time, the nightmares of her
abusive past continue to haunt Qing, serving as a constant reminder of the loveless
and painful childhood she endured. Her parents' echoes of being called ugly,
unwanted, and worse reverberate through her mind, a cruel reminder of the
emotional and physical pain she suffered at the hands of those who were supposed
to protect and love her unconditionally. The following extracts from the PSR
detail the abuse Qing McGaha had to endure during her childhood:
While residing with her parents, she was physically and
mentally abused. [She] recalled her mother belittling her by
calling her ugly…. her parents would beat her hands with field
sticks until they bled, at least once weekly …. her mother would
also threaten to kill her …. her father would beat her for
slurping too loudly on soup and tell her that he did not like her.4
When she was approximately 17 years old, her father dragged
her down three flights of stairs, tried to strip her, and then he
beat her in public …. she was also beaten for crying over the
death of her kitten …. despite her being a good student and
always following directions, her parents always preferred her
4
See PSR, pg. 18.

9. 8
brother.5
She still has nightmares about the abuse that she endured ….
her parents controlled her every decision, including what she
was permitted to study at school …. she wanted to study
journalism or become a movie director, but her parents made
her study science …. she felt hopeless and would often run
away from home.6
…. [H]er depression worsened when her mother made her end
a relationship with her high school boyfriend because his
mother was schizophrenic …. her boyfriend subsequently tried
to commit suicide as a result of their breakup. The defendant
reported that her parents abuse continued well into adulthood,
adding that her mother continues to be mentally abusive
towards her.7
Qing McGaha's psychological evaluation report confirms the deep-seated
anxiety stemming from her traumatic past, affirming that these harrowing
experiences continue to cast a long shadow over her life. The report states:
Past traumatic experiences are a source of her anxiety.
Extremely distressing past experiences continue to affect
critical areas of her life. Her rumination about past traumas
brings about particular apprehension. The anxiety features,
though not extreme, might sometimes create lapses in her
attention and concentration. Worrisome thoughts, nervousness,
tension, and apprehension may distract her from the task or
problem at hand and, over time, affect the way she views a
variety of situations. There may be occasions when this also
interferes with her sleep, concentration, and sense of physical
well-being. The frequency or intensity of these problems relate
to her guilt and discomfort with herself. She anticipates that
the future will be much the same as the past, filled with sorrow,
5
Id.
6
Id.
7
Id.

10. 9
disappointment, and misery.8
Letter after letter unveils the intimate confidences shared between Qing
McGaha and her loved ones, revealing the depths of her pain and the silent cries
for help that echoed through her life. Each correspondence sheds light on the
moments when Qing reached out, seeking solace and understanding in the arms of
those she held dear. Various individuals attest to Qing's inner turmoil and
struggles while growing up.
Jun Lu, Qing’s brother, recalls:
Qing had been taking care of our father and mother even though
they had caused a lot of pain in her life. Our father and mother
both grew up in rural China and had a very traditional Chinese
family mindset and expected us to listen to everything they said
and fulfill their expectations …. Our parents forced Qing both
verbally and sometimes physically, to break up with the love of
her life, Jiang – her childhood love for many years. To be
precise, our parents forced Qing to break up with her love
multiple times over a 5-year span…. That pain never left her
and stayed with her up to the present day. Our parents also did
not give Qing much of a choice in deciding her college major,
career choice, choice of friends, clothing, hobbies, scheduling
her life, how to spend money, where to go to eat etc....9
Her son, Michael McGah, states:
As a child, my maternal grandparents would help around the
house and often stay at our home. Although they were kind to
me, I knew that they had a more out-dated, severe, and Spartan
mindset about life. My grandfather was often quiet and
stubborn. He was comfortable with using physical force and I
8
See Exhibit C - Psychological Evaluation Report, pg. 1 (emphasis in bold added).
9
See Exhibit. A-1 - Letter from Brother Jun Lu.

11. 10
knew that he would beat my mom physically when she was
younger using his hands, household objects, or metal…. My
grandmother would often echo the demands of my grandfather
such as majoring in science and coming to the US. She also
had very severe Spartan views and emphasized health and
finances over finding meaning and fun in life. She was also
sexist, often displaying a strong preference for males. In my
mom’s youth, she would verbally degrade her about her
appearance or personality. She is also very stubborn and when
someone disobeys her, she can shout, pester, and accost that
person relentlessly. She pushed for my mom to break up with
her first love whom my mom had a long term committed
relationship with….I can attest to her severe attitudes and
tendencies to deny people their desires and only care about
one’s health, career, or education.”10
Pastor Junjian Liu recounts :
I know that she has faced many hardships in life such as her
childhood abuse, tense relationship with her parents, divorce,
and often having to raise her three children alone…. Despite
her childhood abuse and the severe attitude of her parents, she
always made sure that they were taken care of. She has a big
heart and would go out of her way.11
Her daughter, Vivienne McGaha, states:
[M]y maternal grandmother often lived at our house. I feel like
[she] was very critical of my mom – often finding the smallest
details to nitpick her on. There would sometimes be yelling in
the house due to her stubbornness, controlling nature, and
builtup tension. Some of the main sources of unresolved
tension would include: forcing her and her first boyfriend of
many years to breakup, forcing her to study medicine, and
pushing her to come to the US despite being very comfortable
in China. More recently, Lao Lao has asserted that I should
break up with my boyfriend of two years. She has voiced that
he is a distraction from school and that I am wasting my time.
10
See Exhibit. A-2 - Letter from son Michael McGaha.
11
See Exhibit. A-3 - Letter from Pastor Junjian Liu.

12. 11
She has previously also wanted me to quit gymnastics, my
favorite hobby when I was younger, because it was a distraction
and had potential for injury.12
In the poignant narrative of Qing McGaha's life, her early years are
overshadowed by a relentless storm of pain and suffering, a silent, haunting
symphony of neglect and abuse that played in the background of her formative
years. This painful prologue of her life is a testament to the unbearable burden of
trauma she carried on her tender shoulders and a subtle yet powerful indicator of
her innate resilience and potential for recovery.
Qing's pain wasn't without consequence; it sensitized her to the silent cries
and invisible wounds of others, making her exceptionally attuned to the suffering
of those around her. While a testament to her empathetic nature, this heightened
sensitivity perhaps inadvertently guided her decision-making process, leading her
down paths she now recognizes as missteps in her journey.
Each painful experience, every tear shed in the solitude of her struggle,
subtly forged within Qing a deep sensitivity to others' pain. It's as if her soul,
intimately acquainted with suffering, developed a reflexive response to reach out,
heal, and alleviate the pain she could so clearly perceive in others. While a
beautiful testament to her humanity, this sensitivity might have also clouded her
12
See Exhibit. A-4 - Letter from daughter Vivienne McGaha.

13. 12
judgment, leading her to make professional decisions she now reflects upon with
regret.
B. Academic Journey and Relocation
Amid a turbulent and painful childhood, Qing McGaha stood as a paragon of
academic excellence, with her achievements casting a bright, albeit somber, light
amidst the shadows of her early life struggles. Each accolade and acknowledgment
she garnered through her educational journey was not merely a testament to her
intellectual brilliance but also a silent cry for approval, illuminating her desperate
quest for parental love and acceptance.
From the nurturing environment of Nankai Elementary School to the
esteemed corridors of Nankai High School in Tianjin, China, Qing was more than
just a diligent student; she was a shining example of dedication and discipline.
According to her psychological evaluation, “[She] excelled in school. As a
student, she was extremely talented academically. She had no learning, attention,
concentration, behavioral, or disciplinary problems. She attended Elementary
Nankai Elementary School, Middle Nankai Middle School, and High Nankai High
School (all in Tianjin, China). She got along well with her teachers, was
respectful, and did not cause any disciplinary issues. Teachers liked her and
lauded her for her academic skills.”13
13
See Exhibit C - Psychological Evaluation Report, pg. 4.

14. 13
However, beneath the glittering surface of her academic triumphs, there was
an undercurrent of expectation and pressure. Each high grade, while a symbol of
her commitment and capability, also represented her silent plea for
acknowledgment from her parents. In the symphony of her academic life, every
note of success was underscored by a subtle melody of longing and desperation for
familial approval.
Qing's relentless pursuit of excellence led her to the prestigious Tianjin
College of Medicine, a significant achievement by any standard14
. The United
States eventually became her new academic home, where “she partially completed
a Master of Science in nutrition from Texas A&M University before accepting her
medical residency at the University of Arkansas.”15
Qing's dedication to her
education never wavered throughout this journey, culminating in her recognition as
a Florida-licensed medical doctor, a status validated by the Florida Department of
Health16
.
Yet, this illustrious path was not of Qing's choosing. Her vibrant and
creative soul harbored dreams of delving into journalism or directing films,
aspirations smothered by her parents' unyielding insistence on a career in science.
14
Id.
15
Id.
16
See PSR, pg. 21.

15. 14
Qing's step towards this enforced destiny was laden with a sense of hopelessness
and the relinquishment of her true passions. “As [she] grew older, [she] continued
to suffer in [her] home life. [Her] parents were relentless in their discouragement.
[She] found solace in [her] studies, enjoying subjects related to language, such as
Chinese literature or studying foreign languages. [She] became proficient in
English early. [She] aspired to build a career as a writer, an editor, or a film
director. [Her] parents diminished such studies, insisting that a study of
humanities would lead to a further waste of life. Both [her] parents insisted that
[she] study math, physics, or engineering. [She] did not have an aptitude or
interest in such subjects. Yet they forced [her] to learn. Since [she] wasn’t smart
enough to succeed in math, physics, or engineering, they required [her] to declare a
scientific academic track.”17
With decades of living under their controlling
influence, she pushed herself through studies of biology and anatomy. “[She]
made it through the rigorous medical program and became an attending physician
in a Chinese hospital outside of Beijing. As an unmarried woman, [she] continued
to live under the dominating control of [her] parents.”18
Despite her unwavering compliance and academic success, Qing was
17
See Exhibit B - Remorse Letter by Qing McGaha.
18
Id at 4.

16. 15
perpetually eclipsed by her brother in their parents' eyes. Despite her being a good
student and always following directions, her parents always preferred her brother.19
This favoritism cast a shadow over her accomplishments, turning each triumph into
a silent reminder of her secondary status in the family.
The United States eventually beckoned not as a land of opportunity for Qing
but as a forced destination. “Wanting [her] to explore something different, [her]
father pushed [her] to migrate to America. He insisted that [she] accept a
scholarship from Texas A and M to study nutrition. [She] did not want to leave
China and worried about migrating to the United States. But [she] lacked the
strength or courage to disobey [her] parents.”20
This relocation was not a pursuit of
the American dream but rather a coerced decision, another chapter in her life
written not by her but for her. As described by her children,
Although [My grandparents] were kind to me, I knew that they
had a more out-dated, severe, and Spartan mindset about life.
My grandfather was often quiet and stubborn. He was
comfortable with using physical force and I knew that he would
beat my mom physically when she was younger using his
hands, household objects, or metal …. My mom is very
culturally connected to China and was regularly pestered and
accosted by him to move to the US. He was sometimes
intimidating, and he was very much “my way or the highway.”
My mom had an interest in literature in her youth and continues
to read Chinese literature in her free time yet was strongarmed
to pursue an education in science. There would often be tension
19
See PSR, pg.18.
20
See Exhibit C - Remorse Letter by Qing McGaha.

17. 16
in the house due to these major grievances.21
[M]y maternal grandmother often lived at our house. I feel like
[she] was very critical of my mom – often finding the smallest
details to nitpick her on. There would sometimes be yelling in
the house due to her stubbornness, controlling nature, and
builtup tension. Some of the main sources of unresolved
tension would include: forcing her and her first boyfriend of
many years to breakup, forcing her to study medicine, and
pushing her to come to the US despite being very comfortable
in China.22
The achievement was bittersweet as she earned her doctorate, the pinnacle of
her academic journey. While it was a monumental accomplishment, it was also a
monument to lost dreams and a life scripted by others. Each diploma and
certificate she received bore witness to her intellectual prowess and the pain and
sacrifice embedded in each accolade.
In the narrative of Qing McGaha's academic odyssey, the chapters are inked
with both the triumphs of scholarly conquests and the silent tears of relinquished
dreams and unattained approval. Yet, her undeniable resilience and
resourcefulness are within her, a spark that has allowed her to navigate life's
challenges with determination and grace. Qing's story is not just a tale of academic
victory but also a poignant saga of enduring hope amidst pain, a narrative of a
spirit unbowed by the weight of unmet expectations and unfulfilled desires.
21
See Exhibit A-2 - Letter from son Michael McGaha.
22
See Exhibit A-4 - Letter from daughter Vivienne McGaha.

18. 17
C. Marriage, Motherhood and Divorce
In the tapestry of Qing McGaha’s life, the threads of marriage, motherhood,
and divorce are intricately woven, each strand imbued with the hues of joy, pain,
and resilience. Qing entered the realm of marriage in 1995, uniting with Chris
McGaha in College Station, Texas. This union, marked by the tender promise of
companionship and support, offered Qing a sanctuary, a haven where she sought
solace from the echoes of her painful past.
“During [her] first months of study at Texas A and M, [she] felt lonely,
afraid, and alone in a foreign country where [she] had to learn so much... Feeling
that [she] needed guidance and direction to help [her] escape the trauma of [her]
childhood, [she] found comfort in Chris’ affection.”23
Their marriage, blossoming
amidst Qing’s pursuit of medical credentials and Chris’s journey into technology,
was a tapestry of shared dreams and aspirations.
However, the fabric of their union bore the subtle, indelible stains of
infidelity and betrayal. “Seven months into [her] pregnancy, however, [her]
marriage took a terrible turn when Chris told [her] that he had been having an
affair with another woman. With his betrayal, the trauma of [her] youth returned,
23
See Exhibit B - Remorse Letter by Qing McGaha.

19. 18
leaving [her] depressed and alone.”24
The shadows of Chris’s infidelity cast long,
dark silhouettes across the canvas of their marriage, subtly eroding the foundation
of trust and companionship they had built.
Despite the turmoil, the tapestry of Qing’s life was adorned with the vibrant
threads of motherhood, each representing the birth and growth of her three beloved
children: Travis, Michael, and Vivienne. These threads, while radiant with love
and devotion, also bore the weight of Qing’s silent struggle with depression and
alcohol, shadows that subtly influenced her ability to immerse in the joys of
motherhood and professional life fully. “[Her] marriage to Chris was volatile, as
he betrayed [her] on numerous occasions... [she] didn’t have the strength to leave
the marriage and tried to comfort [her]self with alcohol. Although [she] felt terribly
unhappy, [she] had three children that [she] loved very much.”25
. The narrative of
Qing’s marriage eventually transitioned into the somber hues of divorce, a painful
process marked by contentious legal battles and emotional turmoil. “Finally, in
2009, [she] mustered the courage to abandon [their] marriage and begin divorce
proceedings. Those proceedings were contentious, taking longer than two years.”26
Her son, Michael McGaha, states:
24
Id.
25
Id.
26
Id.

20. 19
Some of my earliest memories are of hiding behind my mom
and trying to avoid my father who had anger management
issues at the time. She often played the role of “good cop” while
my father was the “bad cop.” During my early childhood, my
dad would often be away on business trips, leaving her to be
our primary caregiver. I remember when she found out that my
dad was having an affair with a woman he met on a business
trip to China. It affected her deeply, and I knew that she tried
to make it work - quickly purchasing many books on how to
save her marriage. It really troubled her, and I remember my
dad deciding to move out one afternoon. I did not understand it
at the time, but I helped my dad load some things into the back
of his car and I just remember the shock, betrayal, and pain on
my mom’s face at that moment. She then bought many self-
help books on how to handle divorce and finding meaning in
life as she tried to navigate her new life circumstances.
As a newly single parent, my mom would still support many of
our ambitions while my dad was often on business trips -
sending the three of us to school, working full time as a
physician, and coming home at 5 or 6pm to pick one of us up
to send us to extracurricular activities such as my sister’s
gymnastics - essentially often being busy nonstop from 7AM
to 10PM.27
Junjian Liu, a pastor at the Tampa Chinese Presbyterian Church, states:
“The divorce was an especially difficult time for [Qing]. I know
that she felt very hurt and betrayed. During this time, she read
religious books and would come to church to talk about finding
meaning in life. Despite her ex-husband often being away, I
know she made sure that her three kids were performing well
socially and academically. While she is also very active in the
lives of her older two sons, I am especially concerned about
how a harsh sentence may impact her 16- year-old daughter
who she is very involved with taking care of.”28
Her Brother, Jun Lu, writes:
27
See Exhibit A-2 - Letter from Son Michael McGaha.
28
See Exhibit A-3 - Letter from Pastor Junjian Liu.

21. 20
[F]or more than a decade, the pain of breaking up with love of
her life was mended by her love for her three kids she had in
the US. However, that all changed when she found out that her
husband had an affair during his business trip and continued to
keep in touch with the other woman after he and Qing decided
to stay together for the kids after the affair was discovered. All
the pain and frustration Qing experienced in her twenties all
came back and haunted Qing. Financially they were making
well over $200K but had to live cautiously because of the
burden of taking care of a reasonably large family and the
purchase of the new house at Mandevilla ct in 2007. When her
husband moved out of the house, Qing had to support 3 kids
and maintain the house with half of the income. Qing also had
to use her old savings to support the lifestyle the kids were used
to, to give them a happy youth growing up.”29
Qing McGaha's journey through marriage, motherhood, and divorce was a
challenging period that deeply affected her, bringing up past traumas she had long
suppressed. The infidelity and eventual separation from her husband disrupted the
stability she had tried to build and revived painful memories from her past. Each
betrayal and loss during this time was not merely a singular event but a reminder of
the pain she had endured and hidden deep within for years. This series of painful
experiences left Qing navigating through emotional turmoil, dealing with both old
and new wounds, and trying to maintain stability amidst it all. Even in these
difficult moments, Qing's resilience was evident, providing a subtle but steady light
in the darkness, offering hope and the possibility of healing.
29
See Exhibit A-1 - Letter from Brother Jun Lu.

22. 21
D. Professional Pressures and Personal Decline
Qing turned to alcohol as a coping mechanism for her mounting pressures
and untreated depression. At this juncture, she was at the crossroads of
professional pressures and personal decline; each path intertwined with the
shadows of stress, responsibility, and untreated depression. At the dawn of 2011,
Qing launched her independent medical practice. While a testament to her
entrepreneurial spirit, this endeavor was initiated amidst the tumultuous storms of
her personal life.
“When [she] realized the income limitations of working at American
Primary Care, [she] decided to become an entrepreneur and launch a clinic. In
retrospect, [she thought] it was the right decision to start an independent medical
practice—but it was the wrong time. [She] did not know or understand enough
about business. Further, [she] struggled with depression, with alcoholism, and
suffered from a broken heart.”30
In the silent corridors of her heart, Qing grappled with the echoes of loss and
pain, the invisible chains of depression binding her spirit. “Sometimes, [she’d] cry
inconsolably over the losses of [her] life. Not the loss of [her] marriage to Chris,
as [she] knew he had never been the right man for [her]. [She] felt lost because
30
See Exhibit B - Remorse Letter from Qing McGaha (emphasis in bold added).

23. 22
[her] parents had failed [her] in so many ways, and because [she] felt that by
breaking [her] apart from the love of [her] life as a child, [her] parents had doomed
[her] to a life of misery.”31
As the shadows deepened, Qing found solace in the deceptive embrace of
alcohol, a refuge that offered transient relief but ultimately deepened the chasms of
her pain. The psychological evaluation report states: “When queried about alcohol
use as an adult, Dr. McGaha stated that she was consuming alcohol to deal with
stressful life events and episodes of depression. She recognizes alcohol use is an
unhealthy way to cope with depression and trauma.”32
Further, it notes, “Dr. Qing
was observed to experience fairly intense episodes of depression where she would
ruminate about past mistreatment by her parents and consume alcohol to numb her
pain.”33
The report continues, “The measures of alcohol abuse suggest that she does
reveal the characteristics and problems often associated with alcohol misuse. She
discloses some alcohol abuse experiences and a history of using alcohol to assuage
her distress. Dr. McGaha recognizes her need for healthy stress releases, such that
she does not rely on alcohol as a coping mechanism for managing stress in her
31
Id.
32
See Exhibit C - Psychological Evaluation Report, pg. 1.
33
Id. at 7.

24. 23
life.”34
Amidst the turbulent seas of her personal and professional life, Qing also
navigated the challenges of providing for her children post-divorce, bearing the
weight of being their primary provider. The responsibility, while embraced with
love, added another layer of pressure to her already burdened shoulders.
Furthermore, Qing’s physical health mirrored the fragility of her emotional
state. With a diagnosis of Type II diabetes and limited access to necessary
medications, her health was precariously balanced on a tightrope. The report
mentions, “Dr. McGaha’s physical health is compromised. She is having medical
problems managing her type II diabetes without medication.”35
Additionally, the
PSR Report notes, “The defendant communicated that she suffers from diabetes,
hypertension, high cholesterol, and gastrointestinal issues.”36
In the tapestry of Qing McGaha’s life, the threads of professional pressures and
personal decline are intricately woven, creating a mosaic of resilience, pain, and
endurance. Each thread tells a story, a silent narrative of a woman navigating
through the labyrinth of life, bearing the weight of her past, and moving forward
with quiet determination and hope.
34
Id. at 12.
35
Id. at 5.
36
See PSR, pg. 20.

25. 24
E. Journey to Redemption and New Beginnings
In the crucible of life’s challenges, Qing McGaha has emerged with a
heightened sensitivity to the pain of others. While leading her astray at times, this
sensitivity underscores her deep empathy and desire to alleviate suffering. The
pain and struggles she experienced throughout her life have made her sensitive to
others' pain and led her to make decisions in her professional life that she now
recognizes as mistakes.
Qing has been proactive in reshaping her life and mental health. “She is
now proactively shaping her functioning and life circumstances by extensive
reading and attending AA meetings. She is developing greater authenticity and is
in the process of integrating different contradictory aspects of her selfhood.”37
She
has forged close, supportive relationships with her three children, actively
engaging in their lives and supporting their endeavors.
“She recognizes that alcohol use is an unhealthy way to cope with
depression and trauma. While in custody, she has joined alcoholics anonymous
and finds the group support to be helpful.”38
She maintains a healthy lifestyle
through regular exercise and abstaining from smoking, reflecting her commitment
37
See Exhibit C - Psychological Evaluation Report, pg. 4.
38
Id. at 5.

26. 25
to personal well-being and recovery.
Her incarceration period has been a time of reflection and learning. Qing
has gained valuable insights into her role in the opioid epidemic and the limitations
of opioid medications for long-term pain management. “Since being incarcerated,
she has come to recognize her role in the opioid epidemic. She has gained a new
perspective from being incarcerated. She has listened to inmates suffering from
addiction and gained more perspective on sobriety. She is committed to making
amends for her mistakes as a pain management physician.”39
Living in a multi-generational household prior to incarceration, Qing took on
the role of primary caretaker for her 85-year-old mother, who was diagnosed with
dementia. Despite their past conflicts, their relationship has improved, showcasing
Qing's dedication and empathy towards her family. As Qing’s brother, son, and
daughter state respectively,
Our mother has developed dementia which in a way is a good
thing as the news that Qing was kept in jail did not cause her
too much pain. When my mother’s mind is clear she still asks
from time to time where is Qing and she misses Qing very
much. We hope Qing will still be able to come home as early
as possible. Our mother is 85 years old now and we hope when
Qing comes home, she is alive and has the opportunity to say
sorry to Qing. As famous author John Gray said, “life is
meaningful when filled with love tanks. “ Our mother never
gave that love tank to Qing all these years even when Qing was
taking care of her. I think she is ready to say sorry to Qing now.
39
Id.

27. 26
If only Qing has the chance to hear her say that in our mom’s
last remaining days.40
My maternal grandmother is now about 85 and in the past year
has begun demonstrating signs of dementia. Prior to her
incarceration, my mom was one of her primary caregivers
along with my uncle. Like him, she would often spend hours
watching her - ensuring that she does not fall, takes her
medication, uses the bathroom, showers, and eats. I am grateful
for my uncle assuming more responsibility for my grandmother
upon my mom’s incarceration, but taking care of her is not easy
since she is still very stubborn and can barely be left alone and
it is definitely too much for him to handle on his own for a
prolonged period of time.41
[M]y mom has been one of the primary caretakers for Lao Lao
as she is about 85 and has early signs of dementia. She visits
many times a week and regularly watches her for an entire day.
If she does not stay overnight with her, she sometimes came
home as late as 12- 1AM to make sure Lao Lao eats and gets
proper sleep.”42
With her mother now requiring near-constant supervision for basic daily
activities, including grooming, eating, drinking, medication management, and fall
prevention, Qing played a pivotal role in ensuring these needs were met diligently.
The prospect of placing her mother in a nursing home was something Qing firmly
opposed, understanding the adverse impact it would likely have on her mother's
health and well-being.
40
See Exhibit A-1 - Letter by Brother Jun Lu.
41
See Exhibit A-2 - Letter by Son Michael McGaha.
42
See Exhibit. A-4 - Letter from daughter Vivienne McGaha.

28. 27
However, with Qing's incarceration, the caregiving responsibilities have
shifted entirely to her brother, Jhun Lu. This transition is further complicated by
his imminent change in employment status, which will necessitate regular travel
and office visits, leaving their elderly mother without the round-the-clock care she
requires. As her son Michael elaborates on this challenging situation:
This is incredibly demanding for my uncle who is now doing
this alone. This is further complicated by his contract work
ending and him potentially rejoining Oracle or another
company and having to visit offices regularly or travel
frequently as part of his job. My mom would rotate shifts with
him to help care for her and often stay well past midnight to
ensure that my grandmother is taken care of. It is already
difficult enough to feed my grandmother since she specifically
wants to eat Northern Chinese food and requires someone who
can speak Mandarin to take care of her. If she is sent to a
nursing home or even if a nurse is hired, I think it is very likely
that her health and weight will rapidly decline, especially
considering that it is highly unlikely she will receive northern
Chinese food, care in Mandarin, or the incredible amount of
patience required to deal with her.43
Given the unique and compelling circumstances outlined, we respectfully
request the Court to consider a significant downward variance for Dr. McGaha.
This consideration would not only acknowledge the substantial challenges and
responsibilities she navigates daily but also recognize the positive impact she has
had on the lives of her family members and patients. A lenient sentence would
43
See Exhibit A-5 - Downward Departure Letter by Son Michael McGaha.

29. 28
facilitate Qing's continued contribution to her family and community, allowing her
the opportunity for redemption and to make amends for her past mistakes.
Dr. Qing McGaha is revered by her patients for her unparalleled dedication,
empathy, and professional acumen in the medical field. Her approach to
healthcare is not only meticulous but also deeply compassionate, making her an
irreplaceable figure in the lives of those under her care. Patients consistently
highlight her readiness to assist in emergencies, her patient and attentive demeanor,
and her unwavering commitment to providing not just medical aid but also
emotional support during their most challenging times.
“Dr. Qing [McGaha] is a great doctor with a big heart and is an empathetic
person. I miss her. I need her to be back and be me and my family’s doctor again,”
expresses Anna Johnson, underscoring Dr. McGaha’s indispensable role in her life
and the lives of her family members.44
Colleen Wagner attests, “Dr. McGaha is a very kind and caring doctor with
the highest integrity. She even called me at home to check on me after my cancer
surgery and treatment. This is a great loss to me, as I'm sure it is to many. I hope
and pray she will return to her family practice very soon,” expressing her deep
44
See Exhibit A-6 - Letter by Anna Johnson.

30. 29
appreciation for Dr. McGaha’s genuine care and concern.45
“Dr. McGaha is not only diligent in her medical practice but also a source of
trust and comfort,” states Deborah Lewin, who has known Dr. McGaha for
approximately 18 years. Lewin describes her as a “meticulous and compassionate”
caregiver who has offered invaluable consolation and support during the most
challenging times in her life.46
Dallas Ferguson, who credits Dr. McGaha with saving his life through
accurate diagnosis and expedited treatment, urgently calls for her return,
emphasizing, “Dr. McGaha is the best.”47
Eileen Cutshall praises Dr. McGaha as “one of the best doctors” she has
encountered, highlighting her attentiveness, patient-centered approach, and
compassionate nature. “Dr. Qing listens intently to everything you say and thinks
about the best course of action,” states Ms. Cutshall.48
Douglas Seaman commends Dr. McGaha for her exceptional care and
dedication, describing her as “a very fine doctor who cares for her patients.” He
acknowledges that Dr. McGaha’s timely and accurate diagnosis and treatment
45
See Exhibit A-7 - Letter by Colleen Wagner.
46
See Exhibit A-8 - Letter by Deborah Lewin.
47
See Exhibit A-9 - Letter by Dallas Ferguson.
48
See Exhibit A-10 - Letter by Eileen Cutshall.

31. 30
likely saved his life.49
“I've never had a doctor who called me personally because she was so
worried about my health,” expresses Barbara K. Janks, highlighting Dr. McGaha’s
unique concern and care for her patients.50
Jeffrey M. Harris writes, “Dr. McGaha's kind words of wisdom helped us
get through that difficult time,” commending her for showing “great compassion,
respect, and loyalty to others.”51
Julie DelVecchio notes that under Dr. McGaha’s care, she was “the
healthiest I have been in my lifetime,” emphasizing the doctor’s kind and
considerate approach to treatment and patient interaction.52
John and Lisa Cannon provide a compelling testimony of Dr. McGaha's
character and professional commitment, emphasizing her role as a devoted family
general practice doctor. “If she made any mistakes in judgment, we believe her
intent has always been to help her patients. That is the type of person that Dr. Qing
is and always has been, in every interaction with our family over the past 15 years.
She cares!” they affirm, underscoring her dedication to helping people with her
49
See Exhibit A-11 - Letter by Douglas Seaman.
50
See Exhibit A-12 - Letter by Barbara K. Janks.
51
See Exhibit A-13 - Letter by Jeffrey M. Harris.
52
See Exhibit A-14 - Letter by Julie DelVecchio.

32. 31
healthcare training and expertise.53
Marcy Steele commends Dr. McGaha for providing exceptional and
compassionate care to her late mother, Lorraine Steele, and herself. “Dr. McGaha
always said I could call her at any time of the day also at night, and on weekends.
She always took my call to talk about what issues I was having at the time,” Steele
shares, expressing deep appreciation for Dr. McGaha's support during challenging
times.54
Annette Marsden, a patient of Dr. McGaha for 12 years, praises her for
being exceptionally accessible and responsive during health emergencies. “Dr.
Qing's dedication and compassionate nature” have left a lasting impression on both
Annette and Joyce Marsden, who express concern about potentially losing her as
their physician.55
Michael McGaha provides a personal perspective on his mother, Dr. Qing
Lu McGaha, highlighting her role as a primary caregiver and the pain and struggle
she endured during their family's difficult times. “I humbly ask the court for
leniency and urge them to consider how much many people’s lives will be severely
impacted by a harsh sentence,” he pleads, emphasizing the significant positive
53
See Exhibit A-15 - Letter by John and Lisa Cannon.
54
See Exhibit A-16 - Letter by Marcy Steele.
55
See Exhibit A-17 - Letter by Annette and Joyce Marsden.

33. 32
impact his mother has on the lives of many.56
Montoya Walker praises Dr. McGaha for promptly providing the correct
diagnosis and medication within 24 hours of reaching out, contrasting this with
incorrect treatment received at a walk-in clinic.57
Wanda Nobrega expresses gratitude towards Dr. McGaha for her specialty in
diabetes, under whose guidance and support she lost 75 pounds, improved her A1C
and blood pressure levels, and restored her kidney function to normal.58
Patricia Yoke, an 86-year-old retired teacher, testifies to Dr. McGaha’s life-
saving care and commitment to her patients, especially the elderly, recalling
specific instances where Dr. McGaha’s immediate response and care were
crucial.59
Qian Gu supports Dr. Qing McGaha, praising her attentiveness, care, and
genuine concern for her patients, expressing surprise at the allegations against the
doctor, which she finds out of character.60
Richard J. Arcuri, a 62-year-old retired individual, advocates for Dr. Qing
56
See Exhibit A-2 - Letter by Michael McGaha.
57
See Exhibit A-18 - Letter by Montoya Walker.
58
See Exhibit A-19 - Letter by Wanda Nobrega.
59
See Exhibit A-20 - Letter by Patricia Yoke.
60
See Exhibit A-21 - Letter by Qian “Evelyn” Gu.

34. 33
McGaha, emphasizing her expertise in managing Type II diabetes and expressing
skepticism regarding the charges against her. He recommends a retrial, believing
there are discrepancies in the case that warrant reconsideration.61
Jinming Song, a patient of Dr. Qing McGaha for ten years, expresses
gratitude for the effective management of his long-term diseases and praises Dr.
McGaha’s professionalism and responsiveness. Song pleads for a sentence that
allows Dr. McGaha to continue contributing to the medical field and supporting
her children.62
Montoya Walker writes, “Within 24 hours of reaching out to Dr. McGaha,
she welcomed me into her office, promptly provided the correct diagnosis, and
prescribed the appropriate medication.” This was in contrast to incorrect treatment
previously received at a walk-in clinic.63
Wanda Nobrega shares, “There were times when I would visit Dr. Qing and
cry because nothing was working. She always assured me her specialty was
diabetes and with her guidance and support I have lost 75 pounds, my A1C is 6.5
my blood pressure is perfect and my kidneys are functioning normally. I owe it all
61
See Exhibit A-22 - Letter by Richard J. Arcuri.
62
See Exhibit A-23 - Letter by Jinming Song.
63
See Exhibit A-18 - Letter by Montoya Walker.

35. 34
to Dr. Qing.”64
Tyrone Mangum attests, “I am a healthier person, and it is because of her.”
He praises Dr. Qing’s responsiveness and exceptional listening skills, pleading for
mercy on her behalf.65
Yingbo Hu describes Dr McGaha as a dedicated mother with an “outgoing
and positive personality” who has endured hardships while contributing positively
to society. Hu believes Dr McGaha deserves leniency and an opportunity to learn
from her mistakes.66
Yingyi Xu writes, “Qing is a person of integrity, independence, intelligence,
and kindness.” Despite facing hardships, Dr McGaha is depicted as a resilient and
inspiring individual who positively impacts her community and family.67
Jianping Chia, MD, shares, “Qing is a very decent, hard-working, and good-
hearted family doctor who had been very helpful to my in-laws in terms of medical
advice although she didn't have a doctor-patient relationship with them.” He
emphasizes the importance of Dr McGaha’s presence for her daughter Vivian.68
64
See Exhibit A-19 - Letter by Wanda Nobrega.
65
See Exhibit A-24 - Letter by Tyrone Mangum.
66
See Exhibit A-25 - Letter by Yingbo Hu.
67
See Exhibit A-26 - Letter by Yingyi Xu.
68
See Exhibit A-27 - Letter by Jianping Chia, MD.

36. 35
Virginia B Upton highlights Dr. McGaha's expertise and dedication, stating,
“She was the first doctor to diagnose my high blood pressure, then tweaked several
meds and dosages to bring my blood pressure under control.” Upton advocates for
the preservation of Dr. McGaha's reputation and career.69
Susan Rubsamen testifies, “Dr. McGaha never made me feel rushed and
took the time to get my blood pressure under control by finding the right
combination of medications. She also made sure to check on my stressors/mental
health during my visits. She’s reliable, hard working and always ready to assist
others when needed.”70
Despite the challenges and obstacles she faced, Qing has demonstrated
resourcefulness and goal orientation. She has worked diligently to manage stress
healthily and is committed to healing and reconciling with her past. Psychological
evaluations affirm her functional capability despite her history of trauma,
showcasing her strengths in empathy, self-regulation, and self-awareness.
In reflecting on her mistakes and the harm caused, Qing expresses deep
remorse and takes full responsibility for her actions. She deeply regrets her
behavior and is remorseful for the pain and loss that she caused. She is genuinely
69
See Exhibit A-28 - Letter by Virginia B Upton.
70
See Exhibit A-29 - Letter by Susan Rubsamen.

37. 36
sorry for the choices and the pain caused by negligence and indiscretion.71
With a
clear understanding of her past and a commitment to a better future, Qing McGaha
stands ready to contribute positively to society, making amends for her past while
building a future anchored in empathy, understanding, and care for others.
III. THE ADVISORY GUIDELINES CALCULATION
The court in Gupta noted that:
“Imposing a sentence on a fellow human being is a formidable
responsibility. It requires a court to consider, with great care
and sensitivity, a large complex of facts and factors. The notion
that this complicated analysis and moral responsibility can be
reduced to the mechanical adding-up of a small set of numbers
artificially assigned to a few arbitrarily selected variables wars
with common sense. Whereas apples and oranges may have but
a few salient qualities, human beings in their interactions with
society are too complicated to be treated like commodities, and
the attempt to do so can only lead to bizarre results.”72
Imposing a sentence upon Dr. McGaha necessitates a nuanced understanding
of her life journey, struggles, and the intricate web of circumstances that led to this
juncture. Attempting to distill her complex narrative into a rigid formula would
overlook the depth of her experiences, her sincere remorse, and her commitment to
change. Dr. McGaha's life, much like any individual's, is a mosaic of unique
qualities and challenges that defy simple quantification. Recognizing her as a
71
See Exhibit B - Remorse Letter by Qing McGaha
72
Gupta, 904 F. Supp. 2d at 350.

38. 37
human being, not a mere statistic, is essential in arriving at a just and equitable
resolution that considers both the gravity of her actions and the potential for
redemption and contribution to society.
A. Applying the Safety Valve, Imposing a Sentence After a Significant
Downward Variance is Sufficient, But Not Greater Than Necessary,
to Satisfy the § 3553(a) Goals of Sentencing
The "safety valve" provision of the federal sentencing statute requires a
district court to ignore any statutory mandatory minimum and instead follow the
Sentencing Guidelines if a defendant was convicted of certain nonviolent drug
crimes and can meet five sets of criteria. See 18 U.S.C. § 3553(f)(1)-(5). Congress
amended the first set of criteria in § 3553(f)(1) in the First Step Act of 2018, Pub.
L. No. 115-391, § 402, 132 Stat. 5194, 5221, broad criminal justice and sentencing
reform legislation designed to provide a second chance for nonviolent offenders. A
defendant satisfies § 3553(f)(1), as amended, if he "does not have-(A) more than
four criminal history points, excluding any criminal history points resulting from a
1-point offense, as determined under the sentencing guidelines; (B) a prior 3-point
offense, as determined under the sentencing guidelines; and (C) a prior 2-point
violent offense, as determined under the sentencing guidelines." 18 U.S.C. §
3553(f)(1)
On October 04, 2023, Dr. McGaha had a safety valve proffer session with
the government. During the safety valve proffer session, Qing was entirely truthful

39. 38
and forthcoming. She understood the gravity of the situation and the importance of
complete candor in this critical process. She cooperated fully, providing the
government with all available information. Her commitment to transparency
during this session was unwavering, reflecting her sincere desire to rectify her
actions and seek justice through honest disclosure. It underscores the veracity and
integrity with which she approached this pivotal opportunity for redemption within
the federal criminal justice system. She is, therefore, entitled to the 2-point
reduction in her U.S.S.G. calculation and escape the mandatory minimum.
There is no dispute that Dr. McGaha satisfies all the conditions of the safety
valve. Although her conduct was certainly very serious, a significant downward
variance would be appropriate for someone like Dr. McGaha, who:
Has no prior convictions;
Has been consistently employed throughout her adulthood;
Has been a tremendous asset to her family and community in
myriad ways for many years;
Will undoubtedly continue her good work;
Publicly admitted her wrongdoing and feels sincere remorse;
Steadfastly complied with all conditions of pretrial release;
Proactively made positive, rehabilitative changes after her
arrest, including addressing her mental health and spirituality
by disassociating from negative influences; and
Has a low chance of recidivism.
B. Dr. McGaha is Eligible for a Two-Point Downward Adjustment
Because She Qualifies as a Zero-Point Offender
The government sentencing memorandum notes that:

40. 39
[O]n April 5, 2023, the United States Sentencing Commission
voted to adopt a series of proposed amendments to the
guidelines, which will ultimately become retroactive. If
Congress approves the proposed amendments, namely USSG §
4C1.1, McGaha would be eligible for a two-point downward
adjustment because she qualifies as a zero-point offender.73
“The government does not object addressing this by varying downward two
levels only with the stipulation that McGaha will not apply for any retroactivity
concerning the zero-point offender status in the future.”74
Dr. McGaha hereby
stipulates that she will not apply for any retroactivity concerning the zero-point
offender status in the future. She is, therefore, eligible for a two-point downward
adjustment.
IV. A BALANCED CONSIDERATION OF ALL RELEVANT FACTORS
UNDER 18 U.S.C. § 3553(a) DEMONSTRATES THAT A SENTENCE
WELL BELOW THE GUIDELINES RANGE IS SUFFICIENT, BUT
NOT GREATER THAN NECESSARY, TO ACHIEVE THE GOALS
OF SENTENCING
18 U.S.C. § 3553(a) directs that a court “shall impose a sentence sufficient,
but not greater than necessary, to comply with the purposes set forth in paragraph
(2) of this subsection,” which include: “(A) to reflect the seriousness of the
offense, to promote respect for the law, and to provide just punishment for the
offense,” “(B) to afford adequate deterrence to criminal conduct,” “(C) to protect
73
Government’s Sentencing Memorandum at 7-8.
74
Id. at 8.

41. 40
the public from further crimes of the defendant,” and “(D) to provide the defendant
with needed educational or vocational training, medical care, or other correctional
treatment in the most effective manner.”75
In addition to considering each of these
purposes, the Court also “shall consider” “the nature and circumstances of the
offense and the history and characteristics of the defendant” (18 U.S.C. §
3553(a)(1)), “the kinds of sentences available” (18 U.S.C. § 3553(a)(3)), “the kinds
of sentence and the sentencing range established” under the applicable Sentencing
Guidelines (18 U.S.C. § 3553(a)(4)), and “the need to avoid unwarranted
sentencing disparities among defendants with similar records who have been found
guilty of similar conduct.” 18 U.S.C. § 3553(a)(6).
Accordingly, the range calculated under the Guidelines is purely advisory
and serves as just one of many factors that the Court is required to “consider” when
fashioning an appropriate sentence.76
“[T]he sentencing court does not enjoy the
benefit of a legal presumption that the Guidelines sentence should apply.”77
Indeed, “[e]ven where a district court has properly calculated the Guidelines, it
may not presume that a Guidelines sentence is reasonable for any particular
75
18 U.S.C. § 3553(a)(2) (emphasis added).
76
United States v. Crosby, 397 F.3d 103, 113 (2d Cir. 2005).
77
Rita v. United States, 551 U.S. 338, 351 (2007).

42. 41
defendant, and accordingly, must conduct its own independent review of the [18
U.S.C.] § 3553(a) sentencing factors.”78
After thorough consideration of all the relevant factors, Dr. McGaha
respectfully submits that a significant downward variance is appropriate in this
case. As set forth below, such a sentence takes account of the other circumstances
of this case discussed herein and is “sufficient, but not greater than necessary” to
achieve the goals of criminal punishment under 18 U.S.C. § 3553(a).
A. Dr McGaha’s Unquestioned Devotion to Her Children and Ailing
Mother Warrants Leniency
One of the first factors identified for consideration under 18 U.S.C. §
3553(a) is “the history and characteristics of the defendant.” As recognized by
Judge Rakoff in United States v. Adelson:
[S]urely, if ever a man is to receive credit for the good he has
done, and his immediate misconduct assessed in the context of
his overall life hitherto, it should be at the moment of his
sentencing, when his very future hangs in the balance.
This elementary principle of weighing the good with the bad,
which is basic to all the great religions, moral philosophies, and
systems of justice, was plainly part of what Congress had in
mind when it directed courts to consider, as a necessary
sentencing factor, “the history and characteristics” of the
defendant.79
78
United States v. Dorvee, 616 F.3d 174, 182 (2d Cir. 2010).
79
441 F. Supp. 2d 506, 514 (S.D.N.Y. 2006).

43. 42
One goal of the justice system is to catch and stop bad conduct in the
present; a sentence serves to both punish and deter a defendant, with the intent of
changing future behavior. But this Court is tasked with essentially reaching its
long arm through time, into the past, to punish the Qing McGaha of 2016-2021.
Only 2023 Dr Qing McGaha stands before this Court to be sentenced. This is a 57-
year-old mother of two sons, 25 and 22 years old, and one daughter, 16 years old,
who is the center of her life. The defendant’s mother, Lao Lao, is 85 years old and
suffers from dementia, hypertension, renal failure, and anemia. Additionally, she
has suffered several Transient Ischemic Attacks in the past. The defendant is the
primary caretaker for her bedridden mother. The woman before this Court needs no
substantial deterrent, as she has already suffered great punishment and proven that
she permanently abandoned her old ways.
Qing McGaha is not the typical defendant in a controlled substance
distribution case. She is a woman motivated by making her family smile, not by
greed. As discussed in detail above, along with the letters submitted by her loved
ones, show that she is fulfilled by her personal relationships, not profits.
B. A Sentence Well Below the Guidelines Range Will Be More Than
Sufficient to Achieve the Goals of Specific and General Deterrence
18 U.S.C. §3553(a)(2) requires this Court also to consider the need to
“afford adequate deterrence to criminal conduct” and to “protect the public from

44. 43
further crimes of the defendant,” which courts have interpreted to mean both
specific and general deterrence.80
In addition, this case has already cost Dr McGaha dearly. Qing would never
intentionally inflict pain or hardship on her family or patients. Qing, who deeply
desired to be a beacon of support and healing for her patients, now grapples with
the realization that she has been a source of embarrassment, fear, and shame for
her beloved children and dependent elderly mother. The professional reputation
she painstakingly built over the years now lies tarnished, casting a long shadow
over her past efforts and contributions to her patients and the medical community.
She is acutely aware of the role she played in the lives of her patients, many
of whom depended on her for not just medical care but also for empathy and
understanding. The trust that was placed in her by these individuals has been
eroded, leaving in its wake a trail of broken relationships and lost faith. Qing
understands the gravity of her actions and the irreversible damage it has inflicted
on her patients, some of whom have struggled with addiction due to the
medications she prescribed. These are harms for which she will spend the rest of
her life atoning.
80
See Gupta, 904 F. Supp. 2d at 352.

45. 44
Statistics also show that Dr McGaha is highly unlikely to be a repeat
offender. Publications by the U.S. Sentencing Commission confirm that true “first
offenders” like her, with no prior convictions or arrests, have an “extremely low
recidivism rate.”81
Although Qing understands that the Court must also consider
the need for general deterrence when fashioning an appropriate punishment, we
respectfully submit that substantial prison time will not advance those goals.
Moreover, scholars have consistently concluded that it is the certainty of
punishment, rather than its severity, that is the most effective deterrent for financial
crimes.82
C. A Significant Downward Variance Serves the Interests of the Federal
Prison System and Is Fair to Dr McGaha
Both Dr. McGaha and society would benefit more from giving her a
significant downward variance rather than warehousing her for 135 months to 168
months—as suggested by the presentence investigation report—at great expense to
81
United States Sentencing Commission, Recidivism And The “First Offender” (May 2004),
available at https://www.ussc.gov/sites/default/files/pdf/research-and-publications/research-
publications/2004/200405_Recidivism_First_Offender.pdf at 17 (reporting a 6.8% recidivism
rate for true first time offenders). This study notably does not differentiate between different
types of crime even though defendants convicted of fraud are the least likely to recidivate.
82
See United States v. Velazquez, No. 16-CR-233 (AKH), 2017 WL 2782037, *4 (S.D.N.Y. May
26, 2017) (“Current empirical research on general deterrence shows that while certainty of
punishment has a deterrent effect, ‘increases in severity of punishments do not yield significant
(if any) marginal deterrent effects . . . Three National Academy of Science panels . . . reached
that conclusion, as has every major survey of the evidence.’”) (citation omitted). See Richard A.
Frase, A More Perfect System: Twenty-five Years of Guidelines Sentencing Reform (Punishment
Purposes), 58 Stan. L. Rev. 67, 80 (2005).

46. 45
the taxpayers, with no corresponding benefit.83
At a cost in today’s dollars of
approximately $ 44,258.00 84
per year, imprisoning her would cost at least
$497,902.50 for the minimum 135-month sentence recommended by the Probation
Department. Spending nearly $500,000 to incarcerate Dr. McGaha makes no sense
at all—she will remain a financial burden throughout her incarceration and will
have lost over 11 years of time in which she could have been working to make
payments towards restitution. Such expenditures of taxpayer money should be
reserved for only the most dangerous and incorrigible offenders. Dr McGaha is
neither dangerous nor incorrigible. She has demonstrated over the past year that
she is law-abiding, family-oriented, peaceful, and extremely remorseful—she does
not need a substantial custodial sentence to deter her.
We submit that under these circumstances, a significant downward variance
serves the ends of punishment, and is consistent with BOP’s current efforts to
reduce the prison population, especially with respect to non-violent offenders who
present a low risk of recidivism and serve the public interest.
83
PSR at ¶ 107.
84
Id. at ¶ 118. This cost does not account for inflation.

47. 46
CONCLUSION
Dr. Qing McGaha is a committed mother and dutiful daughter who has
been suffering and enduring pain since the day she was born. In light of the above,
we respectfully request that the Court give Dr. McGaha a significant downward
variance.
Dated: October 7, 2023
Respectfully submitted,
Spodek Law Group PC
By:___/s/______
Todd Spodek
85 Broadway, 30th Floor
New York, NY 10004
ts@spodeklawgroup.com
Tel.: (212) 300-5196
Attorneys for Defendant Qing
McGaha

48. 47
CERTIFICATE OF SERVICE
I, the undersigned, hereby certify that on the 7th
day of October 2023, I
electronically filed this Sentencing Memorandum On Behalf Of Defendant
Qing McGaha and the exhibits annexed thereto, using the CM/ECF system,
which automatically sends notice and a copy of the filing to all counsel of
record.
/s/ Todd Spodek
Todd Spodek
Attorney for Defendant Qing
McGaha