I spend a lot of time looking at the sky. When I lived in the
West, I realized that a big sky makes me feel that anything is
possible and that I can never understand it all. I adore this
feeling. I desire to be outside of my comfort zone as often as
possible; so much so that at times I've had to give up and retreat
to calmer waters.
I spend a lot of time looking at the sky. Sunrise on my
morning commute last week.
On a long weekend during my first year at NUHS, before the
program had a chance to wear me thin, my partner and I set out on a
camping and fishing trip to Wisconsin's driftless region. We
meandered through farmland and found our camping spot as the clouds
were gathering, no big deal. We'd once tried to camp at Vedauwoo
near Laramie, Wyoming, in late October with a wicked, biting wind
that threatened both to snow and to overturn our tent. When we
realized they'd shut off the water and closed up all facilities for
the season, we gave up.
My partner Hanzi tying flies at our kitchen table over the
weekend, caused this story to surface.
On this particular trip in Wisconsin, we made dinner over our
camp stove as the rain picked up. We ate our rice and beans on the
tailgate to stay dry. As the downpour intensified, we climbed into
our tent earlier than expected and snuggled into the center, trying
not to touch the wet walls.
At 1 a.m., the 5th drop of water landed on my face and I
realized my sleeping bag was totally soaked; our tent was no longer
waterproof and the Midwestern thunderstorm was still raging. Soaked
and sleepy, we sloppily disassembled our tent and crammed all the
sopping wet sleeping stuff into the trunk and slunk out of the
campsite, our tails between our legs.
The fishing the next day was terrible. The streams ran high
with mud. You can see our soaking wet camping gear piled in
We drove a wide-open rural highway with lightning cracking all
around us in the longest, loudest and most spectacular streaks I've
ever seen. This was some thunderstorm! If you've never experienced
one, do come study naturopathic medicine at National. If you've not
chosen our school for the strong philosophy and awesome
collaborative learning environment, then do at least choose it for
After a drive through the downpour and lightning, we checked
into the only room left at the nearest hotel, a suite with a hot
tub in the corner and the fluffiest king size bed ever (save for
that one that enveloped me during that bout of food-poisoning I got
in Banff, Canada after eating scrambled eggs at the airport. Don't
ever eat scrambled eggs at the airport.)
When you're in medical school, you pretty much can't do these
adventurous, uncalculated things. They squash that tendency to toss
logical thinking to the wind (like setting up camp in the midst of
a deluge) in the process of teaching us to be responsible doctors.
I don't mean my professors tell me to stay out of the rain. I mean
that medical school in general takes you away from the fun stuff by
sucking you dry of energy and sitting you down for some serious
business. It's all worth it though, I promise.
I may not be able to adventure, but I guess my education does
cause me to constantly move beyond my comfort zone. Each new class
I take demands that I commit to memory information I've never known
before. When I see a sim patient, I have no idea what to expect and
have to dive in ready to grapple with whatever story they tell me.
This is undoubtedly like the real world of doctoring and so I rest
assured; I totally AM in the right place.... If doctoring is a
process of continually stepping out of your comfort zone while
seeking the patterns that help you find your way to healing a
patient, then I think I'm on to something.
Really though, I already knew I was in the right place before
writing this rambling essay on thunderstorms and airport eggs and
squished adventures. I came to naturopathic medicine because I
thrive on the different stuff. Our medicine is not well known but
it is intelligent. Our medicine is not entirely understood in
reductionist terms, but it works from a place of truth. Camping in
the rain is not a comfortable choice, but it does make for a good
Here I sit, on a plane bound for Chicago after a weekend on the
East Coast, listening to the air from the blower overhead and the
rushing outside the window as we taxi. The deicers blast the window
inches from my face with a heavy spattering sound. The engines roar
a little louder and I think of the rattle my cousin's smiling,
blonde 1-year-old used to fill my ears this morning.
At this past week's Nu Delta Sigma meeting, Nadene introduced us
to sound healing as presented in the book, "Tuning the Human
Biofield," by Eileen McKusick. I was the lucky recipient of a sound
experiment from my friend John, a brilliant healer and
doctor-in-the-making. You might call us crazy, but when was the
last time you checked in with the sounds in your life? It had been
a while for me.
The sim patient I saw this week in my Advanced Clinical Problem
Solving class complained of tinnitus, a rushing sound in his ears,
and was nearly deaf. This was the only abnormal finding on physical
exam as we searched for clues to the cause of his dizzy, vomiting
spells. When I made kale for dinner on Wednesday night, the leaves
squeaked when I stripped them off their stalks. The sound reminded
me of lemons and a crisp, cold, clear evening with a sky full of
stars, when the frozen snow sings underfoot.
So excited to be out skiing in celebration of one of my very
(She taught me to suck my thumb when I was 2.)
When I rode the chairlift at Cranmore Mountain in New Hampshire
with my childhood friends over the weekend, the chairs clunked as
only chairlift chairs do each time you reach a tower. I reveled in
the swish of skis and the crunch-pop of poles into snow, the whoosh
and shudder of skiers of various skill levels as they rocket
downhill beside you. There were also those split seconds of silence
when I caught a little air and my skis left the snow, allowing me
to hear only the wind in my ears.
Beautiful bluebird day in the White Mountains! There are my
friends, waving at me from the lift.
On Sunday morning, I listened to the coffee maker grumble and
splurt that divine bitter stuff into the pot. The bottle of
champagne made an adorable pop! And we toasted our friend, a
bride-to-be. We thanked her for bringing together such an
intelligent, fun, active and clever group of young women. Our
glasses clinked! I am back at school now, refreshed and
All the lovely, intelligent women in our PJs, toasting our
So now I sit here typing, my fingers trickling across the keys
making that distinct blipping sound with each letter. I spend so
much time using my eyes and my hands to observe and palpate in
medicine, but I haven't engaged nearly enough with my ears. The
more blood pressures I take and the more lungs I auscultate, the
more familiar those healthy sounds become. I listen to the normal
sounds in hopes that I'll recognize when they are different, when
the lungs pop or crackle or gurgle and tell me something about the
environment inside my patient.
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.
Hotpot! (The little mushrooms were the most delicious
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.
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
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.
Pulled out my old notes on Chinese Medicine for a
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
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!
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.
(Image via www.dawn-productions.com)
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.
Mary Calderone was a
physician and public health advocate for sexual
(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
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.
Whew. I'm finished with the boards! At least for now. I didn't
realize how much time and energy I was giving to studying and
preparing for that big exam until the day after. Even the evening
after the exam I was still energized and excited. The day after
however, I was totally burned out and my brain felt like mush. The
emotion of the experience was wholly exhausting.
Cheers to getting through part 1 NPLEX!
On an easier note, how did I celebrate? First, my girlfriends
and I toasted each other's success of making it through while we
complained about the hard questions. The rest of the week was a
difficult mix of catching up on work while also trying to catch up
on sleep. And when the weekend came, I paid attention to my
heart-mind by attending the Integrate Chicago conference
and going out to enjoy Chicago's restaurant week.
My view in a lecture on the philosophy of care at Integrate
Integrate Chicago is a conference put on by students of
medicine from different disciplines. The organizing board included
students from UIC and Loyola med schools, as well as an ND student
from NUHS, and many DO students from The Chicago College of
Osteopathic Medicine (CCOM). One of the most enlightening talks I
attended was about the clinical application of Osteopathic
Manipulative Medicine (OMM). I learned that most doctors of
osteopathy (DOs) do not actually practice their manipulative
medicine, which I always thought was what set them apart from MDs.
The presenters were passionate about bringing OMM back into regular
practice. As part of their presentation, they demonstrated a few
things that can be used on hospital inpatients, such as those who
have recently undergone open-heart surgery, as well as techniques
for outpatient care such as an acute sinus infection. I took
Not only did I learn how a more traditional osteopath uses their
medicine, but I also learned that DOs describe themselves as
"exactly like MDs," except that they get more training in
diagnosing and treating musculoskeletal conditions. The presenters
stressed that as DOs, they always use the appropriate drugs as
indicated for the sinus infection or other disease, but will
combine these conventional treatments with their manual therapies
to help speed healing time.
This presentation was particularly helpful for me, because as an
ND student I often field the question, "So, are you like a DO?" Now
I can be confident in saying that we are much different than DOs
and why, at least based on what I learned from the doc and students
The presenters opened their talk by briefly mentioning the Tenets of Osteopathic Medicine, which include
a belief that "the body is capable of self-regulation,
self-healing, and health maintenance." Despite this, there was a
resounding affirmation in their talk that they are no different
from MDs. Their treatments consist of the appropriate medications
first, with their OMM used as an adjunct to this care. There was no
further mention, beyond their introduction, of the body's ability
to heal itself, nor their application of such a tenet in treatment
Herein lies a major difference in our medicines. An ND forms her
treatment plan around supporting the Vis and addressing the basic
determinants of health, which may be truly very basic (air and
epinephrine, as in anaphylaxis) yet important for all cases. Also,
an ND IS different from an MD, and this distinction is both
important to us and necessary for treating within our philosophy of
the body-mind-spirit as a whole.
We need all of these styles of medicine, each one has its
strengths and integrating them all seems like an effective way to
make sure each patient gets the best, most individualized care. I
came away from this conference confident in what I am studying. I
could keep up with the anatomy and biomechanics talk of the DOs, I
could nod in understanding at the anti-inflammatory diet, I knew
the biochemical pathways implicated in replacing curcumin for
NSAIDs, and I understood the uses of and references to
pharmaceuticals. I also better understand what challenges I will
come against, even in the integrated medical environment.
Thankfully, the skepticism often comes from a limitation of
knowledge, and if the audience is already prepared to throw off
some of their dogma, then with time, there's nothing some extra
education can't fix.
• Leaves, Flowers, Berries, and Bark
• Farmer's Market
• Should I Study Massage Therapy, Too?
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