I think Week 6 is a good time to get into the meat of what I've
actually been up to so far in Tri 6. The best part about this
trimester is that I spend relatively little time sitting in
lecture, and most of my time applying and building upon what I
already know through discussions and hands-on learning.
Physical and Laboratory Diagnosis (aka Phys Dx in student speak)
is a beast of a class, with 6 hours per week of lecture and three
more hours per week in lab. Our first practical comes this week,
and I have been practicing several exams including taking vitals,
as well as the head and neck, pulmonary, cardiovascular,
neurological, eye, ear/nose/throat, and abdominal exams. Besides
demonstrating that we can actually execute said exams, we will be
tested on our ability to translate an objective finding into a
diagnosis (for example, dullness on percussion of the lungs in the
right upper lobe suggests consolidation and therefore pneumonia in
Friday Manual Therapies class celebrations! Tony's birthday
called for learning, pizza, and cupcakes.
Two other classes require me to sit in lecture. The first is
Imagining Diagnosis, in which we just finished learning about how
to recognize arthritides, like rheumatoid arthritis, on X-ray. The
other is Ethical Practice Management, a class that discusses things
like how to use twitter for marketing, and why networking is vital
All my other courses are significantly more hands-on and
interactive, the reason that this trimester is my favorite one so
far. In Homeopathy 3, we sit in class, yes, but we learn remedies
and have discussions about how to take a case, analyze a case, and
subsequently find the correct remedy for a patient. In Applied
Clinical Theory, we discuss paper cases each week and learn about
how to make a diagnosis based on a history and results of a
physical exam. Next, we discuss how to treat these patients by
working through our therapeutic order and addressing each
determinant that is out of balance.
These classes are directly allowing us to apply what we know and
understand about pathology, physiology, biochemistry, anatomy, etc.
(material from our first phase classes) to a theoretical patient.
It is so satisfying to prepare for a class discussion and find out
the next day that your diagnosis was correct and that some of the
therapies you've chosen are the same ones your professor would
These classes are helping me to move beyond simply identifying
what is wrong with the body, to actually creating a treatment plan
to solve the problem. I have two more hands-on labs that fill my
week, one is phlebotomy lab where we've been learning to draw blood
and take urine samples. The other is a class called Advanced Manual
Therapies, which has proven to be a great review of evaluation
techniques we learned in our E&M classes, and allows us to put
it all together. For example, last week we learned the "upper
extremity evaluation dance," which will help us to determine where
a patient's source of pain or malfunction resides if they present
with a problem in their arm or shoulder. We also learn how to use
alternative techniques like pelvic blocking and activator to treat
stubborn or sensitive patients.
Crazy lookin', right? Lisa and Jack practice
My very favorite course this trimester is Hydrotherapy. If
you've been reading my blog the past few weeks, you'll know that I
adore this class. Last week, we practiced constitutional
hydrotherapy, a vis-stimulating treatment that involves alternating
hot and cold towels and applying electrical stim. Two weeks ago we
experimented with Neti pots, as well as steam baths and
naso-sympatico treatment for sinusitis.
Neti Pot time! Pouring water into my nose.
Lastly, I get to spend four hours a week in the clinic, which
you have also read about already if you've been following my posts.
Observing allows us to focus on understanding how the clinic
operates and to practice writing SOAP notes without the stress of
actually having to treat patients or think really hard about the
cases. I am so thankful that I get to watch and think and learn
from my peers; many of the interns I shadow offer useful tips,
teach me the finer points of writing a SOAP note, listen to my
suggestions, and answer my questions about their patients.
Oh! How could I forget to mention my massage courses! I love the
physically exhausting challenge of giving massage in my
Fundamentals of Massage class every Tuesday night, and my class on
Ethics and Practice Management is helping me to visualize how I
will apply this skill in my practice of the future. Despite how
satisfied I am with this trimester, I admit that I am already
looking ahead to what comes next! I can't believe I am already
halfway through medical school; time if flying. On that note, I
better get to work preparing for my Phys Dx practical! Wish me
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!).
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
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
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
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.
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!
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
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.
We watch as Dr. Aikenhead demonstrates proper technique in
Stab Lab, and one of my classmates brings his banana to
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
One morning when I was 18, I went out for a run in the
Adirondack woods and after I rounded a corner, I stopped dead on
the narrow trail and looked up to see a buck standing in my way. I
stood stock still for half a minute as we made eye contact. I think
I took one or two steps back, which made him hesitate and glance
over his shoulder, then stamp once. He was brownish grey with dark
brown eyes and a small-ish rack of antlers that made me think he
was fairly young. Another shift in my posture was all it took for
him to turn abruptly and bound off into the woods to my right.
(This was before smart phones, and there was no power plug within 2
miles of me to power it anyways, so I didn't catch a picture, but
the image stays remarkably clear in my mind.)
This experience was one of several encounters with wild things I
had over the summers I spent at Tanager Lodge, a summer camp in the Northern
Adirondack Park in upstate New York (the same place I traveled to
for that wedding mentioned in last week's post.) That wedding trip
has inspired this meditation on what Tanager fostered in me that
made me gravitate towards naturopathy more than any other school of
the healing arts.
Old Map of Tanager Lodge
Tanager is a self-proclaimed wilderness camp that engages
"campers and staff in a small, non-competitive community dedicated
to wilderness appreciation, life skills, and individual growth."
This is its 90th summer in operation.
A day in the life of a camper or staff member (I was both)
starts with waking to the sound of a flute (a real one, played from
atop a cliff...I'm not kidding), followed by a dip in the lake,
then breakfast on open porches, cleaning and prepping camp for the
day by bailing boats, peeling carrots, sweeping docks, cleaning our
tents, etc., and then choosing an activity for the morning.
My favorite activity was making herbal teas. We would hike out a
mile or so into the woods on a rainy day and carefully harvest all
kinds of edible leaves, berries, flowers and bark. Once back in
main camp, we steeped them in varying combinations. After a while,
we tasted all the different teas we'd made and they helped to warm
us after a morning of tromping around in the rain. The steeping of
teas is pretty darn naturopathic; there's even an elective class
here at National called Special Topics in Botanical Medicine in
which we learn to make medicinal herbal teas (and many other things
like salves, tinctures, and elderflower fritters!)
Looking south from Indian Point (a photo I took at Tanager
If you are just beginning to explore naturopathic medicine,
please do not feel that you need to come with a past full of jaunts
in the woods and time spent identifying plants. I have many
exceptional peers here at NUHS who came right out of the heart of
cities like New York and Detroit. Not every naturopathic student
loves to get their hands dirty in the garden or yearns for a hike
in the woods like I do, but I am pretty sure we all have a deep
respect for the natural world.
The Tanager Lodge community I grew up with strives to live by 12
Woodcraft Laws that will likely resonate with naturopathic students
in some way. These laws generally parallel the community, spiritual
and ethical aspects of our
Determinants of Health (listen to Dr. Louise Edwards speak on
the topic). I'll leave you with the list and hope that you have
learned a little more about what draws me to study Naturopathic
OK readers, I did it! I decided. My parents were a reliable
sounding board in a conversation last week and while I trust my own
intuition and will follow it even in the face of resistance, being
reassured with parental support really sealed the deal. I plan to
start the massage program in September!
Trusting intuition is something we address in class from the
very first trimester. Mostly, we have these discussions in our
naturopathic theory classes, although this week in Homeopathy 1 we
started a topic on How To Take the Case, which is inseparable from
learning about becoming a true healer. "Taking the case" means
listening to our patients without any preconceptions; it means
forgetting ourselves, and dissolving the boundary between the self
and the world so as to note every important detail.
In discussing both homeopathic and naturopathic theory, our
professors have talked about mirror neurons, a term that defines how empathy
is evidenced in brain scans; the listener's brain lights up in
exactly the same places as the storyteller's brain does. Our goal
as doctors is to use our mirror neurons.
One of my peers asked about how, on the one hand, we dissolve
the boundary between ourselves and our patients' stories of
suffering, and on the other, maintain our own sanity and refrain
from shouldering the burdens of every sick patient that walks
through our doors.
It is a good question. How many mirror neurons can we afford to
use? Turns out, the answer is different for every doc. Of course we
knew that, everyone (every case, every patient) is different, after
One professor told us that he sits behind a desk, with the
patient opposite him; this provides a physical boundary to remind
him. Another professor spoke on how her spirituality and the
healing cannot be separated. Her spiritual practice involves
dissolving boundaries and finding compassion for every single
During several of these class discussions our professors have
sited an author named Dr. Rachel Naomi Remen, a doctor known for
her work teaching other physicians how to heal from the heart. On
her blog, Remembering Your Power to Heal, Remen writes of
physicians: "Our habitual way of seeing things and even our
expertise can blind us to the meaning of even the simplest of our
daily interactions and relationships." This tendency towards
blindness is an obstacle to cultivating the healer in us, and comes
at least in part, from our training. One of Dr. Remen's tools for
learning to see through "new" eyes is to keep a "heart journal" in
which you answer three questions each day.
The Heart Journal
The first question is: "What surprised me today?"
The size of the nose ring on the
girl sitting next to us at the beach; it was huge but I figured she
probably loves it that way!
The second question is: "What moved me or touched my heart
On our way to the beach, Hanzi was
looking out the window and said, "That was cute!" I asked what, and
he told me that a little girl was leading her grandmother in an
investigation of something smooshed on the sidewalk.
And the third question is "What inspired me today?"
The camaraderie of the group of "Bears"
gathered at the beach, all bobbing together with their big bellies
in the chilly Lake Michigan water.
If this exercise is something Remen thinks we should do as
professional physicians, why not start practicing it now? In
addition to practicing things like taking blood pressure,
evaluating cervical range of motion, or taking a history from a
SIM-patient, we should probably be cultivating the healer through
exercises like this.
Hard to believe, but I did study at the beach. Here's the
Want to find a Chicago beach to visit? It's easy: CPDBeaches.com.
The skill set of a healer includes knowing how to find the
beauty in the midst of the suffering we are exposed to daily for
the duration of our professional lives. So, to my fellow students,
don't write in a journal every day if the time commitment freaks
you out, but at the very least, have these conversations with each
other. Try to talk about the heart-full things, rather than the
test you're dreading or the professor you can't stand. Look for the
things that inspire you, the things that touch your heart, and the
things that surprise you. Forgetting to cultivate our eye for these
things will, I suspect, prove a grave mistake whose consequences we
will learn when we go out into the real world and try to heal
So, I encourage you to notice the things that make you smile
more than the things that make you groan. You may even find less to
• Leaves, Flowers, Berries, and Bark
• Farmer's Market
• Should I Study Massage Therapy, Too?
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