None so blind

None so blind

“None so blind as those that will not see.”  ~Matthew Henry

Last month the Iowa Supreme Court ruled that the Palmer College of Chiropractic must make accommodations for a blind student, including

an assistant to interpret X-rays and other medical images.

The college had argued that accommodation wasn't feasible, and that vision was a requirement for a degree because reading X-rays is critical for the profession.

There have been other blind chiropractors in the past, starting with C.R. Johnston, the man who made Peekskill famous  (I never heard of Peekskill) who graduated from Palmer in 1918.

Years ago I had a patient who was also blind and I remember him telling me he could still read the spine x-rays to locate subluxations. This could be a false memory that has grown in the telling, but I do not think so.

There are a variety of ways that Chiropractors will look for imagined subluxations, some of those methods are as fanciful as the subluxations themselves, but do not require vision:

The most commonly used method was static palpation (mean score 6.6 +/- 1.1). Seven other methods, including pain description of the patient, orthopedic tests, motion palpation, visual posture analysis, leg length discrepancy, neurological tests and plain static X-rays had mean scores greater than 4.0. All of these methods, as well as functional X-ray views and kinesiological muscle testing, were considered reliable, with mean reliability scores greater than 4.0.

Plain x-rays are of little benefit for the evaluation of back pain by doctors and there are no subluxations to discover that require irradiating a patient

No supportive evidence is found for the chiropractic subluxation being associated with any disease process or of creating suboptimal health conditions requiring intervention. Regardless of popular appeal, this leaves the subluxation construct in the realm of unsupported speculation. This lack of supportive evidence suggests the subluxation construct has no valid clinical applicability.

In England (and no doubt the US) use of x-rays by chiropractors is sketchy at best. And

a basic tenet of ionizing radiation protection for many years has been that all exposures should be as low as is reasonably practicable (ALARP). In the medical world, if you are to expose patients to ionizing radiation, there must be some clinical benefit from that exposure that justifies the risks.

Perhaps a blind chiropractor would order fewer x-rays, and so benefit patients by not exposing them to ionizing radiation with no valid justification.

It would seem that from a chiropractic perspective, being blind is not impediment to practice. After all,

When a respected chiropractic researcher was asked whether he had ever seen a subluxation on an x-ray film, he smiled and jokingly replied, "With my eyes closed."

And a blind chiropractor would have an anatomical correlate to their understanding of science-based medicine.

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