Archive for tag: naturopathic medicine

Happy New Year of the Sheep, Goat, Ram!

So, I guess the exact name for this new lunar year in the Chinese calendar is up for debate. What's not debatable is the fact that I went to a (belated) Chinese New Year party on Saturday and ate a delicious hotpot with ingredients sourced from Chicago's China Town. Yummy! I also tried my hand (mouth?) at a Chinese blowgun and wore house slippers.

Photo of hotpot cooking
Hotpot! (The little mushrooms were the most delicious part!)

According to both the New York Times and NPR, the English translation of this year's Chinese animal is fuzzy. "Yang" may mean a sheep, a goat, or a ram. The sheep/goat/ram debate seems to be a uniquely American and European problem. Throughout Asia, most people are settled on what exactly the word "yang" represents for them, often depending on which one of these animals lives in that particular region and whether they do good or bad things for the ecosystem.

Photo of friend using blowgun
Party host Reed taking aim with the blowgun

For example, I learned that in Mongolia, this year is likely be regarded as the year of the sheep, as opposed to the goat, which is known for eating not only the grass but also the roots, leaving no grass for the following year. Thus, the sheep is more auspicious and one's ancestors would surely name a year for the animal that leaves opportunity for growth.

As part of our naturopathic training, we take an Intro to Chinese Medicine class in our third trimester. The course provides an excellent segue for those ND students who are considering a dual degree in Acupuncture or Oriental Medicine at NUHS. The information we learn in this class barely grazes the surface of Chinese medicine, but it does give us the capacity to converse with its practitioners based on our rudimentary understanding of the substances, organs, elements, and patterns used in Chinese medicine. We are taught to analyze a case to determine imbalances in yin/yang, internal/external, cold/hot, and deficiency/excess.

Photo of laptop and notes
Pulled out my old notes on Chinese Medicine for a refresher

After much debate in my third tri here at NUHS, I realized that studying in the OM program was not for me. Many of my ND peers are working toward dual degrees and take night classes in the Acupuncture/Oriental Medicine program. I hear fabulous things about the professors and the program as a whole! If you're curious about the master of science programs in acupuncture and oriental medicine here at National, don't hesitate to jump over to Juli's blog and read about it!

As for the rest of the naturopathic medical schools, I believe that the Canadian colleges include more training in Chinese medicine in their curriculum than do the American schools because parts of Canada include acupuncture in their ND licensure. Another note to make about this overlap between naturopathic medicine and Chinese medicine is that as NDs we have the opportunity to sit for an acupuncture-specific board exam when we take NPLEX Part 2. If you want to practice in certain Canadian provinces, Arizona or Kansas, I believe you must sit for this board exam. In order to sit for this add-on exam, you must have upwards of 200 credits in acupuncture/oriental medicine. At NUHS, this means you must enroll in 7 specific courses in the AOM program. I looked into all of this because I intended to take every add-on board available to me when it comes time to do so, but in the end I decided I was unlikely to end up in Arizona or Kansas or most of Canada, and if I do end up in one of these places I'll tackle that obstacle when I come to it.

In the meantime, I'll be making an effort to embody these qualities of our new Year of the Sheep (/goat/ram): avoid pessimism and hesitation, be kind-hearted, clever, tender, and compassionate. Happy New Year to you all!

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.

The Equinox, Noticing Change

Summer's slip into fall was subtle until the past week or so; it got cool here, the leaves are falling more rapidly. I am sitting on my porch in a sweatshirt with a cup of tea as I type this and except for the barking dog playing in the park next door, it is quite peaceful here in the wind. Fall is blowing in. Monday the 22nd was the fall Equinox; day and night were equal lengths, and from here on out, the days get shorter. It was the first official day of fall; the season changes.

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I like to think I'm good at changes. I identify as someone who desires to be outside of her comfort zone. Here in Chicagoland, I often pine for change. Usually it happens when I'm sitting at my desk on a beautiful Saturday afternoon staring out the window, or when I'm inching along in traffic to or from campus. The med school routine starts to feel monotonous. So, when the earth does her thing and the land around me transforms, I am thrilled! I found orange leaves on the ground outside the front door this morning. This obvious sign that fall is here made me reflect on how much change really does take place in the midst of my regular routine. I am evolving as a doctor in training, learning to see the world around me with the eyes of a Naturopath.

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I see a man limp down the street and speculate on which muscles or nerves are not functioning properly. I listen to another man with a lifeless arm order sandwiches in a low, nasal voice with little enunciation and I speculate on which part of his brain suffered a stroke. I watch the guy in line ahead of me at the grocery store as he blinks and twitches his head repeatedly and I can identify the part of his brain that might be disinhibited, by medications I wonder? Two years ago, I would see only a limp, hear only a funny voice, and notice only a man who blinks a lot.

In naturopathic medicine, we consider the experience of the change of seasons a determinant of health under the category of light and cycles. Cycles that last longer than a day, and are therefore not linked to our circadian cycle, are called infradian rhythms. Annual cycles of the seasons are infradian rhythms, and can affect our metabolism, appetite, and weight gain. It is healthy and vital to experience these changes that indicate the passage of time. The days get shorter and our bodies respond in kind. The temperature changes and our systems acclimate. We learn that spring and fall are ideal times to cleanse as we prepare for the inevitable hot summer or cold winter.

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As I meditate on summer's bow to the arrival of fall, I remember that every trimester brings change, too. I have a new set of professors, new expectations, and new information to throw into that fragrant soup of knowledge I keep cooking up there. I suppose my task is to recognize the small changes happening every day and find solace in them. I will also revel in fall while it lasts, and try to notice all of its colors and smells while in the thick of my busy academic life.

I think I'll leave you with this, written by Stephen King, about the change of seasons:

"But then fall comes, kicking summer out on its treacherous ass as it always does one day sometime after the midpoint of September, it stays awhile like an old friend that you have missed. It settles in the way an old friend will settle into your favorite chair and take out his pipe and light it and then fill the afternoon with stories of places he has been and things he has done since last he saw you."

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.

 

On Finding Your Favorite Tools

I'm deciding whether or not to study Massage Therapy while I'm here at National in addition to getting my ND. Many of my peers get dual degrees, whether it be ND/DC or ND/AOM because the modalities and philosophies run in parallel and allow us to expand our scope to meet our interests and passions, especially in unlicensed states. Part of the adventure of studying naturopathic medicine is learning what aspects of our vast toolbox suit you best, and then exploring ways to pursue those interests.

I struggled for a few weeks last fall with whether or not to enroll in the AOM program, because Chinese medicine is so wise and its application is so broad and increasingly accepted by mainstream medicine. It serves as an excellent adjunct to naturopathic medicine. Many of our professors use it. Ultimately though, I realized I do not absolutely, definitely, no question, want to be a master of Chinese medicine in the kind of way I know I want to be a naturopathic doctor. And, I am not willing to invest all the time and money in something that doesn't feel quite right for me.

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In E&M Extremities class, Meg demonstrates a gait anomaly as the rest of us analyze it.

Over the past few trimesters, I have gravitated towards physical medicine in application with naturopathic medicine. I was totally surprised when I enjoyed E&M class and found that I was actually pretty good at adjusting. I realized that I know my body and its relationship to weight-bearing and careful maneuvering through my experience of being a competitive athlete. It's been years since I gave up competitive sports in college, but I still have that knack for acquiring muscle memory and fluidity in movement, and it pays off in understanding how the body should, or wants to, move.

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Cranial Sacral Massage elective class with our professors,
Dr. Patricia Coe and Dr. Heather Wisniewski

Also, having never taken any kinesiology classes, I figured I was doomed when it came to grasping biomechanics. As it turns out, knowing my body and its movements has made learning biomechanics and adjusting a lot easier. Inspired by my propensity for understanding and applying physical medicine, I asked for a recommendation of who to talk to or what other avenues to explore beyond the classroom. Dr. Pearson, one of the family practice interns, directed me to Dr. Coe, massage program supervisor and instructor (and totally awesome ND/DC/MT/photographer/character/mentor). I signed up for her massage elective class on Cranial Sacral technique and discovered this awesome new dimension to add to my ND toolbox. By using what I learned in Dr. Coe's class, I continue to study through experience on my friends and fellow classmates. I am learning how to listen with my hands, follow what I find, and make people feel better.

Inside Outside Muscle Hand by Katherine Du Tiel
"Inside/Outside: Muscle/Hand" San Francisco, 1994. Photograph.
U.S. National Library of Medicine. Katherine Du Tiel (b. 1961) [artist]

So, in an effort to distract myself from the stress of 3 exams and 2 assignments due in the upcoming days, I've tracked down Dr. Coe and picked her brain on my options for adding the Massage Therapy coursework.

I also reached out to a recent NUHS grad who tutored me through Phase 1 and studied in the massage, chiropractic and naturopathic programs during her time here at National. She offered some solid advice. (Even after they're gone from campus, NUHS folks are still accessible and willing to help you!) Now I have to make some decisions. It's probably time to make a pros and cons list and a phone call to Mom and Dad, who always offer pretty good advice. Part of what makes naturopathic medicine so strong is this great big toolbox we're given. It also presents a fun challenge to us students: to discover our strengths and trust the process!