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
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.
(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
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.
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
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:
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
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.
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.
Nearly two and a half years, countless exams, memorization of
facts and figures, pathologies, prescription drugs, and maneuvers
that scare you to death -- and you think you might actually know
"something" (but not everything). And then the first patient walks
through the door and you realize nothing you could've possibly done
thus far could have prepared you for what you're about to
experience. Welcome to being a student physician.
Throughout my various collegiate undertakings, I've felt
ignorant. There was never much of a point to thinking I knew
everything or even all that much because I was constantly reminded
that whatever bits and pieces I've pulled together meant only a
drop in the bucket toward what's out there. I hate feeling
ignorant. Maybe that's why I'm constantly reading and researching
-- because I know that I don't know anything.
Ricky in Radiology Positioning class
(Special thanks to Dave Aiello and Ricky King for this
Dr. Harrison, our clinician, brought up an excellent point last
week (he has LOTS of amazing pearls of wisdom). He said that the
stuff that we learn the best is the stuff that we're faced with. If
there's a condition that we, a family member or friend, or a
patient has, we WANT to learn about it. And so we learn those
things the best. But when something is sitting right in front of
you, there's this overwhelming need to know it -- right now.
Sometimes that learning curve can be pretty frustrating.
Questions get asked. Tell me about your family. How are you
feeling? What's going on in your life right now? Can you describe
this or that sensation? As the physician, you're supposed to know,
not only what it is they're talking about, but also how to put all
of it together to make sense of what is in front of you. It's a
complex task. Then you have to take the person in front of you, and
figure out how to make them better, take away the pain they're
having, help them cope with what's going on in their life, and help
them re-enter their space of wellness. And of course, you hope that
they're working with you on this. This takes skills they don't
teach in school. We can take all of the interviewing skills
sessions, basic and clinical sciences, and psychology classes and
still not be able to put all of these "issues" into the complex
Being that sits in front of us. So, as I sit here wearing my white
coat, I can honestly tell you that nothing I've done over the last
two and a half years prepared me for my first patient. Not a thing.
Not even remotely. Of all the things I've learned, even over my
whole life, listening seems to be the most beneficial.
One of my biggest fears when starting clinic, besides being
worried I wouldn't know what to do, is that I would be stuck with
pure musculoskeletal cases. I know, this is chiropractic and
musculoskeletal would theoretically be a big part of most chiro's
practice, but I wanted the hard cases. And I'm getting them. From
complex vascular issues to hormone imbalances, I've had to do
research in the first week on topics that we didn't learn in any of
our classes. Before any physical exams, before any orthopedic
testing, just doing the history, I'm learning so much. I love
learning this way. Get a topic, find out as much as you can, and
then apply it.
Pick up a copy of Harrison's Internal Medicine, and
also a copy of the Textbook of Natural Medicine, and
Textbook of Functional Medicine. All three of these will
serve you very well. Even though these three are great resources,
there are some things that still require digging. I love a
challenge. Good thing I'm in the right field.
Have a great week everybody!
Two weeks of break isn't anywhere near long enough. It seems
like just about the time that I get into a new groove of being out
of school, things start up again. But, this time -- it's different.
I'm an INTERN!
My intern badge
Last week was the first week in Student Clinic. We went through
procedures and charting info and a bunch of other things. I think
it's going to be AMAZING! Dr. Harrison (our clinician) has taken
the time to explain so many things to us already. It's a whole
different world, now. I don't know what I thought it was going to
be like, but it's different. And I think it's going to be great. I
started out this week as a secondary, and I see my first patient on
Break was wonderful. I was able to take some time off, do some
volunteering, and work on some projects. I feel "lighter" -- having
been able to accomplish some things that I hadn't had time for thus
far. That having been said, I'm still behind. That's not
tremendously surprising. I'm making lists and slowly getting things
Sunrise over Tampa Bay
The Master's has been ongoing. My classes right now are in
Botanical Medicine and Immunology. I've learned so many fascinating
things. Last week I got stuck in researching zonulin and tight
junctions. I've been trying to pool together all of the locations
that contain tight junctions in the body, so I might be able to
link proteins and chemicals that disrupt the tight junctions with
disorders that occur at those locations. I have to stop myself
sometimes, from going too far down the rabbit hole with some of my
research -- because I'll get so engrossed that I forget about
everything else. Sometimes I have to stop myself at the point of
too many questions. It turns out that some of the ones that I came
up with last week (according to my professor) don't currently have
answers. I guess I'm not the only one with questions.
I'm looking forward to the Tri mixer -- whenever that will be --
and Wednesday with my first patient. I'm secondary on patients
before then, so that will be interesting as well. Mostly, I just
want to say how excited I am to be here.
Welcome back, everyone! I'm glad you're here.
• After the DC Degree
• Botanical Medicine
• 1 Year at National
• Marketing Project
• First Week in Student Clinic
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