Archive for tag: faculty

Storytelling, Salamanders, and Sol

A few weeks ago, before she left us (sad face) for her new position as an Assistant Dean in the Naturopathic Program at the University of Bridgeport, Dr. Stephanie Draus organized for a woman who calls herself Comic Nurse to come speak to us during a Tuesday lunch hour. Comic Nurse told us about how she uses comics with her patients and with the medical students she teaches at Northwestern to help tell the story of the healthcare experience. Whether it is getting patients to express their frustration with their doctors, or helping doctors-to-be address their anxieties about their future, comics have proven to be a remarkably effective form of expression.

Photo of hand drawn comic

Many of us think of comics as funny things that make us laugh, and with good reason, the adjective means, "to cause laughter." But we are talking about the noun here, and the noun is a form of storytelling that involves words and pictures and lets the storyteller use imagery to express those things that are sometimes too hard to express with words alone.

You can probably tell that I like using words to process my struggles and tell my stories. Some weeks though, those words just don't flow like I'd expect them to. I have the modern day equivalent of a trash can overflowing with crumpled up papers; too many untitled WORD docs in my "student blog" folder laden with half-sentences and stories that never came to fruition. Now I know an alternative outlet to get my creativity flowing!

No matter which medium you use, storytelling is a powerful tool for learning, for self-discovery, for communication, and for teaching. In PT Modalities class a few weeks back, Dr. Hill told us a story about chopping the legs off a salamander and then re-growing them with the application of therapeutic Microcurrent. So of course I remember that Microcurrent is indicated for tissue healing and repair! The rescue of quadriplegic salamanders is a pretty great memory tool.

Photo of hand drawn comic and McKenzie
My study comics, Piper and Sun King

I also tell stories to remember my botanicals. For a recent quiz, I had to remember Solidago virgaurea; common name Golden Rod, used for urinary tract infections and colds with a runny nose, and sometimes mistaken for ragweed in allergies. I associate the word Sol with Sun. So, there's this BIG sun god with a golden scepter and he's a super powerful diuretic/aquaretic! (This god always has to pee.) If you look at him directly, you'll start sneezing like crazy and you'll need him to cure your snuffles. You could think you're allergic to him, but you're probably wrong, this sun king doesn't wear rags.

Another favorite Bot Med study story is of Piper methysticum (common name, Kava.) Piper is an aging socialite in NYC who drinks too much wine while she lounges around, sedated on her couch all day, popping muscle relaxants and pining for the elusive man GSH who she loves but who does not love her back. Piper is also sad because she has a urinary tract infection and is very worried about her skin. As you can see, there is a lot going on here with Piper, so I'll spare you the medical translation.

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Reading some medical comics in the LRC

Storytelling is one of the very best ways to remember and to process emotions, two things we must do often as medical students. If you're more of an artist than a wordsmith, try like Comic Nurse does and draw the story. Or, if you're neither good with a pencil nor crafty with words, screw it, try either one! Because it doesn't matter if the sentences are simple or if the characters are stick figures, what matters is self-expression and creative learning.

Physician-to-Be Heal Thyself

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.

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Post-workout, reminded of the feel-good power of a workout

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."

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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.

I Give You Permission to Research Colorful Sex

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.

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(Image via www.dawn-productions.com)

Dr. 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.

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Mary Calderone was a physician and public health advocate for sexual education
(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 this world.

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.

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.

Learning from Naturopathy's Superheroes

If you're an ND student and haven't attended a naturopathic conference yet, please do! If you're a prospective student, you might consider attending one as well.

Last week was our nationally recognized Naturopathic Medicine Week, which culminated here on campus with the annual conference put on by the Illinois Association of Naturopathic Physicians (ILANP). This year's topic was "Integrative and Nutritional Approaches to Gastrointestinal Disorders." This was the highlight of my Naturopathic Medicine Week celebrations, which also included a lunchtime yoga class and some time spent at our campus botanical garden.

Image of schedule

This year, ILANP hosted a few of Naturopathic Medicine's Greats: Dr. Mona Morstein, Dr. Eric Yarnell, and our very own Dr. Louise Edwards (Dr. Lou). I am so lucky to have had the opportunity to learn from these remarkable docs, and intend to seek out their lectures in the future.

Dr. Yarnell arrived early for the conference and gave a special lecture for the Tri 6/7 Bot Med 2 class on Friday. I am not actually taking this class until next trimester, but the professor, Dr. Sorensen, knows I (and other ND students) have an affinity for herbal medicine and she invited us to attend.

Dr. Yarnell spent the first hour teaching us about formulation: the roles and the selection of different herbs as Leader, Helper, Deputy, Synergizer, and Driver/Harmonizer. I learned that making a list of desired actions for treatment (based on physiology and biochemistry) allows you to select the most appropriate herb as a leader, and to fill in the unmatched actions with other botanicals.

Dr. Yarnell also taught us the concept of Opposing Assistance, or using two herbs with opposite actions in the same formula. For example, if his patient needs some stimulation but not too much, instead of using a mild adaptogen, he will incorporate a strong herb and an herb with a milder opposite action to achieve a balance. He finds this yields the best clinical results. It is also a good lesson for life: moderate and find an answer by applying opposing wisdom. In the second hour, Dr. Yarnell presented a few cases so we could see how he applies these concepts of formulation in practice.

Bright and early on Saturday, the most intriguing thing I learned from Dr. Yarnell's opening talk was about the need for certain bugs in our gut (that make up our microbiome) in order to breakdown certain medicinal herbs. This means that if a particular herb is not working for your patient, the problem may lie in the population of gut flora, rather than in the herb itself. If the herb's active constituents cannot be exposed via digestion by certain bugs, it cannot possibly do its job correctly! For example, research from 2012 tells us that the catechins in green tea (Camellia sinensis) requireLactobacillus plantarum, a particular gut microbe, for metabolism. Interestingly, green tea makes me sick to my stomach. Perhaps I am deficient inLactobacillus plantarumand therefore cannot break it down properly? Amazing!

Dr. Morstein opened Sunday's lectures with a talk on SIBO (small intestinal bacterial overgrowth). If ever there was a doc who speaks with conviction and does her investigative research, it is Dr. Morstein. She taught us that using antibiotics is sometimes appropriate, and that one should never be shy; call any company whose product you question and ask them about it. Go to the source to answer your question so that you may treat your patients with confidence.

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McKenzie and Dr. Lou

I reveled in presentations by many other intelligent and inspirational NDs, and was brought back to our naturopathic roots by our own Dr. Lou, who ended the conference with a presentation that applied everything we'd heard to the core of our philosophy. My congratulations to Dr. Kristina Conner, who was honored as the recipient of the 2014 Henry Lindlahr Award, and to Dr. Lou, who accepted the 2014 ILANP President's Award! I am so proud of my professors (who double as mentors), and am so thankful to benefit from their teaching! I came away from this week of celebration of our profession with the spirit of naturopathy rooted in my heart, and my drive to study hard rekindled.