This past June, John Whaley retired after 45 years as a doctor of chiropractic, but plenty of his colleagues wish he'd hung up his plastic model of the spine years ago. "'You son of a bitch--you're going to get a bullet in the head!'" he says, mimicking the anonymous phone calls he and his wife used to receive. "The plate-glass windows in my office were smashed four times in five years, coinciding with the times I had bills in the legislature. It was costing me over a thousand dollars a hit, and finally my insurance company dropped my coverage....I would go in disguises because I didn't know who was out to get me. It was fun!"
Throughout his career, Whaley has waged countless battles against an antiquated state law that treats chiropractic as if it were medicine. To many of his fellow DCs, Whaley seems bent on taking them back to the day when chiropractors were equated with snake-oil salesmen. His critics are known as "mixers," while Whaley is a "straight." The struggle between straights and mixers is almost as old as chiropractic itself, driven by its founders' personality cults. It's positively Shakespearean in its intrigue, with stories of street fighting, blatant corruption, one-upmanship, revenge, and even suicide. But the real tragedy is that the turf wars have left their profession unable to characterize itself with a single voice. So deep and abiding is the mistrust between the two sides that the chiropractors I've met compare themselves to the Israelis and the Palestinians, or the Catholics and the Protestants in Northern Ireland. This too, they suggest, is a war of attrition.
Indeed, each side looks at health from a different perspective. The straights promote vitalism, the belief that life is more than chemical actions, that it is unknowable and self-determining. The mixers promote mechanism, the belief that our bodies are machines, that their processes can be explained by the laws of physics and chemistry; they make medical diagnoses but follow them up with natural therapies. According to the straights, the mixers are polluting the profession for economic gain and fiercely protecting the laws that sanction their approach because they fail to understand the "nobility of chiropractic."
The debate continues at the highest levels of academia, yet over the past several years, with more and more people embracing a holistic model for health care, the economic, political, and social stakes have risen dramatically. Both sides agree that the schism has allowed other enthusiasts of natural healing, like Deepak Chopra and Andrew Weil--both MDs--to appropriate many of chiropractic's unique principles, popularize them, and walk away with the spoils. Meanwhile, chiropractic remains underutilized and unappreciated, and the more than 260 techniques that have sprouted over the years may have led to confusion not just among the public but even among the current generation of practitioners. As a result, while chiropractors are the third leading health-care providers after physicians and dentists, last year only 11 percent of the U.S. population visited a chiropractor, a growth of only 5 percent over the past 70 years.
On his last day of practice Whaley dashes from office to waiting room as though flames are licking at his heels. At 70 he is still boyish, with his Woody Woodpecker laugh and stick-figure body. The decor seems youthful too, figurines of elves and leprechauns fastened to air ducts and clinging to soffits, the office walls adorned with bons mots, some corny, some religious. A framed notice at the front door informs patients that this doctor still makes house calls.
Many of Whaley's patients have been with him for decades. Coming in off West Belmont, they seem like working-class Middle Americans, hardly the type to go the natural-healing route. They've traveled from all over--Joliet, Milwaukee, Saint Charles--for Whaley's brand of straight chiropractic, which focuses on the upper cervical, the two top bones of the spine known as the atlas and the axis, or C1 and C2. No matter where they hurt, or whether they hurt at all, Whaley adjusts only these two small bones.
Straight chiropractors believe that the nerves housed in the spine control and coordinate every cell in the body and that trauma to the spine causes what they call a "vertebral subluxation." This nerve interference ultimately robs us of our vitality, leaving us open to sickness and disease. The first subluxation occurs at birth, when we're yanked headfirst out of the birth canal; with the regular twists and turns of daily living, it's all downhill from there. By the time we manifest symptoms, we've probably been subluxated for years. When proper alignment is restored through a prescribed force, the body can achieve maximum self-healing potential. Unlike their mixer colleagues, straights refuse to diagnose or treat symptoms; they merely correct the vertebral subluxation and let the body do the rest; when under regular care, they argue, our innate ability to heal ourselves is limitless. Straights call this ability the body's Innate Intelligence. The process is guided by a Universal Force, the source of all space and matter and the power that governs all living things: when a person cuts his finger, it knows how to heal itself.
Whaley's patients are so familiar with his technique--a quick, light thrust on the side of the neck--that many announce whether they're in or out of alignment before he's even checked them. One wonders whether they really grasp the cosmology behind the adjustment, so steeped are Americans in traditional medicine, yet they seem to trust Whaley's simplified explanation, mainly because they've seen results. (In the interest of full disclosure, I've been a patient of straight chiropractic for two years.) One man, a slave to colds and flu, says that the treatment has strengthened his immune system and now he takes hardly any medication even when he does get sick. A 75-year-old woman hopes the upper-cervical adjustments will slow down the macular degeneration recently diagnosed by her MD. A recovering drug addict says his adjustments helped soften the blow of heroin withdrawal and now fulfill a transcendent need. These people may not speak the popular lexicon of the day--wellness this, alternative that--but they do come for a mind/body/soul experience rather than waiting for some malady to befall them, as the medical model dictates.
Illinois was one of the first states to license chiropractors, under the Medical Practice Act of 1899. Its broad scope--and somewhat convoluted logic--defines chiropractors only by what they cannot do. The statute allows them to "treat human ailments without drugs, medicine or operative surgery." This means that anyone can colonize any of the other healing arts and provide supplemental care such as acupuncture or physical therapy without earning a license in those fields. He can offer diagnostic services and medical specialties such as gynecological or proctological exams without a medical degree or a board of his peers governing his profession. Instead he's disciplined by and beholden to a medical examining committee consisting of five medical doctors, one osteopath, one chiropractor, and two members of the public. Osteopaths once stood shoulder to shoulder with chiropractors as opponents of the medical model, but now that they've been all but absorbed by the medical profession, the scales are tipped mightily against the straight chiropractic agenda.
John Whaley spent much of the 80s schlepping in and out of legislative hearings and courtrooms in Springfield, lobbying and testifying for a law that would establish a chiropractic board of examiners--he calls it the "ten-finger law," in honor of the etymology of chiropractic ("practiced by hand"). He declared himself spokesperson for the Consumer Protection Committee on Chiropractic Practice, claiming a membership of 11 million--all of Illinois' residents. "I was the only guy who was a member," he admits, "but I got respect in Springfield."
The evidence proves otherwise. In one of his more futile efforts he went before the state senate's licensing committee in 1985. "I thought, 'This is going to be my chance.' I got support from all the major newspapers, from Saint Louis up to Waukegan." According to Whaley, one of those papers would prove to be his downfall: earlier that year he'd leaked to the Chicago Tribune a conflict-of-interest story involving state senator John Davidson. A chiropractor with mixer leanings, Davidson kept an adjusting table in his office and would give his colleagues friendly tune-ups, which the article alleged might have influenced the recipients in favor of the mixers' agenda.
"State senator Emil Jones was chairman at the time. I walked in the room to testify, and the room was packed with senior-citizen women who were there for other bills to be heard after mine. All of a sudden there was this outburst from state senator John D'Arco. The word has lost its shock value, but he yelled out three times in a row, F-you! F-you! F-you! Do you know what I'm talking about? They were establishing a climate of intimidation, and they were going to teach me a lesson for putting them on the spot. Well, it didn't affect me one bit. I'd been through it before, and it didn't scare me." Whaley never got a chance to plead his case. "Just before my bill was to be called, another state legislator, who has since passed away, said, 'We all know what we're going to do with this guy's bill,' and everyone started laughing. Before I could say anything. Emil Jones announced that [they] were meeting for supper and that was it."
Every year since 1923 a bill has been introduced to the legislature to change the old law, and every year it's been defeated. In 1999, Americans spent an estimated $1.2 trillion on health care, and Whaley believes the current laws are inflating consumer costs. "I've gone to insurance lobbies, the guys who pay for duplicating procedures because of the mixing thing. The answer I got was, 'We deal in billions, so what's a few million?'...I tried to enlist the support of the American Physical Therapy Association and the AMA. I approached the midwest state medical society and said, 'Look, I've got the mouth, you've got the money, and I know that you'd like to get rid of all chiropractors, straights and mixers. Unfortunately, from your point of view, we're still here. But who would you rather live with, the straights, who are not trying to get into the practice of medicine through the basement, or the mixers, who are trying to do what you're doing without meeting your academic standards?'"
The campaign continues, and Illinois remains one of the only states in the country with such a sweeping law. Whaley calls it "legalized quackery" and worries that the public, unaware of the statute, is exposed to potential harm.
"Chiropractic is not an adjective to describe what kind of physician you are; it's a noun. It's separate and distinct. If the mixers want to keep doing what they're doing, why not establish a separate healing science? Let them call themselves Mixer Doctors for MD, if they think they have a medical degree! Then they can give enemas, colonic irrigations, and pluck lint out of belly buttons if they want to."
Dr. James Winterstein wears a navy blazer, gray slacks, aviator glasses, and a thin mustache. His graying hair is patted firmly to one side, and his skin is uncommonly smooth for a man of 57. Winterstein is president of the National University of Health Sciences, the only chiropractic school in Illinois, and his definition of chiropractic is 180 degrees from Whaley's. "Chiropractic," he says, "is what chiropractors do." He sighs deeply. "I would be chastised by the straights for saying that." Having fought this battle for years, Winterstein often amends his statements with comments about how the other side will perceive them. "Here's the point for me. Chiropractic was founded a long time ago. What makes anyone think that our profession should not progress?" This gets to the crucial point of departure: the straights use the past to interpret chiropractic and the mixers let the law be their guide.
To find the source of this festering conflict one needs to turn back to the 19th century. It's been said--sometimes with pride but often with derision--that chiropractic sprang from the ranks of the workers, and before founding the profession in 1885, Daniel David Palmer of Iowa worked as a grocer, a beekeeper, and a goldfish breeder. A self-educated man who eventually became a demanding teacher, Palmer came of age during the era of Thomas Edison and Henry Ford, not the type to let a few holes on their resumes get in the way of success.
Palmer began dabbling in natural-healing methods not long after moving to the U.S. from Canada at the end of the Civil War, and for several years he practiced magnetic healing, or the "laying on of hands." After reading numerous medical texts Palmer began to doubt the allopathic philosophy, which is based on diagnosing symptoms and prescribing drugs, and decided instead that the spinal column held the key to human physiology.
In September 1895, Palmer got an opportunity to test his theory on a deaf janitor, Harvey Lillard, who 17 years earlier had been working in a stooped position, heard a pop in his back, and soon lost his hearing. Palmer found a bump on one of Lillard's vertebrae, administered the first chiropractic thrust, and restored the man's hearing. Shortly thereafter he encountered a patient with a heart condition, found another misaligned vertebra, adjusted it, and again the patient recovered. If two diseases so dissimilar could be treated through the release of spinal impingement, he deduced, then others might too.
Palmer's "one cause, one cure" theory would challenge the newly anointed germ theory and provoke a thunderstorm of criticism from the medical establishment, which labeled him a quack. Nevertheless, the profession flourished, Palmer lambasted traditional medicine, and in 1897 he established Palmer School of Chiropractic and Cure in Davenport (later changed to Palmer College of Chiropractic). In a decision future generations would rue, Palmer also began to train medical doctors in chiropractic, and enterprising converts would open schools everywhere.
In the early days, graduating students simply left Palmer and began to practice. Not surprisingly, the medical establishment swooped down, demanding that they be prosecuted for practicing medicine without a license. The laws regulating medical practice in Iowa were passed in 1887, only two years after Palmer pioneered chiropractic. He probably could have obtained a medical diploma if he'd chosen to, but doing so would have been an affirmation of medicine. Chiropractic was recognized as a separate and distinct profession through an 1888 decision of the Wisconsin Supreme Court. Nelson v. Harrington, a malpractice suit against a physician who used clairvoyance, established the concept of separate schools of medicine and became the basis for all schools of healing arts. A school of medicine, the decision specified, had to have (1) a separate theory, (2) an institution that taught it, and (3) a profession that adhered to it. Chiropractic won its first court victory in 1906, based on Nelson v. Harrington, and eventually state legislatures began to pass licensing laws for the profession.
In order for chiropractic to remain legally defensible as a separate and distinct healing art, Palmer began assigning verbiage consistent with the ruling. From that point on, chiropractors did not diagnose, they analyzed; they did not give treatments, they performed adjustments. Most important, they would refer to a misalignment as a subluxation, while the mixers would later term it a fixation, to be addressed by a spinal manipulation. These terms would politicize the profession, and they remain a foolproof method of determining whether your chiropractor is a straight or a mixer. The hairsplitting extends past medical terms into the statements of the profession's founders. The term straight originated with Daniel David Palmer--"D.D." to his followers--who is quoted as saying, "We give chiropractic to our patients straight. If it were mixed with all the other methods offered, it would soon lose its identity." But the last line is omitted in the mixers' literature, who argue that Palmer meant "straight" to mean truthful and honest practices.
In this regard they had little trust in D.D.'s son. B.J. Palmer was a student in his father's first graduating class, in 1902, and would immediately set about making his mark. In 1904, D.D. Palmer was jailed for three weeks after refusing to pay a fine for practicing medicine without a license. In a move that was marketing-savvy even by today's standards, he capitalized on his predicament and began to build his case for chiropractic and against the medical establishment by writing articles in his jail cell and passing them along to his brother, a newspaper publisher ("Medicine," D.D. declared, "is guilty of not getting people well"). A short time earlier father and son had drawn up legal papers giving B.J. financial oversight of the college, and with his father behind bars, B.J. seized power, demoting his father, barring him from entering the school, and pilfering his title as chiropractic's "developer." (D.D. is still considered the "founder.") Daniel David Palmer would die in 1913, itinerant and financially beholden to his son.
Later B.J. would not so much sway from D.D.'s fundamental principles as tighten the screws on them, demanding loyalty to the legally sustainable definition of chiropractic. A magnetic figure, he made up epigrams (or rather hired someone else to make them up) and even words (spizzerinctum, for instance, denoted the energy unbound by empiricism). He wrote over 30 books on chiropractic, known simply as the Green Books and treated as scripture by the straights. To spread the word, he bought radio stations like WOC (Wonders of Chiropractic), which gave Ronald Reagan his start, and WHO (With Hands Only) in Des Moines. From his mansion on Brady Street, called "A Little Bit of Heaven"--a garish cloister brimming with artifacts from his world travels--B.J. would deliver his broadcasts, pledging to "save, sell, and serve chiropractic." The sell was critical; B.J. ushered in an era of entrepreneurialism that wouldn't level off until after his death in 1961. For example, after an instrument called the neurocalometer was invented to measure heat differentials of the spine, B.J. required his students not only to use the instrument but to lease it from him.
Straights would say that mixing began when some of Palmer's MD students began to jump on the gravy train and integrate chiropractic into their familiar allopathic therapies. But the mixers became a countervailing force in 1906, when John Fitz Alan Howard, a disaffected faculty member, resigned from the Palmer School and founded the National School of Chiropractic in Davenport. Favored and respected by D.D., Howard had lost his primacy under B.J., who made the mistake of humiliating him in front of a group of Palmer students. According to the mixers, D.D. had railed against his son in several letters to Howard and encouraged him to defect. After leaving Palmer, Howard also took the heretical step of enrolling in medical school. Not long after earning his degree he moved his school to Illinois, where the Medical Practice Act was friendlier to his broader interpretation of chiropractic, what he called "the rational alternative" (though whether he meant an alternative to straight chiropractic or just B.J. Palmer is open to debate). The school's first home was on Congress in Chicago; in the 1960s it moved to Lombard, where it remains one of the preeminent mixer schools in the country and a powerful force in Illinois.
Despite their antagonism, both sides agree that the medical profession might have extinguished chiropractic if not for B.J.'s militancy. B.J. refused to apply to a medical board of examiners for licensing, instead forming the International Chiropractors Association--an enduring straight organization--and rallying his forces to deliberately violate the law by practicing unlicensed. When it came to the medicalization of chiropractic, he was unflappable. Subjects like chemistry and physiology were taught at Palmer but were explained through the chiropractic rationale. B.J. balked every time the mixers spoke of enlarging curricula and insisted that the school's 18-month course was all his students required; like his father, B.J. believed that the "educated mind" was on a collision course with Innate Intelligence. Not until years later, when his son, Dave, became president of Palmer, would it comply with accreditation standards. Every subsequent attempt to increase state accreditation standards would raise the hackles of the straights and create new rebellions.
Winterstein, who presides over the school Howard founded, speaks frankly about his frustration with the "zealotry of the straights." As former president of the Council on Chiropractic Education, which provides accreditation for college curricula, he had to contend with the straights whenever the mixers pushed for higher standards.
"Every time we have tried to raise the standards the split has fallen along ideological paths," complains Winterstein. "For example, to get into National you need a bachelor's degree. There's not a single straight college in the country that has that requirement. If you look at other professional doctors--osteopathy, podiatry, dentistry--94.5 percent of allopaths have a bachelor's when they come in to school, whether it is required or not. Why shouldn't chiropractors?"
NUHS has a four-year, 90-credit-hour curriculum. Its chiropractic program, says Winterstein, is highly integrated, with subjects "relating to the spine as an anatomical entity" making up about 30 percent of the course work. It was under Winterstein's tutelage that Howard's National School of Chiropractic changed its name to National University of Heath Sciences and took the spine out of its logo, explaining that its mission "reaches beyond the anatomical borders of the spinal column."
"After reading a book on alternative medicine about six years ago," explains Winterstein, "I went to my board and said to them, 'We have to be thinking about this.' My question to them was, 'Do we want to become competitors or colleagues?' We took the barriers down right away by taking chiropractic out of our name. 'We've spent the better part of the century fighting with the MDs,' I said. 'Let's not do the same with six or seven other healer groups. Let's form a university and bring these things into an integrated practice.'" Winterstein believes the move was in keeping with their founder's intent. "Our work is to harmonize therapies so that the body can heal. Howard wanted to use natural therapies. He meant things offered by nature such as hydrotherapy, nonpoisonous botanicals, and the spinal adjustment--which we can question if that really is."
To some he may sound bent on subverting the legitimacy of his chosen profession. "Their fundamental concept is metaphysical," says Winterstein. National University of Health Sciences "teaches philosophy as a process through which one searches for the truth, and science to objectify our direction and purpose. [Straights] have an idea that what they do is God given, to the extent that they are really wrapped up in their own little world."
Yet for all the lambasting the Palmers heaped upon medicine, both showed a willingness to coexist with it on their own terms--D.D. when he trained medical doctors, and B.J. when he established the Palmer Research Clinic. So committed was B.J. to demonstrating chiropractic's efficacy that he employed a medical staff at the clinic to validate the research using the medical model; patients were fully diagnosed by an MD and then treated chiropractically under medical monitoring. From roughly 1935 to 1961, when B.J. died and the clinic closed for lack of research funds, it amassed documented case studies that revealed positive results.
Winterstein knows as much about prejudice as any chiropractor. While working his way through chiropractic school, he held a night job as an X-ray technician, but he never told his medical colleagues about his studies. When the truth finally came to light, he was told that chiropractors were a "menace to society" and "on the same social level as prostitutes and dope addicts."
How far has he strayed from his beliefs? "I personally believe that the spinal manipulation has a salutary effect on human beings for reasons we don't understand. To try to tie it to a vertebra being out of place doesn't make sense--anatomically and physiologically it's a mistake. Look, I took my youngest daughter through two bouts of pneumonia with no drugs whatsoever. I'm very convinced of chiropractic." Once we become adults, he believes, things are more complicated. "The nervous system in a child is very responsive and any application, like the laying on of hands for example, tends to have a rather dramatic reaction." I'm surprised that he believes the laying on of hands can be measured yet a subluxation cannot, and I ask him a second time to make sure I've understood. "When you put your hands on somebody something happens," he says. "We can see temperature changes, heart rate, and respiration--two people in love can tell you that."
At the time we met, Winterstein's wife had been ill with cancer. "I no longer give my wife adjustments because the last time I did I broke her rib. I don't know what the straights would say about that." His voice is rigid with fury and conviction. "I believe doing the right thing for the right reason will make it come out right in the end. That's where I get my metaphysics."
Vern Whaley, John's father, was an editor for the Chicago American and the Chicago Tribune in the days when newspapermen had more political pull. At a time when the medical profession was routing straights for practicing unlicensed, Vern turned his support of straight chiropractic into coverage when other papers would sooner report UFO sightings.
"It all came from my dad. He was a big chiropractic believer. In the early 1900s he worked in a small town in Iowa when millions of people around the world were dying of the flu epidemic. He said people who were seeing chiropractors were surviving. But they weren't treating the flu, they were adjusting the spine."
He also had his entire family under chiropractic care. "In my third year of high school I was so sick with asthma and allergies I could hardly walk," says Whaley. "My dad took me to an upper-cervical chiropractor, and by my fourth year I was well enough to be running cross-country and track. I didn't get better right away; I still suffered with hay fever and allergies, but as time went on I didn't have any of that. Nothing changed in the environment, I just wasn't reacting to it anymore." His younger brother Jerry was showing symptoms of polio at the height of the epidemic. "His legs were paralyzed, he had high fever, stiff neck, and back pain; he couldn't move. My dad didn't take him to the hospital, he called Dr. Ira Brown, who was our upper-cervical chiropractor. He came to our house, stayed all night in our home, checking and adjusting my brother. By the next day all the symptoms were gone. He's 67 years old now."
Vern continued to use his political clout on behalf of straight chiropractors. In the 50s he is said to have convinced Governor William G. Stratton to pardon Brown, who at the age of 75 had been serving a six-month prison term. As president of the Chicago Editorial Association, Vern advocated straight chiropractic to his members, many of whom became true believers. And in 1971 he successfully lobbied to get chiropractic included in the nation's medicare bill--an effort that would also prove bittersweet for the straights, who would see many of their colleagues add on therapies in pursuit of ever-increasing insurance reimbursements.
John Whaley graduated from Palmer in 1951--the first time. Too young to receive a diploma, he signed on for a second tour, and was in one of the last graduating classes to be called 18-month wonders. "Some of the best chiropractors had the least education," he says. "We were taught to analyze, X-ray, and adjust the spine. All the education doesn't get anybody well. It's how good you give an adjustment. You have to know how to correct the subluxation. There was no glamour or prestige; you just went out and got people well." Whaley remembers Palmer students practicing on automobile tires, using the resistance and give of the rubber to increase their speed and perfect their line of drive. He and his roommates would set their alarm clock for 3 AM and, military style, perform rapid-fire "adjustments" on the tire.
He had his father's stomach for combat and began agitating on his own behalf in 1955. When he returned from Palmer to Chicago to practice, his out-of-state degree was unwelcome. But instead of bucking the legal system, he went to court and sued the medical board of examiners, and it granted him the right to take the medical boards. "I studied 12 hours a day for six months," he says. "I took the test, passed, and became the first chiropractor from Palmer College to practice in this state." He went on to testify for countless other chiropractors and even organized appeals to raise funds for families of chiropractors who'd gone to jail. The early days were exhilarating for Whaley. Idealistic and full of righteous indignation, he and his peers rounded up hundreds of busloads of patients to descend upon the state capital in solidarity.
In the meantime, the medical profession stepped up its smear campaign against chiropractic interlopers. In the early 60s the chiropractic profession filed an antitrust suit charging the American Medical Association with an illegal boycott. Wilk v. AMA revealed that the AMA made it unethical for an MD to refer a patient to a DC or even accept a referral from one. In 1990 the court of appeals found the AMA guilty, ending one of the longest antitrust battles in U.S. history. Chiropractors claim the AMA suit marginalized them and denied them access to federal research funds, and if their reputation has been burnished since the '60s, they continue to play catch-up. Though straights and mixers united to fight the AMA, mixers now contend that their ability to demonstrate professionalism was what won the suit. Everyone agrees that the schism continues to feed the profession's shaky public image. As one chiropractor put it, "We're the only profession who circles the wagons and points inward."
During the 50s two of the most powerful mixer associations--the American Chiropractic Association and the Illinois State Chiropractors--worked to maintain the legal status quo. Some say they routinely undermined the straights' efforts to gain licensure through the creation of a chiropractic board of examiners. "They got the courts to determine that their license was a property right that was being infringed on," Whaley recalls, "and they were able to get injunctions on the unlicensed chiropractors, which would have put them out of business without a court trial. If they violated the injunction they were put in jail. We were being prosecuted criminally and in civil cases." Publicly shamed and cut off from their income source, some straights didn't fare well. Roger Richardson was an outspoken straight in River Forest whose violation resulted in a six-month prison term in the late 50s. The trial cost him $10,000 and his savings, and after failed attempts to provide for his family in other careers, he took his own life.
In 1970 the two sides found a common cause when the Association of Chiropractic Colleges, a union of college presidents, tried to create a unified accreditation agency that would be recognized by the U.S. Department of Education and be free of political control. A year later the chiropractic profession established the self-governing Council on Chiropractic Education, but the honeymoon was short-lived. The old disagreements over standards soon led to binding arbitration, government officials declined to get involved in the dispute, and in 1974, acting in what the straights would call blatant subterfuge, the CCE unilaterally reapplied and won approval for its broader standards. Many college presidents, tempted by federal funding and eager for recognition, jumped ship. With the CCE leaning sharply toward the mixer side, straight schools have been required to expand curricula, which they say is outside their orbit, to accommodate state needs, and all attempts by the straights to have the CCE expunged have failed.
Tim Bessette is a disgruntled graduate of NUHS who "came in when they were taking out the colonics," he says, referring to a therapy once taught at the school until it was judged to have harmful effects. After graduating in 1992, he practiced as a mixer for a while and then flipped to the other side. "I have a problem with the education I got at National," he says. He contends that its scope is so broad as to be unfocused, rendering his education undefined. "I'm giving you money to educate me in chiropractic. I was taught how to do things like look into someone's eye to identify problems. But dilating the eye requires drugs. Why teach me to look into someone's eye if I can't dilate it?
"I had a little girl come in here the other day. She jumped off a deck and hurt her ankle. It looked pretty bad. Did she get an adjustment? Absolutely, but I made the assessment that she should have the ankle looked at by someone else. [The mixers] probably would have X-rayed her, maybe used some electrical stimulation. Would that really have been the best thing to do? I hope I'm wrong, but I know I wouldn't want my parents or my sister to see a chiropractor if they ever had a serious health problem."
During his mixer days Bessette says he became increasingly depressed at the idea that he had become a "pain doctor" and one day decided to turn his coat. "My practice and life took on new meaning when I stopped using all this other stuff. I changed overnight. Let's rock 'n' roll! I felt like the shackles were gone because that was not who I am. Now, when a patient comes in with a problem I educate them on how to make the right decision." Mixers have a harder time with that, he says, because pain is their only system. Bessette tells the story of one woman who came in to see him for lower back pain "and then all of a sudden she came in crying one day, because she conceived after she'd been told she was never going to be able to have a child. My focus was to remove the subluxation, but Innate opened her up and now she's having a baby."
Winterstein is not convinced. "Usually what I find is that people who come out of here and go the other way are looking for something in the way of personal faith. People like Tim graduate and are looking for something that is not part of themselves. They find it in the enthusiasm that is generated by these emotion-based chiropractors. They grab ahold of it and say, 'This is what I've been missing and what a terrible school that didn't give this to me.'"
"He makes a good point," says Bessette. "I think we are all searching for meaning. If you're not open to that then you're probably shutting something off. But am I talking about metaphysics or simple anatomy and physiology? We have to find a common ground or we're not going to get anywhere. What is the common ground? The subluxation. I can pull out Gray's Anatomy right now and read to you that the purpose of the nervous system is to communicate from the brain to the body. My point is, we need to protect the nervous system and make sure it stays healthy. I would love for people to know the word subluxation and think of it as heart disease because it's just as damaging."
Like it or not, the professor and his former student find themselves taking their agendas before the same audiences. Winterstein, a formidable force in Illinois chiropractic, has helped lay the groundwork to have his brand of chiropractic included in government health-care policy. A five-year study introduced chiropractic care on 32 military bases throughout the world and found it to produce positive results and considerable savings. The Department of Defense recently decided to adopt it, and the Department of Veterans Affairs will likely follow suit.
Last March the House VA Committee visited National University of Health Sciences in order to observe chiropractic education and primary care. While Winterstein was making his presentation, Bessette and another straight chiropractor showed up uninvited and circumvented Winterstein's presentation by taking the VA visitors aside and arguing the importance of vertebral subluxation. Bessette recalls the VA representatives' slack-jawed surprise upon learning that chiropractic students conduct palpitory genital exams: "What does a gynecological exam have to do with the spine?" Winterstein remembers it differently, saying that a senior policy adviser told him, "It is clear that we can work with you, but how do I work with them?"
Bessette fears that other healing practitioners may appropriate chiropractic's unique principles. Recently the American Physical Therapy Association has begun to claim that it too addresses vertebral subluxation. As president of the Illinois Prairie State Chiropractic Association, Bessette is spearheading a public awareness campaign, informing people that physical therapists have not been licensed in the specifics of spinal adjustment. According to the straights this message is vital because they believe physical therapists perform a more generalized joint mobilization that may not address subluxation at all. Further, the manipulation can be dangerous in the wrong hands and, according to some studies, may cause strokes.
"I'll tell you what," counters Winterstein. "People don't care whether their vertebra is manipulated by me or an osteopath or a physical therapist. Right now we have the long-term expertise, we have the edge, but you can't legislate competition." As for the duplication of services, Winterstein says, "It is a specious argument because there is a lot of overlap that occurs in every direction. The reality is, people will learn how to manipulate the spine. If you try to keep them from it you're just as guilty of antitrust as the AMA was when they tried to keep us from practicing."
The majority of the 50,000 chiropractors in this country fall into the mixer category, and with the law on its side, the current generation remains mostly above the fray. "Most important is that your patients know how you practice," says Dr. Renee McMurry, a chiropractic physician, a mixer. "There's such diversity in our profession and the layperson doesn't always know what they're getting." Some consumers may think they're getting a medical doctor when what they're really getting is a mixer who's taken a weekend seminar on some other form of natural healing. But as far as Winterstein is concerned, it's caveat emptor. "An MD can go out and take a weekend seminar on plastic surgery and you would never know it," he argues. "Not all professionals may act as professionals, and there's no good way to make that determination. It's part of consumer responsibility."
Whaley finds that sort of reasoning ridiculous--and dangerous. "The biggest single reason for malpractice suits is diagnostic error," he claims. "Weekend seminars do not meet the academic and licensing standards for degrees that are conferred on the professions that the mixers are attempting to duplicate. If medical doctors, who serve internships and have much more comprehensive training, misdiagnose, how can you get this from a chiropractor who crams all this information into a four-year program? And how good can they be at chiropractic if they're a jack-of-all-trades?"
Before taking maternity leave, McMurry was a member of Alternative Medicine, Inc., a group founded in 1997 to offer patients integrated services using a wellness model. AMI persuaded HMO Illinois, an affiliate of Blue Cross and Blue Shield of Illinois, to broaden its definition of the primary care physician to include chiropractors. It now has a presence in 11 states, adjusting the chiropractors' scope of practice to meet state laws. Like straight chiropractic, it describes itself as a preventive plan: whether or not a patient comes in with a health concern, the chiropractor will make an overall assessment and work with the patient on various lifestyle issues. Because chiropractors charge less than MDs, patients are asked to visit more often, so the chiropractor can develop a deeper medical knowledge. The chiropractic physician is responsible for referring the patient to an MD if necessary. McMurry, who says she is also trained in acupuncture and traditional Chinese medicine, estimated that AMI made up approximately 15 percent of her practice. Once she met AMI's qualifications, she said, "We spent nine to ten two-hour sessions to ensure that everyone would be practicing the same way."
AMI is described as the first natural-healing delivery system. Because it's sanctioned by third-party payers, it's a boon for those DCs that support this medical style of practice. Dr. Jim Zechman, chairman and CEO of AMI, makes clear that his organization has no political agenda. Yet AMI's credentialing agent is the American Academy of Chiropractic Physicians, whose committee is made up of a nationwide group of chiropractic physicians and two chiropractic medical schools. Zechman was not at liberty to divulge the company's criteria for credentialing, but he did say that DCs must have a "wide scope of practice, the tools to diagnose and use a shared body of scientific knowledge," which automatically excludes straights.
McMurry, however, was pleased with the freedom of practice she enjoyed. "I'm excited about what I can do with my hands. I have so many modalities to choose from. Being a good physician is knowing what you can and cannot treat and to make the appropriate referral. I pray that that would be the case."
On a sweltering July morning in Davenport, people from all over the world converge for the Bix Race, a 7K run named for native son Bix Beiderbecke, the city's other claim to fame besides the Palmer College of Chiropractic (called "the Fountainhead"). B.J.'s epigrams hang throughout the school: "Chiropractic is specific or it is nothing." "Chiropractic is Health Insurance" seems to reflect a more recent era.
The race begins at 7 AM at the Palmer Skywalk, which affords a perfect view of the 15,000 runners. Odds are, one of the Kenyans will win; they always do. Faculty, alumni, family, and friends exchange jovial repartee. A professor points out to his colleagues that one of the Kenyan runners is exhibiting a "foot flare." "Probably a left PI sacroiliac subluxation," he guesses. "If it were corrected it would increase his speed by an eighth of an inch per stride and he would probably be winning at this point." One of the Kenyans comes in first, as expected, but not the subluxated one.
Today's event is important enough to attract Dr. Guy Riekeman, the newest president of Palmer College. A handsome man in his 50s, charismatic in ways that seem antithetical to B.J. Palmer, Riekeman lets others take the dubious role of provocateur. His is a delicate post at a crucial time in the profession's history. Under him Palmer has adopted a moderate position, highly inclusive yet always centered on educating patients about vertebral subluxation. To buttress this expanding philosophy, Palmer has adopted a 90-hour curriculum that goes into effect this year. Regarding the historical rift, Riekeman says, "What we really should be discussing is keeping people healthy. We know that the higher the intervention, the higher the risk. Our current health-care system is lousy. We know that because it is the third leading cause of death. Chiropractors have the lowest malpractice charges because we're low risk. As a minimum standard, chiropractors should know when higher intervention is necessary."
Riekeman wants a more sophisticated era of leadership that can open up dialogue with neuroscientists, politicians, and complementary alternative medicine providers, making chiropractic understood in biological terms.
Later in the day, many of the alumni migrate down Brady Street to the Palmer mansion, where they're assigned manual labor in an effort to preserve that house of intrigue. They gather twice a year for this purpose and for other motivational events. Though the temperature hovers in the mid-90s, one group cheerfully scrapes, strips, and scours old paint from the wrought-iron gate that encircles the mansion, preparing to paint it as the sun beats down on them. This is the youngest crop of straight DCs, who want the profession to live on in its purity, as B.J. intended. For many years chiropractors were prohibited from advertising or testimonials, but as the laws have relaxed, the straights have revived B.J.'s grassroots entrepreneurialism. If the work project is any indication, they have the enthusiasm.
What does John Whaley plan to do in retirement? He'd really like to file a lawsuit against the CCE in federal court, based on previous decisions. "If we won a suit against the U.S. Department of Education--and if everyone would donate about a thousand bucks or I could win the lottery, because it would take a couple hundred thousand--they would not be able to accredit the colleges for what they now teach and that would cut off the supply from the jugular. It would cut off the economic subsidies to schools, the student loans. They would either have to conform or go out of business. We're still outnumbered in individual states where we lack the numerical and financial strength to overturn these broad-practice state laws. This way we would get them from above down, instead of trying to get them from the bottom up."
Whaley's retirement hasn't lessened his commitment. "I lost all the battles and apparently the war," he says. "But I'm not sad about it, because I had a great adventure and fought a good cause. Some men sow and others reap." Whaley seems to relish the role of the underdog; at one point he remarks: "I liked it better when we were quacks!"
Art accompanying story in printed newspaper (not available in this archive): illustration/Mike Werner; photos/Eugene Zakusilo, Jim Newberry, Peggy Zarneck Photography, Chiropractic Books.