When it comes to zoning for the planned Patriot Care Boston medical marijuana dispensary on Milk Street in Downtown Crossing, Mayor Marty Walsh is stuck between pot and a hard place. On one side there are those who oppose the dispensary—his allies in drug and alcohol treatment programs, and powerful folks at the Downtown Business Improvement District (BID). On the other side are those who wish to see it open—cannabis advocates, presumably the 69 percent of voters in Boston who supported medical marijuana at the polls in 2012, and so on.

On July 7, Patriot Care’s application for a special permit is expected to be voted on by Boston’s Zoning Board of Appeals (ZBA). As I put it to the Mayor over the phone last week on WBZ Radio, as he was fielding calls on “Nightside with Dan Rea” …

“Mayor Walsh, I want to thank you for a column that I wrote for DigBoston. It was 10 quotes from you and it was very popular online; people are upset about your statements related to marijuana reform, considering that, how can patients and voters be confident that you will give the dispensary on Milk Street a fair shake in their upcoming zoning board meeting?”

Walsh’s response: “Well, it’s really not up to me. It will be decided by the zoning board later this month. It’s not yet decided. There is some neighborhood opposition but there’s also [resident] support for it. We’ll see how the zoning board decides.”

I had to ask: “But mayor, are you really giving the dispensary a fair shake? How can patients know you aren’t blocking this with backdoor politics?”

To which he said: “I can tell you I have met with a representative of Patriot Care, the owner. He seems to be a very nice man, so I have done that and we’ll see how the zoning board decides.”

For some perspective on small business permitting in Boston, I reached out to Scott Matalon, a member of the Allston Board of Trade and the owner of Stingray Body Art. “Downtown Crossing is a commercial zone,” he says. “I can’t think of a zone that is more commercial in our city; it’s an ideal location. If not there, then where? If it’s not allowed in a major commercial zone like Downtown Crossing, then where in the City of Boston?”

If Patriot Care is denied a permit on July 7, many residents may be asking the same question: “If not here, then where?”—and looking at Mayor Walsh as the reason for why they have to travel to Brookline or farther for dispensary access. Who won’t be blamed? For starters, Patriot Care backers like the Massachusetts Patient Advocacy Alliance, the Franciscan Friars at St. Anthony Shrine, members of the AIDS Action Committee of Massachusetts, and Boston City Councilors Matt O’Malley, Tito Jackson, Ayanna Pressley, and Josh Zakim.

In the past, Mayor Walsh has indicated that he’s willing to spend political capital on opposing a popular statewide marijuana legalization initiative. But how about medical? In the short-term? Is he willing to hobble his upcoming reelection efforts, and to shoulder the blame for blocking a dispensary that will inevitably end up somewhere else in the city anyway? As neighboring cities and towns move ahead on these matters, Walsh may want to finally take reality into consideration.