Archive for tag: students

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!

Feel Human Again

An ND student friend of mine joined me for lunch on a bench outside on Friday and told me about how her friend who had come to visit. They went to a bookstore, they hung out, and to quote her she, "felt human again!" I'll admit, it's kind of the last thing you want to hear as a prospective student (for those of you reading this), but it's also true.

Med school has this paradoxical way of making you feel on the one hand like the most human human around, with everything that could possibly go wrong with a body probably having gone wrong with yours, and on the other hand, it makes you feel like a strange creature when it comes to "real life." As a student of medicine you will spend a lot of time in your own head, and a lot of time in the company of other med students talking about the trials and tribulations of learning medicine. I presume there's nothing quite like it.

I went out on Friday night to meet my boyfriend Hanzi downtown after his class and we went for a drink with his classmates. I was that girl who didn't order a drink at the second bar and then cut out early on account of having exams coming up this week. That's no lie by the way, week 5 has arrived, along with the first exams of the tri! So, my friend's lunchtime comment and my own experience of having my social life ruled by my books made me think.

When we interact with people outside of medical school, we get a valuable perspective on what we've actually been up to. Whether it's your parents, your best friend, your significant other, or your neighbors, having those conversations that don't require you to probe the depths for that piece of medical knowledge are wholly healing in themselves! We take our minds elsewhere. Also, these humans from outside the medical school world will often offer words of encouragement or awe or appreciation for what we're doing, even if they don't say so outright.

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Indiana vs. Northwestern field hockey game -- set up for a penalty corner

Over the weekend, I got to revel in the world outside of medical school. I went to see one of my very best childhood friends doing one of the things she does best -- coaching the Big 10 Hoosier field hockey team in their game against Northwestern here in Chicago. The experience took me out of my current world; it took me back. For a few years in college, I played Division 3 field hockey. My last year on the team, I spent most games perched at the top of the stands filming so we could study our game play later on. I eventually quit the sport due to injuries that kept me off the field and just wouldn't heal. This past Sunday at Northwestern, I climbed to my place at the top of the stands so that I could see the whole field. I was totally engrossed in the game, and loved getting a taste of the conviviality and competition of college sports. This was an environment that, at one point, played a very important role in my life.

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Coach Kate and me -- a gorgeous day on Lake Michigan

Watching the game was a blast (it made me use my brain in a totally different way than learning medicine does), but catching up with Kate, sitting on the lakeshore while she waited for her team to shower, was the highlight. We talked about our families. We reminisced. We don't see much of each other these days, but when we do it's like no time has passed.

This experience drove home the message to remember what makes me who I am, that I should not forget to peek back at the path I took to get here. The conversations we have with our non-med student people are capable of reminding us of all the other things we do besides study medicine. And actually, it helps me to recognize how many of my life experiences have pinballed me toward medical school and my specific areas of interest.

For example, why am I so intrigued by physical medicine? This is no doubt, because of my experience essentially studying the way my own body moves and how it endures training and sport. Playing college field hockey definitely forced me to do this, and my excursion to watch Kate's game this weekend reminded me of that.

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Shadowing ND intern Alaina in clinic

And now, I get to connect my ruminations with the highlights of my week! I got to observe a physical medicine patient with back pain in the clinic, and it was TOTALLY AWESOME. To clarify, it wasn't the patient's pain I found so awesome, but the fact that I got to watch naturopathic medicine in action, working on issues with ties to my days as a college athlete, with ties to the path that brought me here.

Go Us! Almost There!

Whoa, here we are! It's already my last post for the trimester, a sure sign we have only a handful of days left until we're done! Week 14 signals the beginning of exams with all the lab practicals taking place this week. My E&M Extremities practical on Monday has required me to learn and understand about 60 different types of orthopedic tests and 44 different types of mobilizations/manipulations/adjustments. Let's just say this is prime evidence of how medical school is like drinking from a fire hose.

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This trimester has been a significant one for me. I started the Clinical Sciences portion of my degree, made a decision on when to take boards, followed my intuition and decided to do a dual degree in massage, and learned so much from my sim-patients about what the real experience will be like. It was also the first trimester that I haven't had any classes with any of my best buddies with whom I started the program. This is a blessing and a curse because I miss their company terribly, but I have also made new friends who I value just as much. During this tri, I traveled to see some of my favorite people make the promise to spend their lives together, my best and oldest friend got engaged (I never told you this, ah!), I wrote a blog post here that elicited tears from an exceptional friend (the first time my written words have ever inspired such emotion), and my parents sold my childhood home. All this, and it still feels that these summer months have absolutely flown by!

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If you're not here at NUHS yet, you'll soon learn the value of our brief breaks between the trimesters. This time I will head east, and go on a 4-day backpacking/hut trip adventure in the White Mountains of New Hampshire with my family and Hanzi to celebrate my Dad's 60th birthday (wish us happy trails, we might need it!). After that, I plan to visit with some of my best college girlfriends; one of them just bought a house -- OMG -- grown-up things! Hopefully, I'll find a day to shadow my Mom at her Integrative Dermatology practice, and will crack my Boards study guide at some point (we'll see about that last one). I hope the rest of my peers also have something fun, and especially something relaxing, planned for break!

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But before we can totally engage with our time off, we have to give that last major push through finals. WE CAN DO IT! Remember, it's OK for life to be totally, completely unbeautiful right now. Also, the world is a whole lot bigger than NUHS finals week.

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Throughout my post is a series of photos I took around campus on the Friday before Week 14. I asked students to show me how the impending last 2 weeks of the tri makes them feel; this is what I saw. General consensus says we're all a little crazed, a little worn out, and a little hungry for the sweet stuff...so don't worry, here's the evidence that if this is how you feel, you're not alone!

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Lastly, a little blessing for us all; may our professors ask us the questions to which we have all the answers! Good luck, friends!

Independence in Learning

A treat! Another day off during the summertime! Happy (belated) Independence Day! I went to the beach (again) on our day off with my boyfriend, my friend JheriAnne (also an ND student), and her husband Shane. During our afternoon and evening spent grilling, swimming, laughing, and lounging on the beach, JheriAnne and I talked about school (can't escape it!). Particularly relevant to the holiday was our conversation on independence in our studies and decision-making as we plan our schedules and careers. 

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Thanks to JA for capturing this picture of me on Independence Day
with the sun setting into the palm of my hand.

Let me preface this by saying that I am eternally grateful that I can be dependent on my friends at a moment's notice when the work overwhelms me or I have an idea that needs friendly scrutiny. My friends are there for me, and I am there for them. On the other hand, we can all too easily get wrapped up in each other's lives. As students, we spend around 30 hours together each week in class, and then also spend time outside of class recharging in each other's company. I've had to remind myself several times that I am, in fact, on my own journey here, despite how tightly bound my experiences are to those of the students around me.

One major challenge I experience daily is to break away from the established opinions and habits of students I study with, and those that came before me. Both positive and negative judgments about all things from professors to textbooks to scheduling are passed down from upper tri students and have, at times, been toxically pervasive among my peers. As medical students, we are juggling many balls at once, and it is easy to adopt an existing opinion (especially when you've just been thrown into 25+ credits of professional school), but I implore you to never forget to form your own opinions, no matter how exhausted you become. I truly believe independent thought wins when it comes to learning, which is after all, what we're here to do (whether we feel like it today, from this professor, or not.)

I am not suggesting that we just ignore all advice coming from upper tri students.  I am suggesting that we always take that advice with a grain of salt and view the issue through our own eyes, as we experience it on our own, individual journey through medical school.  Remember this tenet of our medicine: every person is different.

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John, Dr. Brad, Mia, Nadene, and a tree circle up
for a short group meditation session beside Lake Janse.

When I was 19, I worked for my mom, an MD, answering phones and filing charts at her dermatology practice. My first free lunch from a drug rep and his conversation with my mother was one of those experiences that every child dreads. I ate my free sandwich in horrified, bug-eyed silence as my mom interrogated this rep about the studies behind the drug he was touting. I swear that man shrank into his chair with every "Yes, but where is the research? I want to see the actual paper you keep referring to." For whatever reason, whether he was new or wasn't given the tools, this drug rep could not provide my doctor mother with the published paper showing the effects of the drug that this lunch was supposed to make her want to prescribe. By the time he slunk out of the office, promising to return with a copy of the published paper for this crazy doctor, I was just about never going to forgive my mom for displaying such unrelenting behavior. She sensed my anxiety and proceeded to explain that she would never prescribe a drug to a patient without knowing as much as possible about it. She would form her own independent opinion based on the evidence, and would not consider prescribing the drug until then. As NDs, we may not have a future full of lunch dates with pharmaceutical reps, but companies pushing supplements, diagnostic tests and other tools might surely come our way in this same fashion.

So, to my peers, I thank you for exercising your independence and forming your own opinions while on your individual journey. At the same time, I thank you for doing so as part of a team of students or interns who are present, ready to learn, and aware that we are all on our own path to doctorhood. And of course, thank you for allowing me my moments of dependence in the form of a hug, an ear, a shared moment of frustration, or a quiet group meditation session.

To Enjoy a Gorgeous Carrot

Our long weekend off due to Homecoming has come to a close and I am so, so thankful for having had those extra days without classes! While I suppose I could have joined in the festivities on campus, I decided instead to take advantage of 48 extra hours of unscheduled time and do some Mackie things.  

Don't worry! I did contribute to some Homecoming prep; we worked on beautifying the garden with more weeding and new mulch! Current students, if you'd like to stay up to date on garden happenings, check out the NUHS Botanical Garden Project on Facebook!

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After classes ended for the week on Wednesday (amid the cracking of a powerful thunderstorm, the lightening vivid in the grey sky), I joined some ND girlfriends at a nearby wine bar for a drink and some appetizers. The five of us each toasted to intelligent and loving company, the beauty of a steel-grey sky amid the storm, and our ND student friend Anayibe, who took this tri off to go on an adventure to the World Cup in Brazil, and to visit her family in her home country of Colombia. Ana is a vibrant friend, so positive, so present, so quietly loving and funny. She may be only 4'11-¾" tall, but her presence is huge; we feel her with us every day. It is a powerful thing to find a friend like this, and I speak for many when I say we miss her in a wild way.

Illustration by Rigel Stuhmiller - www.rigelstuhmiller.comIn the spirit of my friend Anayibe, I watched an episode of Anthony Bourdain's newest show, "Parts Unknown," (a food travel show), that takes place in Colombia. Now I can't wait to tell Ana about my hopes that she'll take me on a trip to her country and show me around! (Maybe we can even apply our ND training somehow; I guess we'll see when the time comes for adventure…)  The best line in the show came from a Colombian musician-turned-chef who tells Bourdain, "I believe more in a beautiful carrot than in a good recipe." 

Thank goodness for chefs like this!  To me (and in the context of this show), a beautiful carrot signifies the harmonious interaction between humans and nature, the ability for humans to enjoy a gorgeous carrot born of the earth and to glean both nutrition and pleasure from it. According to naturopathic philosophy, if one lives by nature's laws, health is "the innate and natural state of being" because humans evolved on this planet, selecting for traits that allow for survival in harmony with the environment here. We practice Earth Medicine because we do so on Earth.

When I lived in the mountains of Northern California I got a CSA (community sustained agriculture) box bursting with fresh produce once a week. When I moved to Chicago, I vowed that no student budget would keep me from living close to nature through my food. As Michael Pollan says in his book The Omnivore's Dilemma, "Eating's not a bad way to get to know a place." I shop at the farmer's market here in Oak Park every weekend.

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Last weekend a few NMSA members met at the farmer's market
to stock up on veggies, flowers, and yes, those irresistible donuts, too.

Supporting local farmers, especially those who use organic or hazard-free methods, ensures that I get the most nutrients through my food. It also allows me to participate in one important aspect of my community that supports the basic determinants of health (hydration, sleep, nutrition, breath, and rest & recreation aka Vitamin R) that lie at the core of naturopathic medicine. In the back corner of the market there are always musicians gathered for a bluegrass jam session, the local church sells irresistible donuts to support their work, and the high school athletics department sells baked goods to raise money for travel and equipment.

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The vegetable scene at the Oak Park farmer's market.

The weekly market cultivates community, good nutrition, rejuvenation and belonging. Some might say that life in the city is irreconcilably distant from the natural world, but I argue otherwise. I have found, through my friendships and through my community, many ways to live by nature's laws. To name a couple, I eat good food, and I take a wine break every now and then to stock up on some Vitamin R.