The Equinox, Noticing Change

Summer's slip into fall was subtle until the past week or so; it got cool here, the leaves are falling more rapidly. I am sitting on my porch in a sweatshirt with a cup of tea as I type this and except for the barking dog playing in the park next door, it is quite peaceful here in the wind. Fall is blowing in. Monday the 22nd was the fall Equinox; day and night were equal lengths, and from here on out, the days get shorter. It was the first official day of fall; the season changes.

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I like to think I'm good at changes. I identify as someone who desires to be outside of her comfort zone. Here in Chicagoland, I often pine for change. Usually it happens when I'm sitting at my desk on a beautiful Saturday afternoon staring out the window, or when I'm inching along in traffic to or from campus. The med school routine starts to feel monotonous. So, when the earth does her thing and the land around me transforms, I am thrilled! I found orange leaves on the ground outside the front door this morning. This obvious sign that fall is here made me reflect on how much change really does take place in the midst of my regular routine. I am evolving as a doctor in training, learning to see the world around me with the eyes of a Naturopath.

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I see a man limp down the street and speculate on which muscles or nerves are not functioning properly. I listen to another man with a lifeless arm order sandwiches in a low, nasal voice with little enunciation and I speculate on which part of his brain suffered a stroke. I watch the guy in line ahead of me at the grocery store as he blinks and twitches his head repeatedly and I can identify the part of his brain that might be disinhibited, by medications I wonder? Two years ago, I would see only a limp, hear only a funny voice, and notice only a man who blinks a lot.

In naturopathic medicine, we consider the experience of the change of seasons a determinant of health under the category of light and cycles. Cycles that last longer than a day, and are therefore not linked to our circadian cycle, are called infradian rhythms. Annual cycles of the seasons are infradian rhythms, and can affect our metabolism, appetite, and weight gain. It is healthy and vital to experience these changes that indicate the passage of time. The days get shorter and our bodies respond in kind. The temperature changes and our systems acclimate. We learn that spring and fall are ideal times to cleanse as we prepare for the inevitable hot summer or cold winter.

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As I meditate on summer's bow to the arrival of fall, I remember that every trimester brings change, too. I have a new set of professors, new expectations, and new information to throw into that fragrant soup of knowledge I keep cooking up there. I suppose my task is to recognize the small changes happening every day and find solace in them. I will also revel in fall while it lasts, and try to notice all of its colors and smells while in the thick of my busy academic life.

I think I'll leave you with this, written by Stephen King, about the change of seasons:

"But then fall comes, kicking summer out on its treacherous ass as it always does one day sometime after the midpoint of September, it stays awhile like an old friend that you have missed. It settles in the way an old friend will settle into your favorite chair and take out his pipe and light it and then fill the afternoon with stories of places he has been and things he has done since last he saw you."

How to Look Fabulous as a Clinic Patient and Other Related Thoughts

Remember that sprained ankle I mentioned in my last post? I finally went to the clinic for treatment and was reminded of how lucky we are as students to have free care available to us! I received some cold laser as part of treatment for my swollen ankle and left with a BCQ (Boswelia, Bromelain, Curcumin, Quercetin) supplement to decrease inflammation (half price for students!).

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Cold laser therapy

If you're not an established patient of a student intern, I highly suggest you spend the time for the initial intake and reap the benefits! If you're stressed and over-worked, there are hydrotherapy treatments waiting for you! If your neck and shoulders are in knots from sitting and studying all day, there are soft tissue treatments and gentle adjustments in your future. If your skin is misbehaving or you haven't pooped in three days (or the opposite... I mean let's be honest, stress wreaks all kinds of havoc on our systems)... there is realistic dietary advice and vis-stimulating/supporting treatments (like acupuncture or more hydrotherapy) waiting for you at the clinic. 

These are just the everyday med student woes that can be attended to by our fellow student interns and future colleagues. Don't forget they can also help address the bigger things. Perhaps you arrived at NUHS to study naturopathic medicine (or chiropractic or acupuncture or massage) because you or another family member is wiser for experiencing a challenging health condition. Even the conditions that require pharmaceuticals and other higher force interventions can benefit from the complementary, supportive care offered at the clinic. 

Do you have family, friends or acquaintances that could benefit from the services offered at the clinic? Refer them, please! In fact, just last night our server asked for our advice to help with his broken ribs. Since we're not licensed doctors and cannot give medical advice, we referred him to our clinic. We also brainstormed some homeopathic remedies anyone can find at their local health food store that are indicated for stabbing pain and broken bones.

An appointment at the clinic might take up your time, but I encourage everyone to support our peers and future colleagues. If you're not an intern yet, you will be soon and we'll all be thankful for more patients to learn from as we hone our skills and prepare for life after graduation.

So, what are the highlights from my week other than remembering the beauty of free care and the fact that those cold laser protective glasses really tied my outfit together? I practiced back massage in my Tuesday night class, purchased some materials for my massage table (fleece covers, a bolster, etc.), observed a few intriguing patients in clinic, and continually wished my DC peers good luck on their board exam (Congrats guys! You did it!) I also fell deeply in love with hydrotherapy and totally forgive the scheduling goddess for giving me class from 3-5 on Friday afternoons. We practiced dry sheet wraps and salt scrubs; techniques that elicited a feeling of true healing that I can see using often in practice and assigning as homework for my patients.

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Painting with friends

Lastly, my best girlfriends and I celebrated our girl Mia, a new bride who got married in India over this past break! We indulged in a night out that included wine and painting and inappropriate jokes and howling laughter. I am so thankful for these friends! They make me laugh, they make me think, and they inspire me to embrace my creative side in the midst of the brain workout we all endure on a regular basis.

Mountain Time

And we're back! August break was absolutely fabulous! For me, at least...I know that many of my DC student friends were busy studying for their board exams coming up at the end of this week.... Good luck to you all! 

But I went exploring. To celebrate my Dad's 60th birthday, we ventured into the White Mountains in New Hampshire for a 4-day, 3-night hut trip. Staying in the AMC Huts is a total treat; they cook breakfast and dinner for you, and you sleep in a real bed! (Albeit, in a bunkroom with approximately 11 other people....) It makes backpacking with your family a whole lot easier when you only have to carry your lunch and there's no worry about tents and stoves.

Unfortunately for me, I sprained my ankle early in the trip, but we taped it up and I continued on for another 14 miles over the next few days. I am quite thankful that I can go to the clinic here on campus to have a student intern help nurse my ankle back to health! It needs it.

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All 6 of us (Mom, Dad, my brother Arthur, my Uncle Nate, Hanzi, and Me) on the summit of Mount Madison! Day 1 of 4.

After a few breathtaking bluebird days in the New Hampshire mountains, I continued on my high altitude journey to visit with some of my best college girlfriends in the Adirondacks in New York. In addition to spending time sunbathing and catching up on the lakeshore, we visited the Sugarhouse Creamery, a dairy farm owned by some other college friends who gave us a tour of the cheese-making process! After our tour we bought up almost all the cheese in their farm store to take home and share with our families. Yum!

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Here's a photo of us in the cheese cave (underground!), and another of the cows at milking time with barn cat Soup posing in the foreground (In Memoriam: Soup disappeared a few days later; a coyote had been afoot.)

After nearly two weeks of tromping all over New England visiting with faraway family and friends, I came home to the Boston area. There, I checked in on the progress of the construction at my parents' new home and saw our old house for the first time since my parents' move. It is now happily full of a family of six and I feel good about that. I spent my last full day on the East Coast drinking morning coffee and talking wedding plans with my oldest childhood friend, followed by shadowing my Mom while she saw her afternoon patients. It was the perfect way to ease back into medical school mode after my vacation.

I arrived back in Chicago in time to organize my schedule and have some school friends over to celebrate Labor Day. The first week back at school was a short one, but whew, it was big. I have started the massage program, which means I am on campus two nights per week after my ND classes end for the day. It's exhausting because I have to mentally prepare and pack both a lunch AND a dinner, but it is also extremely rewarding because I get to spend time learning with and from a different type of healer.

Highlights from the first week include practicing phlebotomy on bananas (before we "stab" each other this week!), and my first clinic observation shift. I got to wear my white coat and see a patient! It should be noted that when I say, "see" a patient, I literally mean just that. As observers, we are not allowed to talk to or give any input while in the room with the patient; we just watch and absorb. No complaints here though. I learned so much by observing everything that went into one blood draw appointment.

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We watch as Dr. Aikenhead demonstrates proper technique in Stab Lab, and one of my classmates brings his banana to life!

This first blog of my 6th trimester will serve as a reminder that the time for adventures and spending time with friends and family will come again.... Until then, it's back to the grind -- reading, writing, analyzing, thinking, puzzling, and occasionally complaining about it all as we jump back into it for fall. Here goes!

Go Us! Almost There!

Whoa, here we are! It's already my last post for the trimester, a sure sign we have only a handful of days left until we're done! Week 14 signals the beginning of exams with all the lab practicals taking place this week. My E&M Extremities practical on Monday has required me to learn and understand about 60 different types of orthopedic tests and 44 different types of mobilizations/manipulations/adjustments. Let's just say this is prime evidence of how medical school is like drinking from a fire hose.

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This trimester has been a significant one for me. I started the Clinical Sciences portion of my degree, made a decision on when to take boards, followed my intuition and decided to do a dual degree in massage, and learned so much from my sim-patients about what the real experience will be like. It was also the first trimester that I haven't had any classes with any of my best buddies with whom I started the program. This is a blessing and a curse because I miss their company terribly, but I have also made new friends who I value just as much. During this tri, I traveled to see some of my favorite people make the promise to spend their lives together, my best and oldest friend got engaged (I never told you this, ah!), I wrote a blog post here that elicited tears from an exceptional friend (the first time my written words have ever inspired such emotion), and my parents sold my childhood home. All this, and it still feels that these summer months have absolutely flown by!

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If you're not here at NUHS yet, you'll soon learn the value of our brief breaks between the trimesters. This time I will head east, and go on a 4-day backpacking/hut trip adventure in the White Mountains of New Hampshire with my family and Hanzi to celebrate my Dad's 60th birthday (wish us happy trails, we might need it!). After that, I plan to visit with some of my best college girlfriends; one of them just bought a house -- OMG -- grown-up things! Hopefully, I'll find a day to shadow my Mom at her Integrative Dermatology practice, and will crack my Boards study guide at some point (we'll see about that last one). I hope the rest of my peers also have something fun, and especially something relaxing, planned for break!

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But before we can totally engage with our time off, we have to give that last major push through finals. WE CAN DO IT! Remember, it's OK for life to be totally, completely unbeautiful right now. Also, the world is a whole lot bigger than NUHS finals week.

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Throughout my post is a series of photos I took around campus on the Friday before Week 14. I asked students to show me how the impending last 2 weeks of the tri makes them feel; this is what I saw. General consensus says we're all a little crazed, a little worn out, and a little hungry for the sweet stuff...so don't worry, here's the evidence that if this is how you feel, you're not alone!

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Lastly, a little blessing for us all; may our professors ask us the questions to which we have all the answers! Good luck, friends!

The Unbeautiful

All this talk of having found my path in life, the indications that I am "doing the right thing," the gallantry of studying medicine outside of our current paradigm, all the fun being had outside of class, and I forget to show you the unbecoming parts. Isn't that one of the major faults of social media? We share the beautiful pictures, post the good news, write the meaningful stuff.... But a capacity for occasional self-deprecation is pretty important; we're all fallible, and the journey is not always beautiful.

My grades this tri haven't been as satisfying as previous ones. I feel I haven't studied as regularly as I should (maybe the trappings of summer have something to do with it). A few weeks ago I crammed my preparation for a sim-patient and she called me out on it. I rushed through the prep because this was just a practice session; I would not receive a grade for it. To save time and energy when I wrote the instructions for my patient, I used medical abbreviations few non-doctors understand. In our review of my encounter, my sim-patient pointed this out and I responded honestly--I told her I'd banged it out during the boring lecture before this, and knew full well I shouldn't have used those abbreviations, but I did it anyways. She reminded me of the NUHS motto: "Esse Quam Videri" (which means "To be, rather than to seem to be.") Oops, lesson learned.

As for the whole life-outside-the-classroom part, my bathroom gets cleaned only when I can't stand it anymore, same goes for the kitchen. Laundry piles up around our apartment and coffee mugs cluster on any free surface in the living room (especially during midterms and finals)! Cleaning out the fridge recently was terrible; eating healthy food doesn't excuse you from the misery that results from neglecting to toss last month's leftovers. I don't think I've vacuumed my car since I drove it from California two years ago. When my mom came to visit and saw my kitchen sink full of dirty dishes she told me its OK to be messy because I am a busy student. That's some consolation, I guess. Also, last night I had ice cream for dinner because... forget it, no excuses, I just did.

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I wasn't kidding about ice cream for dinner...(cherry with chocolate sprinkles)!

I constantly talk about all the things I'm going to do once I'm a doctor. And I don't mean the type of practice I'm going to create and the type of patients I'm going to attract. What occupies my thoughts is what I'm going to do with my time once I've passed that last exam. I talk about the music festivals I'm going to attend, the dinners I'm going to cook, the books I'm going to read. I have visions of a clean home and cooking with pricey ingredients like lamb and wild-caught fish. I also have this funny feeling that these aspirations are going to continue forever; I'll probably always know I'm going to do something wonderful just as soon as I finish with... [fill in the blank]. (Speaking of unbecoming, there are at least 16 I's in this paragraph.)

I want future students who read my blog to think; I want that! They should think, my life as a student will be glorious! It will have meaning! I will have purpose! It will; you will. But...life will also likely fall apart in a few ways. You will have to push yourself to make time to catch up with your best friends because, well, you're so tired and you could be napping instead. Your family will have Sunday dinners and cookouts together while you sit grumbling at your desk, memorizing facts for tomorrow's exam on the bacteria that's potentially growing in their potato salad.

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My desk strewn with papers...studying is rarely a photogenic event.

Or, there's always that realization that instead of keeping up with your laundry, you could be sitting still doing nothing for a moment. You could just sit and listen to no one, memorize nothing, share no emotion. I've come to appreciate even more the precious moments of alone time without my books, without anyone to talk to, or smile at, or try to understand. Interactions with people are ultimately what keep me going, but in this messy life of a medical student I am so thankful for Saturday afternoons like this one--home alone amid my mess, writing about the unbeautiful parts and bowing to reality.