The year was 2011. I was 13 years old, and school had just let out. I walked back home, exactly four blocks away from school, left-right-left-right, lub-dub, lub-dub.
My feet carried me into my abode; barely visible left-right-left-right indentations of footsteps on the worn rug transitioned to cold, asymmetric tile floors, as my feet — always restless, proactive, and strong-willed despite how the rug attempted to loop itself around my toes — led me to the bathroom. It was the only room in my house with a tiled floor: plain, simple white, with a hint of brown, faded from light and age. The other rooms had snuggly rugs that hugged my feet, but the bathroom tiles were comforting in their own way, bumpy and warm once my feet had inhabited the surface for a long time.
I took my usual shower, but for some reason, that day my skin repelled the warm fog of heat and water, unveiling new indentations in my skin and my body’s underlying asymmetry. My mom took one look at me and said, “Wh-what is this?”
My mom and I had never noticed the asymmetry until that day. A call was made immediately for an appointment with my pediatrician.
At the clinic, while waiting, my feet and toes curled inwards, as if through my socks and shoes they were making contact with the cold tile floor — similar to the tiles in my bathroom but lacking their bumpy familiarity. Lub-dub, lub-dub, lub-dub.
I got called inside. Left-right-left-right.
Clip-click-clip. The doctor arrived. She closed the door as we explained our concerns, and the diagnosis was given right away. Lub-dub, lub-dub. “It’s idiopathic scoliosis. You’ll need an x-ray to confirm it as well as to determine the angle of severity.”
Lub-dub, lub-dub … my heart was racing, but the rest of my body — my toes, my feet, my skin — stayed where it was, not bothered by my new diagnosis nor the stirrings of anxiety curling in my chest.
In the end, I was confirmed to have mild idiopathic scoliosis. My new doctor’s immediate suggestion was spinal fusion surgery, which involved inserting metal rods on either side of my spine, applying a mixture of cadaveric bone and drilling screws into my spine which would hold the rods in place till the bone fused. I was only thirteen years old, but I knew I wanted to do some research before my mom or I made any decisions. With the internet’s help, I learned that because my case was mild, there was certainly no need for an operation. Although surgery would straighten my spine, make me a couple inches taller and reduce the risks of further complications and pain from the curvature of the spine, there were risks.
As with any operation, spinal fusion is associated with risk of complications. There were alternatives I found online that my doctor hadn’t even mentioned: visits to osteopathic physicians, chiropractors, physical therapy, bracing and exercises to strengthen my back muscles, all of which could potentially help me avoid any potential long-term soreness or back pain without the need for surgery. For instance, Mark Morningstar’s study evaluated adult patients with scoliosis who had completed an exercise-based chiropractic program. After being monitored for twenty-four months, twenty-two of the twenty-eight patients showed Cobb angle reductions. Although there aren’t enough studies and scientific evidence to support the effectiveness of alternative treatments for scoliosis, it is still important to consider them especially for cases when the situation may not be as severe or the patient does not wish to proceed with an operation.
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It was shocking and unexpected that the specialist didn’t suggest all the options available, and that I, the patient, had to do the research. I was fortunate to be able to research options and advocate for myself; however, this made me reflect on how people in certain vulnerable groups may be visiting doctors and blindly following their advice. There is somewhat of an unequal power dynamic between doctors and patients, and inconsistent or incomplete communication may affect the latter more than the former. Due to lack of education, patients may be uncomfortable or unwilling to disregard advice from their doctors.
Ever since the day of my scoliosis diagnosis, I continued strengthening my back through track and field in high school as well as being more cautious when carrying heavy objects on my back. Over time, I continued to heal from the emotional distress — until four years later, in high school physiology class. I knew we would eventually approach that one chapter, Skeletal Muscles and Related Diseases. Before we got there, I would always try to keep my eyes and fingers fixed to the chapters before it keenly aware of its looming presence, but that chapter eventually wrapped itself around my bookmark.
That day in class, I couldn’t handle another reminder of the emotional distress from the day of my previous diagnosis. I never discussed my case with the teacher or the class, but the following day, the teacher came up to me and questioned if I had scoliosis. She knew all along from her observations of my posture. We then had an open discussion about best practices to treat scoliosis. We both discussed our concerns about patients naïvely following doctors’ orders without being aware of all options. Our discussion made a smooth transition into an extra topic of the physiology class: medical ethics and informed consent which includes the doctors’ responsibility to disclose alternatives treatment plans.
I had always thought of medical professionals as society’s heroes who could do no wrong, but with my own personal experiences in the back of my mind, I discovered the reality was far more complex. My teacher showed us the film “Doctored,” by Hays and Sheehan, and I was shocked by the well-argued claim that physicians could be concealing the effectiveness of chiropractic methods. In the film, one patient with multiple sclerosis sought recommendations from his physician who only prescribed medicine to treat the disease process and did not recommend any further treatments for the patient’s overall well-being. However, the patient soon found out that the prescriptions not only worsened his health physically and emotionally but also failed to adequately treat his associated pain, leading to drug addiction. It was only then that he was introduced to a chiropractor. His well-being then improved as a result of the chiropractor’s methods.
With all due respect, although the medical profession is bound by the practice of informed consent, in which all risks must be revealed to the patient before treatment is initiated, it is worth noting that some medical professionals omit supplementary details or alternatives because they believe their recommended treatment is the best solution. This is not to say that medical professionals cannot be trusted, but I believe it is necessary that patients exercise their right to say no or ask more questions whenever they feel that they need more information or prefer another alternative.
Before taking classes on the subject and having my own meaningful experience, I had always thought of the medical field as a benevolent force meant to treat, if not fully cure, society. I was completely ignorant of the fact that it can also have negative effects. However, after being introduced to medical ethics, I have taught myself to negate to some of my physician’s suggestions. It irks and disappoints me to see how some medical professionals function without fully following the current practice of informed consent and not acting in the best interests of patients.
My personal experience greatly inspired me to adhere to my passion for the medical field — to become a pediatrician as well as an advocate for justice in medicine and medical ethics. I once imagined my future self as the all-knowing “doctor to the rescue,” but my journey with scoliosis has somewhat eroded that image by revealing new paths paved by medical ethics, informed consent and non-invasive treatment options.
Pre-Medical Guest Writer
Stanford University
Teresia is a junior at Stanford University. In 2020, she will graduate with a Bachelor of Arts in French and Bachelor of Science in biology with concentrations in biochemistry and biophysics. Because she is a child of two immigrants from Shanghai, she is grateful for her parents who have supported her in achieving her goals. She would also like to thank her other family members, friends, professors, and mentors. In her free time, Teresia enjoys playing the violin, hanging out with friends and family, and biochemical research. After she graduates, Teresia desires to attend medical school and then pursue a career in pediatrics.