Tim's Blog

Sometimes I feel like I live, eat, breathe, and sleep medical school and NUHS. Somehow, that doesn't leave balance for any personal time, unless one makes it so. I'm a firm believer in Vitamin R (rest, relaxation and rejuvenation...thanks Dr. Louise Edwards) and decided after the engorged schedule of this trimester and a slight lull just before finals, I would take a little time out and have an inexpensive break on a Friday night.

So, this week I will write about a trip to Chicago's Loop, or the section of downtown Chicago encircled by an elevated railway, or the El.

Friday's classes ended and I was on the train with a good friend riding to downtown Chicago! I decided it was time to visit the Christkindlmarket (funny spelling, it's German) held annually on the Honorable Richard J. Daley Plaza (who gets the reference here?). The market is set up as a traditional German and Eastern European winter market with music, food halls, ornaments, trinkets, and even Santa Claus (the European Claus who will actually bring you coal if you are naughty instead of just an idle threat). The plaza is filled with people of all ages and you pretty much stand "elbow to elbow" as you wait in line for the food, to check the vendors, or scrounge in to hear the band a bit better. I'm not normally a crowd kinda guy yet this has been one of my favorite experiences here in Chicago and I go check out the market every year.

After a couple of hours of music, Glühwein (heated spiced wine) and the crowds, we were ready for a break, so we took a stroll around Chicago's Loop to take in a bit of the atmosphere. After some leisurely walking, I ended up at Monk's Pub and the place seemed to be full of the "after 5 Friday crowd", but a great vibe overall! We grabbed a quick bite and a drink, and then took a walk back to the train station for the ride back to Lombard (a quick 40 minutes or so).

The trip was a wonderful time and having a good friend to share the experience with was icing on the cake (in moderation, of course)! The trip was so good, in fact, that I forgot to take a pic of me at the market or with the German accordion players (which I fully intended to do). So, you get a quick pic of me while writing my blog this week. Notice the disheveled hair and forced smile indicative of a 3rd year ND student nearing the end of 7th Trimester. 

I hope you enjoyed my narrative this week. Not much to say about school, just a little trip into the city to "catch my breath" before finals weeks. I'm thankful (yet again) for good friends who can keep me laughing on a train ride during rush hour and multiple times getting lost in the Chicago Loop and their understanding when I said, "If we run into the El, then we know to turn around and go back to the center." 

With that, I plan to take a nice break over the holidays, spend some time with family, catch up on my personal reading list, maybe do some hiking in the Pisgah National Forest back home, and catch up with friends. When I return to school after the holiday break, I will be entering Student Clinic as an Intern, advancing beyond "Observer" status. This means that I will have real patients for the first time! I'll be sure to share the experience along the way.

I hope each of you has a safe and fulfilled holiday season. Personally from me, Merry Christmas and a Happy New Year!

Until next January, get plenty of Vitamin R and we will catch back up!

Hi Everyone!

Just a quick note this week to wish all of you a very Happy Thanksgiving! I'll share a bit of what I am thankful for this Thanksgiving.

I am thankful for my family. My parents, each with no more than an eighth grade education, ensured that I was reading before I entered kindergarten and I'll always have fond memories of sitting with Mom or Dad reading Little Golden Books. Both instilled a lifelong love of reading and my library is backlogged with books to read after my fill of medical school books over the past three years. I am thankful for my three sisters who put up with my antics as we grew up and moved away from home. I am thankful for all of my nieces and nephews, who carry on the family name and tradition of gathering on Thanksgiving at my folks' home. That's a lot of people in a 900-square-foot home, but the love expands the walls immeasurably when everyone is present!

The Gathering Banquet Table: (L-R) Tim, Danielle, Jenna, and Fatemeh

I am thankful for each of my classmates. I have said that before and I reiterate again today. The group of classmates I have are individually wonderfully people. They are some of the finest, most cooperative over-achievers one could meet. Regardless of the challenge, this group comes together for each other, charitable causes and communication. I am proud to be a part of the class of December 2013 and have made life-long friendships during my times at NUHS.

I am thankful for my friends back home. We have been through "thick and thin" together. Births, deaths, layoffs, downsizing, promotions, marriage and divorce; each of my little group back home is ever present to lend a hand, an ear, a shoulder or a back when work needs to be done. These are the folks who didn't say I was crazy for leaving a good job to become a naturopathic doc at 40 years old. These are the folks who ask every four months, "Are you coming home Ammons?" Friends who want to catch up and are eager to keep in touch are truly a thing to be thankful for.

I hope you are with the ones you care about this holiday. That you have experienced a year of abundance in health, love and happiness and that your dreams, plans and experiences have contributed to your betterment and the betterment of all!

See you next week!

What a week of ups and downs! I went from feeling fairly confident about the results of the Advanced Lab Diagnostics/Endocrinology midterm results to shock when I looked at the results. Holy Cow! I've never studied so hard and felt confident about a subject only to earn a score that was cause for a bit of self-disappointment! Looking at my answers, I thought, "How in the world could I answer that way?!?!"

Upon reviewing the exam with the class, our professor made the point of stating this was a tough exam by design and endocrinology is one of the toughest topics for both students and practicing doctors. There are so many influences on the human body--environmental and emotional stressors, sleep, diet, and exercise--all of which can, over time, take a toll. The exam was geared, both in the question portion, as well as the two cases, to generate thought and come up with the single best answer. The cases were quite general in nature with no specific complaint other than fatigue or inability to sleep. We were required to look at the small factors in each instance to help with the tests we would order, our diagnosis and treatment plan, based upon the Therapeutic Order of Naturopathic Medicine. Ultimately, our professor gave us the advice that sometimes we learn more from our mistakes than we do when we "ace" an exam. Did I mention that humility is a trait that is well utilized in medical school? Lesson learned; that was a hard "pill" to swallow though! (pun intended, hehe).

Well, immediately after I left Endo Class, I had my first "head-to-toe" physical examination of a patient as a lab practical. This practical examination was held in the teaching area of our clinic. Here's the setup: Eight medical students in eight separate examination rooms with a patient for each student and 45 minutes to complete the exam. No professors are in the room as the physical exam is monitored remotely via camera. We performed a head-to-toe physical intake in a predetermined order on our patient as a culmination of each of the regional examinations we learned to Week 8 of the trimester as well as those learned in previous classes. This was a "show me what you know" sort of practical, followed by a quick write-up of a randomly chosen (by the professor, of course) portion of the exam you performed, along with any findings. 

During the exam, we could go back and complete any exams that we might have forgotten or re-perform exams that we knew we could have done better, as long as we were within our 45-minute window. While some points could be deducted, the process was as much for learning the entire procedure as well as for grading. This is the nice part of the clinical studies portion of our curriculum. We are still graded meticulously, and we continue to be taught even during our lab practicals. So, back to the practical. The teaching portion of the clinic was still pretty warm from a power loss (and subsequent loss of air conditioning) during perhaps the hottest days Chicagoland has seen in years! Some are saying we are in a heat wave, but again, I'm from the South and this is normal weather for me. I'm in a shirt and tie with a patient in a gown for a physical. I'm trying to keep my cool, but remember, I just came out of some disappointing news on a previous exam; I'm now setting up and performing the absolute first 'scrutinized' physical exam of my medical career and starting to sweat buckets. What did I do? Stuffed my pockets full of tissues, offered some to the patient to keep him comfy, and in between different steps of the exam, I completed the "time honored forehead swipe" that one sees performed by docs on just about every TV show from the early days of the tube until Grey's Anatomy! The patient ended up being very happy; I was OK, though a bit dehydrated after completing the physical exam; and I think the professors were OK with my performance. A nice boost after a bit of a dip just a few minutes before.

I suppose this is the "take away lesson" this week. Don't get too dejected if an exam doesn't go perfectly; stay steady and be prepared for the next exam. Despite all the preparation, study, memorizing, theorizing, and compartmentalizing, one can have a bad moment, hour or day. Those tough moments are only in that particular window of time. As I sat here by Janse pond writing this entry, I was fortunate enough to have three friends sit and chat with me on a beautiful afternoon. This was a good time. I'm thankful for both and hopefully learn from each moment, whether good or bad.

Knee High by the 4^th of July!

Regarding the 4th of July (Independence Day), I'm thankful for the founding fathers' courage to draft and sign the Declaration of Independence. That first step provided the foundation for our great nation and the optimism that I believe still exists enough for people to continue to desire to immigrate to the U.S., plant their roots, and live out their destiny as they choose.

Now, for the "knee high" reference. Around here in Illinois, the saying goes for corn, "knee high by the 4^th of July." Check the picture! July 6th and our corn is well over 6 feet tall! Can you find me? Now granted, this is a variety of heirloom corn called Southern Gentleman, appropriate, that is best suited to the hot, humid weather of the southern United States. I'm not sure if my roomie and I have green thumbs or we have simply been fortunate (and lucky) enough that we planted this corn during the hottest summer on record in Northern Illinois! I am grateful that nature has smiled upon our garden though. See if you can find me in the photo!

Hi Everyone!

Today I reflect on my father and his positive impact upon my life. My father is a man of few words; he lives by example. He has always worked hard and continues to work in his early 80s in addition to his gardening and work around the house.

Me as a toddler with my dad.

When the four of us (my three sisters and I) were growing up, our dad was often working overtime at a furniture factory, where he was a quality inspector. After working all day at the factory, we would work well after dark with our crops for extra money to have a nice Christmas holiday. Dad would allow us kids to play sports in school or pursue other activities, other than that, we were to work with him in the field. I think now that the "work unless you participate in the community" rule was a way for us to become involved, learn success as well as failure, and realize the necessity of getting along with others.

When I was growing up as a youngster, I always felt safe with Dad in the house. Some of my earliest memories are sitting on his lap learning to read "Little Golden Books" well before entering kindergarten. The amazing thing is that a man with an 8th grade education (as well as my Mom) saw the immense value of learning to read…early. I remember Dad teaching me about raising chickens, tending a garden, fixing up our old cars as a teenager (not so much there, I was too stubborn to listen unless I needed his help). Finally, the project that I will cherish for the remainder of my life--the weekend that we built a bookcase together in my late 20s. 

The bookcase as it stands in my apartment now, full of medical books and doo-dads!

I didn't realize the importance of that project at the time. I never liked woodworking much and Dad and I weren't exactly close at that point in our lives. No animosity, we are just both strong-willed and somewhat stubborn men and each had our idea of how to live as an adult. We spent the entire weekend working cooperatively on the bookcase from only a hand-drawn sketch. No griping, arguing over measurements, or creative disagreements--just a vision and the beauty of the finished project--both the bookcase project and our relationship as adults. I've never told Dad how much that project meant, I reckon I will someday.

Dad's (and again Mom's) insistence that we kids learn to read when we were just "young'uns" has stayed with my sisters and me. For myself, I think the fun of reading with my Dad translated into a passion for the written word and a thirst for learning that has me here, at NUHS on my third career! Believe me, we get our share of reading here!

Dad in his garden last year.

Now, as an older student at NUHS, I try to share the lessons that my dad taught me, through example, by living as an expression of his work ethic, sharing, patience, understanding, and guidance where I can with my colleagues and friends. His lesson of 'leveling' the highs of success and lows of failure has been perhaps the most applicable lesson while here in med school. 

I am grateful for my father, his work ethic and insistence that his children learn in areas he never did. I am grateful for my father's appreciation of all human beings, creatures and kindness toward others. I am grateful every day that I am the son of Roscoe Ammons of Mars Hill, North Carolina.

This week's entry is simply to thank those who have given the 'Full Measure of Sacrifice' for each of us who lives in the United States. My father lost a brother, Edward, in the Pacific Campaign in World War II as well as his twin brother, Otto in the Korean Conflict. Many of my classmates have lost friends or family in the current conflict. Regardless of opinion on decisions made by leadership in this country, each generation has stepped forward and answered the call to defend our Great Nation. The rank and file Citizen Soldiers of the United States has secured the freedom to determine our destiny regardless of any classifying factor, as well as the freedom to disagree in a civil manner and exercise the tremendous power of the voting process to maintain a just and balanced leadership.

The posting this week is best summed up by a note shared by Sharilyn, a classmate who is a veteran and worked in a military hospital:

"I was working the MICU (Medical Intensive Care Unit) one night at an Air Force hospital with a patient who was having an MI. He was there alone. When I asked him if there was any family we could call for him, he said no, that his family had left him long ago. He was no longer the person they knew before he went to war. It became real at that moment for me. There are many casualties of war, each just as devastating. I can't help but think about military families and soldiers whose lives have been forever changed, especially those close to me. There are never sufficient words of comfort, but know on this end, today and every day, I offer you a grateful heart."

I am eternally grateful to those who have sacrificed their lives in the defense of our United States of America. My heart goes out to their loved ones, full of empathy and thanks for their sacrifice as well. May our current generation of veterans be the last who need to leave our shores and may they never be called to defend our home on our soil. Blessings to them all.