DAY 122 - Pigeonholed ... but not intentionally

Pigeonhole principle from Wikipedia

I’m a chiropractor, and I know my limitations; few.

Merriam-Webster defines a pigeonhole as “a neat category which usually fails to reflect actual complexities.” As a verb, pigeonholed can mean, “to assign to an often restrictive category.” And that’s my frustration, the name of my profession is a “neat category”, and boy have we assigned ourselves, and been assigned by our culture, to a “restrictive category” as back doctors.

In the beginning (1895), chiropractors focused on, and advertised as central, our adjustment of the spine, as a mode of improving health and function in all parts of the body. We provided much relief for a variety of conditions, but performed particularly, even remarkably well in the realm of back, neck, and general musculoskeletal conditions. Between the difficulty in making the case for spinal function influencing health in other organs and systems, and the often immediate relief of back and neck pain, we became known as back doctors.

Medical doctors, on the other hand, have created a clear understanding with the public that they treat anything and everything. Nice work.

For chiropractors that specialize in backs, things are good; the shoe fits.

But, for chiropractors like me, who treat everything from sinus infections to hemorrhoids, from vertigo to esophageal reflux, from colic to menstrual cramps, from high blood pressure to diabetes, and from anxiety to ADHD, there’s a mismatch. Thank goodness I also love fixing backs!

The challenge is obvious; powerful historical factors over the last 115 years have unintentionally, and impersonally pigeonholed me.

I find myself grateful for the awareness to climb out of the pigeonhole, and grateful for the strength to fly into the wind.

DAY 104 – ‘Till the End

photo courtesy of di the huntress at flickr commons

Larry was 44. He had a two year-old son, a loving wife, and leukemia.

I was his chiropractor.

Before his cancer diagnosis, I had recommended that he examine his diet, make general improvements, and consider the possibility that he might be allergic to a few foods that he was eating. I made these suggestions since foods are one of the most common causes of the muscle and joint complaints that I was treating him for.

Larry was none too keen on looking at, nor making changes in his diet.

Food is one of the single greatest causes of chronic degenerative disease, including musculoskeletal aches and pains.  As a responsible physician, I educate each and every patient about the risks of poor diet, and food allergies. Most patients are distressed at being advised that foods may be impacting their health. Not wanting to provoke them, I say, as I did to Larry, “If at any time you would rather that I not discuss the possibility of foods affecting your health, please let me know, and I will stop.”

Chemotherapy had its usual side effects; nausea, fatigue and hair loss. But, Larry appeared to be holding his own.

When the invitation to his 45th birthday party came to the office, I was honored to be included.

The gathering was festive; his friends, many. OK, so I’m a doctor, but the food was hardly appropriate for an ill man. Some of the gifts from loving friends, included candy, cookies and other sweets.

A few days after the party, Larry was in my office for a treatment. I had been going round and round with myself; his food choices were a clear risk to his recovery and his life, but I knew that he wasn’t going to be happy with me if I brought it up. What I came to was that my fear was no excuse; I had to tell him my professional opinion.

My words and tone were chosen carefully. He acknowledged my advice. There was some tension, but the visit ended without incident.

Walking into a treatment room a week later, Larry, already seated, said, “Dr. Young, sit down.” My sensitive gut churned. “Sit down.”, with that tone, had to mean, “you are in trouble.”

“I come to see you because you are the best chiropractor I have ever found, but if you mention food one more time, you will never see me again!”

“Larry, thank you for telling me. This is exactly what I have asked; tell me what you want. I care about you much more than I care about what you eat.”

... Turned out, Larry wasn’t holding his own. As the weeks clicked by, he became sicker and weaker. One day his wife, Rachel, called and asked if I could come to the house to treat him; he just didn’t have the strength to get out.

Arriving, I made space in his bedroom for my portable chiropractic table. He was weak, but glad to see me. I helped him onto the table and kept him warm with a blanket. This was not the time for spinal adjustment; I lightly massaged his back and neck, and held his hand.

Back in bed, I tucked him in as he closed his eyes ... for the last time.

Larry had let me know what he needed; making it possible for us to work together ‘till the end.