Posted to Journeytosolidarity.org by Jay Breitlow. Photos by the author.
Harriet is a 19-year-old woman who walks through the room and immediately demands your attention. I wish I could tell you that it was her beaming personality or her ‘I can stop traffic’ good looks that turns heads. Instead, Harriet draws stares and strange looks because she is a little person. Even worse (culturally speaking), she is a little person living in Africa. Living in Africa as a little person is analogous to being a New York Yankee Fan in Downtown Boston, or perhaps walking down the street holding hands with a Rhino. It just doesn’t happen, and when it does you wonder (sometimes aloud) ‘What is wrong with that person?’
Sadly in cases like Harriet’s, as with most people who are born here with a physical disability, Ghanaian culture tends to throw the blame on bad spirits or something that was done previously by the family. The disabled in Ghana have been known to be poisoned or straightaway executed by their own families because of the way they were born. Shocking! What is just as shocking is the common practice of hiding the disabled in rooms where others can never see them. To the family’s credit, they loved and cared for her, although she was clearly treated more of an outcast than the other siblings.
When I looked over the history intake form, the family was particularly concerned with ‘why are her breasts so small?’ and under reason for injury was written ‘Spirits.’ I also discovered that she wasn’t eating more than a few small snacks for meals that were sprinkled randomly around the week. This was also bothersome to the family, but when we chatted, the father had no beef about changing the topic and asked with no hesitation ‘why are her breasts so small?’ It was one of those moments when you can see things flashing in slow motion. As the father was starting the sentence, I knew where it was going and what the reaction was going to be. All the while in my head, I was performing a superman like dive across the table, to put my hand over his mouth. Of course I just sat there professionally and took notes and sadly watched as Harriet slunk even further into her chair, chin now resolutely tucked to her sternum and her eyes focused on an arbitrary speck of dust on the floor. The chances of her getting married in Ghana were slim, and she is fully aware that is a chapter out of ‘bad news bears.’ Culturally women here place great emphasis on getting married, especially since they live at home until a man comes and sweeps them away.
As a student, you read about these ‘cases’ and study for tests on them, but as a real life doctor I have zero work with little people. What to do? I stalled. I did this for two reasons 1) to let my brain play catch-up and 2) to detach myself emotionally from this depressed 19-year-old woman who looked like a 10 year old girl that (in my head) may have just needed a hug and a ‘it’s OK your family loves you’ talk from a perfect stranger. As my analytic mind started to rejoin me in reality, I was remembering school lessons that brought me to the conclusion that despite her age, many of her bones and other structures were developmentally eons behind. Thrusting into her spine would probably be a candidate for bad idea of the year.
Shifting back into real-life doctor mode, I told the family that I would like an X-ray of her spine and that ‘yes I think I can help.’ However, I needed to be clear that they should not expect to find any major ‘endowments’ (so to speak) anytime soon, nor should they expect to see any major developmental changes. Instead, they needed to understand that sometimes things like this happen. I also mentioned that I didn’t think it was anything they or anyone else did to cause this condition. I did NOT begin to talk about the spiritual aspect for fear that this may have stated a ritual of some sort that needed to be performed just before every adjustment. Even worse something like a voodoo-doll being brought into the picture what not out of the realm of possibility.
I studied Harriet’s spine the first time with standard Palmer package style checks; including leg length changes, skin correlations, muscle tension, and motion/static palpation. I wasn’t sure really what to expect, but I adjusted her with a low force precision instrument just as we were taught in school. To go on a bit of a tangent: The idea that we as Chiropractors are just back crackers or bone movers is to leave a tremendous amount of potential unaccounted for. There is so much more that we can do, and in lieu of I wish to offer that first and foremost we are nervous system doctors. Even if I had a narrow definition of Chiropractic before I came to Ghana, Harriet alone would have blown my doors off into next week. Here’s Why. I immediately started to see changes by the end of the second visit. Harriet first of all started eating better. By the third visit she relapsed a little, but now after two weeks of care, is holding her head high, talking for the first time to strangers, eating regular meals with her family and feeling altogether much happier.
She still is clearly the odd person out in the family, but it’s truly amazing to see how she now interacts with the staff, and with the other patients who come by the office. In the photo, you can see Harriet wearing a blue bandana, much like the author can be seen sporting around town. When I told her this, it was as if she was given an early birthday present. Now I keep one blue bandana in the office just incase my favorite blue bandana wearing woman strolls in.
Clinically speaking (if you don’t want the clinical stuff skip this paragraph), Harriet has not been diagnosed with anything by a medical doctor and without being a specialist I am left guessing that she has dwarfism or Morquio’s syndrome (which I believe is a slightly more serious version of Dwarphism). Either way, both involve skeletal achondroplasia, which leads to the short stature. The cervical AP-open mouth and lateral X-ray both showed evidence of Atlanto-axial instability due to a hypoplastic odontoid on C2 and a somewhat associated agenesis of the C1 posterior arch. Cervical vertebral bodies were all diminished in height. Although I am awaiting the remainder of the full spine images, I expect to find these bullet shaped vertebrae throughout the spine. Her muscle tone is diminished and despite a depressive mood, her mental development is on par for that of a 19-year-old female.
With merely three weeks of the light force Chiropractic instrument adjustments the changes have included the following: increased appetite, increased sleeping time at the night, decrease in urination frequency (despite the increase in foods and fluids). No changes noted developmentally. Emotionally there is marked improvement with her mood with respect to extroverted conversation. Her posture is improved, and although a biomechanical change may play some part, I suspect this is due more to her improved mood. For the first time, today her father told me that, she is now sleeping through the night.
I will have more on Harriet before I leave, but wanted to share some of the good news that all of you are making possible. I hope you have enjoyed the photos and please do find us as a ‘Cause’ on facebook by clicking here. In love, light and gratitude…