A Big Start and My Washington Adventure

Wow. It's been an enormous few weeks since I last sat down to write! First of all, I get to start seeing patients in the clinic! The time has come. We've been doing something called Counsel Practice with Dr. Marier, one of our ND clinicians, and we always start this practice of speaking in a circle by checking in. If I were holding the talking stone right now I'd tell you I am overwhelmed, excited, thankful, nervous, and ready to learn from my mistakes.

All of us 8th Tri ND students spent last week's clinic hours in orientation, which was all about drinking from the fire hose of information. We learned a wonderfully overwhelming mix of things, from tips on how to work with patients, to the tedious checklists to keep in mind, to learning the machinery that keeps our campus clinic running. There is so much to learn!

Besides starting in the ND clinic, I am also starting in the Massage Therapy clinic. After working on two of my professors last week, I have been granted their approval (not without a list of things to work on, of course), and will begin seeing real live clients this week, eek!

In the midst of all this clinic-starting excitement, I am still responsible for taking 10 other courses: eight in the ND program and two in the massage program. One of my massage classes is called Chair, Sport, and Trigger Point. I came home from our first class last week to a message from a friend telling me how great he felt after I'd worked on him in class a mere hour earlier. Positive feedback from peers is so reaffirming! Note to self: communicate to my peers when they do an awesome job… maybe it'll be just the boost they need!

So, I'll be working hard this summer, but let me catch you up on my exciting break!

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Katie and me on Lobby Day.

On May 4th, I participated in the [American Association of Naturopathic Physicians] DC Federal Legislative Initiative, the naturopathic community's lobbying day in Washington, DC. During the two days preceding our day running from senate office to house office and back again, we had lectures and workshops on our initiatives and on how to articulate our medicine. I left the event with the realization that participating in democracy is relatively easy! Showing up for a meeting with a legislative assistant is intimidating at first, but after a meeting or two, the jitters disappear and you have fun explaining what you do and why it matters.

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In the Library of Congress

I learned a lot and also made some powerful connections with students from other schools while at DC FLI. We have some incredibly motivated student leaders, and I imagine these will be the people who rally in the public eye to carry our profession forward as we graduate and become practicing doctors. I also realized that our program here at NUHS is really excellent; it keeps pace with the other, more established programs, and our work alongside chiropractic students is pretty unique.

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Exploring DC's botanical gardens

Not only did I meet and enjoy the company and camaraderie of students from other schools, but I also got to know a totally fab group of Tri 2/3 ND students from my very own school! Starting clinic certainly makes me feel like I don't know anything, but networking with students from trimesters past has given me some confidence by remembering how far I have come over the past two years. I fielded questions, offered advice, and learned a whole lot about myself from my interactions with Mariah, Sarah, Katie, Michael, Kolby, and Alex. Thank you all!

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All of us from NUHS at DC FLI.

Rain, Looming Finals, and a Trip to the Spa

It's springtime! And so it is also, inevitably, final exam time. Talk about torture...staying inside to study while the birds are chirping and the neighbors are out grilling and chatting and generally having fun without me; story of the student life. I've started my tri-annual 2-week-scramble as I head into the last week of classes, also known as the first week of finals. I have been busy tracking down research (for a paper I have yet to write), making checklists, studying modalities and psychopathology, and writing up a business plan, while also filing my taxes, cleaning the bathroom, and.... Do you even care about the details? Let's just say things are winding up (and taxes are a huge pain!)

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Last week's storm clouds clearing, leaving behind super green grass on campus!

In between the torturous number crunching for my business class and scouring PubMed for articles, I managed to get out to our botanical garden season-opener party and pull last year's leaves off an awakening Ruta plant. I also practiced massage in preparation for starting in the clinic next tri (exciting!) and got out for a date night with my main man.

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Headed into the King Spa!

Hanzi and I redeemed our Groupons for the King Spa over the weekend. If you haven't been there, seriously, do yourself a favor, you stressed out student! The spa has about 8 or so different rooms ranging from warm to wickedly hot, the walls covered in all different things from salt to gold to amethyst to coal. These rooms are co-ed and everyone wears the same funny T-shirt and shorts uniform (gals in pink, guys in grey). Hanzi and I started out sauna-ing in the various rooms, our favorites being the salt room and the amethyst room. Oh, and the Ice room also feels really excellent after working up a sweat.

Once we'd had our fill of lying or stretching quietly in each of the rooms, the two of us split up and headed for our respective sides of the spa. In the ladies-only section, there are three different temperatures of hot tub, one cold pool (eek!), and a steam room. Each time I've been to the King Spa I rotate through the tubs, then dunk in the cold pool, and move to the steam room. I do this routine 2 or 3 times and I leave feeling absolutely divine! (Note: no bathing suits allowed. You've been warned.)

After at least half an hour rotating through the tubs and steam, I showered off, put on a clean pink outfit, and headed back out into the common space to meet Hanzi for dinner. We ordered some delicious Korean food with plenty of veggies. After dinner we retired to the comfiest chairs on the planet and lounged for a while, digesting dinner and letting our spa-ified bodies totally relax. Around 9pm, we split up again for our respective sides of the spa, changed back into our street clothes, carried our shoes out to the entrance, and paid for our dinner before driving home.

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Sunny spring day, brewing sun tea on my porch

I can't think of a better way to spend a few hours toguether before our household goes into finals mode. Hanzi's semester in his master's program at Loyola is also wrapping up, too. Taking the time to indulge in spa time quite obviously counts as "physician-to-be heal thyself." (See my last post for more on this subject.) It also fits with this emerging spring. Relaxing, sweating, and purifying at the spa mimicked the drenching April rain we had this week that left campus sparkling green. I might have a lot to tackle over the next 10 days (1 project, 1 paper, 1 practical, 1 quiz, and 7 exams), but after my evening at the spa, I'm feeling more centered and ready.

So here we go! I'll be back in a few weeks to regale you with tales from my break, and in the meantime, good luck with exams and enjoy your time off!

Storytelling, Salamanders, and Sol

A few weeks ago, before she left us (sad face) for her new position as an Assistant Dean in the Naturopathic Program at the University of Bridgeport, Dr. Stephanie Draus organized for a woman who calls herself Comic Nurse to come speak to us during a Tuesday lunch hour. Comic Nurse told us about how she uses comics with her patients and with the medical students she teaches at Northwestern to help tell the story of the healthcare experience. Whether it is getting patients to express their frustration with their doctors, or helping doctors-to-be address their anxieties about their future, comics have proven to be a remarkably effective form of expression.

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Many of us think of comics as funny things that make us laugh, and with good reason, the adjective means, "to cause laughter." But we are talking about the noun here, and the noun is a form of storytelling that involves words and pictures and lets the storyteller use imagery to express those things that are sometimes too hard to express with words alone.

You can probably tell that I like using words to process my struggles and tell my stories. Some weeks though, those words just don't flow like I'd expect them to. I have the modern day equivalent of a trash can overflowing with crumpled up papers; too many untitled WORD docs in my "student blog" folder laden with half-sentences and stories that never came to fruition. Now I know an alternative outlet to get my creativity flowing!

No matter which medium you use, storytelling is a powerful tool for learning, for self-discovery, for communication, and for teaching. In PT Modalities class a few weeks back, Dr. Hill told us a story about chopping the legs off a salamander and then re-growing them with the application of therapeutic Microcurrent. So of course I remember that Microcurrent is indicated for tissue healing and repair! The rescue of quadriplegic salamanders is a pretty great memory tool.

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My study comics, Piper and Sun King

I also tell stories to remember my botanicals. For a recent quiz, I had to remember Solidago virgaurea; common name Golden Rod, used for urinary tract infections and colds with a runny nose, and sometimes mistaken for ragweed in allergies. I associate the word Sol with Sun. So, there's this BIG sun god with a golden scepter and he's a super powerful diuretic/aquaretic! (This god always has to pee.) If you look at him directly, you'll start sneezing like crazy and you'll need him to cure your snuffles. You could think you're allergic to him, but you're probably wrong, this sun king doesn't wear rags.

Another favorite Bot Med study story is of Piper methysticum (common name, Kava.) Piper is an aging socialite in NYC who drinks too much wine while she lounges around, sedated on her couch all day, popping muscle relaxants and pining for the elusive man GSH who she loves but who does not love her back. Piper is also sad because she has a urinary tract infection and is very worried about her skin. As you can see, there is a lot going on here with Piper, so I'll spare you the medical translation.

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Reading some medical comics in the LRC

Storytelling is one of the very best ways to remember and to process emotions, two things we must do often as medical students. If you're more of an artist than a wordsmith, try like Comic Nurse does and draw the story. Or, if you're neither good with a pencil nor crafty with words, screw it, try either one! Because it doesn't matter if the sentences are simple or if the characters are stick figures, what matters is self-expression and creative learning.

Physician-to-Be Heal Thyself

Last week I mentioned the principle of Physician Heal Thyself, a concept we discuss in our first trimester of school in our Foundations of Naturopathic Medicine class. To my fellow students reading this blog, when's the last time you pulled out those notes? Reading Dr. Lou and Dr. Draus' words and the notes I made in the margins reminded me of all the other-than-science things we learn and must continue to learn. As Dr. Draus reminded us, this is neither the first nor the last time we will learn anatomy, physiology, etc., and it's not the first time we learn about the importance of self-care.

I drove past the gym on my way home from school a few days ago and wondered how I had managed to get there to work out every other day while I was studying for boards and attending classes, but how I had somehow lost the time to go after I took that huge test. So, I made it a point to go and aaaahhhhhh it felt soooooo good!

I sat on a stool in the locker room after my workout and sauna feeling like melted gold, and as I stared at my satisfied self in the mirror, I realized, going to the gym needs to be a priority on my weekly agenda.

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Post-workout, reminded of the feel-good power of a workout

Physicians do not have a good track record of self-care. As a whole, physicians are statistically more likely to be depressed, sick, commit suicide, become addicted to or abuse substances. We are more likely to have tendencies towards perfection and yet, as Dr. Lou put it, there is no such thing as perfect medicine. As physicians we must walk a fine, exhausting line between using objectivity and engaging our emotions to care for our patients. The profession as a whole has trouble taking time off, and we rarely get a sense of closure or achievement as the process of healing is never complete. And then there are the inevitable financial pressures as we struggle to maintain an expensive business while still finding ways to offer care to all of those in need.

Dr. Lou reminded us in her Tri 1 lecture that we should take a page from our own book when we ask our patients to please take care of themselves so that they can take care of others; we must do the same. It makes me think of my father's wise words that I hold close: "You cannot truly love someone unless you love yourself." Well, as a physician, you cannot truly help someone unless you help yourself. To this end, Dr. Lou reminds us that "Self-care is not an indulgence -- it is a responsibility to the work and to your patients."

Part of self-care involves cultivating interests outside of medicine. We should all remember from our neurology and psychology classes that a healthy brain works on a wide range topics, skills, and problems. By diversifying our activities and interests, we support healthy neuronal growth and limit our risk of diseases of the brain. Robert Heinlein, a bright and controversial science fiction writer, once wrote:

"A human being should be able to change a diaper, plan an invasion, butcher a hog, conn a ship, design a building, write a sonnet, balance accounts, build a wall, set a bone, comfort the dying, take orders, give orders, cooperate, act alone, solve equations, analyze a new problem, pitch manure, program a computer, cook a tasty meal, fight efficiently, die gallantly. Specialization is for insects."

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Champagne and conversation self-care, toasting boards results and registering for clinic!

Now, I've got a lot to work on based on that list, but I'll allow that building a fort out of sticks and pine boughs might count as designing a building, and conning a ship could include paddling a solo canoe, and so I've achieved some of these things in their smaller forms. The point of sharing this quote is to remind us students and future students of medicine that we should make time, however miniscule an amount, to engage in things other than learning our profession. And yet, we should also remember that right now our job is to be students of medicine and that requires a lot of us. It demands that we spend an extra amount of time with this subject and this set of skills, for the time being. Believe it or not, a time will come when I can get exercise by hiking and skiing rather than biking indoors at the gym. Until then, I'll take the time to care for myself in the ways I can, within the limitations of the task at hand, and I know this will make me better at my job.

Your Beast, My Unicorn

This weekend I tried to move slowly. I will spend all week moving somewhat obsessively and efficiently from one task to the next. I look forward to the weekend because I don't have to be anywhere at any particular time with my brain on and ready to go. Despite this, it's ridiculously hard to slow down after moving through life at such a clip. I had to make a sincere effort to have an unhurried shower on Friday evening. I had no plans, and yet I was operating like I had better soap up quickly so I could rinse off fast and move on to the next task. The weekends are supposed to be my reprieve from go-go-go! I'm not kidding guys; I had to actually think about lathering shampoo with patience.

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While we're talking about unicorns and positivity...
(Image source: www.twisteddoodles.com)

Why move so fast in the first place? I would prefer to go through life at a relaxed pace, but medical school is the perfect storm of lots of time required for sitting in class and for learning stuff, and high expectations for doing it well. I was blessed/cursed with the ability to move quickly, as will happen when you grow up with ambitious parents in a progressive Boston suburb. Because of this, I can all too easily accelerate to match the flow of med school traffic and maintain that speed.

Part of the reason I am drawn to massage and bodywork is that a general attitude of peace and flow permeates such treatments. If I want to give a good treatment, I must relax into the spa music and foster an environment that allows my client to relax. I reap the benefits of relaxation when I meet my client where they are, ready to slow down and be quiet.

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My home office, set up to practice massage and in doing so, calm my mind.

On the other side of things, an inescapable aspect of working in the ND clinic is that an air of quick anxiety permeates, especially on certain days. It can be hard to come in to work a 2-hour hydrotherapy shift and create a bubble of calm in the midst of an existing sizzling atmosphere. I have found that if I can channel that massage mindset and embody the feeling I'd like my patient to get from their hydrotherapy treatment, the whole appointment goes much more smoothly. If I succumb to the tension that lurks in the clinic hallways, I have a harder time taking blood pressure, or I forget to heat the hot towels for my transition phase of constitutional hydro. Sometimes it takes this little moment of poor planning or fumbling with my stethoscope to realize that I am letting every one else's fervor drive my thoughts and actions.

In a recent appointment, I sensed that my patient was a little more on edge than usual. Before entering the room again after checking in with my clinician, I took a deep breath and made up my mind to fill my being with the word "compassion." I moved more slowly as I pushed gentleness out in front of me in an effort to dissipate the angst I'd sensed earlier. And you know, I think it worked.

I'll admit that pushing a positive emotion ahead of me, or embodying a feeling or a word in order to change the feel of a space and support a patient, is exhausting. However, I know it has to be like anything else; practice will certainly make it easier and self-care (physician heal thyself) has never been more relevant.

I've been both praised and questioned for my optimism. The skeptical people want to know why I am so positive, especially in the midst of finals, for example. My answer is that while it might be tiring, I can always sleep. It is easier to be happy than to be sad. It serves me so much better to look at the bright side than to wallow in the fog. You can approach medical school as if it is a dark and scary beast, or you can make it into a giant, shiny unicorn that might blind you or run you over if you aren't willing to grab it by the horn and ask for help. Yeah, I like that; medical school is a huge unicorn. I think I'll stop there.