This week is quite the busy week! Between finishing the
move from my old apartment to the new place on campus for my final
trimester, work, and seeing patients in clinic, I have been a busy
This week I'm introducing two of our new clinicians in the
Naturopathic Clinic here at NUHS.
(L-R) Dr. Melissa Dybala, Intern Tim Ammons (myself), and Dr.
Dr. Kathy Kaminis a naturopathic medicine graduate of Bastyr
University. She recently sold a successful practice in Arizona that
she owned for over 20 years to return to Illinois. Dr. Kamin has
had much success with weight loss therapies, chronic illness, and
as a general practitioner while in Arizona. Dr. Kamin brings a
wealth of clinical, business and practice experience to our clinic
and program. Her clinical pearls and vignettes on how to set up,
start, run, and build a successful practice are invaluable. She
will help many of us who will be stepping out on our own in the
coming months and years.
Dr. Melissa Dybalais both a naturopathic and chiropractic
medicine graduate of NUHS. Dr. Dybala has been a member of a
successful practice in Chicagoland for the past several years. She
brings the physical medicine aspect of naturopathic care to her
guidance of our interns. Combining physical medicine with the
naturopathic philosophy to return our patients to a basis for
health is one of Dr. Dybala's guiding principles. Combining this
treatment modality with her vast knowledge of botanical treatment
protocols is an advantage that our interns enjoy here at NUHS.
We are lucky to have both of these excellent clinicians join the
faculty as our mentors, guides and leaders on the naturopathic side
of the NUHS Whole Health Center. Each day is a joy to learn, grow
and thrive under their tutelage.
Until next week, stay warm and keep plenty of vitamin D3 on hand
until winter is over!
This past week was spent finishing and polishing my presentation
for Grand Rounds titled "Safely managing prehypertension and stage
1 hypertension with botanicals." This is a subject that is close to
my heart if you will since hypertension and strokes are a common
occurrence on my father's side of the family.
Hypertension has been called the "silent killer" as a patient
may not notice any symptoms until a significant medical event such
as a stroke or heart attack occurs. A skilled, thorough doctor
performing a routine general physical exam can sometimes uncover
masked symptoms, which a patient may not even be cognizant about. A
well-performed physical exam can help prevent illness or even
prevent an early death.
At NUHS, we are trained on basic physical exam skills beginning
in our second of 10 trimesters. We are taught to fully examine the
patient through observation, listening, touch, and measurement. As
we progress through the curriculum, we build upon our basic
skillset and learn to interpret what we discover. This
interpretation is honed under the guidance of our clinicians in the
Whole Health Center and satellite offices.
A quick rundown of some of our exam procedures includes:
This seems like a lot to do in one visit, especially if the
patient is in a hurry. We have the physical exam presented so
often, that by the time we are in clinic, we can perform this exam
in 30 minutes or less! This gives plenty of time for the remainder
of the patient visit and conversation. The general physical exam is
intended as a screening tool to determine if more focused
examinations are required for the patient. The physical exam
skillset we learn at NUHS helps us to target key systems with
quick, accurate examinations. When in practice as primary care
doctors, we will rely on this skillset each day with our future
patients. These skills will help us save lives.
Time to settle into the weekly routine again, albeit things are
a bit different this trimester. With class and clinic rotations 5
days each week, along with work on the side during some mornings
and each weekend, time is a precious commodity.
This is what a typical clinic schedule looks like for a 9th/10th
trimester ND Intern.
During clinic, we sit down for "preview" each day to discuss
upcoming patient cases and strategies for best helping our patients
in a roundtable discussion. This is a "safe zone" to bounce ideas,
debate the best strategy amongst peers and under the guidance of
our clinicians. The idea is to share knowledge through discussion
in a practical manner without judgment. This approach allows us to
discuss all treatment modalities, their benefits, drawbacks and
limitations, then move forward with the best overall treatment for
After preview, we see our patients, chart, research, develop and
bring our suggested treatment plans to our clinicians, who vet the
plans and approve or amend as required for the benefit of our
patients. We must complete all of these tasks during our shifts as
HIPPA regulations dictate that no patient records leave the
premises. We learn quickly to be accurate, concise and have all
work completed by the end of the day out of necessity.
Even though this seems like a lot of work, clinic is a fun,
nurturing environment that I look forward to every day. The smiles
on patients' faces when they begin to feel better, heal and share
is priceless! The patience, knowledge, skill and care that our
clinicians share with each intern on a daily basis set an excellent
example for all of us as future doctors.
Me with Carrie (left) and Juanita (right), both 6th trimester
The photo I'm sharing this week is of two friends and me. I was
printing something at the library the other day and ran into them
after having not seen either for about two months! This made me
realize that I was separated from the rest of campus now that I'm
in clinic and needed to visit my old friends still in their
clinical courses. Challenge accepted...
This week I'm just sharing a few words to reminisce and look
forward to the next chapter in my life and career as a doctor. As
the weather has been very mild for this time of year in Illinois,
along with a good amount of rain, I have had the opportunity for
many long, brisk walks and bike rides with my "significant
As we sat down under the willows to study this past weekend (she
prepping for Botanical Medicine and Homeopathy classes while I was
finishing up research for a patient in clinic), I started thinking
about my time under these willows studying for the same classes she
was now learning. I thought about our first conversation together a
year ago, as she was taking a bike ride, stopped to chit-chat over
books, and ended up staying for two hours under these willows--not
very productive for study, yet the most fulfilling for getting to
know a wonderful woman!
I thought about the friendships forged, the laughter, stress,
and some tears shed under these very trees. I thought about the
planning process for the Naturopathic Student Gathering. The spot
underneath these two giant willows was the birthplace of the
Talking Stick of the Naturopathic Student Gathering. These willows
gave shade and solace during that time; they shared the concept of
the willow and even gave of themselves for the opening ceremony and
its trappings, after some fierce storms came through town last
During our small adventures around and about DuPage County, just
outside of Chicago, where NUHS is located, we would talk about our
times here at school and plans for the future. Where will she
practice; where will I practice? What about our specialties,
communities, how much of our training we will need to brush-up on,
modify, or grow to meet the needs of the town or towns we settle
within. We talk about licensure, legislative efforts and growing
our profession on a national scale, and the responsibilities that
come with being a part of the growth of naturopathic medicine. We
talk about educating the public in a sensible, concise manner on
exactly what naturopathic medicine is and what we can accomplish
for our fellow human beings' health.
Finally, as I was sitting under the tree, thinking about my life
before naturopathic medicine, the journey here at NUHS and the
career that lies ahead, our Mama Swan and her three new cygnets
stopped by the table under the willows. They were reminders that
each passing year brings new rewards, new challenges, new people in
our lives, and hope for the future. Each new year brings hope for
health, hope for success, hope for joy and fulfillment; hope for
the ability to provide for others and ourselves. My sweetheart
looked over, asked my thoughts and why I was smiling. I took in all
the symbols of past, present and future around me, the willows over
me, the Mama Swan and her little ones behind me, my lady next to
me, the patient research in front of me, the wind whipping the
willow branches, and mixing all together, I replied, "Just enjoying
the present, babe."
When my old Nissan Xterra passed 200,000 miles this week, I was
reminded of the reliability, longevity and commitment to completing
a naturopathic medical degree.
How appropriate that this weekend saw the passing of our
school's presidency from Dr. James Winterstein to
Dr. Joseph Stiefel. Dr. Winterstein's leadership of NUHS for
past 27 years has seen his overseeing of the expansion of
National from a college to a university with multiple professional,
graduate and undergraduate programs both in Illinois and Florida.
The most notable to me was the reintroduction of the naturopathic
program to National's campus in 2006.
Dr. Winterstein led the effort to bring naturopathic medicine
back to NUHS after a more than 50-year hiatus. He met resistance
and persevered, with reliable commitment to the cause of
naturopathic primary care being taught at our university. Dr.
Winterstein's philosophy as a chiropractic physician is that
chiropractors are primary care physicians and are responsible for
screening each patient who visits a practice. He took that noble
rule of thumb and expanded it to include the naturopathic
program on our campus.
Dr. Winterstein had to be patient, persistent and committed to
obtain his goal of returning the naturopathic medical degree to our
campus. He had to recruit knowledgeable, dedicated leaders and
educators to work at an upstart program in the Midwest, about as
far away ideologically and culturally as one can get from the
existing naturopathic schools in the far western states at the
time. Yet, he brought in Dr. Fraser Smith and Dr. Louise
Edwards to build a naturopathic program with a sound basis in
naturopathic philosophy. He lent a guiding hand and mentored our
leaders to accreditation within seven years of inception of the
program and has left a thriving naturopathic college on the campus
of National University of Health Sciences!
I'm certain Dr. Stiefel will continue the excellence exhibited
by Dr. Winterstein and his "200,000-mile" effort in bringing back a
vibrant naturopathic medical school, which is improving with each
trimester! Thanks to you, Dr. Winterstein, for your leadership and
may you have a long, healthy and joyful tenure as President
• Combined Classes
• Observing in Clinic
• Botanical Medicine
• Minor Surgery
• Intern Skills
To read older blog posts, scroll to the bottom and click the "Older Posts" button.