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
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
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
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.
Crazy lookin', right? Lisa and Jack practice
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.
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
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
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
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.
Indiana vs. Northwestern field hockey game -- set up for a
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.
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
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.
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
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!
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!
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
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
Lastly, a little blessing for us all; may our professors ask us
the questions to which we have all the answers! Good luck,
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.
Thanks to JA for capturing this picture of me on Independence
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.
John, Dr. Brad, Mia, Nadene, and a tree circle up
for a short group meditation session beside Lake
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
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!
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.
In 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
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.
Last weekend a few NMSA members met at the farmer's
to stock up on veggies, flowers, and yes, those irresistible
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.
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.
• Leaves, Flowers, Berries, and Bark
• Farmer's Market
• Should I Study Massage Therapy, Too?
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