Archive for tag: friends

Med School Firsts and More Traveling

Another good week come and gone and we're already a month into the Fall Tri! This past week was marked in particular by more travel and some med school firsts: suturing and a Grand Rounds presentation.

Wendy, Mallory and Lisa prepare to learn suturing

For years I've watched my dermatologist mother suture her patients after removal of suspicious moles or biopsy of suspicious skin conditions. She works so methodically, looping the long end around the forceps and securing a tight knot in one smooth motion. After my first attempt at suturing I can tell ya, it's harder than it looks! However, after another hour of practice following that first attempt, I'm already feeling better about it, though I still need more practice. The tricky part is focusing on all the components; holding the tools properly, spacing your stitches just right, and pulling them just tight enough, but not too tight....

Lisa performs her first sutures on a plastic arm!

I also gave my first Grand Rounds presentation to a room full of interns, clinicians and students from lower tris. In 9th Tri we present for about 30 minutes on a clinical question, whereas in 10th Tri we spend an hour discussing a case and research. As I mentioned last week, I presented on The Case of the Missing Organ. My talk focused on the concept of considering a new basis for health in patients who present for care after having an organ removed, and on the importance of identifying the cause of dis-ease if removal of the organ has not solved the problem. This presentation was inspired by two of my patients, one who has had the colon removed, and another who has had the gallbladder removed. I was nervous, but it seems to have been well received and now I can check that off my to-do-list for the tri!

After an interesting week I took to the skies again for a trip to Vermont to celebrate the marriage of one of my very oldest friends. In addition to getting all dolled up with a delightful group of young women (I also wrote about them in a post from March: Crunch-Pop and Lovely Intelligent Women), I got to go for a beautiful, brisk morning stroll with my mom and discuss patient cases, and danced with my dad to music played by a live band. Everything about the weekend was beautiful!

A view from the top of The Flume, a little hike in northern NH.

Hanzi and I made a point to stop for a walk in the woods of the White Mountains on our drive back to Boston, where we caught an early flight back to Chicago the next day. We also got to watch the lunar eclipse/blood moon with my parents on their back porch. I hope you all got to see that celestial masterpiece; what a perfect symbol of the impressiveness of this world that has conspired to bring about all the things from the marriage of two wonderful people this past weekend, to my reaching this stage of naturopathic medical school. 

Hanzi checks out the White Mountains scenery from a covered bridge.

Speaking of a world conspiring to bring about things for us, please do not hesitate to email me with any of your questions, thoughts, concerns, or celebrations from your process of applying to, or considering this Naturopathic journey. I am never too busy to reply; I love your emails! You can reach me at

Clinic Collaboration, Gorgeous Weather, and Work To Do!

In preparation for some days I'll be missing for wedding travels, I did a double shift in the clinic last Friday. After working 7 to noon for my regular ND shift, I tagged along on the DC side from 1-6. It was definitely a long but rewarding day.

Gone apple picking on a beautiful Sunday!

While on the DC shift, I consulted with a DC intern friend of mine on his patient who recently experienced symptoms of a GI bleed. I helped put together the puzzle pieces to recognize that the likely culprit of this patient's gastrointestinal misery was the prescription NSAID he has been taking for his knee pain, and not the GI support supplement recommended by another ND intern. It is well known that GI bleeding is a side effect seen with use of NSAIDs due to their capacity to degrade the mucosal barrier of the GI tract.

I was also able to help my friend understand the source of his patient's pain based on the fact that cortisone shots work to control the pain. Cortisone blocks phospholipaseA2, an enzyme that mobilizes arachiadonic acid. This step is at the very tippy top of the biochemical inflammatory cascade. Picture a large family tree where arachiadonic acid is the great grandparent. There are good cousins and bad cousins, and by blocking the cascade of the family tree way up at the top we block both the good cousins and the bad cousins from ever being conceived. Eradication of the bad cousins makes pain decrease significantly, but blockage of the good cousins, or the healthy inflammation, ultimately causes degradation of tissue from loss of a healthy inflammatory response.

If corticosteroids work to decrease pain, we can extrapolate that the patient's pain is caused by inflammatory cytokines (bad cousins). While prescription drugs work to block this inflammation, many botanicals and nutrients (as well as proper nutrition and exercise) can also work to modulate the inflammatory response that causes pain.

My DC intern friend and I had a great conversation about the difference in response he sees with different rehabilitation patients. The patients that respond best to his exercise prescriptions are most often physically fit, they consume a relatively healthy diet, or their injury is relatively new or benign. The majority of patients who do not recover well are either non-compliant, or often have poor eating habits or poor body composition; they live their daily lives in an inflammatory state.

Our conversation was a testament to why we naturopathic doctors/interns always address the basic determinants with our patients. No matter how much physical medicine we try, it will undoubtedly work better if we attend to the first 3 levels of the therapeutic order as well. We must establish reasonable nutrition, support the vis, and attend to engaged or compromised organs and systems. More on our Therapeutic Order at another juncture!

Night out with my ND faves

Besides all this excitement of collaboration in clinic, we had an absolutely beautiful weekend! I got to spend a night out enjoying live music and food with my ND student friends, and Hanzi and I went apple picking! Now, I have to buckle down and prepare my presentation for Grand Rounds. It's called "The Case of the Missing Organ." Stay tuned....

This Sweet, Fresh First Few Weeks

And, we're back! 

I'm sitting at my kitchen table with a glass of wine while a pot of risotto stews on the stove, salmon is marinating and waiting for the oven, and the first week of the tri is complete! It is important to remember to do as much regular living as possible before we hit Week 4 and midterms are upon us. There's something sweet and fresh about the first 3 weeks of the tri that really should be savored.


My first week back was short; we had the holiday on Monday and thank goodness for it! I flew back from Washington, D.C. early Monday morning after an intense and amazing 4 days of an IV Nutrition Therapy Seminar, taught by some outstanding NDs. I am now certified in IV therapy!

IV therapy is a topic we cover in our Minor Surgery class in Tri 9, but due to the nature of practicing/interning in a pre-licensed state without an MD here on staff at the NUHS clinic, we cannot actually perform IV therapy treatments in our clinic. The course taught me so much useful information applicable to my practice of the future, and I got to apply the skills that I don't get to use actively in our clinic here. I am now confident that I could, at the very least, rehydrate a patient, and at the very most offer basic nutritive support to any variety of sick patients. The group also offers further education in IV therapy on specific topics such as cancer support and detox. Judging by my great experience with the basics course, I'm likely to take more in-depth courses in the future. I highly suggest the course if you can find the time and funds to make it happen.


My friend Guy, a 10thtri intern, also attended the course with me. He leaves at the end of Week 2 for an externship in Montana (licensed state)! He expects to use his newfound skills in IV therapy at the clinic in Billings, where he will work for the next few months before graduation. I'll keep my fingers crossed that I can follow in his footsteps next tri... imagine the stories I will be able to share from the West! (Wishing Guy safe travels on his upcoming adventure!)

View hi-res photo

Back to my reality, or at least sort of. I spent the first weekend back at school attending the wedding of two dear friends. Hanzi and I traveled to a club in Pennsylvania and besides watching Hanzi rock it as a handsome groomsman, I got to go for a paddle in a solo canoe, catch up with college friends I haven't seen in 6 years, dance 'til I could dance no more, and shoot trap with some excellent help from the resident shooting instructor. I have returned from the weekend fully revitalized! 

My old college friend Harrison put it pretty well at the end of the weekend, "I hate hangovers, and I especially hate goodbyes." It was hard to leave such a beautiful place and such beautiful friends, but I have returned to campus ready to rock! And speaking of friends, a handful of my closest ND student buddies who started in January 2013 with me are now 8th tri interns in the clinic, and I am so, so excited to have them there with me! Congratulations to ALL the new interns entering this next stage -- DC, ND and AOM alike.


And now the risotto is demanding my attention and the salmon must go in the oven... Hanzi returns from work at the library momentarily and we'll sit down to enjoy dinner together during one of these rare early-in-the-tri nights with no assignments hanging over my head quite yet. Welcome back all; let us have a fabulous fall!

NDs Around the World

Over the weekend, I got to speak with one of my dearest friends for the first time in two years. She has been living in South Korea with her husband where they both work as teachers. Sara and I met when we studied abroad in Australia 8 years ago. In the years since then, I've been the lucky recipient of many visits from Sara and her husband wherever I've lived, all over the country. I have totally reaped the benefits of their summer vacations as teachers. This time, they are in the U.S. for a few weeks seeing family and I am so excited to pay them a visit in Michigan next weekend! It's my turn to make the trip to visit them.

When Sara came to visit in me in Truckee/Tahoe.

One of the most important reasons I moved out west from New England after college (where I subsequently decided on naturopathic medicine as a career), was based on my experience of studying abroad in Australia with Sara. While studying on the other side of the globe, I met so many Americans who hailed from all the very different parts of the United States. I realized that I, an East Coast girl, was so different from those girls from the Midwest, or those girls from Southern California. We all came from very different American backgrounds, and yet these Australians, as well as all the other foreigners we met while out exploring, grouped me in with all the others. I was just another American girl to them.

Adventuring in Australia -- getting inspired to explore my own country.

On account of this, I decided I had better go figure out what the rest of my country was like before I went travelling abroad again. While we all had some American patriotism and our language in common, I felt so different from so many of my countrywomen. I wanted to know what assumptions people might be making about me based on some other Americans they'd met who, as far as I could tell, were nearly as different from me as the Australian girls were, or the Germans.

Now that I can see the light at the end of the medical school tunnel, I am starting to think about where to explore next. I think I have a pretty good handle on what an "American girl" is, based on my experiences living around the country, so perhaps it's time to head into foreign lands!

Between binge-watching Anthony Bourdain episodes, perusing photographs of far away places on BuzzFeed, and reminiscing about our travels of the past, Hanzi and I have caught the travel bug. We regularly toss around the idea of living and working in another country, and have even set some lofty goals of learning a foreign language before we graduate with our respective master's and doctorate degrees (we haven't made any headway on this, yet). Even if we don't make it out of the country, we are ready to explore another region... perhaps Alaska, or Montana, or Maine...

Of course, I also have to think about actual employment after graduation, and for the record, I am equally excited to work as a doctor as I am to see new places. If you're like me and think you might want to explore, either now or later on, keep these resources in mind. There are several networks for naturopathic doctors around the world. Several of my friends at NUHS have traveled to work with Naturopathic Doctors International and Naturopaths Without Borders during their breaks between trimesters. My peers have returned with totally awesome stories of hands-on experience treating patients, living in rural areas, assisting in the delivery of babies by flashlight, and connecting with local people whose worlds are so very different from ours.

In addition to delivering care to the underserved abroad, naturopathic medicine is going global with the recent creation of The World Naturopathic Federation in 2014. This organization connects naturopathic doctors in 40 countries around the world, and endeavors to connect our work with that of the World Health Organization. We might be a small population here in the United States, but we are also out there, all over the world, sharing and advancing our medicine!

An Illinois Forest Bath

It's pouring rain right now. Our basement is probably flooding, slowly. But all that water coming down makes for crisp, clean air! *Takes deep breath in...*

A few weeks ago I read the abstract to a scientific paper out of Australia that aimed to quantify the effect of exposure to nature on participants' health, and to identify an ideal dosage of nature. The conclusion was alarmingly reductionist. How many trees should we plant on the roadsides in order to make people less stressed? How can we manipulate nature in order to best serve our health needs?

A winding path

A practice called Forest Bathing started in Japan in the 1980s. It was developed as a treatment to relieve stress. Newer studies have recognized that a consciously meditative walk in the woods can boost the immune system by increasing natural killer cells. One set of guidelines on Forest Bathing suggests you spend 3 days and 2 nights in the woods if you really want to boost your immunity. Otherwise, you may choose to spend just one day Forest Bathing to reduce stress.

Hanzi and me, out for a walk in the woods

Hanzi and I went for an extremely rejuvenating walk in the woods the other day. Relationships always take work, and my relationship takes extra work because I'm in medical school. We brought our cameras and our rain jackets, but nothing else. There is a trail that ducks off into the trees that I noticed when I first started commuting by train. I keep meaning to go find it, and we finally did. It was a rainy day, and cool. The forest was especially green and fragrant. We encountered two yearling deer; they were definitely curious and not afraid of us at all. We hung out in their presence for a few minutes while they devoured low-growing plants and watched us curiously through their sparkly black eyes. Hanzi and I chose to move on first; we left them to their lunch. 

And when it rained and poured we went for some pseudo-nature at the climbing gym

I found an article written a few years ago by our newest clinician Dr. Denis Marier titled, "Ecotherapy: Embodying the Vis Medicatrix Naturae in Clinical Practice." In it, Dr. Marier writes about the relevance and importance of incorporating nature into naturopathic care. I love the idea of taking a "Natural History" with each patient in an effort to understand the patient's exposure to and experience with the natural world. Naturopathic doctors believe in working with the Vis, or that healing power of nature "which always endeavors to repair, heal, and to restore." This is evidenced in those walk-in-the-woods smells of new greenery, the mud and wet grass, and damp rotting wood. The natural world turns over, heals itself. So too, do humans, who are just as much a part of nature as new leaves, mushrooms, and rotting stumps.

Besides going out to seek nature, I am particularly fond of Dr. Marier's idea of "naturalizing a part of your clinic grounds." Even a city office can be naturalized with potted plants and fresh air. One aspect of my vision for my future practice includes an outdoor space where I can consult with patients. In his piece, Dr. Marier also suggests assigning a Medicine/Nature Walk, which he describes as a 3-6 hour fast from food, people, and electronics. He encourages patients to notice how they are observed by nature, rather than focusing only on their subjective experience. This makes me think of the deer on my walk the other day; they were so curious! I was observed. And I observed, too.