Archive for tag: classes

Milestones

The first A, the first D, the first B when you thought it was going to be an F. There are many milestones that all of us at NUHS experience. They are the turning points that stick in our minds and mostly serve to boost us when we occasion to remember them.

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In the beginning -- my tri 1 lab group

There's the bittersweet end of pathology with Dr. Khan, and the viscera final aka your last anatomy practical ever! The first practical in the TAC shaking in your dress shoes and sweating through both your nice shirt AND your doctor coat. Grading yourself on that first practice spine and extremities practical and realizing you failed only to pass it when it comes to the real deal a week later. The first time you watch Dr. Lou take her shoes and socks off and not miss a beat in delivering her lecture.

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My group & me after our last ever anatomy practical (photo from Teegan)

The first time you've ever thought of J.Lo and a plumber in the same context, and the first time your head jerks up because Dr. McRae just SHOUTED in lecture. The moment when you realize that the 3-compartment model actually kind of makes sense (maybe). There's the first splash or smear of cadaver fat on your lab coat, and the first time you realize you're actually super hungry in the middle of dissection lab. Experiencing your first adjustment and then the first time you get a cavitation when giving someone else an adjustment, yes! The first exam during which you notice your palms are not sweaty and you're actually breathing just fine. The first time you forget to return the markers to the library desk and you have to pay a silly amount in fines (and decide to buy your own markers.)

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My nametag milestone

There's the last time you have Dr. Ed for class, and the last time you sit through one of Dr. Humphreys' neuro-heavy lectures. The moment you realize that Dr. Richardson's stories just keep getting better, so you vow to pay attention and you learn tons of pharmacology in the process. And then you realize that Dr. Ed had Dr. Christiansen as a professor, too. The day you receive your official intern nametag to be worn at all times in the clinic. The first time you tie a tourniquet and choose a vein in phlebotomy lab, and the first time you see the red flash. The first draw you mess up that either makes blood squirt, your patient cry out, or leaves behind a little hematoma (whoops!)

And then there are the things I haven't experienced yet but that I anticipate -- the first patient in clinic, the last patient in clinic. The first colonics patient, the first real live constitutional hydrotherapy you administer in clinic. And before you get to the clinic, there's the first real live gyn exam and digital rectal exam on a sym patient. Then, there's the first actual real patient presenting for a gyn exam, or the patient who refuses to receive a treatment you really think would help. The first time a patient cries in the exam room. There will be the patient who must be told the less-than-favorable results of a blood test; the patient that keeps you up at night wondering if you said the wrong thing, or the right thing. There will be the patient who isn't responding to treatment, and the patient who comes in singing your praises.

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Officially registered for boards

And then there is this week's milestone; registering for the NPLEX Part 1 Biomedical Science Examination. I've long been thinking about February's exam, but registering today made it REAL. Honestly, it's almost too bad I couldn't have registered several months ago, as it would've brought that realness to life at the time when I should have started taking my preparation more seriously. Oh, and there's another recent milestone; watching that first video in the board review series and having your eyebrows permanently raised in anguish as you painstakingly extract basic biochemistry from the recesses of your brain. You must take several deep breaths to calm those nerves you thought you were done with after that exam when you noticed your palms weren't sweaty and your breathing was even.

I have A LOT of information to retrieve from the depths and bring back to the forefront of my memory by the first week in February. I'm totally anxious about it, and every time I sit down to study, I have to fight the urge to ditch it and do something else that doesn't make me feel quite so bad about myself. Lately, I've been reflecting on how far I've come in order to remember that all the basic science information is there; I DO own it. Writing this post has helped me continue that affirmation process, and I hope it's maybe done the same for you in some way... or maybe it made you smile or laugh, or perhaps it made you curious about what lies in store.

My Favorite Tri So Far

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 that area.)

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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 for success.

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 apply!

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.

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Crazy lookin', right? Lisa and Jack practice naso-sympatico.

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.

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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 luck!

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!

Leaves, Berries, Flowers and Bark

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.

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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!)

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Looking south from Indian Point (a photo I took at Tanager years ago)

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 Medicine.

  1. Be clean; both yourself and the place you live in.
  2. Be strong. Understand and respect your body.
  3. Protect all harmless wild life. Conserve the woods and flowers.
  4. Hold your word of honor sacred.
  5. Play fair for fair play is truth and foul play is treachery.
  6. Be reverent. Worship the Great Spirit and respect all worship of it by others. For none have all the truth and all who worship reverently have claims on our respect.
  7. Be brave. Courage is the noblest of all gifts.
  8. Be silent while your elders are speaking and otherwise show them deference.
  9. Obey. Obedience is the first duty of the Woodcrafter.
  10. Be Kind. Do at least one act of unbargained service each day.
  11. Be helpful. Do your share of the work.
  12. Be joyful. Seek the joy of being alive, for every reasonable gladness that you can give or get is a treasure that cannot be destroyed.