Piles of Laundry and All the Strong Hearts

Ugh, guys and gals, it's been a tri! I'm sitting here trying to bang out a meaningful blog post for my loyal readers and... turns out the only thing I can focus on is that I am surrounded by three loads of unfolded laundry (clean at least, thank goodness) and that's just the start of what's not getting done around here...

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My mom would be mad -- sitting in my messy room, mustering energy to do lots of things.

What week in the tri is it? I keep trying to write a comment about it being "that week" of the tri, and to quote my fellow ND student friend Wendy, "I just can't even." I keep telling myself that taking boards in week 4 or 5 (or whenever that was) is why I'm all out of sorts, but really, it's just that med school is med school is med school, and there's just no changing that.

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Classic medical student portrait -- sleepy and studying.

In the summer I wrote about the unbeautiful part of being a naturopathic medical student. That was the last time I had ice cream for dinner and even though it's not exactly ice cream weather, tonight's lookin' like its time for a repeat.

Enough complaining! What I HAVE managed to do lately is this: I get out of bed every morning! I put on clothes, and I think I always look presentable, if maybe, occasionally, a little weird. Each morning I succeed in making myself coffee, and if I had a "To Do List," I would almost always put a satisfying check next to "make breakfast." But, it's a good day if I manage to actually eat the breakfast without also doing two other things simultaneously; I'm usually taking bites between packing a lunch and scrambling to gather up all my things.

I can say with confidence that each weekday I make it to campus! Yes! I am proud to say that I stay awake in class, and I almost always know which room I'm supposed to be in, and when. Also, I generally always know what's going on in lecture, although... I have my days.

Today, when taking a blood pressure I struggled to multiply 17 by 4. It's OK, not all doctors can do math every single time, right?

Some days seem unbelievably long, and others I just wish, wish, wish could extend by just an hour or two! If you had an extra hour in the day, what would you do with it? I used to say, "Yoga!" Now, I would sleep. I would definitely sleep. I used to think sleeping was for the faint of heart. I'm not sure anyone could get through a medical education without a strong heart, and so, my views have changed.

Speaking of strong hearts, I am surrounded by them and Hallelujah! If it weren't for my friend Blaine's reliable punchy sarcasm, Wendy's big grin and occasional colorful language, Tina's quick laugh, Mallory's eager smile, Abdulla's kind eyes, Lisa's happy conversation, and Brad's constant confidence, I might have imploded by now. And these are only the people I see the most often! I have so many other fellow student friends who keep me laughing, who commiserate with me, and who help me talk through my thoughts everyday. Thank you all! You guys rock.

Sigh. Thank you for reading about my blunders and my teeny, tiny daily successes. Now I think its time for that ice cream dinner...

You Could Choose National for the Thunderstorms

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.

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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.

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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.

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The fishing the next day was terrible. The streams ran high and brown
with mud. You can see our soaking wet camping gear piled in the trunk.

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 the thunderstorms!

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 story.

Crunch-Pop and Lovely, Intelligent Women

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.

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So excited to be out skiing in celebration of one of my very oldest friends!
(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.

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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 grateful.

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All the lovely, intelligent women in our PJs, toasting our bride-to-be!

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.

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.

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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.

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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.

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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.