Tim's Blog

Well, finals are finished (see the rainbow after the storm), my brain is pretty tired and my body feels like it needs a bit of a reboot.

The sharing of the past four months has been fun. I wasn't quite sure that I was ready or even wanted to open up my studies, thoughts, challenges, successes--essentially my academic life for all to see--yet at the end of the trimester the first thought that comes to mind is one of gratitude. 

The theme this trimester has been tending one's garden. Through the process of blogging I have found many areas I thought were tended, yet only to discover many weeds that need to be "rooted out" so that my garden, life, classes, health, whatever needs attention, may thrive.

This past trimester was perhaps the busiest with the heaviest class load that I have attempted to this point in my studies. I had a hard time getting into the groove for the first four or five weeks, and the results showed in my grades on my midterms. So, for the second half of the trimester, I needed to redouble my efforts, find a more productive study strategy, and at the same time continue prepping for boards (another story for another time), which fell on Week 14 (week before finals) of the trimester.

Joe and Christine studying for their Homeopathy III Final

Sometimes the calendar just turns out this way, so no use overstressing, complaining or procrastinating; just set a schedule and stick to it. Combine that with recognizing one's limits, pushing them a bit, knowing when to stop to recharge, and relentlessly do one's best. Sometimes the best is not an 'A' on a test when one has 5 finals in three days. Other times, the best is straight As; the situation varies. At this point in study, sometimes a 'C' on the last final of the last day of finals week is the best, happiest grade one receives!

I'm not saying that straight Cs are something to set as an achievement goal. I believe that the difficulty of carrying a full load at NUHS is such that even the best students, on what might be their best effort at the end of a trimester on their last final exam may only have enough 'mental gas' to garner a C. This is the reality for most of us here. I believe this process--the mental marathon of medical school--takes its toll. I believe that part of the medical school process is to prove to those who are high achievers, expect perfection and for the better part of their lives have achieved perfection in academic pursuits, that failure will happen. Better to learn to deal with some minor setbacks while in school than to graduate as a Doctor, step into the role of Healer with other human beings' lives in one's hand, and not be able to deal with a difficult pathology that may require some time, problem solving and flexible thinking to solve.

One must have the attribute of "dogged determination" to pursue medicine along with passion for improving the health of others. At the same time, caring for one's self, knowing one's own limits and how to expand those limits mentally, physically and emotionally is key to understanding the effort needed to complete this course of study--this journey that only takes us students to the edge of the true school, the real world with real patients with real and debilitating sicknesses. This is where we will truly learn, and that learning will never cease until our final heartbeat.

Alrighty! I think I'm off my soapbox now! I extend congratulations to our August 2012 naturopathic and chiropractic graduates! May your journey of learning, healing and growing never end! I'm ready for a relaxing couple of weeks of catching up on reading some history books, prepping materials for the opening and closing ceremonies for the Naturopathic Student Gathering coming up in November 2012 at NUHS and even a cleanse after a steady diet of caffeine and carbs for the past three weeks!

I will be entering clinic as an observer next trimester so I'm super excited about this opportunity! This is the essence of naturopathic medical school, sitting with the patient, learning about their history, ailment and attempts to remedy it. My plan is to introduce you to some of my classmates who are interns in clinic and their motivations for becoming a doctor, share some more of my experience along with successes and failures, and have a bit of fun along the way!

I'm thankful that you chose to accept my offer of sharing a bit of my journey and hope you will continue along with me as I finish up the last year and a half of my studies! This trimester, during a very challenging time about halfway through, a quote came back to me from Dr. Seuss. It helped me to get back on track. I'm thankful for Dr. Seuss and my folks for teaching me read with Dr. Seuss books! 

"You have brains in your head. You have feet in your shoes. You can steer yourself anywhere you choose."

See you in a couple of weeks!

Well, last week's midterms are done and I survived, if you call living on about 5 hours sleep per night and coffee throughout the day as "survival"! :) That was just about the toughest week of exams I can remember! Not so much because of multiple exams in one day or that any one subject was the 'killer' class. These exams just seemed to march relentlessly in order (think White Stripes' Seven Nation Army music video). Sample thoughts for the week…Monday, exam…whew! Wait, I have another on Tuesday, better study; time for coffee. Tuesday, exam again…whew! Crud! Another one tomorrow! What?!?! I forgot about writing that summary for the Practice Management Project; that's due when? Oh! Great! How about another cup o' Joe? Until Friday…what? Who are you? Oh! You're my Endocrinology professor…and we have an exam right now? Awesome! :)…and the slow knock at the door just keeps tapping, tapping, tapping…close with the Twilight Zone theme.

While my description of the exams last week is a bit dramatic, suffice to say that after days on end of little sleep, little exercise and lots of study, a naturopathic medical student's 'Determinants of Health' are a little out of whack!  I suppose I should give a bit of info on the determinants of health. Naturopathic medicine considers the determinants of health the 'basis' for a healthy human being. Our medicine focuses on returning people to that 'basis' for health by first regaining balance amongst the Determinants of Health. These determinants are:

• Breath (or air)
• Water (or hydration)
• Exercise (movement and flexibility)
• Sleep (no brainer here)
• Nutrition and Digestion (our diet, ability to absorb nutrients and eliminate waste)
• Rest, Relaxation, Rejuvenation (or Vitamin R, credit to Dr. Louise Edwards)

The determinants can also be anything a person is 'born with' vs. 'environmental' exposures throughout life. The focus can be as broad or narrow as the naturopathic practitioner deems necessary for each unique case and each unique human being. Other key determinants are genetic, mental/emotional state, education level, work environment, history of illness, access to health care, etc. The list can go on and on. While learning to become a naturopathic doctor, we keep the determinants basic and simple. With each of these basic six categories, a person can be led toward or away from a 'Basis for Health' and a healthy person is our ultimate goal! When we are in practice, we will listen to each patient, take a thorough case study and find the unique combination of determinants to help that person become as healthy as possible.

While medical school has never claimed to be the best thing for a student's 'basis for health', we take measures sometimes in attempt to balance our determinants and keep our basis somewhat stable, even during midterms and finals. My effort to balance' is to print study notes and walk at a nature preserve near NUHS called Hidden Lake Preserve. Taking my 'study walks' helps to maintain a bit of exercise, Vitamin R and fresh air while prepping for exams. I've even done this in freezing temps during the winter!

The preserve has two small lakes, one wooded and the other on open prairie with a small network of paths winding around the lakes. While walking and studying, I have found and returned baby snapping turtles who had lost their way from the water, with blessings to be the 'scourge of the pond for decades to come.' Chipmunks have also stepped up on a stump right beside me as I sat and studied. I don't know how these animals keep finding me; I just enjoy their company quietly (entirely out of character if you know me) and we each go on our way. That is, unless a baby snapper about the size of a silver dollar traipses away from their aquatic home, then I'll usher them back to the water. I have included a pic this week from the footbridge during my walk last Wednesday. This is such a beautiful place, I don't mind sharing as long as you don't tell too many folks!

This week I'm thankful that the 'slow tap, tap, tapping' at the door signaling another midterm is only heralding the arrival of two exams this coming week--an imaging (X-ray) midterm as well as a 'Head to Toe' unsupervised complete physical on a live patient in less than one hour. The physical is filmed and graded based on 'proper sequence' of exams as well as proper procedure, patient instruction and explanation of findings. Come to think of it, I think that tapping is getting…just a little…bit…LOUDER!

See you next week…if I make it! :)

Let the exams begin!  We finished up this week with the first of the many exams, quizzes, midterms and lab practicals that 6th Trimester is known for providing (if that is the proper term). The first quiz was centered on the endocrine system, its involved structures and their interaction. What a doozy to kick off the trimester!

The classes aren't all work and no fun however! In our 'Special Topics in Botanical Medicine' class this week, we had the opportunity to make tinctures for the first time! A little about tinctures first. Tinctures can be made from the fresh or dried medicinal parts of plants. These parts could be the leaf, flower, stem or root of a plant, or all of the above, depending on the plant. Next, these medicinal parts are 'soaked' in a solution of alcohol, glycerine or vinegar, depending on the type of plant and the 'plant constituent' or chemical part of the plant that we want to use in the tincture.

The tinctures are made in ratios such as 1:2 or 1:4 or higher. The first number is the amount of plant material, typically in grams. The second number is the amount of 'vehicle' or alcohol, glycerine or vinegar in milliliters.  So, if you have 10 grams of plant material being soaked in 20 milliliters of alcohol, you would have a 1:2 ratio tincture! The units of measure don't really matter as long as you stay consistent with your ratios if you make a tincture and like the outcome. Simple really!

Some of the tinctures our class made this past week.

I made a Lavender (Lavandula augustifolia) tincture in a 1:18 ratio as a fragrance for a future cleaning solution. I also made a Bilberry Leaf (Vaccinium myrtillus) tincture in a 1:4 ratio as an experiment for future tinctures. Bilberry Leaf is reported to have anti-aging properties through improved circulation in the small blood vessels near the hands, feet and farthest reaches of the circulatory system from the heart. With an aging patient population, research continuing and the possibility of a potent herbal medication, Bilberry shows some promise!

Herbal medicine is just one of the strong tools at the naturopathic physician's disposal. The chemical constituents in many pharmaceutical medications are either the exact phytochemical or a derived component of many botanicals (or plant medicines). The great thing we are learning about the botanical medicines is that while the patient gets the benefit of the botanical medication (albeit at a much lower concentration than a corresponding pharmaceutical medication), the botanical medication typically has other components that reduce or eliminate any side effects of taking the botanical medication. While not true all the time, this is typically the case with botanical medications. As with any medication, any physician needs to take the precaution of understanding how the botanical medicine interacts with any other medications the patient may be taking, whether botanical or pharmaceutical.

This week, I am grateful for botanical medications that Nature has provided for us.  I personally have utilized a botanical remedy a number of times in various circumstances from a poultice for a pretty big scrape to helping ward off a nasty ear infection.  Thanks to those who have come before us and paved the way learning, gaining knowledge and sharing over countless generations for all that Nature provides for our health.