|
1965 — Your evidence and point of view as a
chiropractor can be of inestimable value to the attorney
representing a client in a personal liability action.
Members of the legal profession are seeking the answers
to the problem of why somatic injury frequently produces
symptoms far removed from the traumatized tissues
and often expressed in viscera that suffered no known
or possible damage as a result of the accident in
question. Many of these attorneys have realized that
the answers are to be found in the nervous system
and have made an effort to study this system of coordination
and correlation of the entire human body into a unit
of structure and function. It is a difficult task
for a man whose basic education and mental discipline
is far removed from the biological sciences. These
men welcome assistance in this are by experts.
No
other group of practitioners has laid greater emphasis
upon the nervous system in its relationship to somatic
structure than the chiropractic profession. Therefore,
co-operation between these professions should assure
the greatest likelihood of justice for the client.
To accomplish the greatest good for client and counsel
alike, as well as making the best impression possible
for the chiropractic profession, the doctor of chiropractic
must first be willing to recognize some fundamental
anatomical truths and avoid being ensnared by distortions
of truth, no matter how well-intentioned or sincerely
believed.
The
facts of anatomy must be accepted that the first and
second cervical nerves cannot be pinched in their
egress from the spinal canal. The five pairs of sacral
nerves and the coccygeal nerves cannot be pinched
between the osseous borders of foramina. The twelve
pairs of cranial nerves leave the cranial cavity via
formina of fixed size.
It
is doubtful that the ordinary subluxation of a vertebra
forming a typical intervertebral foramen causes pressure
on the spinal nerve. If you hold to this outmoded
view, it will be necessary to show why there could
be pain, muscle hypertonicity and visceral hyperactivity
when other forms of nerve pressure, such as herniated
disc, produce a loss of muscle strength with atrophy,
a degree of anesthesia of the dermatome and even symptoms
of decreased nerve supply to viscera in some areas
of vertebral involvement.
Another
interesting fact that must be kept clearly in mind
when taking the witness stand is the lack of nerve
fibers for visceral supply in the eight pairs of cervical
nerves, lower two or three lumbar nerves and the first
and fifth sacral and coccygeal nerves. To put it in
the positive format it may be said that only the twelve
thoracic nerves on each side and the first two or
three lumbar nerves, as well as the second and third,
or third and fourth, sacral nerves contain fibres
that contribute to the supply of viscera.
The
time to give consideration to these anatomical facts
is prior to reaching the stage of cross-examination.
Do not underestimate the depth of knowledge of opposing
advocate. These men are thoroughly prepared for the
case, if they are worthy of the name and at all conscientious.
They approach the time of trial like a new doctor
of chiropractic preparing for his basic science board
examinations. The chiropractic witness must do likewise.Preparation
for trial is an intensely interesting and stimulating
experience; one that should be accepted as a challenge
and a public service, for the doctor has the opportunity
of being a “friend of the court” as an
expert witness and aids materially in assuring that
justice is the outcome of the trial. It does take
considerable effort and study to prepare for trial
and must include at lest one session with the lawyer
who has called the doctor as a witness to determine
the questions to be asked and the answers to be supplied.
For
the doctor who has not made a thorough study of the
nervous system in recent years and may not have the
explanations of how structural distortion may interfere
with nerve transmission in the above examples, considerable
assistance is to be found in the text, “The
Neurodynamics of the Vertebral Subluxation.”
From the examples provided, the doctor can rework
his case in the light of present neurology and thereby
do the most good with the least likelihood of finding
himself in an untenable position as the facts of anatomy
are presented by opposing counsel.
There
seems little doubt that the doctor of chiropractic
is going to find himself called upon with ever-increasing
frequency to testify in the courts of law. This should
be accepted as a privilege and an indication of the
new prestige enjoyed by a profession that is proving
its worth in the circle of the academic world. With
each privilege comes a corresponding duty.
The
necessity for accurate and detailed records of each
personal injury case cannot be over-emphasized. These
prove to be the basis upon which explanation can be
built and are required to refresh the memory of the
attending doctor a year or two later when the case
finally comes to trial. It is these details that make
it possible to explain the working of the nervous
system and demonstrate the alterations in function
resulting from somatic injury. Thoroughness of records
is the first step. Thoroughness of preparation is
the second step.
Upgraded
chiropractic evidence based on the facts of anatomy
and neurology is difficult to disprove or disparage.
The
doctor of chiropractic owes it to himself, his profession,
hiss patient and to society in general to be thoroughly
prepared and will to testify in these public liability
cases.
It
is, of course, axiomatic that the chiropractor will
never be party to an unwarranted claim for this could
seriously damage the image created by much prior effort
by so many.
—
By A. E. Homewood, DC
Chairman of the Department of Chiropractic, Lincoln
College
Editor’s note: You can read the full text of
these articles by visiting our special 50th Anniversary
Web page (www.ChiroEco.com/50)
and clicking on the appropriate year in which the
article was published in Chiropractic Economics.
|
