Intervention

9

12:55 P.M., MONDAY, DECEMBER 1, 2008

NEW YORK CITY

(7:55 P.M., CAIRO, EGYPT)

By the time Jack braked to a stop in front of Ronald Newhouse’s Fifth Avenue office, he felt better than he had in months. He was motivated, thanks to Keara Abelard, by having stumbled on the perfect diversion: a crusade of exposing the dangers of alternative medicine. He couldn’t wait to come face-to-face with the man.

Jack hopped off his bike and went about applying the collection of locks he used to secure his Trek. As he was applying the last one, someone tapped him on the shoulder.

Jack looked up into the face of a uniformed doorman, looking like he stepped off a movie set in his old-fashioned greatcoat with two rows of shiny brass buttons. “Sorry,” he said in a tone that suggested he wasn’t sorry at all. “You can’t leave your bike here. It’s against the rules.”

Redirecting his attention to the final lock, Jack finished the task of securing the bike.

“Hey, buddy!” the doorman said. “Did you hear me? You can’t leave the freaking bike here. It’s private property.”

Standing up without saying a word, Jack fished in his pants pocket, pulled out his wallet, and flashed his official New York City medical examiner’s badge. It looked to all the world like a policeman’s badge, unless you looked closely.

“Sorry, sir!” the doorman said hastily.

“It’s quite all right,” Jack said. “The bike won’t be here long.”

“No problem, sir. I’ll keep my eye on it. Can I help you in any way?”

“I’m here to see Ronald Newhouse,” Jack said. He couldn’t bring himself to use the title “doctor.” Nor did he say whether he was there in an official capacity or as a patient.

“This way, sir,” the doorman said obsequiously, gesturing toward the front door and leading Jack into the foyer. He opened the inner door with a key and pointed. “Dr. Newhouse’s office is down the hall, first door on the left.”

“Thank you,” Jack said, wondering if the man would have been equally gracious if he knew Jack was a medical examiner.

DR. RONALD NEWHOUSE AND ASSOCIATES was stenciled in gold leaf on the door. When he walked in, it was immediately apparent that Newhouse ran a successful practice. Not only could he afford the Fifth Avenue rent, which Jack assumed was significant, he’d had the waiting room decked out in style. There were original oil paintings on the walls, plush furniture, and a large Oriental rug. What made it appear different from any successful medical doctor’s office he’d seen were three stools with contour seats connected to their bases by a movable ball joint. A woman in her twenties occupied one of the stools. With her hands on her knees and her legs spread apart such that her dress drooped between her knees, she was in constant motion in a manner that reminded Jack of his daughters using their hula hoops. While he watched her, the woman caught his eye and smiled. She appeared completely unselfconscious, leading Jack to believe the unique activity was normal in the environment.

“Can I help you?” a pleasant female voice asked from Jack’s right. He turned to face an immaculately dressed woman with every strand of dark hair in place. Jack was impressed. Even her manicure was perfect.

“I think so,” Jack said. He stepped over to the woman, who smiled up at him. “To be perfectly honest, I’ve never been in a chiropractor’s office.”

“Welcome,” the receptionist said. Her nametag read LYDIA.

“That’s an interesting piece of furniture,” he remarked, tilting his head toward the woman rotating and counter-rotating on the stool.

“She’s using one of our swivel chairs. It’s great for the lumbar vertebrae of the lower back,” Lydia explained. “It causes the intervertebral discs to lubricate themselves and actually swell to a degree. We encourage people to do it before their adjustment session.”

“Interesting,” Jack said. “Is Dr. Ronald Newhouse available?” He gritted his teeth after forcing himself to use the appellation “doctor.”

“He is here,” she said. She gestured toward the woman on the swivel chair. “He has his next patient at one-twenty-five. Do you have an appointment?”

“Not yet,” Jack said.

“Would you like to make one?”

“I’d like to see the doctor,” Jack said ambiguously. “I don’t know nearly as much about chiropractic therapy as I would like.”

“Dr. Newhouse is always interested in new patients. Perhaps he could see you for a few minutes before he sees Ms. Chalmers. If you don’t mind waiting for a moment, I’ll go ask him. Who may I say wishes to see him?”

“Jack Stapleton.”

“Okay, Mr. Stapleton. I’ll be back presently.”

“I appreciate your help,” Jack said. While the receptionist was out of the room, he glanced back at Ms. Chalmers as she dutifully continued her hip rotations. She had her head back, her eyes closed, and her lips slightly parted. For a moment Jack was mesmerized. She seemed to be in a trance.

“The doctor will see you now,” Lydia said, breaking Jack’s concentration. He followed her through an interior door and down a short corridor passing a series of closed doors. At an open doorway she stepped back and gestured for Jack to enter.

The office looked out on Fifth Avenue and beyond into Central Park. Inside there were two men, one sitting behind a desk, the other in a visitor’s chair. The man behind the desk, who Jack assumed was Ronald Newhouse, immediately stood up and leaned over the desk, stretching a beefy hand in Jack’s direction.

“Welcome, Mr. Stapleton,” Ronald Newhouse said with a salesman’s enthusiasm.

Jack allowed his hand to be vigorously pumped. Newhouse was about an inch or so taller than Jack’s six feet, and one and a half times his hundred-and-eighty-pound weight. Jack estimated he was in his mid-forties. His coloring was dark with carefully groomed eyebrows on prominent brow ridges. His eyes were dark and piercing. But the most striking aspect of the man’s appearance was his hairstyle, or, more accurately, the lack of it. His hair was medium-length, dark, and shiny, as if slathered with styling gel, but totally uncombed. Spiky clumps sprang from his scalp at odd angles.

“Meet one of my associates, Carl Fallon,” Newhouse said, gesturing toward the gentleman in the visitor’s chair.

On cue, Fallon sprang to his feet, and with alacrity that matched Newhouse’s, gave Jack’s hand a second spirited shake. “Very nice to meet you,” he said to Jack. He gathered the remains of a pastrami sandwich and a half-eaten dill pickle along with a small brown bag. “I’ll catch you later,” he said to Newhouse.

“A great guy,” Newhouse commented. He pointed to the chair Fallon had vacated. “Please, sit! I understand you are interested in chiropractic therapy. I’m happy to give you a quick intro before I see my next patient. But before I do, how did you find me? Was it through my new website? We’ve been putting a lot of effort into it, and I’m curious to know if it’s working.”

“I was referred,” Jack said. He was aware he wasn’t quite telling the truth, but he wanted to see how things would play out.

“Wonderful!” Newhouse responded smugly. “Would you mind if I asked the patient’s name? I can’t tell you how rewarding it is to get positive feedback from a satisfied patient.”

“Nichelle Barlow.”

“Ah, yes! Nichelle Barlow. A lovely young lady.”

“I’m interested to know what you as a chiropractor feel competent to treat?”

Newhouse’s smile deepened, and for a moment he seemed to be deciding where to begin. Jack focused on a series of books on the windowsill directly behind him, held upright by bright brass caduceus-shaped bookends. The titles were telling: How to Build a Million-Plus-Dollar-a-Year Chiropractor Practice and How an E-meter and Applied Kinesiology Can Double Your Practice Income. Jack had vaguely heard of e-meters, which had been described as bogus technology when a number had been confiscated by the FDA. He’d also heard of applied kinesiology, which had been discredited as having no medical value by controlled trials.

“I’d have to say chiropractic therapy in my hands can treat just about any medical ailment known to man. Now, to be fair, I’d have to qualify that by admitting up front that chiropractic cannot cure every ailment, but it most definitely relieves the symptoms of those problems it cannot cure.”

“Wow!” Jack said, as if impressed. Actually, he was impressed by the sheer boldness of the claim. “Do all chiropractors feel the same about the field’s capabilities?”

“Heavens, no,” Newhouse said with a sigh. “There’s been an unfortunate falling-out, so to speak, since the field’s great founder, Daniel David Palmer, discovered the techniques in the nineteenth century and founded the Palmer School of Chiropractic in Davenport, Iowa.”

“Davenport, Iowa,” Jack repeated. “Isn’t Iowa where the Transcendental Meditation movement is based?”

“Indeed, it is, although different towns. Fairfield, Iowa, is the location of the Maharishi University. I suppose you could say Iowa’s the nation’s most fertile center for the development of alternative medicine. Of course, the most important discovery of all remains the chiropractic movement.”

“Can you give me a thumbnail sketch of the scientific basis for chiropractic’s therapeutic power?”

“It’s based on the flow of innate intelligence, which is a kind of life force or vital energy.”

“‘Innate intelligence,’” Jack repeated, to be certain he’d heard correctly.

“Exactly,” Newhouse said, raising his hands palms out with fingers spread like a preacher about to make an important point. “Innate intelligence has to move freely about the body. It’s the basic governing force making sure all the organs and muscles work together for the common good.”

“And when this flow is impeded, then there’s disease.”

“Exactly!” Newhouse seemed pleased.

“What about bacteria, and viruses, and parasites,” Jack said. “How do they fit in when it comes to disease — let’s say with sinusitis.”

“Very simple,” Newhouse said. “With sinusitis there is a sharp decrease in the flow of innate intelligence to the sinuses. There is a resultant decrease in the normal physiological function of the sinus cavities, opening up the opportunity for any resident bacteria or fungus or whatever to grow.”

“So let me see if I understand this,” Jack said. “The pathological process starts with the blockage of the flow of innate intelligence, or life force, and the overgrowth of the bacteria is a result, not a cause. Am I getting this right?”

Newhouse nodded. “You’re getting it perfectly.”

“So, the chiropractor’s job is to restore the flow, and as soon as he or she does that, the bacteria, or whatever is secondarily involved, goes away.”

“You are exactly right.”

“I said ‘he or she,’ but it seems to me there are more men chiropractors than women.”

“I think that is safe to say.”

“Is there some reason?”

Newhouse shrugged. “Probably the same reason there are more surgeons who are men than women. Chiropractic therapy takes a certain amount of strength. Maybe men find it easier.”

Jack nodded while in his mind’s eye he could see the internal tears in Keara’s vertebral arteries. He had to agree. It took strength to cause the kind of damage she’d suffered. After clearing his throat, Jack asked, “How is it that the innate intelligence gets blocked?”

“One of Daniel David Palmer’s very first patients had a severe hearing problem brought on seventeen years previously while straining to pick up a heavy load. When Dr. Palmer examined him, he determined a cervical vertebra had been racked out of position. When he replaced it, the patient’s hearing returned. What had happened, simply put, was the displaced vertebra had been pressing on the nerves, enervating the ears. When the pressure had been released the flow was reinstated and function returned.”

“So, the innate intelligence flows through the nerves.”

“Of course,” Newhouse said, as if this particular fact was self-evident.

“So, it’s the backbone that’s the culprit,” Jack said, “when it comes to blocking innate intelligence.”

“Yes,” Newhouse agreed. “You have to realize that the spine is not just a stack of bones but rather a complex organ, with each vertebra able to influence the other as well as the group as a whole. It’s what supports us, holds us all together, and integrates us. Unfortunately, it has a strong tendency to get out of line. That, in a nutshell, is the responsibility of we chiropractors. It’s our job to diagnose the irregularity — or subluxation, as we call it — and restore the involved vertebra to its normal position, and then make sure that it stays there.”

“All this is accomplished by spinal manipulation, correct?”

“You got it. We, of course, have a special name for it. We call it adjustment.”

“Are you saying you can function as someone’s GP?”

“Absolutely,” Newhouse said, pronouncing each syllable as if it were a separate word. “I believe I serve as your friend Nichelle Barlow’s GP. And I’m sure she’ll tell you she is in terrific health. I adjust her regularly, because her spine needs constant attention.”

“I suppose you don’t have a strong feeling about antibiotics.”

“Generally, they are not needed. Once I get the innate intelligence flowing normally, any infection clears up rapidly. Besides, antibiotics are dangerous. You see we dispense remedy, not drugs.”

“How about vaccinations?”

“Not needed and dangerous,” Newhouse said without a second of hesitation.

“All vaccinations for all kids?”

“All vaccinations for all kids,” Newhouse echoed. “Vaccines are more dangerous than antibiotics. Look at this autism tragedy. I tell you, it is a terrible shame, if not a national disgrace. If one of those kids had come to me before getting vaccinated, they’d be normal today.”

Jack literally had to bite his tongue to resist arguing with this off-the-wall charlatan. Though it seemed Newhouse believed what he was saying, Jack couldn’t tell whether he was a well-intentioned but misguided therapist or a modern-day snake-oil salesman.

“What about infant colic?” Jack asked hesitantly, since the issue struck too close to home. “Can you treat that?”

“Not a problem,” Newhouse said confidently.

“You’d treat an infant with spinal manipulation?” Jack asked nervously. He couldn’t help but envision JJ being tortured by the man sitting in front of him.

“Well, first there’d be the diagnostic stage.”

“Which would involve what, exactly?”

“Visual examination, careful palpation, observation of movement, and, of course, X-ray.”

“You’d do a full spinal X-ray on an infant?” Jack asked, just to be certain. He was incensed. He wondered just how many infants Newhouse had exposed to the amount of radiation necessary for spinal films, even if his equipment was digital.

“Of course. It’s a major part of our thorough diagnostic and therapeutic process. We use X-rays to diagnose, to document the course of treatment, and to make sure troublesome vertebrae stay in place. Since X-ray is so central to our mission, we have the latest digital system. Would you like to see it?”

Jack didn’t answer. He was still trying to digest the information about infants being bombarded by ionizing radiation to make a bogus diagnosis of their youthful normal spines being somehow out of line.

Taking Jack’s silence as acquiescence, Newhouse leaped from his chair and motioned for Jack to follow him. Dutifully, Jack got to his feet and shadowed him out into the hall and through one of the previously closed doors. The calm he’d achieved during the bike ride had been replaced by anger directed at Newhouse and his like-minded colleagues. Jack felt personally embarrassed, as if their existence was his fault.

The X-ray unit was impressively state-of-the-art. Knowing approximately how much such a unit cost, Jack could guess why they used it as much as they apparently did: It had to be paid for. Jack didn’t listen as Newhouse, like a proud father, went through a litany of the machine’s attributes.

In the middle of Newhouse’s spiel, Lydia poked her head through the doorway to tell him that Ms. Chalmers was waiting in treatment room one.

“Have Dr. Fallon see her!” Newhouse said, hardly breaking stride with his presentation.

“I don’t think she’s going to be happy about that,” Lydia said.

In an instant, Newhouse’s demeanor changed from jovial to malevolent. “I said have Dr. Fallon see her!” He repeated each word with equal force.

“As you wish,” Lydia said, beating a hasty retreat.

Newhouse took a deep breath. In a blink of the eye, the storm had cleared and sunlight had burst forth. Jack was astounded at the transition.

“Now, where was I?” Newhouse questioned, glancing over the keyboard and up at the monitor as if the X-ray machine would tell him.

“So, you follow people with X-rays,” Jack said, ignoring Newhouse’s question.

“All the time. We are interested in documenting the patient’s progressive improvement, and the patients find it particularly reassuring.”

“Could you show me such a progression?” Jack asked.

“Absolutely,” Newhouse said. “We have a series available as a presentation for prospective patients like yourself, since we’d love to fulfill your health-care needs. Please, come back into my office. I’ll show it to you on the computer.”

Jack marveled at the effort Newhouse was willing to expend to gain another client. Until his last comment, Jack had wondered why Newhouse was being so generous with his time.

Jack moved behind Newhouse’s desk so the two of them could view the monitor. Newhouse brought up a lateral cervical X-ray, allegedly that of one of his patients. Superimposed on the film were a number of straight red lines intersecting carefully measured angles. It all looked legitimate, as if it was some complicated system to analyze the film. Yet the more Jack looked at the X-ray and the profusion of red lines, the less sense it made to him. The one thing he did notice was that the patient’s head was bent forward, with the chin practically resting on the anterior chest.

“In this preliminary film,” Newhouse said, “the curve of the cervical spine in this symptomatic patient is just the opposite of normal. As you can see, it exits the skull not curving forward as it should, but rather backward. Now, this was the initial film before therapy commenced. As I show you subsequent films of this patient, watch how the cervical spine changes as therapy progresses.”

Jack watched subsequent lateral films and could clearly appreciate the cervical spine change from curving backward to curving forward. At the same time he could see that the change was not from any therapy but due to the fact that the patient was slowly raising his head on each successive X-ray.

“Pretty dramatic, isn’t it,” Newhouse cooed.

Jack glanced from the monitor to the man who was admiring the final film of his presentation as if it were a piece of art. What it was, in reality, was a bit of trickery involving X-rays, used to fool an unsuspecting public. What Newhouse and his ilk were doing was lending a false sense of legitimacy to chiropractic therapy by using something that was a legitimate tool in the hands of conventional medicine. Not only was that fraudulent, it was dangerous, exposing people to harmful radiation.

Newhouse acted surprised when he turned to find Jack staring at him with silent intensity. Newhouse quickly misconstrued Jack’s expression as awed appreciation. “Lydia will be happy to make you an appointment. I’m sure we’ll have an opening within the month, if your symptoms can wait. We are booked solid with follow-ups, and initial visits take considerably more time to go through the diagnostic procedure and X-rays. Don’t take the relaxed situation today as typical. Monday afternoons are booked lightly for continuing educational purposes. Usually, it’s pandemonium around here.”

Jack couldn’t believe what went on in that office. If it wasn’t so pathetic, it would have been funny. Understanding Newhouse was one thing. But what about the patients? Nichelle Barlow seemed intelligent and educated. So how could she be so foolish as to trust this man peddling phony therapy based on screwball ideas of innate intelligence?

“Mr. Stapleton?” Newhouse questioned. “Hello! I didn’t mean to overwhelm you quite so much. Are you okay?”

Jack shook himself out of his mini-trance. “Earlier, in the beginning of our conversation,” he began, “you said there’d been a falling-out among chiropractors? Somehow we became distracted and you never finished what you were going to say.”

“You’re right! We got off the track of talking about Daniel David Palmer, the founder of chiropractic, to talking about Davenport, Iowa, where he set up the first chiropractic medical school.”

“What kind of falling-out were you referring to?”

“Simple! During the nineties a whole bunch of turncoat chiropractors allowed themselves to be browbeaten by conventional doctors into limiting themselves to treating back problems alone.”

“You mean, giving up on treating such things as acute sinusitis.”

“Exactly! The AMA had been against chiropractic forever, instigating lawsuits and the like. They were afraid we’d steal their business, which of course we were doing, because patients aren’t stupid.”

Jack wasn’t so sure of that, but he didn’t interrupt.

“Anyway,” Newhouse continued, “sometime around 1990 the Supreme Court finally silenced the AMA, ruling in favor of chiropractors by stating categorically that conventional medicine through the AMA had tried to discredit chiropractic therapy to maintain a monopoly over health care in this country.”

Jack made a mental note to look into that ruling. Considering what he’d learned that afternoon about chiropractic, it seemed inconceivable the Supreme Court would have ruled in chiropractic’s favor, although he assumed that the ruling involved the monopoly issue only and had nothing to do with efficacy.

“You’d think that such a ruling would have helped chiropractic,” Newhouse continued. “But strangely enough it split us. A number of conventional doctors, obviously from seeing our benefits, started working with us, at least with those chiropractors willing to limit themselves. Over the years these traitors have been dubbed ‘mixers’ because they’ve been duped into limiting themselves to back problems exclusively and by doing so betraying the chiropractic movement.” Newhouse paused momentarily, then added derisively: “Meaning, of course, they are not real chiropractors.”

“And what are you stalwart patriotic chiropractors called?” Jack demanded, allowing a full dose of his infamous sarcasm to manifest itself.

For a beat Newhouse gazed at Jack almost as if Jack had slapped him. It was apparent the sarcasm hadn’t been lost on him, but he appeared more confused than affronted. Ultimately he ignored it and said: “We’re appropriately call ‘straights’ because we are true to our beginnings.”

For the hundredth time during his relatively short conversation with Newhouse, Jack had to restrain his reflex urge to speak his mind. Modulating his voice carefully, he said, “I’d like to ask you about another patient. Her name is Keara Abelard.”

“Ms.Abelard,” Newhouse repeated, allowing his sunshine face to reappear. “Another classy young lady. Did she also refer you to me?”

“Ultimately, I’d have to give that a qualified yes.”

Newhouse’s smile faltered. He was mildly confused again. Jack’s response seemed unreasonably convoluted. “She was a new patient,” Newhouse said. “Did she say something to you about her experience here?”

“Indirectly,” Jack said, purposefully trying to be somewhat mysterious to fan Newhouse’s curiosity. “Ms. Barlow told me she had suggested Keara come to see you but didn’t know if Keara had followed through.”

“She did. She came in as a new patient this past Friday. We squeezed her in because she said she was in considerable pain.”

“So you remember her distinctly?”

“Oh, yes. Quite distinctly.”

“How is that possible, given how busy you are? You must see a lot of patients to cover your overhead and pay the installments on your digital X-ray machine.”

“I remember names,” Newhouse said, looking askance at Jack. Jack’s comment seemed inappropriate at best. “I have a facility for it.”

“Do you remember her complaint?”

“Certainly. She had a severe frontal headache that was unresponsive to drugs. She’d had it for weeks.”

“So, you thought you could help her.”

“Most definitely, and I did. She said her headache melted away like magic.”

“Did you take an X-ray?”

Newhouse nodded. He was sensing there was something wrong with the conversation, but he didn’t know what it was or when it had started. Jack’s attitude had suddenly changed from being impressed to being strangely challenging.

“Where exactly were her subluxations?” Jack questioned.

“All up and down her spine,” Newhouse said, with a new edge to his voice. He didn’t like being challenged, especially on his own territory. “Her spine was a mess from ignoring it for so long. She’d never been to a chiropractor.”

“How about her cervical spine? Was that a mess?”

“The whole spine, including the cervical area.”

“So, you thought she was in need of an adjustment.”

“Many adjustments,” Newhouse corrected Jack. “We discussed a treatment schedule. I’ll be seeing her again twice this week and for four subsequent weeks. Then once a week for four weeks.”

“And if I remember correctly, an adjustment is another word for spinal manipulation. Is that correct?”

Newhouse made a show of looking at his watch. “I’m afraid it is getting late. I do have a few patients I must see. I’m going to have to ask you to leave.”

“I’d like you to give me the courtesy of answering my question,” Jack said, standing his ground.

A wry smile crept across Newhouse’s face. He suddenly decided this uninvited visitor was a possible troublemaker and ought to be thrown out on his ass. Yet an inkling of concern that Jack might be some sort of city inspector instead of an oddball made him hesitate. Jack had, Newhouse thought, an authoritative air, an unexpected inquisitiveness, and a bold confidence that gave weight to his possibly being an official. And even though Newhouse’s office had never previously been inspected, he thought there always could be the first time, which could be a disaster. He knew for a fact that his X-ray room was not properly shielded in the ceiling. With all that in mind, he asked, “What was your question again?”

“I want to know if Keara Abelard had a manipulation of her cervical spine.”

“Generally, we don’t divulge confidential information about our patients,” Newhouse said defensively.

“Do you keep records of what you do to patients?”

“Of course we keep records! We need to document the course of improvement. What kind of question is that?”

“I can subpoena your records, so you might as well just tell me.”

“You can’t subpoena my records,” Newhouse declared, although without much confidence. He was now more worried Jack was not quite what he’d assumed: a prospective new patient with the thought of making an appointment.

“You said Keara Abelard’s headache went away after your treatment. Did you know it came back?”

“No, I didn’t know. She didn’t call me. If she had, I would have seen her immediately.”

“The headache came back with a vengeance,” Jack snapped. “And I need to know if you adjusted her cervical spine.”

“And why do you need to know, Mr. Stapleton? Who are you, anyway?”

“I’m Dr. Jack Stapleton,” Jack spat. “New York City medical examiner.” He flashed his badge in Newhouse’s face. “Keara Abelard died suddenly last night, without apparent cause, which makes her a medical-examiner case. I am the investigating medical examiner. I need to know if you manipulated her neck when you saw her on Friday. If you don’t tell me, I’m going to get the police over here to take you in.”

Jack knew he was exaggerating his power and a bit out of control. There was no way he could have Newhouse arrested. But Jack was furious enough to make such a claim, because the man had snuffed out the life of a beautiful, promising young woman. What was really at the bottom of Jack’s over-the-top behavior — which he would have realized if he’d stopped to think about it — was his anger at his son’s illness and his inability to do anything about it.

“All right,” Newhouse shouted, after recovering from the shock of learning of Keara’s death. “I manipulated her cervical spine like I’ve done for thousands of others. And you know something? It worked. It worked because I fixed her subluxated fourth cervical vertebra. And she walked out of here a grateful, well woman, without pain for the first time in weeks. If she died, she died of something else, something that happened to her over the weekend, not because of my treatment, if that’s what you are implying.”

“Of course I’m implying your treatment killed her,” Jack yelled. “And do you know how you did it? Your thrust, as you call it, tore the delicate lining of her vertebral arteries, which in turn caused bilateral vertebral artery dissections and ultimately blockage. I trust you know what the vertebral arteries are?”

“Of course I know what they are,” Newhouse shouted back. “Now get out of my office. You can’t prove I did anything wrong, because I didn’t. And I cannot imagine it’s okay for you to be accusing me like this. You have some nerve coming in here under false pretenses. You are going to hear from my lawyer. I can promise you that.”

“And you’ll be hearing from the DA,” Jack yelled. “I’m going to sign the death certificate as homicide. ‘Innate intelligence,’ my ass! That’s the screwiest nonsense I’ve heard in my life. You mentioned you ‘straight’ chiropractors call your colleagues mixers or traitors who restrict their work to back problems exclusively. What do the mixers call you guys, quacks?”

“Get out!” Newhouse roared, his face threateningly close to Jack’s.

It was as if a lightbulb went off in Jack’s head. He suddenly realized he was within inches of an enraged man, nearly to the point of fisticuffs. What was he doing? What was he thinking?

Jack backed up a step. He wasn’t necessarily afraid — Newhouse didn’t look especially fit — but Jack didn’t want to make a bad situation worse. What he wanted to do was get the hell out of there.

“Now that we see eye to eye, I think I’ll be going,” Jack said, reverting to sarcasm. “Don’t bother to see me to the door,” he added, holding up his hand as if waving Newhouse off. “I’ll see myself out.”

Jack made a beeline out of the inner office. Lydia and several patients had heard at least part of Jack and Newhouse’s shouting match. All were sitting tensely, ready to bolt for safety’s sake. Their mouths were slightly open, eyes unblinking, as they watched Jack transit reception. Jack’s last gesture was to wave ’bye at Lydia before ducking through the office’s outer door.

Outside Jack went straight to his bike, fumbling with the multiple locks while glancing nervously over his shoulder. He was astonished at his behavior, marveling at how out of control he’d become with Newhouse. Of course, now that he was thinking rationally, he recognized it all went back to JJ, emphasizing how important it was for him to get a grip on that situation. It also emphasized the importance of his crusade to help in that regard, but he needed to be thinking of the forest, not the trees. He had to focus on alternative medicine in general, not just chiropractic nor Newhouse because of an emotional response to Keara Abelard’s tragedy.

Once his bike was free, Jack jumped on and sped away, heading south. Reaching speed he began to worry about the potential repercussions of his ill-considered site visit. If Bingham or Calvin got word of his latest shenanigans, it could very well cause a premature end to his nascent crusade. It might even be serious enough to get him put on administrative leave. From Jack’s perspective either outcome would be a serious problem.