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Gadgets & Gizmos by Perkal

There is a "sales channel" on satellite TV that often has a program called "The Knife Show." I am strangely attracted to this show. It must strike some primordial spot in my male brain, because I find myself coveting giant bowie knives and imagining that I am slashing down saplings in the wilderness in order to build an emergency latrine ... or something. The host of the show presents a collection of knives and the dock begins to tick, leaving less and less time to call the 800 number to purchase the cutlery before the "deal" expires. I begin to rationalize that I should buy the collection of 300 assorted hunting and sporting knives and give them out as Christmas gifts to professional friends and referral sources. It would be a business expense!

Then, just before the time is about to run out, and the beads of perspiration form on my brow, I yell to my wife upstairs, "Honey, the 'Knife Show' is on again. Will you come down here and duct tape my hands to the arms of my chair, so I can't reach the phone?"

I like gadgets and gizmos, which can be a dangerous problem in chiropractic, because there are so many of them to buy. I figure a gadget is some kind of tool, nostrum, apparatus, etc., but a gizmo is defined as a gadget that needs a power source. And I have bought a lot of them in my time. Some are still in use, like my "T bars" used in myofascial stimulation. Some just lost their luster and go unused, like that little "spark gun" for acupuncture or trigger points. (That thing hurts! I wonder how many patients I have lost using it?). Many are broken or obsolete, or turned out to be dangerous. None were on any recall list from the FDA, as far as I know.

Most of the clinical instruments to which I have been attracted are treatment items, like manual electrical stimulators. I have one electrical point stimulator that can shoot a little laser beam at the same time. Sweet! And speaking of lasers and light-therapy units, I am so glad that I finally bought one and quit agonizing over which one was the best. The misery is over and now I can sleep at night. I often had lain awake, fearing that I wouldn't buy a unit with enough power and penetration. Buying the "wrong" one seemed to be a threat to my masculinity.

Mechanical adjusting instruments? I got 'em. They range from "jack-hammer strength" to "barely annoying" in intensity. I've tried vibrators that punch, bang, tickle or even bruise if necessary. My patients request the gadget they like best. "Use that woodpecker thing, doc." "Try that nail set... that stapler." "How 'bout that floor polisher gizmo?"

I have a DC friend who refuses to use any modalities, gadgets, etc., and is dedicated to a hands-only practice. Yet, he owns about five different types of exotic adjusting tables. He often marches patients around the office from room to room, using pelvic benches, fancy drop tables, odd-sitting cervical stools and stern-looking traction units, reminiscent of medieval inquisitions. "You should use the right tool for the right job," he says with great pride. Yet, he complains about the rent he pays on the huge 5,000 sq. ft office that he needs to house all that machinery.

The second category of "Stuff I Couldn't Do Without," includes diagnostic and analytical items that confuse me or that I don't trust. I have experimented, or become familiar, with most of the "readers" - the instruments that seek out bad spots for chiropractors to correct These machines attempt to measure variables such as the status of vasomotor activity, galvanic response, or even the roughness of goose bumps on the skin(?). I keep waiting to buy one of these things when the validity and reliability equals the amount of money I can be reimbursed for using it, and when the price falls to about what a high-density TV costs at Best Buy.

There are so many diagnostic gadgets; it's hard to know when to stop. Usually, that time is when the bank account is low and the closet is full. Early in my practice, I was having a manic day and purchased one of those module blood chemistry machines at a seminar. I seldom used it, in fact, I have forgotten why I thought I needed it A few years ago, I found it and was willing to send it to Romania via a charitable foundation. But it was rejected as being too old, even for them. So I made it into a kitty litter box.

What happened to some of the more interesting clinical gizmos of the past? What about Moire photography showing those cool spinal contours? Younger DCs have only heard about such a thing during nights around the campfire with the old timers. There are examples out there of instruments that had research potential, but often lacked practical business sense in a small DC practice.

But what never seems to fade in popularity, for a select group of practitioners, are the mystery machines that supposedly measure things like the color of your aura, how many parasites are in your colon or the invisibility of your urine. And these, of course, seem to be the contraptions about which my patients are curious. "Dr. Hanks, I saw an advertisement for a machine that chases toxins out of the body through the ear lobes. What do you think?"

The next time I see something without which I just can't live, I'm waiting for a while before I purchase it. I am going to make sure that if it breaks or fails to amuse me, I still have the option of making the gadget into a lamp or a container for a potted plant. After all, I'm a practical guy.

This article was published on Friday 03 October, 2008.

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