Problem: John, a fifty-five-year-old farmer, has come into the office of Dr. Cooper complaining of an increase in the symptoms of a chronic problem. John, who has had a recurring history of low back pain, now presents with complaints of constant pain with movement or at rest, as well as intermittent episodes of numbness and tingling down his left leg. John agrees to a CAT scan and follow-up visit in which Dr. Cooper shows him the herniated disk, points to imminent danger of nerve damage, and emphasizes the need for immediate surgery. For the first time in their relationship, John refuses to follow the doctor's suggestion. Instead, John insists on seeing Dr. Jones, a chiropractor. Dr. Cooper is convinced, not only that chiropractic cannot help John, but that manipulations could cause irreparable damage.