The Chiropractic-Russian Connection

In July of 1998, I was an instructor for a spinal biomechanics seminar in Seattle. (I have been teaching seminars in spinal biomechanics through various chiropractic colleges for the last 23 years.) At the Seattle seminar were several DCs and four MDs. One of the chiropractors, Dr. Harold McCoy, had been with a medical spine clinic in Vladivostok, Russia since April of 1996.

Dr. McCoy had a Russian businessman as a patient. After receiving a life-changing adjustment and relief from chronic health problems, the patient helped set up an educational, scientific and cultural exchange. Its goal was for Americans to teach Russian medical doctors about chiropractic by establishing a clinic in Vladivostok. This would begin by sending doctors to Russia to work with a university and Russian hospital. The clinic would receive the most difficult cases. Chiropractic care would be given not primarily for neck and back pain, as it is in the United States, but for patients with cerebral palsy; scoliosis; mental illness; seizures; Lou Gehrig's disease; brain tumors; and health maintenance and prevention of disease. This would be correlated with studies and research projects.

Dr. McCoy sent delegations of DCs to the clinic in Russia to teach them their trade. In Russia, chiropractic is recognized as traditional medicine, and is called manual therapy. After five years of medical school, the Russian MD must take a postgraduate course in this field in order to practice it.

Dr. McCoy introduced me to Dr. Ekaterina Molakova, the director of the Spine Clinic, who invited me to work with her. I have always felt strongly that there is a responsibility to share chiropractic with the rest of the world. With this invitation I felt a special calling.

My trip was preceded by a few other chiropractic delegations, one including Matthew McCoy,DC, who worked and lived in Russia for almost two years. He found the Russian economy in turmoil.

In 1991, democratic changes in Russia began. Up until that time, the health care system was staterun. Democracy opened the doors for a few independent clinics.

Politics do not play a large part of the health care in Russia as they do in the United States. Dr. McCoy stated, "The Russian people don't have the media, drug companies, and medical doctors pushing drugs on them 24 hours a day, partly because they don't have a third-party insurance system, and drug makers don't control research dollars. Most importantly, Russian patients don't feel drugs work and they don't want them." The Russian doctors have always relied upon manual therapy as a major part of their health care system.

It was with nervous excitement that I prepared for this trip. I asked DCs David Butler of Alexandria, Minnesota, and Stephen Saunders of Seattle, Washington to accompany me on the trip. Both of these chiropractors are well-respected in the field of spinal biomechanics. Between the three of us, we have 50 years of clinical experience.

From the beginning I knew it would not be a vacation. This area of Russia is considered a third-world country, and is economically 50-60 years behind the United States. In August 1998, the ruble collapsed, and with it the Russian economy. Inflation was at 67%, but it was expected to escalate to between 300-500% by the end of the year. We were told by previous delegates not to visit because of the hard times there. Many businesses were closing. It was not safe to go out in the streets after dark. There was a rumor that the hotel at which we would be staying would be closing its doors very soon. There were stories of the Russian airline Aeroflot having to take up a collection from passengers to pay for airplane fuel, as certain areas would no longer accept the ruble. We were flying Alaskan Airlines and didn't worry, but two weeks before our departure, they canceled all of their flights to Russia due to economic concerns. We rebooked on Aeroflot.

Dr. Butler and I left Minnesota on Monday, October 12, and flew to Seattle. There, we would rendezvous with Dr. Saunders. We spent a day repacking our luggage to meet the airline's 44-pounds-per-bag maximum. As this was a humanitarian trip, we took along health-related books, equipment, x-ray supplies, teaching information, and a human spine to donate to the Spine Clinic. We left for Anchorage, where we would board our Aeroflot flight to Vladivostok. As we walked down the entrance ramp to our plane in Seattle, Dr. Butler received a page from his wife. Our flight had been canceled due to an electrical fire. The next flight to Russia was not until Friday, October 16th.

We finally arrived in Vladivostok on Sunday, October 18, 1998. Dr. Malakova ("Katia"), Lena, our interpreter, and a driver had been waiting for us, despite all the delays.

We had time to clean up, and then drove to the Spine Clinic to meet the doctors: Katia, a pediatric specialist, Dr. Kirill Anisov and Yuri Safonov, neurology specialists; and Tatiana Messanina, medical radiologist. All were certified in manual therapy.

There is apparent friction between the medical doctors in the clinic and the other manual therapists in town, a circumstance with which we are familiar in the U.S.

The Russian television crew was scheduled to film a special about us. As is the custom in Russia, nothing happens on time, and they didn't show up, probably due to elections that were being held. Filming was rescheduled, and we spent Sunday afternoon and evening teaching a seminar to the doctors on spinal biomechanics and the spinal model. I presented them with the spine we had brought. Though it was called the Spine Clinic, it did not have a spinal model. They were very interested in the new adjusting procedures. I gave them copies of a textbook I had recently written (Pettibon Spinal Biomechanics Adjusting System). There is no word in Russian for a spinal adjustment, and I was told it was translated to "correction." All of the doctors lined up to receive this treatment.

Typically, Russian people on the street do not smile, make eye contact nor say "hello." Their minds are elsewhere - on basic necessities: food, water, and electricity. They feel that small talk or street courtesy is a waste. As I mentioned earlier, nothing happens on time. A store owner may have two signs by the door indicating the hours they are open. The signs will have different hours. When questioned about when they are open, the store owner will say, "Read the sign."

During my stay there, Vladivostok had two stoplights and no stop signs. This was unusual for a town of 750,000, yet there seemed to be few accidents. "Whiplash" is not in the Russian vocabulary, but this was probably due to a lack of attorneys, rather than a lack of car accidents.

We were scheduled to work in the clinic, seeing patients on Monday. The clinic was booked through January with new patients. Each of us was assigned to a doctor with a translator. I was with Dr. Katia and Lena; Dr. David was with Dr. Yuri and Dima; and Dr. Saunders was with Dr. Kirill and Dennis. Dima and Dennis are both students of Lena, who teaches English at the Russian university.On Monday, we completed our first day working with patients. It was time-consuming, translating numerous patient histories, though it was wonderful working with them. Most were referrals from the hospital. Cases included: "poor posture," a big concern to the Russian people; babies with "stiff necks"; epileptic seizures; allergies; slow mental development; skin problems; herniated discs; asthma; bronchitis; chronic pain syndromes; headaches; and many more.

I was able to work with a number of babies and children. Russian parents have a tendency to overdress their babies, frequently using up to five layers of clothing. This is thought to be a sign of a good parent, as well as a sign of wealth. Unfortunately, this leads to perspiration, then chills. It took time to convince some of the mothers of this.

One 14-year-old boy had endured epileptic seizures for 10 years. After I adjusted the boy, his grandmother, the babushka, had tears in her eyes. "Thank you for restoring my grandson's health and giving him a better life," she said. In another case, a two-month-old baby had suffered an extremely difficult birth, caused by her umbilical cord being wrapped around her neck twice, resulting in a lack of oxygen to the brain. As I adjusted the baby, she smiled and cuddled in my arms.

One of the young boys I saw had "bad posture," according to his grandmother. She asked about using a stick to improve his posture. I thought that perhaps she wanted to hit him with the stick every time he slouched. She informed me that she would put the stick behind his back and have it locked by his elbows. This was new to me, but they have been using it for years.
A nine-year-old girl had experienced bad headaches every day for the last five years. After her first adjustment, they were gone. Both the mother and daughter cried tears of joy.
Working with the Russian patients was one of the most fulfilling experiences of my life. They were extremely grateful for the care. In the United States, we take our health care for granted.

We also had lunch at Vostok 1, one of the largest fishing companies in Russia. They are the sponsor of the Spine Clinic. The food was standard Russian cuisine, and was excellent. Alexander, who is the head of Vostok 1, was seeking office as a state representative in the Duma. Unfortunately, only 18% of the people voted. It was required that 25% of the population vote in order to have a valid election, so the next one was rescheduled for January.

It was explained to me that few Russians vote, as they see no potential for change. It does not seem to matter to them who the elected officials are - for them there is no difference. This political apathy appears to be universal. The political situation in Russia is based on power and corruption. Bribery is the norm, and is considered "giftgiving." Taxes on any profit at the Spine Clinic are 80%. The country's high tax leads to many questionable and "unofficial" businesses. The "new" Russians are the ones with the money and power. When asked about their profession, they simply say they are "businessmen." Even with this situation, the Russian people have an incredible endurance, and a desire to persevere and survive.

The Russian women are among the most beautiful in the world. Perhaps their miniskirts and high-heeled shoes add to this opinion. We tried to explain to the women that the high heels are very bad for the back, and their response was that the shoes made them beautiful. In Russian society, women expect men to be courteous to them, opening doors and helping them with their coats. They are not considered socially equal, but I believe they feel they are superior.

We finished with the patients at 5:00 p.m., but stayed at the clinic until 10:00 p.m. to explain x-ray analysis and procedures to the doctors there. They were extremely eager to learn and decided to forego dinner. Their desire for knowledge and to improve their health care system was insatiable.

On Tuesday, at the clinic, we saw 10 new patients in the morning, and we tried out the new x-ray procedures that we taught the night before. We now had many x-rays to analyze before patients returned on Wednesday. I saw a 13-year-old girl that had come in the day before with scoliosis. She was doing much better, but her family couldn't bring her back for two months, as they could not afford to travel 500 kilometers to get to the clinic. I gave the girl a set of specific spinal active stretching exercises for her scoliosis.

As a bribe, I gave my scoliosis patient a Princess Di Beanie Baby that my office manager gave me to take to Russia. I bargained that if she did the exercises twice a day until she returned in two months, she could keep the Beanie Baby; otherwise she would have to return it. My Russian patients had never heard of Beanie Babies. We also brought Snickers candy bars, crayons, little stuffed bears, pins, and other small gifts to give to them. "Spaseeba," or "Thank you," they all said, and seemed excited and appreciative of the gifts.

My 14-year-old patient, the boy with seizures, was also improving. Although his posture had improved 90%, his major concern was a sore wrist on which he fell two weeks ago. The doctors in the clinic were amazed at his progress. Another 14-year-old boy, who had fallen 18 feet from a tree, had been hospitalized for four weeks. I took x-rays and found the area in his spine that was causing erratic high fever, and giving him difficulty breathing.

The mother of a two-month-old baby who had been referred by the hospital for "birth trauma" - the umbilical cord had been wrapped around the neck - was extremely pleased about the baby's progress under our care.

For many of the scoliosis patients, corsets had been recommended. I explained how a corset would cause deterioration of the spinal muscles, and gave them exercises instead.

Dr. Katia and Lena took us out to dinner that evening at an "undiscovered" Chinese restaurant. The food was fantastic, but the streets leading there were filled with potholes that made us all volunteer for chiropractic care the next day.

The next day, Wednesday, was a full day at the clinic. The changes we began to see with patients were phenomenal! My seizure patient did not have any seizure activity, which was a first for him, and the young girl with 32-degree scoliosis was 50% improved. The doctors at the clinic were amazed, and frankly, so was I!

Dr. Saunders called me in to examine a Korean man with a herniated disc in his neck, with arm pain so severe he couldn't move it. After treatment, the pain was gone. A young woman with severe whiplash had constant headaches. She returned the next day-without the headaches. I treated a 14-year-old ballerina. Her mother brought her in because she heard the American doctors were at the clinic. The clinic doctor had her 7-year-old son visit today for me to treat. This is the first time she has asked a chiropractor to work on him.

I felt a special bond with Dr. Katia, the clinic director who specialized in pediatrics. I loved treating the babies and the children, and so did she.

The Russian doctors were paid about $250 per month. Dr. Katia had not had a vacation in three years. They obviously weren't doing this for the money. During my time at the clinic, the doctors never prescribed any medications for their patients. They only wanted them to have chiropractic care. I had to remind myself that they were medical doctors, since they appeared to have a better understanding of chiropractic and the inherent healing properties of the body than many chiropractors.

That evening, we spent many hours teaching the doctors about spinal rehabilitation. There were some local electrical "interruptions" and a couple of days without water. Telephone service was erratic. We were informed that the water shortage was created by the regional directors to make the mayor of Vladivostok look bad. Apparently, he did not always conform to their level of corruption.

On Thursday, the medical doctor, who is vice president of the women's medical clinic, brought her 11-year-old daughter to the Spine Clinic for midback pain. This was a new development for her, as she had never before considered manual therapy. She was very impressed with the results.

Anton, the 14-year-old seizure patient, gave me a postcard. In English, he wrote, "Dear Doctor, I am very glad to undergo treatment. Thank you very much! Welcome to Vladivostok. I shall come to you again. Anton." With tears in his eyes, he gave me a hug and said goodbye. His mother observed that during the five days of treating him, his study habits had improved and he was doing better in school. "Spaseeba for helping my son!" she said.

Before leaving, we had time for an excursion of the bay in a trawler. Alexander, from Vostok 1 arranged the trip. It was interesting to see Vladivostok, a large fishing port, from the water. That evening, we worked with the doctors in the clinic until 10:30pm. They presented us with souvenirs. Dr. Katia expressed her thanks for our help, and said that we had given them much more than they expected. I replied that one never gives without receiving, and that we had gotten just as much out of the experience as they had gained.

On Friday, we worked in the clinic in the morning, before we left at noon. It was wonderful to see the improvement in the patients in just a few days. The medical doctor's daughter returned for a followup visit, and she was doing much better. I was also asked by Dr. Katia to adjust her. She was amazed at the improvement in her spinal ranges of motion after the adjustment. One of the young girls with scoliosis brought me an origami and a picture that she had drawn for me.

We left the clinic with a feeling of satisfaction that we had done a good job. The doctors and staff were very appreciative, and kept asking us when we would be coming back, and it was difficult to leave. We had created new friendships that would last forever.

Our friendship with the Russian people was based on a mutual desire to help, and improve the quality of life, regardless of politics, economy or borders.

On our return flight, there were three DCs returning to the United States who felt differently than when they had arrived. We had come to realize how important chiropractic care is to people. We don't just crack people's backs due to pain; we changed people's lives!

In comparison with those in the US, patients have a greater respect for the doctors at the Spine Clinic, and they follow a doctor's orders, especially in regard to specific spinal exercises.

It is extremely difficult to summarize my feelings about this trip with words. The clinic was impressed that three doctors of chiropractic from the U.S. cared enough to finance this program and teach, and that they would offer to help and expect nothing in return.

We touched many people, but more importantly, we also established the foundation to ensure that our care would continue even after we were gone. It was a humanitarian mission from the heart, connecting both East and West.

We have continued to work with the Spine Clinic. The doctors have emailed us about some of their difficult cases. They have even scanned x-rays and emailed them to us for our analysis. It is a meeting that will last forever. We are planning to return there in the near future.