It's springtime! And so it is also, inevitably, final exam time.
Talk about torture...staying inside to study while the birds are
chirping and the neighbors are out grilling and chatting and
generally having fun without me; story of the student life. I've
started my tri-annual 2-week-scramble as I head into the last week
of classes, also known as the first week of finals. I have been
busy tracking down research (for a paper I have yet to write),
making checklists, studying modalities and psychopathology, and
writing up a business plan, while also filing my taxes, cleaning
the bathroom, and.... Do you even care about the details? Let's
just say things are winding up (and taxes are a huge pain!)
Last week's storm clouds clearing, leaving behind super green
grass on campus!
In between the torturous number crunching for my business class
and scouring PubMed for articles, I managed to get out to our
botanical garden season-opener party and pull last year's leaves
off an awakening Ruta plant. I also practiced massage in
preparation for starting in the clinic next tri (exciting!) and got
out for a date night with my main man.
Headed into the
Hanzi and I redeemed our Groupons for the King Spa over the
weekend. If you haven't been there, seriously, do yourself a favor,
you stressed out student! The spa has about 8 or so different rooms
ranging from warm to wickedly hot, the walls covered in all
different things from salt to gold to amethyst to coal. These rooms
are co-ed and everyone wears the same funny T-shirt and shorts
uniform (gals in pink, guys in grey). Hanzi and I started out
sauna-ing in the various rooms, our favorites being the salt room
and the amethyst room. Oh, and the Ice room also feels really
excellent after working up a sweat.
Once we'd had our fill of lying or stretching quietly in each of
the rooms, the two of us split up and headed for our respective
sides of the spa. In the ladies-only section, there are three
different temperatures of hot tub, one cold pool (eek!), and a
steam room. Each time I've been to the King Spa I rotate through
the tubs, then dunk in the cold pool, and move to the steam room. I
do this routine 2 or 3 times and I leave feeling absolutely divine!
(Note: no bathing suits allowed. You've been warned.)
After at least half an hour rotating through the tubs and steam,
I showered off, put on a clean pink outfit, and headed back out
into the common space to meet Hanzi for dinner. We ordered some
delicious Korean food with plenty of veggies. After dinner we
retired to the comfiest chairs on the planet and lounged for a
while, digesting dinner and letting our spa-ified bodies totally
relax. Around 9pm, we split up again for our respective sides of
the spa, changed back into our street clothes, carried our shoes
out to the entrance, and paid for our dinner before driving
Sunny spring day, brewing sun tea on my porch
I can't think of a better way to spend a few hours toguether
before our household goes into finals mode. Hanzi's semester in his
master's program at Loyola is also wrapping up, too. Taking the
time to indulge in spa time quite obviously counts as
"physician-to-be heal thyself." (See my last post for more on
this subject.) It also fits with this emerging spring.
Relaxing, sweating, and purifying at the spa mimicked the drenching
April rain we had this week that left campus sparkling green. I
might have a lot to tackle over the next 10 days (1 project, 1
paper, 1 practical, 1 quiz, and 7 exams), but after my evening at
the spa, I'm feeling more centered and ready.
So here we go! I'll be back in a few weeks to regale you with
tales from my break, and in the meantime, good luck with exams and
enjoy your time off!
Last week I mentioned the principle of Physician Heal Thyself, a
concept we discuss in our first trimester of school in our
Foundations of Naturopathic Medicine class. To my fellow students
reading this blog, when's the last time you pulled out those notes?
Reading Dr. Lou and Dr. Draus' words and the notes I made in the
margins reminded me of all the other-than-science things we learn
and must continue to learn. As Dr. Draus reminded us,
this is neither the first nor the last time we will learn anatomy,
physiology, etc., and it's not the first time we learn about the
importance of self-care.
I drove past the gym on my way home from school a few days ago
and wondered how I had managed to get there to work out every other
day while I was studying for boards and attending classes, but how
I had somehow lost the time to go after I took that huge test. So,
I made it a point to go and aaaahhhhhh it felt soooooo good!
I sat on a stool in the locker room after my workout and sauna
feeling like melted gold, and as I stared at my satisfied self in
the mirror, I realized, going to the gym needs to be a priority on
my weekly agenda.
Post-workout, reminded of the feel-good power of a
Physicians do not have a good track record of self-care. As a
whole, physicians are statistically more likely to be depressed,
sick, commit suicide, become addicted to or abuse substances. We
are more likely to have tendencies towards perfection and yet, as
Dr. Lou put it, there is no such thing as perfect medicine. As
physicians we must walk a fine, exhausting line between using
objectivity and engaging our emotions to care for our patients. The
profession as a whole has trouble taking time off, and we rarely
get a sense of closure or achievement as the process of healing is
never complete. And then there are the inevitable financial
pressures as we struggle to maintain an expensive business while
still finding ways to offer care to all of those in need.
Dr. Lou reminded us in
her Tri 1 lecture that we should take a page from our own book when
we ask our patients to please take care of themselves so that they
can take care of others; we must do the same. It makes me think of
my father's wise words that I hold close: "You cannot truly love
someone unless you love yourself." Well, as a physician, you cannot
truly help someone unless you help yourself. To this end, Dr. Lou
reminds us that "Self-care is not an indulgence -- it is a
responsibility to the work and to your patients."
Part of self-care involves cultivating interests outside of
medicine. We should all remember from our neurology and psychology
classes that a healthy brain works on a wide range topics, skills,
and problems. By diversifying our activities and interests, we
support healthy neuronal growth and limit our risk of diseases of
the brain. Robert Heinlein, a bright and controversial science
fiction writer, once wrote:
"A human being should be able to change a diaper, plan an
invasion, butcher a hog, conn a ship, design a building, write a
sonnet, balance accounts, build a wall, set a bone, comfort the
dying, take orders, give orders, cooperate, act alone, solve
equations, analyze a new problem, pitch manure, program a computer,
cook a tasty meal, fight efficiently, die gallantly. Specialization
is for insects."
Champagne and conversation self-care, toasting boards results
and registering for clinic!
Now, I've got a lot to work on based on that list, but I'll
allow that building a fort out of sticks and pine boughs might
count as designing a building, and conning a ship could include
paddling a solo canoe, and so I've achieved some of these things in
their smaller forms. The point of sharing this quote is to remind
us students and future students of medicine that we should make
time, however miniscule an amount, to engage in things other than
learning our profession. And yet, we should also remember that
right now our job is to be students of medicine and that requires a
lot of us. It demands that we spend an extra amount of time with
this subject and this set of skills, for the time being. Believe it
or not, a time will come when I can get exercise by hiking and
skiing rather than biking indoors at the gym. Until then, I'll take
the time to care for myself in the ways I can, within the
limitations of the task at hand, and I know this will make me
better at my job.
Here I sit, on a plane bound for Chicago after a weekend on the
East Coast, listening to the air from the blower overhead and the
rushing outside the window as we taxi. The deicers blast the window
inches from my face with a heavy spattering sound. The engines roar
a little louder and I think of the rattle my cousin's smiling,
blonde 1-year-old used to fill my ears this morning.
At this past week's Nu Delta Sigma meeting, Nadene introduced us
to sound healing as presented in the book, "Tuning the Human
Biofield," by Eileen McKusick. I was the lucky recipient of a sound
experiment from my friend John, a brilliant healer and
doctor-in-the-making. You might call us crazy, but when was the
last time you checked in with the sounds in your life? It had been
a while for me.
The sim patient I saw this week in my Advanced Clinical Problem
Solving class complained of tinnitus, a rushing sound in his ears,
and was nearly deaf. This was the only abnormal finding on physical
exam as we searched for clues to the cause of his dizzy, vomiting
spells. When I made kale for dinner on Wednesday night, the leaves
squeaked when I stripped them off their stalks. The sound reminded
me of lemons and a crisp, cold, clear evening with a sky full of
stars, when the frozen snow sings underfoot.
So excited to be out skiing in celebration of one of my very
(She taught me to suck my thumb when I was 2.)
When I rode the chairlift at Cranmore Mountain in New Hampshire
with my childhood friends over the weekend, the chairs clunked as
only chairlift chairs do each time you reach a tower. I reveled in
the swish of skis and the crunch-pop of poles into snow, the whoosh
and shudder of skiers of various skill levels as they rocket
downhill beside you. There were also those split seconds of silence
when I caught a little air and my skis left the snow, allowing me
to hear only the wind in my ears.
Beautiful bluebird day in the White Mountains! There are my
friends, waving at me from the lift.
On Sunday morning, I listened to the coffee maker grumble and
splurt that divine bitter stuff into the pot. The bottle of
champagne made an adorable pop! And we toasted our friend, a
bride-to-be. We thanked her for bringing together such an
intelligent, fun, active and clever group of young women. Our
glasses clinked! I am back at school now, refreshed and
All the lovely, intelligent women in our PJs, toasting our
So now I sit here typing, my fingers trickling across the keys
making that distinct blipping sound with each letter. I spend so
much time using my eyes and my hands to observe and palpate in
medicine, but I haven't engaged nearly enough with my ears. The
more blood pressures I take and the more lungs I auscultate, the
more familiar those healthy sounds become. I listen to the normal
sounds in hopes that I'll recognize when they are different, when
the lungs pop or crackle or gurgle and tell me something about the
environment inside my patient.
Where do we start when we talk about love in medicine? In
naturopathic philosophy, love is one of our basic determinants of
health; we require it to be truly well, just like we do air, water,
and nutritious foods. But there are endless ways to love, and a
doctor can never understand them all. What a doctor can do is
appreciate love's presence with an open mind, without judgment, and
with the awareness that love comes in all forms.
(Image via www.dawn-productions.com)
Stephanie Draus' lecture in Clinical Problem Solving class this
week was inspired by love. We discussed how to talk about sex with
our patients. One excellent phrase I collected from her lecture was
this: "Do you have sex with men, women, or both?" I never realized
that question could be phrased with such simplicity. We talked
about the out-dated stigmas attached to sexually transmitted
diseases and why a lack of sex education causes these to run
rampant, especially in the geriatric population.
We touched on the fact that sexual preference, desire, and
practice are similarly stigmatized; we assume everyone having sex
likes it "vanilla," that is to say, plain and simple, no bells and
whistles, no games, nothing interesting. Just sex. As doctors, we
cannot assume this about our patients, nor do we always need to
know all the juicy details. What we do need to try to gather is
whether our patients' health is at risk based on their sexual
preferences, whether in regards to use of protection, or the myriad
of alternative ways to experience pleasure.
Mary Calderone was a
physician and public health advocate for sexual
(Image via izquotes.com)
So, what do we do as doctors-to-be if we find ourselves judging
based on our own histories, the things we've been taught, or the
lack thereof? I suppose the best place to start is by talking about
it with our professors, and with each other. If you are someone who
finds his or herself cringing inside at the notions of same-sex
love or multiple lovers, I personally think you need to start
learning by reading, listening, and well, Googling stuff. Perhaps
your professors and friends can't or won't expound on the vastness
of possibility and risk involved in more colorful sex, but we need
to remain open to the frank notion that lots of people in our world
experience pleasure in unorthodox ways. As doctors, we must be
prepared to listen without judgment. We must also be willing to do
our research so that we can advise our patients appropriately.
So, yes, in the name of becoming a better doctor, I am
encouraging you to read up on any alternative sexual practices you
can imagine. I've just given you the go-ahead to research gay
culture, to wonder at how polyamory is comfortable for so many, to
investigate the intricacies of anatomy and physiology in trans
people, and to look up that thing you've always been curious about.
I encourage you to explore resources for learning about and finding
compassion for the zillion ways that one can love and be loved in
My experience in finding acceptance for ways of loving that
differ from my own can be understood like this: my partner doesn't
like feta cheese. I like feta cheese! When I cook dinner with feta
cheese (because I think its delicious!) he just decides to eat the
food because he knows I'll be hurt if he doesn't eat what I've
cooked, and you know what? After a few feta meals he decides he
doesn't really hate feta cheese. After a few more feta meals, he
decides he might actually kind of like feta cheese. What he does
know is that he appreciates my satisfaction at the taste of this
food, and he loves me, so he eats feta cheese for dinner with me.
And of course, I do make sure to cook feta-less meals, too.
What happens when you've been studying microbiology for your
Part 1 boards and you see a sim patient in clinical problem solving
class? You come up with a somewhat obscure viral infection as your
diagnosis, when something along the lines of autoimmune disease was
what your professors had in mind... Such was my first reminder this
week to take a step back and remember the big picture. Who can
blame me though, really? I've been busy!
The Desert Room--where I found a good reading bench.
This week's second lesson in considering the totality of things
also reminded me to make space for wonder. After picking up my new
glasses on Saturday (Yay! Happy eyes!), I walked over to the Oak Park Conservatory to find a reading bench
among the plants. It was late morning and there were small children
exploring in each of the three greenhouse rooms. Most of them were
working on a scavenger hunt prepared by the curators, but some were
too small for that. I alternated between reading my NPLEX study
guide and watching and listening to the small humans as they went
through cycles of amazement (Mommy, Mommy look at the pink flower!)
and frustration (I can't find the snake! Help me!)
The Fern Room--where I sat to smell the flowers (no joke, so
Thankfully, I was granted about an hour of uninterrupted study
time among the cacti during which I made some good headway through
the section on the urinary system. Around the time I developed a
numb butt from the wooden bench, I packed up my books and set to
exploring the place with my new glasses on. I'm sure some of you
reading this know that feeling of newly crisp vision; texture has
returned to my world! I didn't plan it so, but the Conservatory was
definitely one of the very best places I could go first with my
sharp new eyes. The cacti were spiny, the tropical leaves were
waxy, and the flowers were bright and complex. The climbing vines
sprouted tiny brownish green curly-cues and the huge, fragrant
lemons hanging on their branches were beautifully pock marked
(What's that disease process I was just studying with "orange-peel
The Tropical Room--where I conversed with some
When I finally headed out, the volunteer docent was apologetic
that I had to study over the sound of kids. I reassured her it was
a welcome distraction, and a good reminder before I sit for my
board exam to attend to all the possibilities. Also, that I should
not forget to delight in the details.
• Leaves, Flowers, Berries, and Bark
• Farmer's Market
• Should I Study Massage Therapy, Too?
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