The doctor moved his fingers down his patient's spine with the focus of a engineer, seeking the problem area in the mechanism.
The 29-year old had come to Dr. Clarence Nicodemus complaining of upper back pain. Probing with his fingers, Nicodemus pinpointed strain in two vertebrae caused by a "stuck" sacroiliac joint in the patient's pelvis.
There was a time when the 70-year-old Nicodemus solved biomechanical problems as a principle scientist for NASA. In 1992, Nicodemus gave that up to pursue a career in medicine. Now, four years into his Monterey practice, he says he is getting more patients, remodeling his office and has recently hired two additional employees.
"We can affect the inside by working on the outside," he said of his work.
Before he started practicing osteopathic medicine — which focuses more on using slow, gentle manipulations with his hands instead of drugs and surgery — he was coming up with ways to help people roughly 220 miles from Earth.
Many of Nicodemus' reports on the International Space Station are available on the Internet through the NASA Technical Reports server.
In one of them, Nicodemus and three colleagues identified ways to create a better work station for a "microgravity" climate and how to get around constraints while working in a space suit.
"I wanted to work with the astronauts," said Nicodemus, rather than mechanics.
After leaving NASA in 1992, he went onto do orthopedic spine
At 57 years old, he went to medical school, despite already obtaining a bachelor's and master's degree and a doctorate in biomechanical engineering.
At 61 he became the oldest graduate in the history of Michigan State University's College of Osteopathic Medicine.
"We expected him to do well," said Dr. Phil E. Greenman, the associate dean who admitted Nicodemus to the program. "He's been a star all the way along."
Greenman said because of Nicodemus' age he was considered a "special admit" but soon proved he was "younger than his age."
The college's dean, Dr. William D. Strampel, said he had reservations when Nicodemus was admitted but soon came to see him as one of the most important members of his class.
"Everyone forgot his age after the first year," he said.
Linda O' Brien, of Prunedale, said she was "at her wit's end" after more than seven years of severe back pain. She had tried massage, acupuncture and other methods.
Only in her mid-60s, one doctor told her she was "six months from a walker" and another suggested a titanium rod be inserted in her back.
Although skeptical, even after a few visits with Nicodemus, she quickly experienced improvement through a mix of stretches, "gentle pressure" on her hip and occasional cortisone injections at trigger points.
A year and half later she said she was dancing at her nephew's wedding and now, three years after her first visit, takes pilates classes.
"It's a miracle," she said.
Osteopathic medicine focuses on using the body's own mechanisms to heal itself. Osteopathic physicians (they don't like to be called "Osteopaths") can perform surgery and prescribe drugs like their M.D. equivalents — but have a different philosophy.
Nicodemus said drugs and surgery don't always "solve that problem."
By using his hands to detect where pain comes from, he said he uses the body's own "levers" to nurse it back to health.
The doctor typically spends an hour with a patient on an initial visit and 30-minute sessions after that. He said if he can't solve a problem in six visits he "throws in the towel," which he claims only happens 1 percent to 2 percent of the time.
He said he approaches the human body much like he did before he was a doctor — analyzing it as an engineer looks at a whole project, not just one aspect.
In addition to increase in patients from word-of-mouth, more than half come from the Defense Language Institute and Naval Postgraduate School.
Yet, not everyone is sold on osteopathic medicine. A paper written by Dr. Stephen Barrett, M.D., on a highly-cited website he runs called Quackwatch, claimed osteopathic medicine had "cultist roots" and the American Osteopathic Association exaggerates the value of manipulative therapy.
Nicodemus said "the proof is in the pudding" for his success rate. He also pointed out Michigan State's osteopathic school is ranked in the top 20 primary care medical schools in the country (not just for osteopathic medicine), according to the U.S. News & World Report.
Despite his age, Nicodemus and his wife, who is the co-owner of the business, don't plan on retirement anytime soon.
Grace Nicodemus, who went back to school at the same time to become a minister, also offers spiritual-based medical preventative counseling at the same Monterey clinic.
"We're still 70 years old and have student loans," she joked.
Phillip Molnar can be reached at 646-4487 or at firstname.lastname@example.org.