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.
We made it! Well, almost. It's week 14 -- which means there's
only one week left. This week and next week are finals. This week
is mostly practical finals, but I have a few written as well.
Acupuncture, the practical, was over the weekend. We also had the
clinical entrance exam for physical therapeutics. We have to pass
that exam, in order to progress to the clinic and treat (using
those modalities). We were all pretty nervous -- because we're all
anxious to get to clinic.
After next week, I'll be in Tri 8. Tri 8. (did you hear that
sang angelically and see the beams of sunlight streaming down onto
those two words?). They did. We've been talking about schedules and
who will take what shift -- and how nervous some of us are. I'm not
nervous -- at least that's what I'm telling everyone. I'm anxious
to see what all we'll end up doing. What most people don't know is
that any of the St Pete College and NUHS students can come to our
clinic for free (and their immediate family too). We're really
hoping that we see a lot of people -- that need all kinds of help.
We do more than MSK -- just to let you know. I'm really hoping to
get some functional medicine and nutrition patients as well.
So, after the "festivities" of the next 2 weeks, we have break.
Break (did you hear the angels again?). This will be the first
break that I've actually had since Fall of 2012 -- not because we
didn't have a break, but because I was so busy. I worked, moved,
studied for boards, worked -- and now, I finally get a break. I'm
so excited! What will I do? I am going to a festival, the first
weekend of break -- and I'm really looking forward to it. I haven't
been to one here in about 4 years. I'll be volunteering as a Medic
(only requires CPR certification), and I always have an amazing
time. I also still have Master's work to do (which starts back this
week), and random stuff around the house -- projects, prospects,
and purpose. I'm trying to stay focused on finals and studying, but
the allure of "free time" is haunting the back of my mind.
So, I figured you all needed to see something new around the
area, so I went to Gulfport. I don't know why I haven't taken you
all to Gulfport before -- it's only a hop, skip, and a jump from my
house. While most people spend their nightlife in Ybor in Tampa or
in Downtown St Pete, I tend to go to Gulfport. My favorite karaoke
bar (O'Maddy's) is there -- where on random weekend nights I might
be found singing Pink, Bonnie Raitt, or Evanescence. Really,
Downtown Gulfport feels like a really small town right on the
beach. There are some little shops, open air bars/restaurants, and
a beach. It reminds me of the little beach towns in movies from the
50's and 60's.
So, featured in the pictures today is the Gulfport Casino --
right at the center of Downtown Gulfport. Here's some history about
Then And Now: The Gulfport Casino Ballroom. The Casino, as it
stands now, was built in 1934 -- and architecturally it fits into
the time -- beach-Craftsman era. They host all kinds of events
there now -- including ballroom dancing. If you're in town --
before or after you come by the school, I recommend stopping by.
And if you see me at karaoke, I might even sing you a song. I know
that I'll be spending some time there over break. I'm really
looking forward to it.
So, I'll see you guys after break. Good luck on finals. Enjoy
the time. Next Tri means big, big things.
Have you made your study schedule yet for Finals? (You know they
actually start next week, right?) My schedule is somewhat made;
exams, practicals, and last minute assignments have been entered,
and from this point I just have to get busy! I'm on a brief
reprieve from the Master's, until next quarter starts (during Week
15 here), and I've had off from Acupuncture for the last 2 weeks,
so the Universe, and school, saw fit to give me some time. Of
course, I still feel behind and also am a little bit panicked (as
always happens). Right now it looks like 6 exams for me next week,
and 7 the week after that. I'm already ready, but will definitely
be more ready for a break.
Sunset at Treasure Island Beach
Last week's Cadaver Workshop was AMAZING! I was, admittedly, a
little nervous when I found out I'd be going over the musculature.
After all, other than diagrams, I hadn't been back in the lab since
I left basic sciences. And I hadn't worked on the back or limbs
since first and second tri. I'd forgotten how much I love being in
there. I suspected that would be the case, but I was actually
thrilled and surprised at how much I remembered. I loved it so
much, that I'm going back this week to do it again. We did a bit of
show and tell, and also asked questions and quizzed the students
that showed up.
We had students from the undergrad program, PA program, nursing,
and EMT at St. Pete College. I'll be interested to see who comes
this week. It's absolutely invaluable experience. It also reminded
me how much I enjoy teaching. Back in undergrad, my internship was
TA-ing biology for non-majors. THAT was an experience. It's
frustrating, sometimes, to be teaching people who aren't always
interested in what you have to discuss, or to approach things from
a manner that everyone can understand (or that encourages
I have been planning, for about the last year, to spend at least
part of my career teaching. I'll be honest; I'm really looking
forward to it. Who wouldn't want the opportunity to geek out on a
regular basis, and get paid to do it? What would you teach?
Biochemistry? Physiology? Functional Medicine? Nutrition? Yeah, I
could really get into that. The tough part will be finding a
location that will allow me to practice, and has opportunities for
Last week, I did a Rehab demonstration on therapies to use for
Rheumatoid Arthritis. I learned a lot in prepping for the demo --
like how the joints in RA patients can be hotter than normal, and
how heating the joint itself can be damaging (but heating the
muscle is fine). I learned how important it is to protect the joint
-- even to the point of how the patient sits. The "point of
relaxation" for the knee, for example, is full extension. This is
the position that is least likely to promote joint degeneration.
There are other positions for other joints. This week, I'm giving a
presentation on Raynaud's Phenomenon (which I've had since I was a
teenager) and therapies for treatment. I fully intend to go get my
thick wool gloves for the demonstration -- just for effect.
Although, if they continue to keep it so cold in this building,
I'll have to wear them all the time. It does make it difficult to
type and take notes.
There haven't been any other events going on for the last week
or so, other than a ROCK tape seminar this weekend (that I didn't
go to). But if you remember back, not that long ago, when I
volunteered at the St. Pete Beach Classic and met Mr. Incredible, I
have something to share. Mr. Incredible found ME! Last weekend, I
received an email out of the blue, from Mr. Incredible himself, who
found the blog and wrote me. (I do answer all of the messages that
come through here, in one way or another.) He's starting on a new
adventure with his training. Feel free to check out his
blog: Superheroes on
All right kids, have an amazing pre-finals week! Remember to
keep going to the gym, keep sleeping, and keep eating good food.
You'll be glad that you did.
We're nearing the end of the trimester. It's the calm before the
storm. Since my classmate Lexxi just reminded me, I'll remind you.
Did you: do your FAFSA? Taxes? Register for classes?
This week starts the last minute projects and presentations
before practicals and finals. Actually we have part of a practical
on Friday for PT. I'm going to rehab a knee with Rheumatoid
Arthritis -- which I'm finding as a bit of a struggle. How do you
give someone exercises for a degenerating joint, when they have to
move the joint? I've been pondering it quite a while. Here's hoping
I come up with something good.
This week and next week, our program hosts a cadaver lab
demonstration for the nursing, PA, and other health professions
programs that we share space with. For those who aren't familiar,
we share some campus space with the St. Petersburg College health
profession programs and Barry University PA programs. Since some of
our classroom space is at the St. Pete Caruth Health Education
Center, we see a lot of students from other programs running around
-- including RN, PA, EMT, etc. Unlike our program, they don't have
cadaver exposure, which always surprised me.
So, since we do, we host workshops toward the end of each
trimester to expose those students to what the body really looks
like. Several of our students will spend an hour or more in the lab
going through some general parts of the anatomy, and explaining
function, etc. I've always been surprised that the other programs
don't have cadaver exposure. I honestly feel that dissecting has
given me invaluable information that there's no way I would have
known otherwise. Even still, when someone asks me a part of the
anatomy, my mind automatically goes to the cadavers to visualize
it. I do this during classes; I've done this during boards. It
helps to actually SEE where the origins and insertions are, how the
vasculature and nerves surround and penetrate the muscles, and how
the muscles layer and invest in each other.
I haven't been in the cadaver lab since I finished that portion
of basic sciences several tris ago. I'm REALLY looking forward to
it. I think most of the other student-instructors will be from
basic science tris. It'll be fun to get to interact with them.
That's a privilege I don't often get.
On Saturday, I went to the Gluten Free for Life Expo. Last year
Grey and I went, walked through, and received a ton of samples,
coupons, and business cards from local gluten free businesses. This
year, I was by myself, as Grey was at an FBLA conference. I ran
into Julia, my classmate, and her daughter-in-law, Stephanie.
Beyond running into them and seeing my friend who runs a local
acupuncture clinic, the expo was a total waste. And it wasn't just
because of the samples and coupons -- which I guess were there --
it was because of the quality of products. If you've ever been to a
health food store (and I'm guessing all of us have), you've seen
that there's just as much junk food there, as there is at any other
store. It's labeled as "organic" or "all-natural" or "healthy", but
the difference is only that they use sugar instead of corn syrup,
organic versus conventional, and substitute refined with less
refined. That doesn't make any of it healthy.
So, I talked with the reps for a company (that I won't name),
because they recently reformulated their products. They are
dedicated to having gluten free, GMO free products. I respect this
tremendously, however, they still have some pretty big problems.
Previously, they were using sorghum flour -- which has been a
staple in gluten free cooking for a while. Even I have used it on a
regular basis (although not for several years). The rep mentioned
that they were having problems with their sorghum flour becoming
contaminated with GMO soy. So they changed formularies and started
using buckwheat and millet instead. The problem is, that these
other grains contain lectins, in very high quantity. Lectins, in
brains, beans, and potatoes, cause disruption of the tight
junctions in the gut -- leading to leaky gut. Leaky gut leads to
food intolerance, inflammation, and lipopolysaccharide invasion
(toxins from gram negative bacteria that naturally live in the
gut). Big problem. Check this out: The
Lowdown on Lectins. And if you're a real glutton for punishment
Dietary Lectins as Disease Causing Toxicants
for far more in depth information.
So, I talked to the rep about how the choices they've made in
substitutions are likely to affect their customers. The lady didn't
have a clue what I was talking about. But she seemed pretty scared
in response and said she'd pass it on to their recipe people. I'm
sure it won't go any further. I looked through the ingredient list
on EVERY product they had there. The few that didn't have millet or
buckwheat had TONS of sugar. *sigh* Gluten free isn't always healthy.
Since my "conversion" to mostly Paleo, I just can't look at food
the same way. I'm always thinking about the grain or carbohydrate
content, how much I'm allowing my gut to be exposed to the lectins
and sugar, and what it's doing to me. I'd say I'm about 80% Paleo
now. I go back and forth -- trying to only have rice a couple times
a week, and sugar maybe once. It IS a struggle sometimes,
especially when I'm stressed out. But I feel SO much better.
And before I go, I've wanted to share this guy with you all for
quite some time. He stands outside a defunct mini-golf turned car
dealership parking lot. I often wonder why he's still here -- maybe
it's because he's so awesome. I haven't come up with a name for him
yet. I'm willing to entertain suggestions. There are lots of
oddities around St. Pete.
Have a great week everybody.
• After the DC Degree
• Botanical Medicine
• 1 Year at National
• Marketing Project
• First Week in Student Clinic
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