Inside Out is a short story lifted from Frog in my Throat.
"The world is indoctrinated in medicine. People are born in a medicine cabinet and grow up in a drugstore. They have been brainwashed, hypnotized, mesmerized and drugged to believe their life-force comes from the Outside-In. Chiropractic must un-brainwash them and demonstrate that health comes from Inside-Out."
- Dr. B.J. Palmer, D.C.
Damn! I’ve got a bloody puncture, I realised, annoyed. Motorcycles
don’t carry a spare, and I was at the mercy of some kind soul.
I was commuting to the clinic on my BMW dream machine one
morning, down through the rolling hills that lie high above Shafton from
the little village of High Whytten where I live. The summer heat and
humidity of the city drives those who don’t mind a half-hour ride home
each evening, to move to the hills that rise over the city; just like
the ancient Romans used to do, only they had to rely on regular
horsepower. It is at least five degrees cooler and, more important, a
constant breeze relieves the all-pervasive humidity. My drive home
takes me through three temperature zones, which one only really notices
if one is of the privileged few who ride a motorcycle. With each change
the mood improves, the cool air chilling the brow, and reminding one
that High Whyttenis one of the loveliest places on planet Earth to live.
And there is no better way to get there than on a large, powerful
motorcycle, notwithstanding my orthopaedist friend, Jeremy Thomas’
taunt: ‘See you in hospital one day with your leg up in traction.’ What
is this fascination I have with danger, I wondered?
So I had found myself dreamily cruising down the freeway to work one morning on the dream machine. I had been glancing, out of the corner of my eye, at the Eucalyptus forests that shouldered the road, each tree covered with pale cream pom- pom blossoms, knowing that my bees, early risers like their master, were visiting those very trees that morning, bringing me in their sweet harvest, and I had not seen the sharp piece of angle iron dropped, no doubt, by one of the heavy trucks carrying steel to the coast for export. Gum tree honey may be the best, but it doesn’t pay to dream and drive. A puncture! Damn! But that’s what happens when one takes one’s eye off the road. I was irritated with myself, knowing there was no spare wheel, and I had been lucky not to have had a blowout. That would have fulfilled Jeremy Thomas’ prophecy, and I certainly did not want to give the orthopaedist that pleasure! Fortunately I had left early, planning to get on top of some outstanding reports, and so I found myself hitch hiking to work early one Monday morning. A large vintage Mercedes Benz pulled up after a few minutes and I opened the door gratefully; effusive with thanks, I slid onto the worn leather seats, thinking the Germans had certainly left their mark on the world. Motor- cycles, cars, gliders, beer. The holocaust, too.
‘What happened, doc? Run out of petrol?’ he laughed. I immediately recognized an elderly man who had consulted me a year or more before.
‘Worse than that, Mr Sanders. A puncture, and it’s going to be a few hours before I can get back here. Hope the bike isn’t stripped. How has your neck been behaving?’ I went on, relieved that I remembered his name. The old man had a very arthritic neck from an old rugby injury sustained in his misspent youth and, when I had showed him the x-rays, and explained that, since I wasn’t God, it was quite likely going to take a lot of treatment. He had declined.
“Too expensive. Can’t afford it,” he had said. You can’t win them all, I had reasoned, really believing deep down that it’s the patient’s right to decide what I may or may not do with his body, but also feeling that he had made the wrong decision.
‘Oh, it’s reasonable, all things considered. I went to my GP and he prescribed some anti-inflammatories, which do the trick. They don’t cure it, of course, but as long as I keep taking them I’m fine.’
‘That’s great,’ I replied, trying hard to be sincere and to give credit to medicine. It had obviously been successful for this old man.
‘Sorry, but it’s a lot cheaper than what you have to offer,’ he went on with a glint in his eye and an accusing look on his face that he couldn’t hide. I squirmed, realising that he thought I had tried to rip him off. Billy the Kid in a white jacket. We chatted on about the Tri-nations rugby tournament, and this and that, until we were quite close to my office. As a parting question I asked: ‘And have you been well, generally?’
He turned to glance at me and then grunted, ‘Actually I nearly died last month. I got a terrible pain in my tum one Saturday night. Bleeding ulcer. Cost me a packet.’ We had just reached my office and, as I was getting out of the comfortable leather seats, one last question still begged an answer: ‘Still on the anti-inflammatories?’
‘Of course. They are the only things that work for my arthritis.’
He looked at me mystified and still clearly had no idea that it was
the drugs that had nearly cost him his life and which had certainly
dented his fortune. He did not know that anti-inflammatories, especially
when taken for long periods, were a prime cause of stomach ulcers, and
someone was still supplying him with what was, for him, a terrible
poison. I resolved to make a bigger effort to encourage my patients not
to be penny-wise, pound-foolish. The reductionist philosophy of health
that modern medicine was offering Mr. Sanders certainly wasn’t working
for him and he obviously couldn’t afford the new generation
anti-inflammatories that allegedly didn’t rot the gut or increase
bleeding, though I had my doubts.
Inside-Out? Outside-In? Where is the irrepressible life- force found? In magic bullets bought in a pharmacy? Deep within our inner being? And what blocks that love of life? These are questions that every doctor is faced with and, depending on how he or she grapples with them, profoundly affect the way he practises. Trained as a chiropractor, of course, I knew how subluxations of the spine can and do block that innate life force that lurks deep within each of us, but I had not been in practice long when I began to realise how much more doctors have to offer than simply adjusting subluxations of the spine and prescribing drugs. For the passage of life is far more complex, and that which impedes the life-flow far more sinister, than just bacteria and viruses, subluxations and fractures. Everyday I am faced with people whose life-force is being blocked by exhaustion and too few holidays, a lack of exercise and indulgence in the junk we like to call food. At war with themselves and with God, and under the judgement of others and self, doctors are surrounded by patients whom we diagnose and categorise with a “dis-ease”, but who are in fact just ill at ease with themselves and with life. ( Inside Out )
One of the strangest parts of practice
is that it never rains but it pours. My first patient that morning was a
middle- aged Indian woman who had consulted me for some years with a
variety of ailments ranging from a sprained ankle to a clicking and
painful jaw joint. Mrs. Naidoo was deeply distressed and it was some
time, and several handfuls of tissues, before she could talk to me.
Every time she started, the sobs and tears would begin all over again.
‘M-m-m-Morgan d-d-d-died last week,’ she finally
managed to blurt out, followed by another flood of tears. I had known
Morgan since he was a boy. He suffered froma dreadful affliction called
Juvenile Rheumatoid Arthritis to which none of the healing arts or
sciences seems to have an answer. Morgan controlled the pain and
swelling of the arthritis with aspirin and was managing quite well while
studying for the bar in Johannesburg. So much I knew. I recalled that
his mum had told me that he also needed anti-depressants to control his
‘He had this terrible pain in the stomach,’ she finally managed to
continue. ‘His housemates finally took him to the hospital, but there
had been a combi accident with some terrible injuries just before they
arrived with Morgan, and so they put him in a cubicle for an hour. By
the time they got to him Morgan had bled to death. In his stomach,’ she
went on, pointing to her abdomen.
It remains one
of the great dilemmas of health care that we all have to guard against.
The obviously broken arm appears to need attention before the still
undiagnosed pain in the abdomen. The very painful back seems more
important than soaring blood pressure. The fractured hip may distract
from something far more serious - but less obvious. Morgan had died
needlessly, simply because an overtaxed emergency room simply didn’t
have the staff to keep a check on the vitals of a young man with a pain
in the abdomen. And he was allowed to medicate himself with an
over-the-counter drug as common as aspirin which, when taken in
conjunction with anti-depressants, had greatly increased the risk of
I had tried all day to keep my perspective
on orthodox medicine and found myself quite disturbed by the day’s
events, when my last patient, an influential elderly cleric consulted
me. I first saw him out the corner of my eye as he walked down the
street outside my office, when he stooped to look at my BMW, which had
by then been retrieved. He peered at the gauges and then stooped to look
at the classic horizontal pots, unique to the famous German design.
Gingerly he sat astride the old motorcycle, looking for the kick-start.
Even from my window I could see the slight frown that creased his brow
as he fiddledwith the electric starter button. He certainly looks right
at home on the old girl, I thought, watching him through the window,
getting over my apprehension at this stranger sitting on my motorcycle.
‘Good afternoon, sir,’ I opened the conversation, shaking his hand as my secretary passed me his file, wondering about this tall, slightly stooped, old man obviously near or over eighty. He was neatly and formally dressed as was the way with his generation. Nothing less than a collar and tie when you consulted any doctor, or even went to the public library. The Reverend Sean Fitzpatrick was a retired Irish Baptist minister.
‘Good afternoon,’ he replied in a strong voice with a beautiful Irish lilt. He still had a full head of hair but I could see that he wore thick spectacles. He was obviously suffering from less-than-excellent eyesight, a cataract perhaps. ‘I hope you can help me. I seem to have hurt my shoulder.’
‘When did it begin? Do you know what caused it?’ I was already beginning to warm to the man. He had the charm and relaxed manner of a person who knows what he’s about. No fumbling about in the dark, here, I thought.
‘Yes, I think it started after I ran into the wall chasing a short ball about a week ago, while I was playing squash.’
‘You were playing squash?’ I asked, somewhat dubiously.
‘Yes, I have a weekly game with a friend of mine.’
I had quit playing racquets myself in my mid-forties after repeated episodes of low back pain, and I looked at the man with growing respect. ‘And are you in good health?’ I asked. ‘Any serious injuries or diseases?’
‘Yes, I’m in very good health, all things considered. My eyesight’s not so good anymore but I passed my flying medical six months ago.’
‘You’re an active pilot?’ I asked, astonished. ‘You’re pulling my leg, surely?’
‘No, I got my license at sixteen but, after two years on Spitfires during the war, I had to let it lapse. Couldn’t afford it on a minister’s salary,’ he went on with a smile and no hint of bitterness. ‘Then my son bought a Cessna about twenty years ago, and I started flying again.’
‘So it’s sixty-six years since you got your pilot’s license.’
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I shook my head, feeling very inadequate with only ten years in my glider. ‘You could be in the Guinness book of records!’
‘Yes, that’s correct, it is over sixty years, but I have digressed. You asked about injury and other disease. I had to bale out once and broke some ribs but fortunately I landed in France and the Marquis smuggled me out once my bones had healed. And I became diabetic soon after the war.’
‘So, you’ve been diabetic for over fifty years,’ I said, looking down at his date of birth. ‘On insulin?’
‘That’s correct, I inject myself three times a day, occasionally four,’ he replied. ‘The enforcer has been my saviour,’ he went on with a smile. ‘She makes sure that I get the right diet and we’ve walked daily ever since I was diagnosed with diabetes.’ ( Inside Out )
I was completely astonished by the elderly vicar.
Obviously he applied the same rigor and discipline to his physical life
as he did to his soul, and the benefits were plain for all to see. An
active pilot, racquets once a week and an insulin- dependent diabetic -
at eighty plus! And he still preached on a regular basis but without the
responsibility of pastoring a church.
‘You’re retired, I presume?’
‘Well, yes. I’m not responsible for pastoring a congregation, but I still preach regularly.’ That word “retirement” isn’t found in the Bible, I thought to myself. It certainly hadn’t done this old man any harm. That prompted me to think about my own profession where not too many chiropractors retire either. They just drop dead in harness. I must have frowned.
‘It’s not all bad,’ he said with a smile. ‘We also travel regularly to visit family and friends. The preaching gives me a focus and meaning whilst most men my age are just waiting to die.’
‘True. It also keeps you out of the dreaded old-age home,’ I remarked. ‘You’re also less likely to get Alzheimer’s disease, I suspect.’
The elderly cleric had pulled a muscle in his shoulder when he
had run into the wall, trying to defend his face and spectacles with an
outstretched arm. He responded very quickly to some straightforward
chiropractic treatment for a pulled rotator cuff muscle and I referred
him on to my partner, a physiotherapist, who specialised in
rehabilitation. I set a lot of store by rehab of spinal conditions but
other injuries I usually refer to my colleague for the final care.
Otherwise the pain soon returns.
One day, after the fifth treatment, he looked up at me after seeing my red demon standing outside the window: ‘Is that your motor cycle out there?’
‘Yes, it is. I noticed you admiring it the day you came for the first consultation.’
He blushed for just a moment: ‘My apologies, yes, I took a liberty there. I hijacked one once from the Boche in the Northern Desert and rode it for almost two years. Same bike but mine was black, of course. The Bing carburettors are new, and those disc brakes are an improvement. Pity about the electric starter, though,’ he finished with a wink.
‘You are certainly a stickler for keeping it authentic!’ I said
with a laugh. I knew that my short legs would battle to start the heavy
engine. ‘Same engine, though. Precisely the same configuration. I had to
strip mine a few times to get the sand out. Fortunately the tolerances
were designed fairly generously.’
It was only later that evening, as I pondered the day’s events, that I realized that the Reverend Fitzpatrick was the corollary to my dilemma. He was utterly dependent on insulin; and it came from the outside-in. Good allopathic care, a wife who kept him on the straight and narrow at the dining room table, and plenty of exercise, had kept him in fine fettle. ( Inside Out )
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