On Aug. 2, 1996, a 45-year-old Toronto woman named Lana Lewis went to see her chiropractor to get relief for her migraine headaches. He cracked her neck, the standard treatment, and she went away. Six days after her visit, the mother of three suffered a crippling stroke. She died 11 days later.
Today, the Lewis family is finally getting its day in court -- coroner's court. After years of delays and wrangling by the chiropractors, a formal inquest into her death is finally under way. It will be the latest round in the knock-down, drag-out fight between the chiropractors and their critics. The critics believe that many chiropractic practices are quackery, and that neck manipulation kills.
The stakes are huge. Chiropractors have set up shop on every street corner. They've been fighting for respectability (and business) ever since 1895, the year the founder of chiropractic claimed he had cured a man's deafness by vertebral manipulation. They've been so successful that public health insurance now pays for millions of dollars worth of chiropractic treatment in five provinces.
The chiropractic lobby argues that stroke from neck manipulation is an exceedingly rare mishap, and that Ms. Lewis's death could well have been coincidence. Meantime, three medical investigators from the coroner's office have already concluded that neck manipulation was definitely to blame. "I think there isn't any doubt about the cause of death," chief investigator Murray Naiberg told reporter Wayne MacPhail two years ago. "And that is agreed to by all -- other than the chiropractors."
Roland Auer is a leading stroke scientist and neuropathologist. "There's a list as long as your arm in the medical literature of chiropractor-induced stroke," he says. Just ask Kim Barton, who had a stroke on the chiropractor's table in 1996. Or Diane Rodrigue, who had one in 1994. Or ask Sharon Mathiason, whose daughter, Laurie Jean, died in 1998 when she was 20.
Last year, Ms. Barton described her stroke in Chatelaine. "With a quick jerk, I could hear my bones crack. At that same moment, I felt a tingling in my left side. She moved my head again. I heard another sharp snap. Numbness surged through my body as my brain seemed to explode."
Ms. Barton was also being treated for migraine. At 36, she had a full-time job and had just given birth to her second daughter. The neck manipulation dissected the inner linings of the vertebral arteries that run up the back of the head. The injury caused her blood to clot. When she reached the hospital, the neurosurgeon looked down at her and said he'd seen this problem too many times before.
In February, more than 60 Canadian neurologists signed a statement warning that strokes and crippling injury caused by neck manipulations are not at all uncommon. A study published in the Canadian Medical Association Journal says they may cause as many as 200 strokes a year. Pediatricians are unhappy, too, because chiropractors routinely market their services to parents with kids. They claim they can treat a wide range of childhood maladies, including attention deficit disorder, asthma, ear infections, bedwetting and colic, by manipulating the spines of children and even infants.
Hugh O'Brodovich, chief of pediatrics at Toronto's Hospital for Sick Children, is one of many pediatric doctors who've formally complained about outrageous chiropractic beliefs and claims. (Some chiropractors don't even believe in vaccination.) "One has to differentiate the legitimate societal debate around alternative therapy from this advocacy that says as soon as your baby's born you need to get his neck manipulated."
The chiropractic lobby has fought back with denials and threats. At the inquest for Laurie Mathiason, a representative from the Canadian Memorial Chiropractic College testified: "This is the only chiropractic death that has ever been reported or recorded in Canada related to spinal manipulation. This is the only time."
Ms. Barton knows differently. After years of physiotherapy (and a successful lawsuit), she's now back at work -- but she will be impaired for life. Another blow to the neck could kill her.
After the neurologists spoke out, the Canadian Chiropractic Association accused them of being unscientific and wrote letters threatening legal action. After four pediatric doctors at the Hospital for Sick Children complained to the Ministry of Health, they, too, received nasty letters. No wonder: In 2000, taxpayers forked over roughly $15-million for pediatric chiropractic treatment.
"I refuse to be intimidated by these people," says Dr. O'Brodovich (who, after 11 months, has yet to hear back from the government). More and more wounded patients and their families are also refusing to be intimidated. They've found out the hard way that what you don't know can hurt you very badly indeed.