Midterms II - The Creepy Knock on the Door that Won't Stop

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! :)