Tim's Blog

Hi, everyone!

The first official week of Student Clinic is in the books and it was a full one! I was able to see five patients the first week and the time flew! Of course, it seemed as much time was spent with paperwork as with the patients, yet this is a necessary part of the patient visit to ensure that those who see a patient after me know exactly what I talked about with the patient. 

First a little background on student clinic here at NUHS. During 8th trimester, ND students are interns in Student Clinic. In other words, we only see students and their families during 8th trimester. This is to prepare us for seeing the general public in 9th and 10th trimesters. We are allowed and even encouraged to recruit our patients from the student population here on campus, as recruiting patients is part of building a practice once we graduate. When a patient doesn't request a specific intern, the patient is assigned based upon an objective alphabetical rotation. In other words, we have plenty of patients to see and help in Student Clinic even with minimal recruiting efforts. 

The week kicked off with a new patient visit, which typically is supposed to take about 90 minutes. Of course, a brand new intern with a new patient, new file, fresh paperwork and a steep learning curve means that 90 minutes is an attainable goal, yet often is one that is not met with a first visit. Take that first visit and follow it immediately with a patient who is returning for a follow-up visit and you have the recipe for a full day! Now, since our Student Clinic hours are Monday, Wednesday and Thursday from 1pm to 7pm, multiply that by 3 and add all patient file paperwork that must be completed before leaving at the end of the day! Whoa! :) 

Thank goodness, our ND clinicians are around to give us a helping hand, guidance and solid suggestions when we "err off course" just a bit! Without their short bits of advice and a finger pointed in the proper direction, I'm certain 10 interns would have been scurrying in all directions. :) A quick shout out to our clinicians in the ND clinic and their patience, guidance and sense of humor! 

The rubber is meeting the road and it's time to apply everything that has been learned (or absorbed) for the previous three years. I'm honored and grateful that others trust their well being to me in Student Clinic at NUHS. I'm grateful that we have the strong clinicians to guide us during our internship!

Hi, everyone! All of us here at NUHS are back from break and getting into the rhythm of classes or clinic schedules. In my case, I have finally started the final lap here at NUHS and have entered Student Clinic. 

But first a little about this past break and my trip back home to the beautiful mountains of western North Carolina. I've included a pic from one of my favorite hilltops behind the "homestead" back in WNC. 

During my trip back home I was able to catch up with my family and friends, spend some quality time together and relax just a bit. I hiked a few miles on the Appalachian Trail that is very near my home at Sam's Gap in North Carolina and the views were spectacular! I caught a few odd looks from those who had been on the trail for awhile (guess they were wondering where my gear was), but all in all had a nice chat with one hiker as they descended from the trail to get a few supplies at a little store nearby the trail. Amazing how we traipsed all over the woods as kids never worrying about supplies, hiking poles, packs, etc., yet as an adult, I was concerned about hiking a few ridges that I had covered many times as a kid. All in all, a great trip and I'm thankful for my family and friends back home, catching up while seemingly not missing a beat, and leaving with a sense of love and fulfillment.

Now, back to school. I'm entering Student Clinic this trimester as an intern who will be working with students currently attending NUHS and their families. The cohort entering Student Clinic this trimester is, I believe, the largest cohort yet for our naturopathic medical school and the groups following are even larger! This first week is going to kick off with a bang, as my appointment schedule is booked for the week with students completing their "freshmen physicals." A freshman physical is a complete head-to-toe physical and naturopathic intake that typically takes about two hours, after some practice. I believe most of us will take somewhere between two and three hours for our first couple of intakes until we get our time management skills improved. :)

Well, with that I suppose it's time to get the shirts pressed, the slacks creased, the intern's white coat spotless, and step into the role of the student healer. A big welcome to all of our first trimester students in the professional programs and our undergraduate students! Until I graduate, I'll do my best to share life in the clinic over the coming year--stories of my time there as well as insight into other interns' journeys here at NUHS! 

Talk to you next week!

Well, everyone, now is the time to close out yet another trimester of classes. Next week is finals week and we will have a two-week break before returning the second week in May. 

This trimester has seen some short-range changes in schedule, work and diet in order to affect long-term outcomes for the better with regard to clinical learning, finances and health for years to come. 

The classes this trimester have been brutal with the workload between exams, quizzes, papers, presentations, prescribing, assignments, and attendance. At the same time, I feel like our studies have come full circle and we have applied all of the facts that are thrown at us in the basic sciences portion of our studies.  We have prescribed, differentially diagnosed, treated and critiqued both our own work as well as that of our classmates. We have delved into complex topics such as the impact of biofilms on the human organism, the impact of an improperly functioning methyltetrahydrofolate reductase (MTHFR) enzyme and its necessity within the human body as well as the efficacy of liposomal delivery of supplements, just to name a few topics. 

When I took a firm look at my finances currently and projected them to graduation day, I knew I needed to take action to change the situation. When assessing the income opportunities while attending medical school, I weighed staying on a "full tilt" schedule versus slowing down to finish classes before clinical rotations and working a part-time job. Finally, mapping out the resources necessary for moving back to North Carolina, gaining a residency position or joining a practice, allowed me to be prepared for any situation I could think of. Of course, things may come up or ideas may come about that I didn't fathom before. This is when I will take time to pause, reassess and adjust the plan as conditions warrant. 

My diet has changed for the better. I have established the habit of taking a long hard look at the foods I put into my body. I have had to make some hard decisions as eating healthy, organically produced whole foods is a bit more expensive and time consuming to purchase and prepare. I plan my shopping trips better, don't waste time or fuel on multiple trips to the store, all while maintaining enough food without it going bad. Disclaimer: I have tripped up a couple of times when I felt rushed or simply too lazy to take time to cook properly. Good lesson for future patient care and "patience with patients" in there somewhere. :) 

I suppose the primary thing I have learned from the last 15 weeks is that we can accomplish what we need with the resources at hand. We simply need to look at our options, see what is available, then map, develop and proceed with the plan. Take a few stops along the way to measure progress, reassess direction and make changes if necessary. No rigid dogma required; flexibility and ability to admit error is key, as long as corrections (and progress) are made. I'll be working, then heading home to western North Carolina for the break. I'll definitely catch up with family and friends back home, do some work around the property and relax mostly. I hope each of you has a wonderful spring season! See you next trimester when I will be entering clinical rotations (for certain this time!) and sharing a bit about the "clinic life"!

In the spirit of getting by and excelling with what one has, here is a pic of two early ducks in a tiny puddle on campus after a rain and a quote from Ralph Waldo Emerson! Make do with what lies "within"you, develop and excel those traits and be your best! 

What lies behind us and before us are tiny matters compared with what lies within us. -- Ralph Waldo Emerson

Well, this week has pretty much been the same as every other week of eighth trimester classes. This is a short synopsis of the past week prior to my blog entry. A very heavy workload with quizzes three of the five days, two presentations along with another paper due (this is the busiest and I think it's a bit downhill from here). 

The presentations this week consist of the impact of various heavy metals and their toxic impacts upon the human body's systems; as well as an informative presentation describing the method of naturopathic medical approaches. The heavy metal presentation is presented at the level of medical professionals while the naturopathic medicine presentation is constructed for use with the average person after I open my practice. 

The hat is a shout out to my 84-year old dad, Roscoe Ammons, who is
still working a full 40-hour workweek at the recycling center at our home
in Madison County, North Carolina. (Also, note the shirt; it says it all!)

The heavy metal topic, prepared for presentation in my Functional Medicine class takes a look at three metals we encounter every day, their function in our lives, what constitutes a toxic load (or dose), the vector of entry and impact upon the human body, as well as testing procedures and remediation methods, if possible. This was a huge undertaking! I had to scale down to three metals (not including mercury) and the presentation will still be around 45 minutes long. 

The presentation on naturopathic medicine for my Practice Management II class centers on the philosophy (or five principles) and therapeutic order of naturopathic medicine. The presentation describes what is NOT naturopathic medicine, then follows with the principles, therapeutic order and how a properly trained naturopathic doctor would apply the therapeutic order to treat an illness, including referral to a specialist, where necessary. I feel that this presentation will be quite the useful tool for presenting to local clubs, libraries and groups for building my future practice. 

This is about as exciting as things get right now everyone. I said it before, and I'll say it again, I heard all the rumors about eighth trimester classes being relentless with work and I chalked it all up to hearsay and drama. This is not the case. Be ready for your eighth trimester here at NUHS. Topics are more deeply covered, subjects are relentlessly probed, topics are researched ad nauseum, and the feeling of learning has never been stronger! The light is at the end of the tunnel! 

Until next week, here's a little something from Henry Wadsworth Longfellow:

Perseverance is a great element of success. If you only knock long enough
and loud enough at the gate, you are sure to wake up somebody.

Keep on kicking everyone, spring is technically here! :)

As spring approaches, I like to watch for the early signs of warmer weather. The flowers sprouting from the earth, the trees as they begin to bud, and the sandhill cranes as they migrate back north over our campus--the surefire sign that spring is finally here... or nearby anyway! 

Part of becoming a doctor is to learn to observe our patients before we ever palpate, percuss or test motion. We observe the patient's patterns of movement, any visible signs of distress. As we begin our intake, or conversation, with the patient, we observe how they communicate, their story. As we begin the examination, we observe the patient's skin, hair and nails looking for any sign of illness or injury. 

This is where our dermatology class helps with our examinations. As we progress through the program, dermatology is interspersed throughout the curriculum, introducing us to various conditions presented on patients' skin and other visible areas. We are introduced to macules, papules, nodules, patches and furuncles from the early days of our program until it finally culminates in the dermatology course in eighth trimester. 

By the time we are finished with this class, we will be able to know the pathologies that are associated with acrochordons (skin tags), eczemas, contact dermatitis, boils, papules, etc. Each class, now that we are in the clinical sciences portion of our studies, puts together all the pieces of our basic science 'data driven' classes. We are applying the principles into larger concepts and drawing conclusions based upon clues that we can see, examine and test, just as any good healer would do. 

Speaking of signs, the sun is coming up and I have another presentation to do! Eighth trimester is full of presentations, papers, cases, etc., as I have mentioned ad nauseum the past few weeks. 

Here is a picture of some of the tulips on campus sprouting through a dusting of snow we received this weekend. They present an excellent lesson in perseverance! 

Until next week, may your journey be light and you keep a happy heart with a big smile!