Why Keep the Future in Mind

Happy Belated Fourth of July! We were blessed with a three-day weekend and I took full advantage of it to get out of town and into the woods! Hanzi and I drove north to see his parents in Michigan, way up to the tip of the mitt. I had to spend a lot of time working on papers and presentations as it's midterm week (more like fortnight), but I did still manage to spend time outdoors. And, I always studied with the windows wide open because the air in Northern Michigan is clear and smells like the trees; I love it.

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Over the weekend I learned how to shoot sporting clays for the first time,
and I actually met with some success! So much fun!

Besides playing outside there were those obligatory parent-child conversations about the future.

  • Where do we see ourselves headed next?
  • What kind of work will we look for once we graduate?
  • What is the job market like out there right now?

And you know, I must be growing up because I wasn't immediately turned off by these questions. Historically I'd never want to discuss my future; it will be what it will be, I would say. I'll just wait and see what comes my way! Lately, I'm willing to entertain some tangible ideas; I can picture myself in a clinic with my white coat on, seeing patients all day long. I know, too, that I want to continue writing, so I can picture myself at a computer, surrounded by books, crafting paragraphs that share my medicine.

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Sunset from the Leggs Inn where we had dinner on Sunday night before
leaving at sunrise on Monday so I could get back in time for clinic.

I'm still relatively undecided on my future compared to many of my peers who either know where they want to go after school, or have a vision for exactly what type of practice they want to work in or create. I recently had the idea to construct a mobile clinic that I can hook up to my truck and tow off into the sticks to work with patients in rural communities. I envision a wall lined with rattling tincture bottles, waiting for me to mix up the appropriate medicine. Of course, this mobile clinic also contains all the necessary tools for physical exam, production of hot water for hydrotherapy, and space for physical medicine.

Regardless of the reality of the vision, I've decided that entertaining one is a good idea. Not only does it give me something to talk about with family, but also it helps keep me afloat when I'm dragging through that last page of a research paper, or waking up before sunrise to cram some information in my brain before a test.

So in the spirit of independence, cheers to our visions, cheers to our future!

I Know I'm Becoming a Doctor Because...

I know I'm becoming a doctor because...

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  • I dumped the contents of my doctor bag on the floor and reorganized the thing.
  • I am currently sitting with a thermometer in my mouth.
  • I just finished listening to my own heart and lungs.
  • All exams thus far are unremarkable, which could be surprising considering how much work hangs over my head at the moment...

If you are on the flex track and are considering completing most of your coursework before heading into the clinical portion of our education, I support that decision! This trimester has been a challenge for me, and I really feel like I had my study strategy down to a near-perfect science. I guess I am finding the transition from student-in-class / absorbing information, to intern-in-clinic / synthesizing and applying said learned information, difficult.

All things considered, I have a pretty light few weeks of midterms; only 4 exams and one paper to write (right? fellow 8th tris, feel free to keep me on track here!) This trimester is definitely keeping me constantly busy between trying to recall information in patient care, to keeping up with online quizzes, writing weekly botanical prescriptions, and preparing for various presentations. 

It certainly is a mental challenge to continually switch gears and be ready to play either student or teacher depending on the circumstance, even within the same few minute stretch. I suppose this is a lot like real doctor life... Listening and wearing your doctor hat, then turning as a student to your books to refresh on information to help the patient you are simultaneously doctoring. I'm realizing in this moment that I've been living in my student-brain so intensely for so many months now, that I'm struggling to make the transition/cultivate the multi-brained me.

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Seeing the farmer's market through doctor glasses

Geez, my friends and family must be relieved to see glimmers of my dynamic brain emerging from the information-crushing stage I've been mired in for the past 2½ years...  And as I recognize a shift in my thinking process and interaction with my world, I know I'm a changed gal. I notice I am becoming a doctor because of the way I have learned to listen and actually hear people when they talk to me. I notice I am becoming a doctor because I know the answers to my friends' questions about the body. I suppose I am never going to be able to take off these doctor glasses. You know, unlike the beer glasses that come off so readily the next morning... Maybe it's a little late to realize this but, readers, I'm going to be a doctor and it can't be undone.   

Recently, I was reading about the life and work of a photographer named Mary Ellen Mark. Hanzi brought home a book of her images from the library the other day, and then I encountered a write-up of her life in the New York Times. I read it, looked at her photographs, and thought, gosh, I'm never going to devote my life to being a documentarian photographer. That's one thing I'm just not gonna be, because instead, I'm going to be a doctor. I'm OK with this, and I know I'll eventually find time to do other things with my life as well, like play the piano, read novels, go for hikes, have a family... but I must admit, I'm suddenly struck by the intensity of these few years of medical school. I know doctorhood has always been on the horizon, but now it feels extra real. I suppose I'd better rise to meet it. Also, incase you were curious; my temperature is 98.2 degrees Fahrenheit.

NDs Around the World

Over the weekend, I got to speak with one of my dearest friends for the first time in two years. She has been living in South Korea with her husband where they both work as teachers. Sara and I met when we studied abroad in Australia 8 years ago. In the years since then, I've been the lucky recipient of many visits from Sara and her husband wherever I've lived, all over the country. I have totally reaped the benefits of their summer vacations as teachers. This time, they are in the U.S. for a few weeks seeing family and I am so excited to pay them a visit in Michigan next weekend! It's my turn to make the trip to visit them.

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When Sara came to visit in me in Truckee/Tahoe.

One of the most important reasons I moved out west from New England after college (where I subsequently decided on naturopathic medicine as a career), was based on my experience of studying abroad in Australia with Sara. While studying on the other side of the globe, I met so many Americans who hailed from all the very different parts of the United States. I realized that I, an East Coast girl, was so different from those girls from the Midwest, or those girls from Southern California. We all came from very different American backgrounds, and yet these Australians, as well as all the other foreigners we met while out exploring, grouped me in with all the others. I was just another American girl to them.

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Adventuring in Australia -- getting inspired to explore my own country.

On account of this, I decided I had better go figure out what the rest of my country was like before I went travelling abroad again. While we all had some American patriotism and our language in common, I felt so different from so many of my countrywomen. I wanted to know what assumptions people might be making about me based on some other Americans they'd met who, as far as I could tell, were nearly as different from me as the Australian girls were, or the Germans.

Now that I can see the light at the end of the medical school tunnel, I am starting to think about where to explore next. I think I have a pretty good handle on what an "American girl" is, based on my experiences living around the country, so perhaps it's time to head into foreign lands!

Between binge-watching Anthony Bourdain episodes, perusing photographs of far away places on BuzzFeed, and reminiscing about our travels of the past, Hanzi and I have caught the travel bug. We regularly toss around the idea of living and working in another country, and have even set some lofty goals of learning a foreign language before we graduate with our respective master's and doctorate degrees (we haven't made any headway on this, yet). Even if we don't make it out of the country, we are ready to explore another region... perhaps Alaska, or Montana, or Maine...

Of course, I also have to think about actual employment after graduation, and for the record, I am equally excited to work as a doctor as I am to see new places. If you're like me and think you might want to explore, either now or later on, keep these resources in mind. There are several networks for naturopathic doctors around the world. Several of my friends at NUHS have traveled to work with Naturopathic Doctors International and Naturopaths Without Borders during their breaks between trimesters. My peers have returned with totally awesome stories of hands-on experience treating patients, living in rural areas, assisting in the delivery of babies by flashlight, and connecting with local people whose worlds are so very different from ours.

In addition to delivering care to the underserved abroad, naturopathic medicine is going global with the recent creation of The World Naturopathic Federation in 2014. This organization connects naturopathic doctors in 40 countries around the world, and endeavors to connect our work with that of the World Health Organization. We might be a small population here in the United States, but we are also out there, all over the world, sharing and advancing our medicine!

An Illinois Forest Bath

It's pouring rain right now. Our basement is probably flooding, slowly. But all that water coming down makes for crisp, clean air! *Takes deep breath in...*

A few weeks ago I read the abstract to a scientific paper out of Australia that aimed to quantify the effect of exposure to nature on participants' health, and to identify an ideal dosage of nature. The conclusion was alarmingly reductionist. How many trees should we plant on the roadsides in order to make people less stressed? How can we manipulate nature in order to best serve our health needs?

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A winding path

A practice called Forest Bathing started in Japan in the 1980s. It was developed as a treatment to relieve stress. Newer studies have recognized that a consciously meditative walk in the woods can boost the immune system by increasing natural killer cells. One set of guidelines on Forest Bathing suggests you spend 3 days and 2 nights in the woods if you really want to boost your immunity. Otherwise, you may choose to spend just one day Forest Bathing to reduce stress.

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Hanzi and me, out for a walk in the woods

Hanzi and I went for an extremely rejuvenating walk in the woods the other day. Relationships always take work, and my relationship takes extra work because I'm in medical school. We brought our cameras and our rain jackets, but nothing else. There is a trail that ducks off into the trees that I noticed when I first started commuting by train. I keep meaning to go find it, and we finally did. It was a rainy day, and cool. The forest was especially green and fragrant. We encountered two yearling deer; they were definitely curious and not afraid of us at all. We hung out in their presence for a few minutes while they devoured low-growing plants and watched us curiously through their sparkly black eyes. Hanzi and I chose to move on first; we left them to their lunch. 

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And when it rained and poured we went for some pseudo-nature at the climbing gym

I found an article written a few years ago by our newest clinician Dr. Denis Marier titled, "Ecotherapy: Embodying the Vis Medicatrix Naturae in Clinical Practice." In it, Dr. Marier writes about the relevance and importance of incorporating nature into naturopathic care. I love the idea of taking a "Natural History" with each patient in an effort to understand the patient's exposure to and experience with the natural world. Naturopathic doctors believe in working with the Vis, or that healing power of nature "which always endeavors to repair, heal, and to restore." This is evidenced in those walk-in-the-woods smells of new greenery, the mud and wet grass, and damp rotting wood. The natural world turns over, heals itself. So too, do humans, who are just as much a part of nature as new leaves, mushrooms, and rotting stumps.

Besides going out to seek nature, I am particularly fond of Dr. Marier's idea of "naturalizing a part of your clinic grounds." Even a city office can be naturalized with potted plants and fresh air. One aspect of my vision for my future practice includes an outdoor space where I can consult with patients. In his piece, Dr. Marier also suggests assigning a Medicine/Nature Walk, which he describes as a 3-6 hour fast from food, people, and electronics. He encourages patients to notice how they are observed by nature, rather than focusing only on their subjective experience. This makes me think of the deer on my walk the other day; they were so curious! I was observed. And I observed, too.

Resources:

Patients Change the Way I Study

One of the more frustrating things about taking classes while also spending 18 hours a week in patient care in the ND clinic is that I'll be in the midst of studying, you know, really getting things done, when all of a sudden I'm -- Whoops! -- off down the rabbit hole! I'm irresistibly curious about how this particular botanical applies to that patient case and... then all is lost. I may be losing my knack for efficient studying, but I must say, I am really, truly LEARNING.

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Morning coffee, study mode

I've had this conversation with ND student friends before; wouldn't it be nice to spend some more time in the clinic earlier in our education? While I agree it would be rewarding, I realize now that having done all the groundwork, I am much more prepared to effectively approach a patient case. A mere 2 trimesters ago I was on clinic observations, and while there were a handful of things I couldn't quite wrap my mind around, I really thought I was ready to be seeing patients. Now that I'm actively involved in providing care, now that I'm responsible for the thinking and problem solving, I realize that I know SO MUCH MORE than I did as an observer.

The difference between then and now is that I've had classes that teach me how to actually make decisions and proceed with care based on what I've learned about how the body works. By now, I have tools to create an actual treatment for a patient, whereas before I had merely the understanding of how it all works, what can go wrong, and why. Still, in every lecture I am collecting strategies and clinical pearls for helping my patients. I am learning about what works, what doesn't, and where to begin. I still have a lot to learn; I have many more tools to add to my belt.

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Down the rabbit hole

Medical school has definitely taught me to acknowledge what I do not know. Each trimester I learn more than I thought I could have ever known about a particular topic, and I am rewarded with a deeper understanding that makes it easier to translate what I've learned in a classroom to patient care. With this in mind, I should pick up where I left off studying botanicals... before that patient case wiggled it's way into my brain, tore me away from routine studying, and inspired this post!