Greed. It's always wise to enquire ahead of time the cost of a service
Life is not inherently fair, at least not from our human perspective. Some people, poor people we would say, seem to get a double portion of pain. Danny McFie was one of them. I had known the McFies for some years, not particularly well as they were fortunate enough to have healthy bodies or, at least, so we thought.
‘Been sitting too much in front of your computer again, Danny?’ I asked during one such consultation, not long after my extended American holiday.
‘Yes, I guess, Doc.’
‘And has your skipping-rope been stolen or just neglected?’ I knew Danny wouldn’t mind me pulling his leg. Theft was what gave him a job. He was an electronic engineer who had made considerable mileage out of South Africa’s grand auto theft industry. The word grand described it very adequately. In a society of such contrast between have and have-nots, car theft was deemed by some to be a legitimate way to redistribute wealth in the new South Africa. It was Danny’s company that discovered a niche market: electronic devices to make the thief’s work a lot more difficult. Such was Danny’s prowess that the company became a world leader in the design and manufacture of such devices. One of the things that makes the practice of Chiropractic so interesting is the insight into people’s lives that comes while I am at work on their spines. He laughed. ‘Just neglected. Now that winter is coming on, it’s dark when I get home in the evening and I don’t feel like exercising.’
‘Come on, Danny. That’s just the time when the rope comes into its own. During the summer you should be taking to the pool or playing a set or two of tennis with Sharon after work. Winter is skipping-rope season.’
I’m a great believer in the skipping-rope. Gyms don’t turn many people on and some don’t have the money for a gym contract. Danny did have the money but, like me I might say, just didn’t have the time or the inclination; but we all need exercise in a society where we sit far too much. The skipping-rope is the busy man’s total body workout in ten minutes.
‘How’s business?’ I asked, changing the direction of our conversation, not wanting to be a fishwife. I had made my point and there was no need to belabour it. Danny fortunately had a very healthy back and had only the odd episode of low back pain that responded very quickly to half a dozen spinal adjustments and a set of exercises. When he did them, that is.
‘Fantastic! We’ve just landed a contract to supply the total world-wide market with anti-hijacking devices for a large German manufacturer. It will be worth millions.’ ‘That’s amazing. Congratulations. And how are Sharon and Tamsin?’ ‘Oh, I wish Sharon would sell her dry-cleaning business. We don’t need the money any more, and now that Tamsin has turned fourteen, she’s needing a mother when she gets home from school. The boys are starting to take an interest and that gets me nervous. I don’t know who her husband will be but, already, I dislike him!’
‘That’s quite normal, Danny, even more so seeing that she’s your only child. Just get the shot-gun loaded with salt,’ I laughed.
Danny’s first portion of pain struck about six months later. Sharon was diagnosed with leukaemia, ostensibly from the nasty chemicals that dry-cleaners are exposed to. Danny seemed to need more treatment for his back during the months that followed so I knew something of his misery.
‘Doc, would you consider becoming a tissue donor?’ Danny asked me one afternoon. He knew that I visited the vampires periodically and they were searching in vain for a suitable donor of bone marrow stem cells. I didn’t match but it was good to have joined the register of donors. Maybe one day my blood would match someone else in need.
Danny loved to tease me. He always parked his convertible directly outside my office window. It was a dark green colour which matched my mood and my envy. One day I watched him struggling to get out of the low sports car. ‘Serves you right, Danny, for always parking it where you know I can see it.’
‘With only one pair of hands, you’ll never earn enough money to buy one of the topless ladies, Doc, but just in case you win the lottery, the French are making really good sports cars for about half the price of the Germans and Italians. Perhaps I’ll design a robot that can give manipulations and then you can treat dozens of people simultaneously.’
Nine months later I watched Danny struggle out of a battered old Beetle, an old, tatty sombrero lopsided on his head; he had parked in his usual spot. He limped down to my office with more than his usual pain. I was concerned, not only because of Sharon, but because this was definitely a more serious episode than his usual mild sacro-iliac strain. And the car? After I had completed my examination, I asked him to sit for a moment which he did with some difficulty. ‘Danny, most of the orthopaedic tests point to an SI strain, which is what you usually have.’
‘Tell me again, Doc. What’s an SI? Sorry, I know you’ve explained it all before.’
‘It’s this joint between the sacrum and the ilium,’ I said, demonstrating to him on my very precious old dry spine. ‘SIJ for Sacro-Iliac joint.’
‘Is that plastic?’ he asked, looking at the spine.
‘No, she was a real Indian lady. India has so many unclaimed bodies that they made an industry of it, exporting spines to the world. She’s very special and I have a sense of being on hallowed ground every time I touch her. But to return to your back: As we have discussed before, SI strain can lead to injury to the disc. I’m afraid today you have a strongly positive Slump test, so I want you to take three days of bed rest. Do these three exercises every half hour, and every hour get up and go for a short walk around the house. Make a cup of tea, have a pee, you know, just get onto your feet.’
‘Why is it important to get up, Doc? It hurts so much to get out of bed and it literally took me nearly five minutes just to pluck up the courage to lie down again!’
‘During prolonged lying down, the injured joint swells, Danny. All the research shows that extended bed rest is not helpful, but I find that the rest coupled with these exercises, and getting up periodically, is what helps. Use an ice pack twice a day for half an hour, followed by a little heat, please.’ We went through the exercises carefully again. I had to be sure that he did them correctly and that they were suitable. ‘Did you design these exercises, Doc?’
‘Actually, Danny, a physiotherapist by the name of Williams gets the credit, but I’m sure the ancient Egyptians were doing them about five millennia BW.’
‘BW?’ He looked at me blankly.
‘Before Williams. Sorry, that’s a bit corny!’
‘You don’t mind using exercises credited to a physio?’ Danny laughed. He was regaining his sense of humour.
‘I’ll use anything that helps you, Danny. Physio, acupuncture, massage, even medication or surgery if it’s necessary. It’s your health, not my philosophy of care that counts.’
The next day Danny was a little better. While I was working on his back, I again noticed the battered old Beetle parked where the Carrera usually sat, provoking my envy. ‘What’s happened to the car, Danny?’
Danny was silent for a while. I gave him space. ‘The medical insurance would only pay for Sharon’s treatment for twelve months. We’re now having to find the money for her chemo. The M3 had to go.’ ‘That’s a shame. You’ll get another one in time. Bigger and better. Maybe smaller and better?’
He ignored that. I could see he was struggling with something. ‘Doc, could we talk about something that’s been bothering me?’ ‘Go ahead.’
‘Once our medical insurance ran out, the attitude of the oncologist towards Sharon changed. He just said, “Well, there’s not much more we can do now.” It was almost that now he couldn’t make any more money out of us, he lost interest.’
‘Didn’t you tell him about your topless Italian lady that you were selling?’
‘Yes, I did, but the bank owned that car anyway. Most of the saving was in the insurance that I had to pay. That insurance was enough to keep a poor man in a luxurious life style!’ he said, with a fragile grin.
‘This whole thing of the money is one we all struggle with, Danny. I know when I started in practice, I didn’t want to take people’s money so I would discharge them long before they were better. Then I swung towards greed when I wanted to buy my first glider, and tried to squeeze an extra treatment or two out of my patients. It took quite a long time to reach higher ground: that place where you take your eyes off the dollar signs and do what you have to do.’
After one year, through some fine print in the contract, the insurance company refused further medical payments. Quite rapidly Danny was stripped of all his wealth. First he had to sell his fancy car, and then their house went on the market. Sharon was a fighter, not wanting her daughter to go through the formative all-important teenage years without a mother, but first the chemotherapy and the prolonged radiation, and then the bone marrow transplant impoverished them.
‘Doc, my back’s nearly better, do you mind if we miss the last few treatments?’ Danny knew how much store I placed by the proper rehabilitation of spinal injuries. ‘I’m sorry, but I just don’t have the money for your treatment, and I think I know what to do.’
I weighed his request carefully. Should I offer free treatment? Or place the extra responsibility on his own shoulders? He did indeed know what was needed but would he do it?
‘Okay, Danny, just remember that it will be at least two weeks before you can trust your back. Those exercises must go on at least twice a day, and please try not to sit too much yet, particularly in the car or on the lounge furniture.’
Danny nodded, looking away. I was saddened to see how the first bite of poverty had reduced his usual ebullient self. Life was stripping off his protective layers, leaving him vulnerable and naked.
‘Will you phone me in a week?’ I always like to keep control until I know the patient is well. Too often one sneeze or some foolishness starts things up again.
Danny got better, as he always did, in a few weeks. But Sharon didn’t. Danny phoned me periodically, just to chat, so I knew of his wife’s slow decline as her body rejected the new bone marrow. They never found a perfect match. The funeral was a sad affair.
Danny’s second portion of pain was much worse. Fortunately, Sharon was spared the agony. About a year after her death Danny arrived home one evening, finding a dark and silent house. That happened periodically, but Tamsin always phoned him to ask if she could stay with a friend or go to a movie. By nine o’clock he started to worry and began phoning friends. ‘Have you seen Tamsin?’ But none of her friends knew anything of her whereabouts. By midnight Danny was panicking. He had phoned Tamsin’s boyfriend and all the hospitals, and the police had put out photos and her description to the newspapers. ANOTHER TEENAGER GONE AWOL. Nothing unusual about that, the police told him. They had reports of them all the time.
When I saw Tamsin’s photo on the front page of the East Griqualand Herald, I picked up the phone. ‘Any news, Danny?’
‘None, Doc. Absolutely nothing.’
‘I’m sure the police have asked you, but was everything between you okay?’ ‘Yes, absolutely normal.’ ‘If there’s anything I can do to help please let me know, Danny.’ ‘Sure, Doc.’ I could hear he was in tears.
She was never found. She just vanished from the planet. About a year later the police attempted to arrest a paedophile in East London. He first shot his girlfriend accomplice and then blew his own brains out, taking the secret of Tamsin and at least five other girls with them into eternity. They found her purse in his house.
The phone rang one Saturday evening as I drove in the gate from soaring. Helen passed me the phone. ‘Hello, Bernie Preston,’ I said.
‘Hi, Doc, this is Danny.’
‘Hello, Danny. Any news?’
‘Yes, Doc. Can I come up and chat? Would you mind?’
‘Of course, Danny. Do you know where we live in High Whytten?’
‘Yes, I’ll be there in half an hour, if that’s okay?’
With only himself to care for, relative wealth had returned to Danny’s life. He had no inclination for another ‘topless lady’ but the battered old Beatle was gone. He arrived in a good second-hand Honda Ballade.
Helen made us coffee and we sat out on the veranda. Being stuck indoors for so many hours of the week, I prefer the outdoors to the TV room. I also have a strong suspicion that when they come to write the ‘Rise and Fall’ of this civilization, TV will be one of the main causes of its demise. In any case it’s much better to have fun yourself than watch others enjoying themselves. That evening with Danny wasn’t fun, though.
‘Still no sign of Tamsin, I presume.’
He sighed: ‘Nope, she’s gone for ever. I’m sure she’s dead.’
I didn’t know what to say, so I said nothing. Eventually after another cup of coffee and a piece of Helen’s fruit cake covered with a dollop of ice cream, Danny said: ‘I’ve had an offer for a job in New Hampshire and I think I’m going to take it. What do you think?’
‘Too many bad memories here,’ I said. ‘If I was you I would go for it. I was born there strangely enough.’
‘You were born in New Hampshire! That’s a coincidence. What’s it like?’
‘Beautiful,’ I said. ‘It’s the big outdoors with dozens of lakes, and forests and ski resorts. Breathtaking. Very cold in the winter, of course.’
There was a silence for a while. ‘My only worry is if somehow Tamsin should show up, or call for help or something. I know she won’t, but I just feel I can’t go off and not leave something behind. Would you mind terribly if I put my phone through to your house for a year? I would pay for it, of course. And keep your ears open.’ He looked at me, pleading, anguish in his eyes. ‘Of course, Danny. I would be absolutely delighted to help in any way I can. When you know you’re going, give me a call and I’ll write a report for a chiropractor in the States. That way he won’t have to reinvent the wheel. We already know what pattern of adjustments and exercises work for your back.’
Within three months Danny was gone. He got his report and his x-rays which were almost new, and I got an extra phone line. It had its uses in those early internet days. I had the odd email from him but, of course, there was no sign of Tamsin. Nearly a year passed when I received a frantic email from Danny: Hey, Doc, could you advise me. I’ve started getting a few twinges in my back, so I went to the chiro in Charter’s Creek. It was no big deal but I thought I had better go before it got bad. I gave him your report and the x-rays. He gave me a thorough examination and insisted on a new set of full spine x-rays. In his report of findings, he then proceeded to tell me what serious problems I had in my spine. I would need to go to him three times a week for three months, and then once a week for 9 months. It seems an awful lot of treatment, and I’m not even really sore. In fact, with your exercises and that one treatment, I feel fifty per cent better. At the next consultation I have to sign a contract for a whole year. It sounds bogus to me, but I thought I would ask what you thought.
Charter’s Creek! What a coincidence; precisely where I was born and where most of my American family still lived.
I did a quick calculation:
3 months x 4 weeks x 3 treatments per week = 36.
Add to that:
9 months x 4 weeks x 1 treatment per week = another 36. 72 manipulations in a year! Times about $40. Nearly $3000! Medicine has been honest and openly admitted that the frequent use of antibiotics amounts to abuse. Not that some doctors are not still overly enthusiastic with their prescription pads, but at least as a profession they have begun to be more cautious. Antibiotics have saved millions of lives but over-prescription has killed a good many too.
As a much younger profession, we have not yet come to the place of defining how much manipulation is ‘too much manipulation’. Some chiropractors don’t even think there is such a thing. Research on the amount of Chiropractic care needed is now beginning to trickle in but one thing I knew: Danny was being ripped off, and his spine was about to be abused. It was little wonder my family wouldn’t consult their local chiropractor. Danny’s instincts were absolutely correct.
I’m sorry to have to say this, but under no circumstances go back or sign anything. If you have paid for the x-rays, go and collect them.
Then I would suggest you start to ask around. None of us in the healing world have a perfect record but you will quite quickly find the people will start saying: this guy is good, or stay away from that woman, for one reason or another. Follow your instincts as you did this time.
In this hemisphere, no news is bad news, I’m afraid. Not a word about Tamsin. I have taken over the payment of your phone. The extra line has come in very useful.
Let me know how you get on with the next chiropractor.
I got a reply from Danny some weeks later. Thanks for the advice. I found a fantastic lady chiropractor in the next town. I’m fine and you won’t believe it: every night when I get home it’s pitch black, so I do ten minutes of skipping!
The good chiropractor has to be something of a fishwife, something of a bully, and something of a confidant and friend. Not an easy balance to find. Then it goes without saying that you miss some patients, thinking about them long after they die, or emigrate.
That’s great, Danny. Please let me have her name. My family also lives in Charter’s Creek and they are desperately in need of a good chiropractor.
It was another five years, on a visit to my American family, before I connected with Danny again. He had married a widow with three children. They had a lovely home on the lake and we enjoyed a beautiful cruise in the boat that he kept at the dock just in front of their home. I noticed there was another topless lady parked outside their home. Yellow befitted his mood these days apparently, rather than the olive green that still suited mine.