Happy Summer, Everybody!

Summer is in full swing here (not that it hasn't been for several months). The temperatures are consistently over 90; the daily Florida rainstorms are happening; and we're expecting our first Tropical Storm/Hurricane tomorrow. By the way, I'm not even remotely worried.

White Coat Ceremony

I had the great joy of being a part of the White Coat Ceremony for the 1st Trimester students. It's such a different experience to be on the opposite side of the stage. As an 8th trimester student, I'm looking at this from the other side of Basic Sciences, Phase 2 Clinical Sciences, and the first round of boards. I know that I didn't have any idea what was in store for me when I was on that stage. I was nervous, excited, and scared. I didn't know how hard of a road it was going to be, how much I would learn, and what challenges I would face. If I could give one piece of advice to incoming students and students in the early tris, it would be this: be dedicated; be tenacious; but be kind to yourself. This is a long, hard road--but all the stress, work, and pain is worth it.

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Educating the Uneducated

I want to revisit a topic that I've touched on before: education about the profession. Misconceptions about chiropractic, our education, and what we do run rampant in society. Just yesterday, I received a graphic on Facebook from a very popular site that listed us as "Quacks." They've published similar graphics/articles before. I'm not going to name them, because I don't want to endorse; that's not the point here. There is still the misconception out there, that we're all trying to alter "the force," and that by believing the body has the ability to heal itself, we're a bunch of lunatics. A large portion of the public believes that we only associate well-being with the spine, and that we only treat the spine. They're uneducated about how extensive our training in physiology, microbiology, pathology, pharmacology, biochemistry, and nutrition (to name a few) actually is. They don't know that many of us are evidence-based, research-oriented, internal medicine-focused students and practitioners.

This is a call to arms, my friends and colleagues. We have to change this; right now. Chances are that if your friends and family have kept touch with you during your educational escapades, that they're familiar with what you're doing, and probably support you. For those reading the blog that aren't students (or prospective students), chances are you're reading this blog because you support the institution or someone involved in it. So I realize, by saying all of this, that I'm preaching to the choir. But what about everybody else? What about the people we meet on the street? What about our Facebook friends that live far and wide? What about all of the misconceptions floating around about who we are and what we do?

The American Chiropractic Association lobbies in Washington for chiropractic legislation, but we don't have a cohesive organization that handles education of the public. We are it. We are the educators.

I'm going to challenge each and every one of you, to go out there and share what you do, what your training is, how our education is different, and how we are making a difference in health and well-being. For those that are supporters of the field, I thank you for that. I'm going to challenge you as well, to share your knowledge and experience of the field of chiropractic with those around you. Let them know how we're making a difference.

Have a great week everybody, and a safe and happy 4th of July.

Another Week, Another Blog Posting

How are everyone's midterms going? I'm on break from the master's program. I had finals last week. I'm glad to have a couple of weeks off to catch up on a few things, including all the reading that I didn't get done during the quarter. My pile is still astronomically large. We'll see how much I can get done. I figure if I don't get it done before classes start there again, it's probably a lost cause.

Last weekend, my friend and classmate Julia, went to homecoming at the main campus in Lombard. I want to say, to everyone there in Lombard, thanks for taking such great care of her! She had glowing remarks for everyone that she met. There were meetings and events, information sessions, etc. She was able to meet Dr. James Cox (of Cox flexion-distraction fame), and many of our illustrious alumni.

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Dr. Strauss and Florida students with Dr. Cox at Homecoming

Julia was able to reassure us students about one of the issues that we find frustrating. We are always hearing that we'll not be able to find jobs or make a decent salary. Even though I've yet to meet anyone at school that's "in it for the money," we're all hoping that we'll be able to make enough to at least pay back our student loans, and maybe have enough for food. Even speakers that have come to the school (non-alumni) have commented that it would be tough for us to make a living.

The problem is, with all of my research, and all of the alums that I've spoken to and heard from indirectly, this is FAR from the case. Julia confirmed this when she spoke with alumni at homecoming. She said that everyone that was doing VERY well for themselves. People were not only successful and able to pay back their loans, but also contribute back to the school. It was inspirational for her that not only would we be out and in the community, but thriving. I'm glad she shared that with me, because I needed the inspiration as well.

We're finally starting to see the light at the end of the tunnel. It's halfway through 8th Tri. In a few months, we'll only be in the clinic. No more classes. No more random exams. No more quizzes, papers, or random presentations. It's been REALLY easy to lose track of time this tri. Alarmingly easy. I've been caught up with patients, in my own stuff, with the master's, and classes. I honestly can't wait for classes to be over.

I was asked today how I liked clinic. I've said this before, and I'll say it again -- I love it. I love the idea of being able to do this every day. Even with the challenging cases (my favorites), the idea of being challenged to learn all the time is exciting. I never know what I'm walking into, and I find that absolutely enthralling. I can't imagine any kind of job, ever, that would be anything like this. When I'm in clinic working, I am more than pleased with my choice.

Have a great week everybody!

Patients and Patience

You're not behind the desk, you're sitting in the chair next to it. Waiting. Waiting, for what seems like FOREVER for them to come look at you, examine you, swab, cut, bleed, sample, whatever you. They're taking forever. You feel wretched. Everything aches, stings, hurts. You're tired from staying up all night worrying, hurting, stressing. You only want to know what's going on and you feel like you're simply the only person on the face of the planet, and no one is able or willing to help you.

I'm trying to explain what it feels like to be sick -- to be frustrated with the status of the medical profession and confused and angry and scared. I'm trying to explain what it feels like, no matter how melodramatic it may be, to feel like someone else has control over your health, what's wrong, and if and when you'll get better. There's a feeling of being completely helpless that comes with being sick -- when there's pain, when there's no observable pattern or relatively easy diagnosis, or when it just seems to drag on forever. It's a feeling that no one seems to understand -- like being held hostage by something or someone and being powerless to do anything about it. And it doesn't go away -- that feeling -- until there's some grasp over the problem, like some answer, lab result, diagnosis, something, ANYTHING that seems to give some control over the situation.

If you, as a person, have never felt this way, count yourself lucky. But many others can't say that. Our patients likely can't say that. They come to us hoping for understanding and compassion, and the willingness and ability to find out what's wrong. I only hope that they find it.

It's hard to be the patient when you're used to being the physician. It's also hard to be a physician when you've never been a patient. William Hurt, in a 1991 movie called "The Doctor" illustrated just this. Having been an important, influential physician, he finds himself with cancer -- and realizes just how horrible of a physician (no matter how skilled) he (and some of his colleagues) could be.

People come to us in their worst conditions. They're not always in a good mood. They're not always understanding of our limitations as physicians (or students). They come to us seeking help and advice -- and of course, our expertise. Finding answers is what we're supposed to do. It's what our training is based in and what we've been working towards for our academic/professional careers.

But all of that training only provides a fraction of what our patients need from us. They need our compassion and understanding. This isn't taught in school. It comes from within, and unfortunately, it comes from experience.

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(Image source: hopeinhealingblog.wordpress.com)

For some of us, it's been sickness that has made us this way -- or abuse, or poverty, or just LIFE. For others, it's those things that are in the process of making them that way.

Be kind to each other this week, Everybody. Have a great one.

Food for Thought

Surely you've heard the phrase: "Eat to live, not live to eat." It seems that our relationship with food is extremely complicated. It turns out, it's not just our mindset right now, but also every attitude that we've had about food from our childhood that affects how, what and why we eat. Did you ever make cookies with your grandmother, or have a special birthday dinner? Was there some treat that you only had on special occasions? Did you go trick-or-treating for Halloween? Unless we've somehow managed to avoid all of those things, food has become a reward and measure of comfort in our lives.

Of course, there's nothing wrong with this. But we have to be aware of it. As we go through our lives running crazy, working ourselves ridiculous hours, studying, going from obligation to obligation, taking on way too much, it's really easy to seek consolation in our food.

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Of course, there's more to it than that. Eating these things ignites reward chemistry in our brains. Dopamine is produced leading to the sensation of pleasure. Serotonin, which most people recognize as the hormone affecting depression, is dramatically affected. In fact about 95% of the serotonin is produced in the gut. This not only regulates how much food we eat, but how we feel about how much food we eat. It has direct impact on our mood about food.

There are other, seemingly less interesting, hormones involved with food intake. Leptin, produced in adipose tissue, regulates food intake and fat storage. Deficits or defects in it lead to overeating. Another hormone, CCK, which is released from the small intestine while you eat, provides negative feedback about the quantity of food. Deficits in it (or damage to the small intestine) lead to overeating. Ghrelin, insulin, cortisol, and glucagon are also involved. *Whew!*

You see, we treat food as medicine, not just because of the hormones it induces, but because of the nutrients it provides. We can use food to medicate or nourish our bodies.

We need those nutrients to live. They provide the building blocks of everything that we are, the chemicals that sustain us, and the energy that keeps us going.

I've been doing some reading (in all my spare time) about the psychology of eating. It turns out there's a whole Institute for the Psychology of Eating. I've been exploring the ideas of why people eat; how much food we really need to live; and how we can nourish ourselves body/mind/spirit without overindulging. The topic itself is absolutely fascinating, and challenging in ways beyond all of the science.

It's food for thought.

Everybody have an amazing week!

For more information on the psychology of eating and hormonal control of eating, check out:

Summertime and the Living Is Easy

Well, that's what Billie Holiday thought. Here in good 'ol' Florida, it's HOT (and also very busy). This is the boys' last week of school; clinic is in full-swing; classes are well underway; and the schedule is getting crazy. I'm 3 weeks away from finals for the Master's program. Schedule changes are tough. I'm still getting used to being in clinic and splitting my time between classes and working.

How was your Memorial Day weekend? Mine was SUPER low key. After Acupuncture on Saturday, I spent time with friends in Tampa, and Sunday and Monday were focused on reading, research, and recovery (the new 3 R's). The Master's has me working on all kinds of stuff. I'm most fascinated, right now, with articles on lifestyle factors and inflammation. Dr. Seaman's classes really focused on some basics of inflammatory cytokines and the biochemistry of the food we eat and what it does to our body. Now I'm at a whole different level of learning with this, and it's REALLY cool. I'm discovering how the same set of cytokines, combined with other hormones use the foods we eat to make things even more complicated. How we think and feel about what's going on in our lives can lead to chronic inflammation, autoimmune disorders, and chronic disease. I'm so glad that I've chosen to study this for the rest of my life.

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Image Source: http://blogs.trb.com/news/opinion/chanlowe/blog/

Right now we have several classes on how we, as physicians, should interact with patients. Whether it's doctor-patient relationships, jurisprudence, or clinical natural medicine -- we're discussing everything from what we're responsible for ethically, to how patients (or potential employers) might perceive us. The latter topic has created a bit of a rift in my life. We were counseled to be careful how much of our personal life we allow the public to see -- specifically, our patients. Do we give patients our phone numbers? Do we friend them on Facebook? Do we give advice out in public? Do we share pictures of ourselves online? The idea behind it incites a lot of fear -- that we'll have stalkers, or share too much that can be used against us, or somehow lose patients because of things we do, say or show.

I don't like this at all. As alternative practitioners, I think we have a little bit more lee-way than others might. Some of us are into some unique areas of study. We are more touchy-feely, and that lends itself to a different type of interaction. They say that we're less likely to get sued because we tend to be more interactive with our patients. So, except for the stalkers, why would we want to withhold that information from those people in our lives every day? I guess it's something that we all have to think about. What do YOU think?

Have a great week everybody. As always, if you have any questions or comments, please feel free to contact me.