My wife and I were having dinner at a fancy restaurant one summer when the maître d' came to my table. "Dr. Hanks, you have a phone call from a patient, and it sounds urgent." This was before cell phones, so I followed him into a small office and picked up the phone.
"Hey man, I screwed up my back and I can barely walk!" It was Cy, an old college friend I saw frequently, and who knew where I was dining. I told him I would see him first thing in the morning at my house, but he couldn't wait. "I'll be right over," he announced, and hung up.
I was annoyed. It was rare in those early days of practice for my wife and I to have enough money to go to a nice place to eat. Now, here comes my goofball friend, who expects me to find some way to treat his back without an adjusting table available.
I met Cy in the parking lot. His girlfriend was driving, since he had been treating his pain with a combination of aspirin and Pabst Blue Ribbon. He had a 1966 Mustang convertible, which allowed me to climb in the back seat to treat his neck. He sat in the front passenger's seat while I stood on the floor behind him (remember, it's a convertible) and released his neck.
Treating his lower back was trickier. I had him lie on his side, on the hood and delivered a less-than-masterful "side posture" adjustment. Patrons going in and out of the restaurant stopped and watched our grappling with more shock than curiosity. I hoped that no one would call the police to report an assault.
Since then, I've asked a couple of colleagues how they would have handled this situation. "Open both of the back doors so the guy's feet can hang out, and then you have room to adjust his neck," said one. Another suggested a tactic to treat the mid- and lower back. "Lift the trunk up and get out the spare tire. Then, dump it on the ground, and cover it with the floor mats to keep the patient's clothes from getting soiled. Have the patient lie over the tire and start adjusting. Works great for me!"
Virtually every chiropractor has faced the dilemma of where and how to adjust a person when no treatment table is available. When out of the office, emergencies can occur. But it doesn't take long for a neophyte DC to learn that a soft bed is no good for pushing around on the spine. The usual second choice of treatment surfaces for a DC is the floor. But even with pillows strategically placed under the patient, it is a poor place to treat the lower back with commonly used techniques. Even when I was young and elastic, I had to move around on the floor like an ultimate fighter to accomplish anything.
So, it is understandable that the next household surfaces usually considered in the quest for adjusting opportunities are the dining room table or the coffee table. But these tables must be especially sturdy to hold up the weight of a hefty patient, which depends upon where the table was made. In other words, in today's reality, it depends on which Chinese province it was assembled in, and I don't recommend any furniture from Shezwhan.
I have treated my family and friends on everything from ottomans to desks. They get it, and appreciate my efforts. But what about a patient in need, when there is no "professional" place to treat them? Years ago, my chiropractic office partner and I moved our office. We had not yet unloaded a treatment table off the pickup when a patient showed up and begged to be adjusted right away. I have fond memories of watching my partner adjusting this guy on the table still on the pickup truck. The patient was satisfied and that's what counts.
Sometimes, circumstances create odd circumstances. I once had a new patient who was the "harp" or harmonica player with Bo Diddley, a legendary rock/bluesman, and one of my favorites. I went to that night's gig and ended up treating the harp player again, on the floor in some hallway between sets. He was already an established patient, so it was officially an "emergency" adjustment. However, I must admit, I have no daily SOAP note to refer to concerning this encounter.
Other DCs have told me of some of their most memorable treatment challenges. One confessed to adjusting a funeral director on top of the casket of the departed, just before the funeral ceremony. Another chiropractor has described adjusting his wife's neck in the restroom on a transcontinental flight - because it might have looked too weird if he did it in the cabin seat. But these examples are probably tame, considering the imagination and experiences of my colleagues.
At this point in practice, I only want to treat patients in my office. I can imagine myself at some social gathering at which one of my patients is also present. The patient says they need an emergency treatment, and I answer, "Do you think I can do a better job tomorrow, adjusting you on the $6,000 treatment table in my office, or right now with you draped over two folding chairs?"
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