The last month of my life has been marked by constant, often severe lower back pain. I have had back pain off and on since I reached adulthood, both the achey kind that lasts a few days and the horrible twang that flattens you and leaves you crawling agonizingly to a chair you then can't even get yourself into, followed by a day of barely being able to walk, muscle relaxers and rest, and a few days later everything is okay again. This is the first time it has gone on and on. Muscle relaxers have had little effect, and I am hosting Christmas this year so I'm mildly stressed about cleaning and preparing for company.

None of this is meant to be a complaint, however; it has been a fascinating chance to look into the options available to somebody in consistent pain of some level and learn some interesting things about the medical community. It doesn't take a lot of digging into the dry reading of basic medical texts to learn that exercise is the best treatment for back pain. After a couple visits with my primary care doctor, who is a clever and wonderful woman, I was referred to physical therapy. At the same time, some of my loudest friends proclaimed their adoration of the local chiropractor, a woman who goes to my church and seems like a lovely person. Hoping to gain some more functionality, I decided to try both.

Chiropractors are, it turns out, eager to get you in. I think they'd have scheduled me for that very day if I'd been available, but as I called on a Friday, they got me in on Monday. PT couldn't even see me till that Wednesday. If you want to see many specialists you can wait weeks or months, so you'd better not have an urgent issue or anything important going on. The following week I went to my first chiropractic appointment and my first physical therapy appointment, and it spurred this recognition (not new or original to me) of two kinds of care for problems, which I will now refer to as "Medical Care" and "Therapeutic Care".

Medical Care encompasses care that seeks to treat and cure a problem in a clinical environment, by licensed medical professionals. It tends to be aggressive (in a good way) and make use of prescription medications as it deems necessary. It involves some sort of medical doctor and the vast array of staff that make a medical facility function. Because its focus is on a problem and a solution, the person being cured is largely immaterial. What matters is fixing the issue.

Therapeutic care is a little fuzzier. It can involve medical professionals, or professionals in medicine-adjacent fields. This would encompass actual mental health therapy or cognitive behaviour therapy, or perhaps it would also encompass things like massage, acupuncture, or other alternative therapies. The thing that makes it therapeutic is its focus on the person and their individual needs. While individual needs do matter in the medical care environment, they only matter as far as ones reaction to treatment goes. Whether the patient has kids at home or a job that requires heavy lifting or a history of some seemingly-unrelated issue is not important in a medical care situation. In a therapeutic care situation, those things are the point. The actual problem that the individual came in to address are seen as symptoms interrupting the life of the whole person.

Here is the contrast for you:
When I see my personal care doctor, I am shown in by a nurse who takes my weight and blood pressure, asks me why I'm there, writes it all down, and then leaves me in a small, clean room with the paper-covered medical bed. It crinkles when I sit on it. The lights are aggressively bright and there is an advertisement for some sort of new birth control or menopause treatment on the counter. Eventually there is a knock at the door and my doctor enters. She is petite and professional and asks if I want the lights dimmed because I have a history of headaches and she had dimmers put into her rooms specifically for this reason. I love this about her. She has maybe 10 minutes for me and makes me feel seen and heard. I have not always felt this with doctors. I have had an array of OBs parade in and out during my 6 pregnancies and some of them barely seemed to notice there was a person there. They measured my belly, asked if I had any questions, and walked out in less than 2 minutes. Truly a magical experience. After the appointment I just... leave. There are people in the hallways, typing on little computers or carrying clipboards and walking very quickly. They ignore me. As I leave, the valet parking attendant at the desk always smiles and says something along the lines of "Have a nice day."

The very first time I walked into the chiropractor, the lady at the desk greeted me with, "Hello, Sarah! It's good to see you!" I have never seen this woman before in my life but I'm the new patient and so she knows my name. She offers me water and there are comfy chairs and carpets, some books to read on the table, and little signs with encouraging mantras on them. Two separate essential oil diffusers are glowing and filling the room. They have different oils in them and the competing scents are, to me, extremely unpleasant, but I think most people would find them cozy. The chiropractor greets me by name as well, and asks me all about my life. She wants to know what I do, how many kids I have, what my goals are both for the next few months with pain relief and in life generally. These things are important to planning treatment. The receptionist brings me a cup of hot cocoa, warning me that it is too hot to consume yet. I can smell the peppermint candy cane she has dropped into it as well. The first visit lasts nearly an hour as she and her assistant get to know me and my needs. Later appointments will be shorter, but will always involve tea or water, questions and specific actions based on my responses. She remembers my kids' names and asks about them. I am not just a walking problem to solve, I am a person she can help.

I have always been a sceptic about chiropractic. The claims made by the industry feel nonsensical to me and the evidence of efficiacy is not very strong. I also hate essential oils. The whole issue is compounded by the fact that chiropractic is something that is done to you and I have always lived in a world where health was about things you did to take care of yourself. Not that medication and other interventions aren't necessary, just that they are not enough by themselves. But the chiropractor just does things and sends me away. I am a few weeks in now and still decidedly unconvinced, or rather I am even more certain than before that it is mostly nonsense. The magic of being made to feel like a human, however, is incredibly potent. I see now why people rave about their chiropractor and are devoted to their monthly or weekly adjustments. For a brief moment in time they are told that their problems are real (they are), they matter as a person (they do), and that the chiropractor wants to help (they do!). The person is no longer alone, in pain, and feeling like a walking problem to be fixed or shrugged at and told "Well that's the way it goes." There is immense power in simply being seen.