J'Accuse...! (I Accuse)

So stated the enormous headline in the Paris newspaper L'Aurore (The Dawn) on Thursday, Jan. 13, 1898. The article, which some have called the most important in newspaper history, was a letter to the president of the French Republic by the great French novelist, Émile Zola. He was writing to accuse the French government of a great miscarriage of justice in convicting Capt. Alfred Dreyfus, a Jewish artillery officer in the French army, of treason. As a result of this polemic, Capt. Dreyfus was eventually exonerated.

March 9, 2004: Joanne M. Gallagher, DC, was sentenced in her federal mail fraud case. She received an 18-24 month prison sentence; a fine of $9,000 and restitution of $631; relinquishment of her chiropractic license; and the order to never practice chiropractic again. Ten days later, she was sentenced in county court for violating Pennsylvania chiropractic regulations and ordered to pay a fine of $500 and serve three to six months in prison (which will run concurrent to the federal sentence).

Gallagher was prosecuted for billing Medicaid for spinal manipulation for neck and shoulder problems. In fact, she was treating Kimberly Lee Strohecker, a 30-year-old woman, for her chronic epilepsy. Ms. Strohecker's fiancé, a Jehovah's Witness, wanted her to discontinue her medication. Gallagher told Ms. Strohecker that her treatment would eliminate the seizures and that she had to discontinue taking the anticonvulsive medications, which had successfully managed her condition for 20 years.

On the last visit to Gallagher's office before her death, Ms. Strohecker was wheelchair-bound, wearing adult diapers, choking on her own vomit, and had bitten through her tongue. On the night of her death, Gallagher was taped telling Ms. Strohecker's caretakers that the seizures (which were occurring every 10-15 minutes) were part of her body detoxifying from the years of taking anticonvulsive medication. Gallagher also said that under no circumstances should Ms. Strohecker be taken to a hospital, because they would give her anticonvulsive medication that would kill her. Gallagher also told them that Ms. Strohecker would go into a deep sleep and awake drug-free. She never awoke.

Ms. Strohecker's family urged the district attorney to charge Gallagher with involuntary manslaughter, but the D.A. refused to prosecute the case. Legal action only occurred when the U.S. Attorney's office got involved.

One might wonder what chiropractic treatment Gallagher provided to Ms. Strohecker that was supposed to eliminate her need for medication. From the accounts in the media, it appears that Gallagher used cranial manipulation to "balance the meninges," although Ms. Strohecker's mother described the DC waving her hands around her daughter's head and shoulders. One thing is certain: The Web site of Gallagher's partners/associates indicates these chiropractors were subluxation-based, and thus, would counter that the treatment was not for the epilepsy, but for the vertebral subluxation.

Words can hardly express how utterly disturbing this case is. First, I wish to apologize to the family of Ms. Strohecker on behalf of my profession. Were there some way to prevent this senseless, horrible death from ever occurring, I would do it in a heartbeat. In part, this column is my act of contrition on behalf of my profession.

I am infuriated by the fact that Gallagher had a chiropractor testify in her defense. This person, in a report cited at the anti-chiropractic Web site chirobase.com, wrote that Gallagher's treatment was within the standard of care for a chiropractor in Pennsylvania. Such a statement is an insult to every chiropractor in that state and the world!

Let the world know that Gallagher's treatment was never acceptable chiropractic care - by any stretch of the imagination - despite what her "expert" said.

It is hard to know who caused greater harm to the reputation of the chiropractic profession: Gallagher or her expert witness. Chirobase.com has a long and detailed story about this case. To the credit of the story's author, Stephen Barrett, MD, a longtime critic of the profession, he does not say this is how all DCs practice, but there is the implication that Gallagher is emblematic of a considerable problem within chiropractic. Unfortunately, Gallagher's expert witness provides evidence that her behavior is acceptable.

Again, I say that Gallagher's attempts to treat epilepsy and other conditions discussed in the media (e.g., Down's syndrome) are not acceptable. It is neither acceptable to tell a patient to discontinue taking medications - especially essential, life-preserving ones - nor is it acceptable to say one will just treat the vertebral subluxation, and that will help the body heal itself of these disorders. That is a technical difference patients do not comprehend. To a patient, this still means, "Chiropractic will cure whatever else I have," even if the doctor does not say that. The meaning of a communication is the response it provokes, not its intent. So, if telling the patient that the only thing the chiropractor will do is treat vertebral subluxations, and this causes a patient to give up all other treatments before there is a positive response to chiropractic care (if one is even possible) - then what it means to the patient is that chiropractic is the cure.

Circling the wagons to protect every chiropractor is not only unethical; it is harmful to the whole profession. Our duty is to the patient, then the public, then our profession. Ridding the profession of those chiropractors who are a danger to the public improves the chiropractic profession. I say "Thank you" to U.S. District Court Judge Christopher Conner, who ordered Gallagher to never practice chiropractic again. It is a crime that someone had to die in order to reduce the size of the profession by one. When we chiropractors find a colleague who practices like this, remember Émile Zola and Kimberly Lee Strohecker, and call the disciplinary boards and say, "J'accuse."

Sources (as of March 28, 2004):

• www.chirobase.org/16Victims/gallagher.html
• www.timesleader.com/mld/timesleader/news/8174503.html
• www.timesleader.com/mld/timesleader/8138723.html
• www.timesleader.com/mld/timesleader/8137183.html
• www.zwire.com/site/news.cfm?newsid=11097326&BRD=2311& PAG=461&dept_id=482260 &rfi=6