Must question cause of sports-related injuries [letter; see comments]

              8 • JAOA • Vol 102 • No 1 • January 2002 Letters
LETTERS
Osteopathic approach
may be helpful in war
on terrorism
To the Editor:
The October issue of the Journal of the Amer-ican
Osteopathic Association arrived the same
week as the October 11, 2001, issue of the
New England Journal of Medicine. Both jour-nals
contained editorials about the terrorist
attacks of September 11, 2001 (JAOA
2001;101:569-570 and N Engl J Med 2001;
345:1126). Both journals called for the
knowledge and skills needed to care for
the survivors of terrorist attacks.
As stated in the New England Journal of
Medicine, “we are physicians, not politi-cians.”
However, there are specific issues
the osteopathic medical profession should
step up to and raise that reflect our con-cern
for disease prevention and the ramifi-cations
for public health. Consider this idea:
If the terrorist attack has irreversibly
changed life in America, as all seem to
agree, the war on terrorism demands new
ways of thinking, not the old responses.
We need to eliminate all financial, moral,
and psychological support for the Taliban.
The primary source of revenue for the Tal-iban
has been international drug trade, gen-erating
$30 billion per year. In fact,
Afghanistan holds the dubious distinction of
producing 80% of the world’s heroin. As
the war on terrorism clearly must be fought
on many fronts, Americans need to rethink
our nation’s approach to the war on drugs.
Until now, our government has confronted
the problem overseas as the isolated political
or military failings of foreign governments,
rather than as a complex social problem
with international ramifications and shared
humanitarian responsibilities. Any new
approach must include a larger, more inter-national
sensibility, integrating the demand
for respect of human rights and the elimi-nation
of torture overseas.
It is increasingly recognized that the
strategic genius behind the work of Osama
bin Laden is Ayman Al- Zawahiri, an Egyp-tian
physician who learned his trade as the
leader of Al Jihad. It is said that Zawahiri
became a terrorist because of his experi-ence
in an Egyptian prison. According to his
friends, he was tortured so severely that
“something snapped,” which led directly to
his transformation into an international ter-rorist.
Similarly, a commitment to humani-tarian
issues might influence the millions of
people who provide financial and moral
support to international terrorism. Bin
Laden no more represents Islam than David
Koresh represented Christianity in Waco,
Texas. Nonetheless, if even 99.9% of Mus-lims
despise bin Laden and the terrorism he
promotes, millions of people remain sym-pathetic
to his cause. A war of propaganda
needs to be aimed at this segment, and the
weapons successful in that war are likely to
be humanitarian aid and medical assistance
to developing countries. The conversion of
at least some of the disaffected to terrorism
may be preventable.
Let’s consider a public health analogy. If
we are to wage war on lung cancer, our
approach is not to build more hospitals and
develop newer surgical techniques to
remove cancerous tumors. New cases of
the cancer would continue to occur. Instead,
we need to learn the epidemiologic factors
of lung cancer; we need to convince people
who smoke cigarettes to stop; and we need
to influence young people never to start
smoking.
In a similar way, eliminating a few ter-rorists
is not going to solve the larger
problem because others will soon emerge.
We need to eliminate the sources of support
for terrorism.
The legacy of osteopathic medicine as a
healing profession that emphasizes disease
prevention and restoration of health pro-vides
a worldview which may prove
helpful in the war on terrorism.
FELIX J. ROGERS, DO
Trenton, Michigan
More on terrorism
To the Editor:
I could not agree more with Gilbert E.
D’Alonzo, Jr’s, DO (JAOA 2001;101:569-570)
call for refined skills to address the enor-mous
grief, anxiety, and panic that has
resulted from the terrorist attacks that
occurred September 11, 2001. It is likely that
the fear generated by any future terrorist
attacks, including plane crashes or bioter-rorism
events, will pale in comparison to
the fear that we are still confronting as a
result of the events on that day. It seems the
most potent medicine we could offer our
patients would be a simple, inexpensive,
and rapid solution for addressing fear and
anxiety.
I have been practicing natural medicine
for more than 10 years, and I am the found-er
and senior editor of a top-rated wellness
Web site (www.mercola.com)—roles that have
allowed me the opportunity to evaluate
many nontraditional techniques thought to
improve health. I would like to share my
experience with the emotional freedom tech-nique
(EFT), developed in 1980 by Roger
Callahan, DO. Although no comparative
trials exist, EFT is clinically similar to eye
movement desensitization and reprocessing;
Smoke billows from the World Trade Center after
terrorists crashed commercial aircraft into the twin
towers of the New York City landmark on
September 11, 2001. (Photo by Robert B. Goldberg, DO)
JAOA • Vol 102 • No 1 • January 2002 • 9
LETTERS
Letters
yet it is simpler to implement, has increased
effectiveness, and provides a more rapid
onset of relief.
Emotional freedom technique is a form of
psychological “acupuncture.” The mecha-nism
of action is clear; the health provider
taps specific acupuncture meridians on the
head and chest while activating the neural
circuits that are involved with fear and anx-iety.
All this is done while the health pro-vider
gives a positive affirmation to the
patient, which the patient states. The com-bination
of tapping and positive affirma-tions
appears to disrupt the field that is cre-ated
from the emotion and its consequences
on one’s physiology, thus normalizing the
bioenergy disruption. The appealing char-acteristics
of this technique are that it is
quickly learned, does not require drugs or
supplements, has no side effects, and is inex-pensive.
However, the most significant
reason to consider this mode of therapy is its
effectiveness; it works in minutes and the
results appear to be permanent.
The emotional freedom technique has
been used primarily by the psychological
community and some psychiatrists for the
past 10 years to successfully treat thousands
of patients with emotional trauma. Unfor-tunately,
there are virtually no primary care
physicians using this tool and no published
trials documenting its efficacy. Neverthe-less,
I have successfully used EFT for hun-dreds
of patients in my clinical practice and
can vouch for its effectiveness. A lack of
peer-reviewed clinical trials would never
have stopped Andrew Taylor Still, MD, DO,
from implementing a simple, harmless tech-nique
with great potential for healing.
I have been searching for truth in health
for many years, and it is my opinion that
EFT-type technology may be a quantum
leap in the management of emotional
trauma. Adeptly implemented in a primary
care setting, EFT-type technology has the
potential to bring the osteopathic profession
back to the basics that Still formulated over
100 years ago. Further information is avail-able
at http://www.emofree.com.
JOSEPH MERCOLA, DO
Optimal Wellness Center
Schaumburg, Illinois
Low-cost solution removes
barriers
To the Editor:
We are besieged each day with increasingly
expensive solutions to our basic medical
needs. But what if our needs are great and
money is scarce? Several years ago, I was
asked by the University of Arizona to solve
such a problem.
A severely handicapped applicant was to
be hired as a receptionist if he could meet the
job requirements. He would be required to
answer two-line phones in two rooms and
forward these calls as requested to the
appropriate parties. The applicant was
severely handicapped, having severe spastic
disease in addition to his other disabilities. In
the interview process, he repeatedly dropped
the phone and had difficulty pressing the
correct buttons on the handset. Could a solu-tion
be found that would allow him to
assume these job duties? The situation also
required, however, that costs be nonrecur-ring
and within the applicant’s budget.
A metal rod seven eighths of an inch in
diameter was fastened to the side of the
applicant’s chair. A polyvinyl chloride tee
was fluted, and a deadlock was filed into the
base of the flute (Figure), allowing the appli-cant
to slide the phone onto the rod and
drop the phone into position, locking it in
place and spacing it so as to keep the
handset just above his lap. A two-line roving
phone from Radio Shack was then fastened
onto this bracket. No detachment from the
bracket was required to remove the phone
for recharge. Jacks were wired into the side
(continued on next page )
1/8“ aluminum
Top view
1/8“ aluminum
7/8“ I.D.
PVC plug
To attach phone
Phone can be rotated 360 
about this axis
PVC sch. 40 “T”
To rod attached
to chair
Side view
Figure. Illustration by Michele T. Mata, Art Director
10 • JAOA • Vol 102 • No 1 • January 2002
LETTERS
Letters
of the phone for the use of a microphone
and earpiece. As the applicant was deaf in
one ear, an earpiece could not be used, so a
radio speaker was placed in his cap to pick
up the phone output. (He could not use a
speaker phone because of its disruptive
effect on nearby classrooms.) Either a boom
microphone or a tie-tac microphone could
be used as a pickup; he chose the latter. This
improvised system worked, allowing the
applicant to become a successful employee.
Tools found in the average home were
used in this simple fabrication. The total
cost was less than $200, including the cost
of the phone.
ALLAN R. CROSBY, DO
Sierra Vista, Arizona
Talents needed to build,
not blend
To the Editor:
The Journal of the American Osteopathic Asso-ciation
and The DO have recently reached a
new high in their selections of articles for
publication and inclusion of special reprints.
I have been personally stirred by the articles
from the library, as well as recent original
contributions, editorials, and articles on
end-of-life care issues. I congratulate you
and your staff.
Finally, I must add a few words
regarding the comments of Mr. Shing, a
second-year student at the New York Col-lege
of Osteopathic Medicine (The DO
2001;42:21-22). Needless to say, I have
encountered his idea of integrating osteo-pathic
medicine with allopathic medicine
before. His comments contain enough truth
to be galling, but his reasons to change are
not helpful. He might better use his talents
to improve the existing situation rather than
eroding it further. I have been through this
before, and the truism “If you haven’t tried
it, don’t knock it” comes to mind.
MAX T. GUTENSOHN, DO
Distinguished Emeritus Professor
Internal Medicine
Kirksville College of Osteopathic Medicine
Kirksville, Missouri
End-of-life care focus critical
to a complete medical
education
To the Editor:
I compliment and congratulate you on the
October issue of the Journal of the American
Osteopathic Association (JAOA). The focus
on end-of-life care is a contemporary issue
of increasing relevance as baby boomers
begin to introduce new cultural expecta-tions
of death, dying, and the care they
wish to receive— or wish not to receive.
I am an associate professor at the
Kirksville College of Osteopathic Medicine
and a certified death educator. I have taught
thanatology to medical students for 14 years
and have followed with excitement the
great strides that have been made in recent
years via the Robert Wood Johnson Pro-ject.
(The program is called Education for
Physicians on End-of-Life Care (EPEC)—
developed by the American Medical Asso-ciation
and supported by the Robert Wood
Johnson Foundation.) The issue is: How
are medical educators to find time in the
curriculum to include more end-of-life care?
Articles such as those in the October
issue of JAOA are helpful in convincing
medical educators of the importance of
death education for physicians and physi-cians-
in-training. I hope JAOA will con-tinue
to serve as a critical resource for end-of-
life care issues, education, and
innovations. Thank you for devoting the
October issue to this topic.
RON GABER
Associate Professor
Department of Family Medicine, Preventive Medicine
and Community Health
Vice President and Dean of Students
Kirksville College of Osteopathic Medicine
Kirksville, Missouri
More on end-of-life care
To the Editor:
I want to congratulate you on the October
issue of the Journal of the American Osteo-pathic
Association, which was so helpful
because of its compassionate view of the
end-of-life care of elderly people.
I am 94 years old and an 11-year retiree
of the osteopathic medical profession. I have
had 2 great marriages and 3 blue-ribbon
children from my first marriage of 40 years.
For nearly 4 years I have lived alone in a
house that was shared with others for 60
years.
I have a good life and I am still in con-trol,
which I credit to my exercise routine
and prudent investments. I agree with
former President Jimmy Carter when he
emphasizes the importance of being in con-trol
as one ages in his book, The Virtues of
Aging.
Again, thank you for the fine October
issue!
EARL C. KINZIE, DO
Lindale, Texas
Travel road that includes
complementary and
alternative modes of therapy
To the Editor:
This letter is in response to American Osteo-pathic
Association Executive Director, John
Crosby’s, JD, comments in “The road to be
taken: AOA leadership on complementary
and alternative medicine” (The DO June
2001;42:11-12). I would like first to applaud
Mr Crosby for officially encouraging the
osteopathic medical profession to explore
complementary and alternative modes of
JAOA • Vol 102 • No 1 • January 2002 • 11
LETTERS
Letters
therapy (CAM). Those of us who have been
consistently evaluating and using CAM for
years have observed their potential for effec-tiveness.
I agree that it is time for the osteopathic
profession to pull its head out of the sand
and courageously declare our uniqueness
and our support of effective CAM modes of
therapy.
Patients are not waiting for the medical
profession; they are making decisions based
on their experience of what works and what
does not. Statistical research has shown that
Americans are already spending billions of
out-of-pocket dollars for alternative medical
care.
I encourage Joseph M. Kaczmarczyk,
DO (MPH, senior medical advisor to the
White House Commission on Comple-mentary
and Alternative Medicine Policy),
to seek advice, counsel, and experience from
fellow osteopathic physicians who have
broad-based experience in the use of CAM.
Experience cannot be learned; it must be
experienced.
CONRAD G. MAULFAIR, JR., DO
Medical Director
Maulfair Medical Center
Topton, Pennsylvania
Must question cause of
sports-related injuries
To the Editor:
In response to the article, “Elbow injuries in
golf” (JAOA 2001;101:509-516), by Alan R.
Stockard, DO, I am impressed with this
interesting and comprehensive discussion
of 1100 cases of golf injuries, with its
emphasis on elbow injuries and their treat-ment.
I would like to add a few comments
to the discussion.
As osteopathic physicians, we should
always ask the question, “Why did this
injury happen?” In the case of an acute
injury (eg, the golf club hits the ground)
the answer is usually self-explanatory. But
in the case that the problem appears
without acute injury and progresses to the
point of seeking a physician’s help, ques-tioning
how the injury happened should
always be foremost in the osteopathic physi-cian’s
mind. In my experience treating
sports-related injuries, it has been rare not
to find remote structural restrictions and
abnormalities that contribute to, or are the
cause of, the problem. Nowhere in medicine
is the osteopathic medical approach more
applicable than in sports-related injuries.
The magnificent total coordination of move-ments,
tensions, and positions of the body
to accomplish a split-second physical feat is
a marvel to behold. Key restrictions any-where
in the body at that moment will
adversely stress a vulnerable area—in the
case of golf, this can be the elbow, shoulder,
wrist, or lower back.
Structural history, evaluation, and
simple nontraumatic muscle energy tech-niques
quickly and logically enhance the
body’s ability to correct itself (ie, heal).
LYNN F. BRUMM, DO
Professor Emeritus
Michigan State University College of Medicine
East Lansing, Michigan
An alert regarding
Canada’s financial aid for
an osteopathic medical
education
To the Editor:
Canadians who pursue osteopathic med-ical
schooling and residency training in the
United States may encounter a surprising
oversight in Canada’s financial aid legisla-tion.
Because of the high cost of an osteo-pathic
medical education and the resulting
student loan payments, the typical take-home
pay of a resident can be dispropor-tionately
low. Thus, many Canadian osteo-pathic
students who rely on the Canada
Student Loan Program to finance their edu-cation
in the United States would likely plan
to apply for interest-relief benefits
throughout their residency. This program
allows those who qualify to delay making
payments on their loans after graduation
for a certain time. However, a hidden reg-ulation
could leave some residents and their
families in a financially catastrophic situa-tion.
The literature commonly directed to-ward
initial borrowers by the Canadian
Government and lending institutions ad-dresses
interest relief and the criteria for
eligibility; it does not include information
that is imperative for osteopathic students
to make informed decisions about how to
finance their educations. As the Canadian
Government readily lends to students at-tending
osteopathic medical school in the
United States, it is reasonable to assume
that the location of their residencies would
be irrelevant when applying for interest
relief. However, most Canadian student
loan recipients are probably not aware that
an osteopathic medical school graduate is
not eligible for interest relief unless he or she
lives in Canada, which is problematic
because completing an osteopathic resi-dency
in Canada is simply not a realistic
option for a medical graduate at this time.
In fact, the American Osteopathic Associa-tion’s
2000/01 Yearbook and Directory of Osteo-pathic
Physicians currently puts the number
of US-trained Canadian DOs at 19. Due to
Part 5, subsection 19(a) of the Canada Stu-dent
Financial Assistance Act and its Reg-ulations,
an osteopathic medical school
graduate who matches in a residency out-side
of Canada could be required by law to
make extremely burdensome loan pay-ments
without regard to his or her financial
situation.
The Canadian Government should be
made aware of the unique situation of
Canadian osteopathic medical residents.
Proper consideration and appropriate
changes should be made to the legislation
and, in the meantime, student loan literature
should be altered so that financial hardship
for Canadians who graduate from Amer-ican
osteopathic medical schools is avoided.
Any Canadian osteopathic medical
physician or osteopathic medical student
who has been or is currently affected by
this legislative oversight can have his or
her name added to a list of those who sup-port
calling the Canadian Government’s
attention to this matter by e-mailing
campbellangeline@hotmail.com. It would also
be helpful to e-mail Jane Stewart, Minister
of Human Resources Development, Cana-dian
House of Commons, at min.hrdcdrhc@
hrdcdrhc.gc.ca.  
ANGELINE CAMPBELL, RN
Spouse of second-year DO resident
Omaha, Nebraska