A Successful Day

I still haven't gotten around to writing about how clinic is in general, and I swear that it's on a list somewhere. I do want to share that information, because I think it's nice to have that available as a current or even prospective ND student.

Today however, I wanted to share some information about a good day in clinic.

This past couple weeks have been a little crazy and stressful. We're 6 months into clinic, and I'm not exactly where I'd like to be with respect to my skills. Sure, I've progressed and know A LOT more than I did 6 months ago. I'm getting better at connecting with patients, providing treatment and exams. But there is a lot more that I'd like to be doing better at, and there's also a bunch of assignments and things to work on right now, so it feels like my time is really limited. I've also noticed that often when people say "Hey Noah, how's it going?" I don't respond too well, usually saying "not well." Things have been getting me down and stressed, and that's not the type of person I usually am.

Anyway, within all the stress, I had a great experience with a patient today that really brought me up and improved my mood and motivation. So a patient of mine came in for a follow-up. They weren't feeling all that well and had considered cancelling, but decided that it was a good idea to come in. Already a good sign, knowing that I am able to provide a space and care that people feel comfortable coming to. The nice thing though, was learning that treatment we had initiated last visit had provided a positive shift for them, and this was based on my own research and clinical judgment. The visit continued and we had a good plan moving forward, and I'm excited to continue helping this person improve.

Sure, this does happen a fair bit in clinic, but it's always a nice reminder when this happens, that I've got the tools and skills to help people improve.

So amidst the chaos of everything else that happens in life, I enjoy taking a chance to step back and just notice what I have done, and what I can do. After all, it's why I got into this in the first place!

Winter Unity Summit

 It's Sunday night with only 3 weeks of classes left, and then exams are coming! But let's forget about that for a minute and do another retrospective post, because that's always more fun!

So I've posted in the past about my own Unity Summit here, but this one was a little different for a few reasons. First, instead of being a new student, this time around I was a 3rd year student, and on the student's association helping to run the event. Being in charge is really cool, because you have responsibility for helping others have a good time, which is quite rewarding, as I described when talking about my blue mountain trip.

Second, the experience of unity summit is very different when you are a student leader, because you are coming in already having some friends, are more comfortable, and as a leader, it's your job to be really open and friendly with everyone. As a result, you end up pushing yourself to meet lots of people, and get to make lots of new friends. This a really awesome part of the experience. I would have to say that being a student leader over the past two years has been really fantastic for many reasons, but pushing myself to connect with more people is one of the big reasons.

Finally, one of the really cool things about this Unity Summit is that it was the Winter one, meaning it was a completely different setting. The Summit in the fall is always at the YMCA camp up north, and that is cool, but it's a little different for the winter. Instead we go to a smaller camp in Halton Hills (west), and there are way fewer people, as the January intake is usually about 1/3 the size of the September intake. The smaller group is a little bit more intimate, there is a lot more free time, plus, it's during the winter! This means snow, and ice, so activities like snowball fights, ice skating and hockey are all part of it. Plus I got to go horseback riding, which was pretty cool, even though it was just a slow tour, because I've never been riding before. And with the really relaxed environment, we came up with an awesome NSA skit that I will remember forever, a ton of fun to do, and ended it off with a really fun dance party. This is the 4th Unity Summit dance party I've been to now, but it was a really special one, because when Dr. Turk played Bohemian Rhapsody, literally everyone in the building started singing it together. Really cool experience.

I thought I was going to write about Medgames, but this post has become long, so I'll save it for another time. Hope you enjoyed your Easter long weekend! I can't remember the last time Easter was in March, so weird to me, but it was a pretty relaxing weekend. My nephews Erik (almost 3) and Andrew (almost 1) came over to stay all day Saturday and Sunday, and they are just adorable. Plus we finally had some fantastic weather, after the ice melted on Friday of course. I even got out for a couple long walk/jogs on Saturday and Sunday. Anyway, have a great week!

There's me with the horse I rode, Cujo. He got a little crazy partway through, started bucking a little bit and maybe almost killed me. But we're cool, he's a good guy...I mean horse.

      

Winter Blue Mountain Trip

So this is one of my retrospective posts, a little more on CCNM life.

Something that I wanted to do throughout my undergrad, but never got a chance to do, was plan a ski trip. The great thing about planning a trip is that: you get a discounted price for yourself for booking, you get a lot of responsibility, and thus satisfaction from helping everything come together, and of course, you get to set up a trip doing something you enjoy, with people that you like.

It was finally this year that I went ahead and did it, and I'm really happy that I did. The trip that I planned was really difficult to pull together. I first started looking for people interested in late October, and once I had a lot of people, I started looking for a place to book the trip. Suddenly, people started dropping like flies, and then there were issues with dates because of other events, a lot of different factors made it really difficult. However, a lot of hard work and persistence allowed things to finally come together, and for my post-midterm Blue Mountain trip, I had just over 20 people signed up with money paid to come.

We had a fantastic time on our trip, leaving for Collingwood just after we finished our exams Friday morning, and staying until Sunday afternoon. We skied in beautiful weather on Friday afternoon/evening and Saturday. We had a wonderful time enjoying a big chalet, spending time together in the hot tub and sauna, playing games in the big great room, and talking late at night. We also went out to the Village Saturday night and created our own party at a small club, having a lot of fun there too. Sunday we went to the spa at the hotel at the Inn at Blue, and enjoyed going from hot tub to cold pool, to massage, and finally a really nice sauna. And a big part of the enjoyment was from spending time together and talking about lots of things, most of all not talking a lot about school. The 2 hour drive there and back was also a great time to talk and enjoy each others company.

Now I'll mention that this was not actually the only trip. Another friend of mine booked a trip to Blue for us to a similar type of chalet just at the end of Finals in December. Same thing, we drove to Blue right after finals were over, and went up to have a great time. The only difference, is that there was no snow in December! So we didn't ski at all, I didn't even bring my skis! That being said, we still had a wonderful time, getting away from the city and just hanging out with each other.

So I guess the reason that I wanted to write this blog post, aside from reminiscing about some great times with my friends, is to talk about the importance of getting out. Escape. This works for people in areas of life of course, but I think this is really important to CCNM students. Depending on how diligent you are or how important going to lectures is for you, CCNM students can spend well over 30-40 hours a week at the school, many more of course if you live in residence (I'm fortunate enough to have my home close enough to school, and a car, so I do get away). There are many wonderful people at CCNM that you get to become friends with and connect with, but when you're at school, we are in a little bit of a bubble. It's not the same as the outside world, and the things that you talk about are very different. Realizing this, it is vital to get out of the school and experience the world with these wonderful people. I have found that the connections you create become much stronger, and the experiences you get to have are amazing. Whether it is going out to a bar on a Friday night, taking in a museum, going to a Harry Potter Trivia night (yes I did that in February, it was really fun!), or going on a ski trip, it's just awesome to connect with your friends in a different setting.

I hope that you, blog reader, take my message to heart, and ensure that you take opportunities to connect with people outside of your bubble. If it is CCNM, push yourself and your friends to participate in activities outside of the school. If you have friends that you work with, offer to do things outside of there. The connections that you strengthen, and the experiences you will have are worth the effort.

Fun picture from the first Blue Mountain trip. Since there was no skiing to do, we wandered and enjoyed the village together, and ended up taking a picture with Santa Clause. It was a really happy and fun day!

Back From Another Hiatus and 3rd Year Winter Courses

So unfortunately I fell off the wagon with blogging again after Finals in the Fall semester. I can't promise that my consistency will be back, but I'm going to try to be a little more consistent again, at least until the end of the semester. And while I'm doing that, I'll try to give a bit of a recap of all the stuff that has happened this semester.

At the moment I'm busy working away at some assignments, but I did finally get something done that I've been meaning to do for weeks. I created a Facebook Page for myself as an intern at the RSNC. Oh by the way, I'm an intern at the RSNC now, that's something new for Winter! I'll write more about that in a future post, but here is a link to my facebook page, which I'm hoping to keep a little more regular than this blog with posts, at least once a week.

Now I've got to get back to my assignments, but I'll give you a quick overview of the courses that we have in 3rd year Winter.

Integrative Therapeutics 2 - This is the same idea as IT 1 from the Fall, just teaching based on the cases we do in Primary Care here, a little bit of OSCE prep, and thankfully, no big annoying paper to write!

Primary Care - As a full year course, this is the same as in the Fall, except that we switch timeslots (in the Fall I had Mondays from 2-420, so now I have 430-650), and we get a new group. In addition, there is an OSCE examination, which I had just last week, I'll write about that in a future post though.

In Office Procedures - This class has a little bit of didactic lectures, but is mostly a practical class where we learn phlebotomy, injection therapies, sample collection (urine, saliva and skin), ear lavage, and nebulized glutathione and magnesium, as well as some basic theory about intravenous therapy (this is a full continuing education course with extra certification required, but we do learn some basics).

Maternal and Newborn Care - Dr. KBT (Kimberly Blyden-Taylor) teaches this course, a great overview of care for mothers and newborns, all the way from preconception through breastfeeding.

Asian Medicine - As a continuation from the Fall, we learn more about TCM formulas, TCM theory on Western conditions and run through lots of practice cases. We also have a big research paper similar to IT in the Fall, except this one was done as a group of 4, so it wasn't nearly as time consuming.

Asian Medicine Practical - A continuation from the Fall, we do 2 partner cases where we take a case from a classmate, come up with a treatment plan for them, and then initiate that treatment plan over 2 visits. We also have several group practicals to further practice our skills in tongue and pulse diagnosis.

Manipulation - In 2nd year Winter we learned all about motion palpation and assessment of the body from head to toe, here we get to learn how to actually perform chiropractic manipulations/adjustments to fix joints that are out of alignment. Keep in mind that "out of alignment" doesn't literally mean the bone is in the wrong place, it means that joints are not moving as well as they should due to spasms and tight muscles, so we help them move with specific adjustments. And the cracking sound that you hear during an adjustment? That is not the bone cracking! It's just gas escaping from the joint as you move it.

Emergency Medicine - This course is a lot of review of Standard First Aid, something that I have a lot of experience with as a former lifeguard and camp counsellor. This is important though because only CPR level C with HCP is required to be a student at CCNM, Standard First Aid is not. So students need to get some training in emergency management. In addition, we learn about the emergency drugs that NDs are allowed to administer such as epinephrine, and we also learn about the use of oxygen. There is some full class lectures and a group assignment, but this course is mostly small group practicals.

Pediatrics - This course is focused around care for children from 0-18, looking at growth from all aspects of health including physical, mental and emotional, as well as the social connections with family and the environment. We have didactic lectures for the first half, and then after midterm (which is multiple choice), all the classes are case based where we work in groups on specific conditions in different age groups. The final is going to be open book (including computers), so I'm a little worried, but we'll cross that bridge when we get there. This course also includes a "lab" component - in early January we had the Pediatric Open House at CCNM where parents brought in their children to be assessed by 3rd year students in groups of 2. We then had to also observe a pediatric appointment either at the RSNC or through some sort of preceptorship. Then we needed to write a reflection paper based on these 2 observation experiences.

Homeopathy - A continuation of last semester with focus on acute remedy prescriptions, as well as practical sessions where we work on case taking. In addition, we've continued following our live case that we saw our instructor do last semester.

Botanical Medicine - Again a continuation of last semester, just going through more body systems and also working on 2 more group cases.

Clinic - Finally, what should be the most interesting course of the semester, clinic! In this course we have 1 clinic shift on a Tuesday-Friday night (2-8pm) or a Saturday morning. I personally got a Wednesday 2-8pm shift with Dr. Ragbir, who was actually my TA in first year health psychology if you remember from this post. On the shift we get a mentor 4th year student, and follow them as a secondary intern for the semester. This means that we see all their patients with them and are slowly incorporated into the visits, helping with physical exams and intake, as well as some treatment. We can't do adjustments or injections, but we can do acupuncture if the supervisor is there. In addition, we work with our interns on charting and treatment plans as well as patient research. Unfortunately my shift and my intern specifically hasn't been that busy, but I have still definitely learned a lot from this experience so far, including from shadowing Dr. Ragbir and seeing a bunch of different patients on the shift.

Alright so that's it for today, I'm going to get back to my assignments for now, but I'll try to be back for another post soon to review some of the events that have happened this semester so far.

I know I've been gone a while, but hey, this owl is pretty cute right?
And I'm a night owl, so maybe that's me?

Holiday Play and Exam Time

I'm sorry I missed my most recent post, it's been a busy weekend, and exams are coming!
Friday I went to a really awesome concert, one of my old favourites Protest The Hero did a reunion show and played their entire album Kezia from 10 years ago (one of their best songs if you're interested). They haven't actually broken up, but two members left the band, so it was nice for them to come back and play this old stuff. It was also fun because I went to the show with a friend from school, and I've never gone to a concert with anyone other than my older friends and my brother.

Saturday night was the holiday play which was a lot of fun. Every December the 4th years put on a holiday play - no actual holiday theme here - and use it as a fundraiser for Grad. This year the theme was Inside Out at CCNM, and it was absolutely hilarious. Instead of emotions, each character was a part of a human, like MSK, GI, Brain, etc. They had really funny characters with a lot of silly jokes - I could especially understand most of them being in 3rd year now! - and even a couple great songs. I don't know what capacity it will be in, but I'll definitely be involved in the school play next year for my 4th year, it's not something I could miss out on!

So anyway exams are coming up, it's going to be busy, but not horrible I think. Definitely manageable, a lot due to the fact that in 3rd year, we have lots of assignments and practicals during the year, so our exams are worth a little bit less. I think I'll be able to manage. Next week I've got Integrated Therapeutics, Botanical Medicine, Radiology, Mens and Womens Health, Clinical Nutrition, Asian Medicine and Physical Medicine exams. The following week I have Primary Care and Health Psychology. So that's 9 exams in 9 days. Seems like a lot, but I'm used to it by now. Also Physical Medicine is a short practical, Nutrition is open book, and Psychology is not worth too much, not to mention I have pretty much perfect from the practicals and assignments. So I've got a fair bit of work ahead of me for some of the others, with IT, Bot and Asian Med consisting of a lot of information, but it will be manageable.

I kind of doubt I'll have a post on Sunday because I'll be really busy studying for exams, but look for a post the following week - I'll still have two more to write, but I think I'll be in a much better state and be able to make a post, not to mention being really excited about being almost done my 2nd last semester as a full time student! (we have one class a semester in 4th year, I don't really consider clerkship being a student, not the same at least).

For those reading who currently have exams or exams coming up, as they say....

Primary Care - Doctor Week!

As usual, it's late on Sunday night and I really should go to bed, but I said I'd do these posts, so here I am. I was actually going to write this earlier, but I decided after 3 years, I'd finally give Game of Thrones another try. I tried watching it years ago and just couldn't get into it, but everyone is always talking about how good it is, plus it's almost December, so you know, "winter is coming." I know I technically saw it in the past, but watching the first episode just now, it was actually really good. I'm excited.

So anyway, a couple cool things this week. First off, I was finally the doctor in Primary Care. I think I explained in the past, but in Primary Care the class is set up as a practical with groups of 8. Every week someone acts as the doctor, we have a standardized patient come in, and for 45 minutes the doctor does an initial intake with questions and physical exams. The kicker is that as we are still learning, your group is available to help guide your thinking if you get lost, or are making a mistake on a physical exam, or miss an important question. This week was case 7, so we've been doing this for a while, but I was only just the doctor this week. It was a very humbling experience. When you're watching the case and doing research in your notes and online, you're disconnected enough that you can really think about stuff. As the doctor, I felt so connected and in the zone with the patient, I almost lost focus sometimes, and of course missed a couple really important questions. Thanks to my group though, I got on track, and I think I did well enough, getting a good amount of information to work with. It was definitely a cool experience, and I'm excited to do it again next semester, of course also doing more of this stuff with real people in my clinic shift. Also side note, I'm also going to be the doctor in Health Psych this week, so that should be interesting too. It's still a 45 minute visit, but a bit of a different focus. I'll talk about that next week.

So another cool thing this week was that it was Men's Health Week. We started off the week on Monday with Suit and Sunglasses day. It was a lot of fun, I usually come to school in joggers or sweatpants, so it felt pretty cool to come all dressed up. At common time we ran a Men's Auction, and raised a lot of money for our charity. I auctioned off some personal training services, so I was glad to be involved. Our charity by the way is Eva's Initiatives for Homeless Youth, a great cause for homeless youth in Toronto that really need help. You can check them out at here.

There was also a really great talk I went to on Wednesday, by Dr. Yashar Khosroshai, ND. He's one of the TAs for health psych at CCNM, and in addition to his practice, runs a company called MindShift Ninja. He has some pretty cool outlooks and perspectives to talk about. His talk this week was very intersting, called "Don't Be A Man, Be A Leader." I thought this was fantastic, because in our society today, there is too much focus on men being this stereotypical character, who is strong, closed off, and doesn't need anyone's help. I have lots of notes on this topic that I'm happy to share if you're interested. He also referred to a cool TED talk I finally watched today by Brene Brown on vulnerability, and how important it is to be vulnerable in order to succeed. To be a leader, to be connected to others, it all comes down to being self-aware, and being strong enough to be vulnerable, to be open and to be able to put your ego aside, asking for help when you need it.

I could talk about this stuff for hours, but I really should get going to bed, it's another long day tomorrow. Fun things for this week? Tomorrow we've got dance practice for Medgames, something I'm really excited about, and hopefully I'll have a video to link for you in January after it happens. I'm also going out to Costco to buy food for the MOSCE, an event I attended last year, but this year as one of the VP Academics for the NSA, I'm actually running! So that's on Tuesday, and I'm hoping it'll be a great event to help support the second years and prepare them for their OSCEs. On Friday I'll be shadowing the Fibromyalgia/Myalgic Encephalomyelitis shift, which should be pretty interesting. Speaking of that, my application was accepted and I got an interview! My interview is next Friday (December 11), so I'm hoping that will go well - we're a few weeks off, but I think I'll know if I get on the shift around the end of December.

Alright, long enough post, and it's almost 1! I'll leave you with a picture of my Mo progress for Movember. I don't do the 'stache only thing because it looks pretty bad on me, but it's been a fun month anyway.

I think I took the original picture really late on November 1st, that's probably why I look so out of it.
Or maybe I planned on making the Mo picture look a lot happier, strategy!

Focus Shifts

Another pretty relaxed week this week, though focus shift applications were due on Friday, so that was a bit of a stress. The Robert Shad Naturopathic Clinic (the school clinic at CCNM) has several different focus shifts that students can apply to. The purpose is to have a focus on a specific patient population during their shifts, and also to learn from supervisors with extra training in that area. The following shifts are available at the RSNC:

Pediatrics
Sports Medicine
Adjunctive Cancer Care
Fertility/Reproductive Health
Fibromyalgia/Myalgic Encephalomyelitis

I decided to apply for the FM/ME shift, so I'll keep you posted on what happens with that. The applications included a CV (I haven't made one of these in forever!), and an essay. The essay was really tough because I haven't really done a lot of personal essays. Give me a research review or a scientific paper to write, sure thing. But writing about myself, and why I want to do something and would be good at it? That is a little more difficult. So it was a bit of a struggle, but with some help from my dad (who is a pretty great writer), I was able to put something together that was pretty good, and hope it'll get me the interview. There's an interview process in December I think, or possibly early January, and we'll see what happens.

Anyway, real quick about FM/ME so you know what it is. Basically they are two very complex conditions that do not have the best diagnosis and treatment right now. Both of these conditions can be very debilitating, and pull people away from work and the things they want to do in life. Naturopathic Medicine has a huge potential to help these people to improve their quality of life, and I'm very excited about the opportunity to help these people. In addition, I want to be the best doctor that I can in the future, and I believe that the challenge of working with complex cases would be a valuable experience. Here is a quick summary of FM and ME if you'd like to read more into them.

That's all for now, and oh ya this week is actually Men's Health Week! A very important time, remembering the importance of Men's Health. By the way, it is Movember, and I did shave clean at the beginning of the month, and I'll have a picture for the blog next week to show how far I've come. Hopefully I've helped raise some awareness and money for good causes as well.

Student Leadership

Quick post today because it's late and I've gotta get to bed. Today we had one of our roundtable meetings for the NSA executive. The meeting obviously has some tedious points, but it also reminded me why being part of student leadership is so great. I really enjoy getting to spend time with lots of like-minded students who want to be involved, and work together to improve the student experience for all our colleagues and classmates. It's also great to hear about all sorts of different activities and initiatives you may not have heard of and learn how to get more involved. And of course, after the meeting, we had an awesome potluck dinner where we got to just hang out and rap about anything.

There's a lot of different aspects to being a student leader, and I'm happy to talk about any of them if someone wants to comment with a question. In general though, I think that being a student leader is an amazing thing that you can do at school. We only have limited time here, and I think that you get what you put into your experience. As a student leader, you have a lot of opportunity to make a difference, both for other students and for yourself. And it's important to note that being a student leader is not restricted to being elected on student government, or as a class representative. There are always opportunities available for those who are interested, all you have to do is ask.

On a quick school note, crazy assignment time has finally quieted down a little bit. After finishing my RCIA last week, having my live patient DRE and GYNE exams, my Health Psych Case Formulation, Homeopathy Case Analysis, Primary Care PEP (busy week because as Scribe I was in charge of ensuring everyone got their work done and doing final edits) and Phys Med Practical Case, it was nice to have a little bit of a break this weekend; some time to chill out and not worry about much. We did start our partner cases in Asian Med this week, so I took the case of a classmate, and I need to workup the case, come up with a differential diagnosis list, and a treatment plan for my classmate this week. I'll present that to my TA on Thursday, and if its approved, then I'll start treating my classmate in a couple weeks. They're also going to do the same for me, which is pretty cool, hopefully we can see some good results with each other.

Alright off to bed, have a good week everyone!

The Importance of Community

Back again for my second "regular" Sunday post. I'm kind of procrastinating doing some work tonight, it's been a long day, but I'm going to do my post as promised.

This has been an interesting week as always, with our first ADNSA meeting, practicing CBT on standardized patients in Health Psych, trying out moxabustion and cupping in Asian Med, the Jays clinching the playoffs (woo! I'm such a bandwagon fan but boy is it a fun energy to be part of! Plus my grandfather loves the Jays and it's really nice to share something with him), and a really big one, the Proclamation Celebration on Thursday. That's right, the Naturopathy Act of 2007 has finally been proclaimed in Ontario - Okay, well it was actually proclaimed in July, but we're finally celebrating it. As with anything politically related, this is just one step on a long road, and you can't appease everyone as many people are a little upset about certain things, but overall, this is really great news for NDs in Ontario and across Canada and the US really. Improved regulation and legal rights leads to better patient care and protection, and better outcomes for doctors in the end. It was great to celebrate this occasion with fellow students and doctors, and to look back on how far we've come as a profession.

Anyway, onto the topic of my post for today. Community. An awesome TV show (well at least season 1-3); but also, an important word. A quick google definition of the word shows the following: "a feeling of fellowship with others, as a result of sharing common attitudes, interests, and goals." Coming from a large family, I think I've always taken for granted the importance of community, but it was really while reflecting on my last week, and doing some digging into some old psych notes that I got a greater understanding. Maslow's Hierarchy of Needs is an interesting concept based upon what it takes to find your purpose in life: self-actualization. I think this is something that everyone should and eventually will want to achieve, to answer the big question, "why am I here?" Maslow posits however, that in order to reach this point, you first need to attend to your most basic needs. This starts with physiologic needs like food, water and air, and then moves on to safety. How can you worry about your purpose if you can't eat, breathe, or drink, or if you don't feel safe from harm? But the next part of the pyramid is actually a feeling of love and belonging. We as humans have always survived and flourished because we build communities; we work together to help each other succeed; together. 

Of course being aware of this concept has led me to reflect on my recent past, going through this difficult program of Naturopathic Medicine. Could I have done this all by myself? Without a strong community? I really don't know. I do believe that we are all amazing beings with tons of potential for success, but I also think that we can all be better with the help of each other. In my first two years of CCNM, I was provided with endless resources from older students to help me succeed in my classes. I was given motivational speeches, invaluable tips, and people to talk to when I've felt overwhelmed. The help this community provides extends beyond just the older students though; my friends and classmates, future colleagues, are always there for each other. We all know that we have what it takes to succeed, but sometimes we need help to get through certain aspects. Individually, we are strong, but as a community, we are unstoppable. It is because of this that I am so glad to be a part of the NSA executive - my goal is to always help foster this sense of community among the students in years below me, and also students in my year and the one above me. 

This week I really appreciated the opportunity to give talks for the 1st and 2nd years on how to approach midterms, as it can be a little daunting. Having been in their position before, I know that it's tough, but I also know that they have what it takes. And more importantly, I know that they have what it takes to help each other get through. I have been pleased to see lots of sharing of resources and responsibilities among these students, sharing notes, creating study groups. This is the benefit of having a strong community, and I hope to continue to help build it stronger and stronger.

That's all for now, I've got work to do and my ability to write well is kind of flopping, but I'll leave you with this quote from Helen Keller: "Alone, we can do so little; together, we can do so much."

- and okay fine I'll put a funny cartoon this week!

But I swear I'm going to do my work today!
.... But maybe a quick break since I just wrote this blog post...

Thursday, and the most posts in a row ever!

It's Thursday, which means only one thing....tomorrow is Friday! Let's just say it's been a long week, the first full week of the year - well technically last week was, but I was still kind of recovering from unity summit and dragon boating (things I'll hopefully touch on in future posts), so it didn't really count haha. Anyway here are the courses for today

Nutrition 3 - As this is a big class, we've got it twice a week, so just the same stuff, though Dr. Prousky tends to get us working on a case together in little groups for part of class on Thursdays.

Asian Medicine Theory 3 - Taught by Dr. Kassam again, here we're learning the more advanced treatment and theory stuff that we'll later on apply in our practical. For fall, the theory and practical class are side by side, and you have the choice of doing them in either order; but no problem, the stuff we do in practical is based on last weeks lecture, so if you have practical first, you aren't in trouble. Having lecture first is beneficial because we start class at 1, meaning we have a break from 11-1; but having practical first is beneficial becauase you end class at 4 instead of 430.

Asian Medicine Practical - Here we get to actually practice all the stuff in theory class. So far we've just been working on acupuncture, doing some advanced techniques, and then advanced points. Today we did the more advanced points that we didn't do in first and second year, the most infamous of course being Stomach 1, 2 and Urinary Bladder 1. These points are infamous due to the fact that they are right around the eye. It was actually completely fine though, you feel these points less than you feel points in your arm. Once you get over the initial fear, and realize the safety and your control, they are no problem. In the future we're also going to do fun stuff like moxabustion and cupping, and we're also going to start doing cases with each other. These will be great because we'll be able to take everything we've learned and and practice developing appropriate treatment protocols. I'm excited!

After class today, I had my regular clinic appointment at the RSNC. I think I've mentioned it in a previous post, but self care is extremely important, especially in this intense program. The RSNC provides extremely affordable naturopathic care for students (free if you're on the student health plan), and it's a great opportunity to learn about what you will be doing soon from people who were in you shoes just 1-3 years ago. It's also nice to act as a patient so to provide more practice for the interns, and of course it can benefit you immensely, helping work on all sorts of issues. I personally have been doing lots of MSK related stuff in my own visits, but some mental/emotional stuff comes up too, and it's always great to have someone non-judgemental to talk with about anything.

Ok it's 11:15 and I'm going to bed a little bit early today! Here's my funny cartoon for the day, see you tomorrow.

Wednesday, and Some Fantastic News!

Back again for Wednesday's classes. Without further adieu, here they are:

Physical Medicine - This is a pretty cool class, it's taught by Dr. Tebruegge; he teaches functional anatomy in 1st year. As an RMT/ND, he has a lot of experience with more hands on physical medicine stuff, so he's got a great perspective. We learn about stretching (both solo and assisted), strengthening exercises and exercise prescription (my favourite, exercise is the best medicine! except maybe food haha), of course all sorts of useful orthopaedic testing and range of motion stuff, and last but not least, machines! There's lots of really cool machines that can do wonders for muscle pain and strains and all sorts of physical ailments. TENs, ultrasound, laser (which by the way is actually not a word, its an acronym for light amplified stimulated emission radiation, who knew), even UV light. We've got this on Wednesday and Friday mornings, but every few Fridays we'll have a practical to actually practice the tests and movements, so that'll break it up a bit.

Radiology and Advanced Imaging - Not my favourite course, but definitely an important one. This is taught by Dr. Fritz who is a chiropractor, so he has a lot more experience with this stuff. We're going through x-rays and will also look at things like MRI and ultrasound, which are of course important diagnostic tools for many conditions. It's going to be good to have a decent understanding of how these work, even though we'll always get reports from radiologists or other technicians when we get them, so I understand why we have it.

Common Time - Wednesday's common time is a little shorter than Monday, only an hour as opposed to two; by the way if I didn't mention, common time is a period where all four years and the IMGs have no class, so different talks and events can go on during the day that everyone can attend, or people can just hang out together. I had a meeting today for class rep training, it's great that so many people want to get involved in the school (especially the first years, awesome on them!).

Botanical Medicine 3 - This is a full year course in botanical medicine, as we've already got a bunch of basics, we're just diving deeper (class of 2019 reference!) into the medicine, and looking at more conditions and doing more intense cases. It's a bit of a tough class to get through, not my favourite, but there is a lot of awesome stuff you can do with botanical medicine, so it's definitely going to be useful.

Now for the good news.........




I passed NPLEX1!!!!!!!!!!!!

It's been a pretty stressful week since we heard the letters were sent out last week, and since Monday I've been hearing results from friends (some good and some bad). I got home today and my dad was out and hadn't checked the mail yet, so I went to the mailbox, and the second I looked in the box I knew it was there. I walked back home with the letter and the rest of the mail, and didn't even walk in, I went to the backyard to my garden. I knew that I needed to be somewhere calm so that regardless of the news, I could feel kind of okay. I took a seat next to my favourite plant - the cherry tomato plant of course - took a couple deep breaths, and then opened it. I figured the letter would be folded up and I'd have to open it, so I started pulling the piece of paper out...and was greeted by three large Ps! The wave of relief that came over me was fantastic, and I followed with a nice little meditation in front of my garden, thanking myself for the hard work I did in the summer, and so damn glad that I don't have to write the exam again.

Anyway that's all for tonight, maybe I'll go to bed early for once......
Edit - forgot to add a silly cartoon for the day (oh and it's 11:30 and I still haven't started getting ready for bed!)

Tuesday! And I'm back for the second one, telling the truth!

Back again to summarize Tuesday's courses. I actually just finished doing some homework, the first homework I've really done all year! It's only the third week, I'll get in the groove I swear.

So the classes for today:

Health Psychology 3 - As our third health psych course, the expectations are getting a little higher, and there is a fair bit more practical work. This year is interesting though, because we actually have 2 SP cases for our group, and every practical, we will continue with those patients. Our first session was today, I fortunately didn't have to go as doctor (I'm a little too nervous to go first!), but it was a great experience to watch my classmates work with the biopsychosocial interview, as opposed to the more clinical focused one we watched yesterday in primary care. It was also interesting to see some of the homeopathy interviewing skills we've learned come into play here. Psych is cool though because you have a little more freedom than homeopathy to probe in different areas, but I find using those homeopathy skills helps really dig deep into what a patient is feeling, and what they actually mean when they speak. I'll also note that CBT (cognitive behavioural therapy) is a big focus this year, so we'll be working on that type of therapy with our patients in future sessions. Lucky for me, I got the textbook for free - it was actually a gift from a family friend of mine, cool enough he is a social worker who actually knows the author Judith Beck (her father is kind of the "father" of CBT as it is, and she has played a big role in it's development and popularity. I'm sure he'll be a good resource if and when I get more advanced and want some help getting better at using CBT. Oh ya I forgot to mention the professor - this one is taught by Dr. David Denis again, our professor from 2nd year. He is really great, a true counselling focused ND. He provides such a great presence when doing demos, and when helping as he floats through the different practical rooms. A wonderful resource to have in this course.

After health psych, we have a 3.5 hour break until nutrition. During this time, all the breakout rooms we use for primary care are scheduled out for the 3rd years, so we can use them for whatever we want, with IT and primary care work the main focus, if we want of course. Today however, I had to go to an exam policy meeting - 1 of my duties as one of the VP Academics for the NSA Executive Council. I'll definitely remember to do a post in the future reflecting on my experience on the exec council so far, as it has been pretty great. The meeting was a little boring, but also interesting. You can really see the faculty working hard to develop good policies to benefit the students, and also push them to better academic success. It's also interesting seeing professionals work in discussion group like this, because even though they are older and more experienced, they still have disagreements, multiple conversations and multiple people speaking over one another, all that fun stuff that happens when you do group work in school. A little more professional for sure, but it's interesting.

Nutrition 3 - Our final nutrition course is taught by none other than Dr. Prousky, who is the chief medical officer of the RSNC. It's pretty cool, because he is just a huge wealth of knowledge with many years of experience, and lots of scientific data. He is similar to Dr. Phil (from second year nutrition) in his strive for evidence based treatment, but he is also a little less intense, and worries about using a combination of evidence based medicine and individualized medicine. He is also big on orthomolecular medicine, which generally involved very high doses of vitamins and nutrients for therapeutic benefit. So this year will have a little less focus on diet and lifestyle that Dr. Phil provided (fish oil, 2 tablespoons of olive oil, a handful of nuts, and 30 minutes of walking a day will fix anything!), and instead look at more therapeutic use of nutrients. I think that a combination of these two courses will provide a pretty good foundation for using nutrition to effectively benefit many patients for many different conditions.

That's all for today, back to a little more homework before bed, but I'll be back tomorrow to talk about Wednesday. For now, enjoy this funny CBT cartoon I found.

3rd Year! And back after a long hiatus...

I've been away from blogging again, school and life have been busy, and the motivation hasn't been there. I recently got a huge boost though - I met a 2nd year CCNM student for the first time, and when I introduced myself, she said that she had read my blog! That is pretty cool, and it really took me back to why I wanted to blog in the first place. When I was doing my undergraduate degree at Laurier, I was considering Naturopathic Medicine, and it was some awesome student blogs from CCNM (Talia Marcheggiani, Navigating Naturopathy - not sure her name and last but not least, Erica Robinson). These blogs were invaluable resources when I was considering school, helped keep my motivated during and after the application process, and have even been useful information during school. So my hope is that I can provide some cool and motivational information in my blog for future students.

I know I've been off with my blogging in the past, but 3rd year is getting really intense with a lot more practical stuff going on, and I think blogging is going to be a great way to let off some of the steam, and reflect on some interesting stuff we learn. I'm also going to post about all the classes again so that prospective students can learn about them a little bit. I'm going to set Sunday as my regular blogging day, and get going with once a week blogging for hopefully the rest of the year, I think if I put it in my schedule then it will actually happen. This will be a big week though, because I'm going to do a quick post every day about all the classes we're in for 3rd year. Hope you enjoy!

So starting today (Monday), here are the classes we're in: (by the way, Monday is kind of a long day....in school from 9am-7pm! But at least we've got a 2 hour common time to relax and see some cool talks or hang out outside, maybe play some sports - like volleyball club!)

Integrative Therapeutics - IT is kind of a continuation of clinical medicine, but with more of a full clinical focus. While clin med was based around integrating anatomy, physiology, micro, immunology and biochem to produce a ddx (differential diagnosis) of potential causes of disease, IT looks at treatment as well, and of course considers what we already learned last year. It's been pretty good so far, some heavy information, but Ellen Wong is a fantastic teacher. She knows her stuff really well and presents a lot of great research. I can definitely see this stuff being directly useful in clinic and beyond.

Primary Care - This is the super serious class/practical of the year. We're in groups of 8 people, and every week we get a standardized patient presenting with some random condition. Each person has to be the "doctor" one time, and during that, they have to manage the patient over 45 minutes as if they were in the clinic - do a full intake and physical exams, and then suggest proper management if possible. The kicker of course is that the doctor has 7 classmates who are busy researching potential causes and can provide feedback and help during "timeouts". The first session was a little messy and I of course was a little too nervous to volunteer as doctor, but I'll get my chance next time. And of course after the case, we have a post encounter probe to work on all week, and then present the case with an appropriate assessment and plan to our TA the next week.

Practice Management - I've heard that this course has been a little messy in the past, but this year, the practice management program has been completely streamlined all the way from first year. Unfortunately I'll only get the course in 3rd and 4th year, but they're altering it a bit for us. New students will have a much better experience than in the past though, and I think this is great. Naturopathic Doctors have an awesome role to play in healthcare, but in the current system, they generally need to run their own business. While it's nice to be philanthropic and help everyone, you need to make money to survive, because if you can't feed yourself and keep the office open, you won't help anyone. I think the new course will really help lead to a more prosperous future for my classmates and me, and it's being run by Dr. Tim Searle who is very knowledgeable and has some great resources. And of course I'm still involved in HEROs this year (which I mentioned in the past). I've got a lot of work to do, but I think I've got tons of great resources to help lead me to a successful future.

Ok that's all for today, see you tomorrow for a review of Tuesdays classes.

Exam Season

Final exams have begun once again at CCNM. The school is filled with students struggling to remember that last detail about that one thing they missed in class, and it's definitely much quieter.
My first exam was this morning, and yes, it was the OSCEs. It was a bit of a nerve racking experience, but it definitely went well. My exam was at 8:56 (on the dot, everything has to be very structured and specific!), so we had to meet as a group on the second floor 20 minutes early. Dr. Roberts explained the process to us one more time, and then filed down to the clinic one by one, with our lab coats, medical equipment, and our clipboards. Dr. Pachkovskaja met us in the clinic and provided us with a last minute pump-up speech, telling us all to smile and be excited. Then we were sent off to our rooms, of course mine had to be around the corner and waste a bit of my prep time. We were then given 90s to read our case stem and write down any notes on our clipboard. Our patient had an earache, which is an interesting complaint because it kind of jumps all over with the types of exams you need to do, but it's definitely a little less intensive than something like cough or hypertension. I walked in the room and my evaluator was actually my resident from clinic 2, Dr. Irons, and the standardized patient was a fourth year I knew from unity summit. Needless to say this didn't really calm my nerves at all. I thankfully remembered to wash my hands right away and introduce myself to the patient, getting consent, and then got started on my exams. For some reason I started taking pulse without giving him the thermometer first, but I recovered and got vitals done pretty quickly. After that I kind of jumped all over the place, not really following my previously set up script, I think in the moment of anxiety I was forgetting some things and just went with what I remembered and what I had written down. I did pretty well I think, getting through all the exams, except for some silly reason I forgot to check his sinuses (I checked his nose why wouldn't I do sinuses!). The bell rang at 20 minutes and I was given the post-encounter probe (like a little quiz), it was pretty easy just 3 questions, and then the next bell rang and it was over. I got out of the room and found my classmates all happy and smiling, the anxiety drained from our bodies and left in the exam rooms.

OSCE 1, you were quite the challenge, especially to prepare for, but we took you down. Now, on to the next 7 exams I have! (oh clinical medicine and microbiology, I can't wait until you're over on Thursday).


As a quick side note, I wanted to just comment on the 4th year holiday play that I had the pleasure of seeing on Thursday night. Their theme was Frozen at CCNM, and it was just fantastic. They did a musical adventure with lots of inside jokes about CCNM, and lots of really great Disney songs adapted to fit the play. The words were changed to include CCNM jokes, but they played a lot of my favourites, like "A Whole New World," "Hakuna Matata," and "Be a Man." Of course they also did "Let it Go," a bit of an overrated song but it was still really great. The whole experience got me really excited about my own 4th year holiday play, something that I definitely want to be involved in. After exams are over I think I'm going to start seeing who will be interested in being a part of it; of course it's 2 years away, but this one was really fantastic so I think the earlier we start the better we can be. I just love musicals!

Some of the stars of the play. They really did a great job setting an atmosphere
considering it was all done in the Lecture Theatre at CCNM

MOSCEs!

I finally got to posting this a couple days late, but this Tuesday was the infamous MOSCEs, or Mock OSCEs. OSCE stands for objective structured clinical examination. Quite a mouthful, but basically it is a standard examination that I think most health professional schools have. In order to prove that you are competent to enter the clinic as an intern and work with actual patients, you need to pass these tests. They are a little bit scary because you have a limited time to get a lot done, but that's why it's really great that the academic reps set up an event like the MOSCEs.

As a second year in first semester, OSCE 1 involves just doing relevant physical exams for a given patient case. So you're given a patient case, for example someone coming in with a cough, and then you have 20 minutes to do every physical exam that is relevant. Did I mention that you need to speak out loud saying everything that you see hear and feel (kind of difficult when wearing a stethoscope!). Oh and you need to say an abnormal finding for every test you do that you could've seen or heard, and what disease/disorder that could indicate. In a way it's actually pretty cool though because we get standardized patients and we'll be doing the test in the clinic, so it will be almost like a real patient interaction. The MOSCEs were just done in some of the classrooms, but it was nice because we had 3rd and 4th year students evaluating and timing us, so it really brought the stress on. I've been prepping a lot for this test and fortunately the MOSCEs went really well and it looks like I'm going to be okay, though I'll definitely need to do a lot more studying before exams start, a week from Monday. Only 8 exams this time around (I think it was 9 last fall?). Back to studying!

Feeling Judged

Seems crazy I haven't posted in so long, and now this is my fourth post in a week! Anyway I was in homeopathy today and we had a practical working on case taking. This was fun because unlike health psych (where we have one person interviewing a standardized patient and everyone just watches), we all got a chance to interview each other. I definitely see the value in health psych, but this was great to get some more experience, and especially in a bit of a less threatening environment.

So while getting feedback on my turn as the doctor, my partner (who played the patient) mentioned that I made a good use of silence. Silence is an incredibly useful tool for a doctor as an interviewer, especially when it comes to mental/emotional things, because it provides patients with the time to think over what they've said and decide if they want to share more with you. This of course doesn't happen if the doctor goes through rapid fire questions and doesn't provide that silence (though of course rapid fire can be important when ruling out red flags for emergent conditions like a heart attack!). Anyway one of the things my partner mentioned was that she was empathizing with me and thinking that I felt like some of the silences lasted a really long time, but that for her it actually didn't feel that long.

I think this is really important to understand because it leads in to what I want to talk about, and that is the a feeling that you are being judged by others. This is something that I feel constantly and I'm sure many others do. You're hanging out in a group of people not saying anything, you're giving a presentation, whatever. You feel like other people and judging you, and as a result you get stuck in your head and don't feel so good. Basically the feeling I want to get across in this post is that in order to get out of this pattern, it can be helpful to be aware that in general, people aren't really judging you. They don't really care that much about the little things you think you are doing that may be embarrassing, because in reality, they are sitting there thinking the same things about themselves. People are incredibly self-conscious and other-focused, worried about what others think of them. As a result, you don't really need to worry about others, because they aren't so worried about you.

I understand of course that this is much easier said than done, and I know it is something that I am really going to start working on now and know it will be a struggle, but this again is of course where mindfulness really comes in. Be aware of your thoughts and feelings, try to understand where they come from, but ensure that there is no judgement. You will see that you can bring more confidence and a more relaxed disposition to your life.

- So if you're feeling too much in your head, what can you do? Push your feet into the ground a little bit and even try to grip the floor with your toes. This action reminds you that are not just in your head, you are in fact touching the ground, here, in this moment.

Men's Health Week!

So this post is a bit late as we are partway through the week, but I wanted to make a quick post because it is Men's Health Week at CCNM! I think this is a really great event because a lot of naturopathic medicine seems to focus towards women. This is not bad at all, I think it's great and really a big part of it is that women are just more likely to take their health into their own hands. That's not to say that men don't care about their health, but for a lot of reasons they are less likely to take proactive measures and thus less likely to see naturopathic doctors. It is because of this that I think it's so important to learn more about Men's Health and be able to help address their problems when they do come in. The other piece is that education on Men's Health at CCNM is quite limited, with just some focus on the obvious culprits like prostate cancer, testicular cancer and maybe erectile dysfunction. Of course the male reproductive system is a lot less complicated than the female one, so there is less to learn about that. But I think that males have a lot of distinct issues when it comes to mental and emotional health, especially in the setting of North America. This is why I think it is great to have a week to focus on those aspects a bit more.

Last night Dr. Jason Clifford gave a talk on the feminine side of maleness. Unfortunately I couldn't go because of HEROs, but I think it was recorded so I'll get a chance to listen to it later on. Today there is an open forum on Men's Health at common time (we had a great discussion last year so I'm hoping for a good one again), and included is the men's service auction (I'm auctioning off so personal training, and all our proceeds will go to Movember!). Finally tonight Dr. Rajesh Ragbir will be giving a talk on male vulnerability and access to health, and I will be able to go this, a talk that I'm pretty excited about.

So that's all for now, hope you spend the week thinking about the health of your men and remembering that we are complex creatures and even though we don't show it, we have just as many emotional and spiritual aspects to ourselves as women.

A little late but here's the poster for Men's Health Week this year!

Updates on School

Ok so I haven't really posted in a long time, I've thought about it but for some reason I just never got the inspiration to write. It hit me though today that it would be great to get back to posting sometimes just to get out my thoughts and also share what goes on at CCNM.

So first just a quick update on school. I'm a little over halfway into first semester of my second year, and of course I've got lots of new classes. It's been an interesting semester so far, a lot harder in many ways, but definitely more interactive and clinical, it's starting to feel a lot more like medical school (not that last year wasn't, though there was a fair bit of review last year, getting everyone on the same page for basic sciences and stuff). So here's a quick overview of all my new classes:

Physical Clinical Diagnosis (aka PCD) - this is a purely practical class, at 8am on Monday morning... I know such a crummy time. But it is really interactive. This is basically time to learn and practice all of our physical exam skills, so everything from listening to lung and heart sounds, inspecting the eyes and ears, and more! It's not nearly enough time to practice everything so I've been helping run some extra practice sessions later in the week, and I actually just got my own massage table at home to practice on friends and family.

Botanical Medicine 2 - This class is a lot more clinically based than last year. We go through different body systems (e.g. Respiratory system, Gastrointestinal system) and talk about specific herbs and actions that work to help with different problems. We also have a practical session Monday mornings where we go through a case in small groups and have to decide on a treatment plan focusing on botanical medicine, but also looking at other treatment options. It's a little tough, but also a great way to try to bring together all the knowledge we've learned so far.

Homeopathy 2 - Advanced homeopathy with Dr. Bakir (she is super excited about homeopathy). We're learning more about specific remedy groups, case taking and how to use repertories (looking up symptoms). I'm still pretty lost with Homeopathy, but hopefully things will start coming together as we continue this course next semester.

Clinical Medicine - This is the mother of all courses; we're in it for about 8 hours a week! This is a tough course but really great, because we're basically going through all the most common conditions that doctors see and looking at all the major angles: a bit of related anatomy and physiology, pathophysiology, diagnostics, all of it. So far we've been through skin (stuff like acne, melanoma and fungal infections), eyes (stuff like glaucoma), ears (otitis media), throat (strep throat), cough (pneumonia and bronchitis) and we've just started heart (hypertension). There is a ton of information but this course really brings our knowledge together and is going to be really useful in the future.

Health Psychology 2 - This course focuses a little more on diagnostics of common psychological disorders like depression, anxiety and OCD, but we've also come back to things like mindfulness. The really cool part though is that we have practical sessions most weeks, and for the first time second years actually have standardized patients! It's pretty scary having to play the doctor and interview the patient, but it's a great experience to try to go through a biopsychosocial interview and learn all about patients, especially to draw out information that is useful but may be difficult to initially get from a patient.

Asian Medicine 2 - We're focusing again here more on pathology of the different organ systems (Heart, Lung, Kidney, Spleen, Liver, etc), building on our knowledge of the basics from last year. We've also learned about tongue and pulse diagnosis, though it's pretty tough because we haven't had much time to practice stuff. Again hopefully this will start coming together with more practice next year.

Acupuncture 2 - We've been working on more complicated points now, getting through more channels and working on the back, the legs and the glutes! It's still hard but I'm definitely starting to feel more comfortable doing acupuncture, and the continual practice is great. This class continues next semester and by the end we'll have gone through the entire acupuncture book (well over 300 points I think between the 3 semesters of point location)

Microbiology - This class is all about this little organisms that can cause diseases and illness, from parasites and viruses to bacteria and fungi. There are a lot of things that can cause problems, but hopefully learning all about them and how to differentiate will lead to better treatment for future patients.

Foundations of Naturopathic Medicine - This is actually our last philosophy based course. The whole course (except the first few lectures) is actually taught by students in small groups. We go through lots of thought-provoking topics (like the usefulness of clinical guidelines, the placebo effect, and more), and have student facilitated discussions about them. It can get a little dry sometimes, but a lot of interesting discussions happen and it's great to have this knowledge about all these related topics to practice.

Clinic 2 - This course is a really great one that involves shadowing fourth year interns in the clinic. Unlike last year, we actually get to sit in with an intern for the entire visit. We also have one shift like last year shadowing a supervisor for a whole shift. In addition, we have to do 20 hours and get 20 patient contacts preceptoring health professionals outside of the clinic. I've actually had all 6 of my fourth year shadowing shifts, and my supervisor shift; it was a pretty cool experience and I definitely learned a lot about the clinic. I've preceptored with two different NDs so far and have one more ND and a chiropractor that I'm preceptoring with next week, and then I'll be done the course. The best recommendation I have for this course is to have a little notebook where you write down all the things that you see people doing that you like or dislike, and notes on things you think you should be doing or not doing in the future. I got a lot of useful notes that I'm sure will help me out in practice in the future.

So that's all my new courses for this semester, it's been pretty crazy so far (I think I'm in school for about 30 hours of class a week, with breaks it works out to almost 40 hours a week (even more when I had my clinic shifts or preceptoring). Time to take a break!

Automatic Perceptions, and Mindfulness

   We had our second psychology practical today. It was pouring rain and Dr. Creech was running late, so one of the more experiences TAs started the class with a little bit of meditation, and then went over the lecture portion which related to automatic perceptions, especially with respect to transference and counter-transference in the doctor-patient relationship. Transference refers to when someone (e.g. the patient) puts an unconscious redirection of feelings onto someone else (e.g. the doctor) based on their feelings about someone else. For example, if a patient is mad at a co-worker and the doctor looks like their co-worker, they may act mad towards the doctor even though they aren't actually mad at the doctor. Counter-transference refers to the opposite, specifically when a doctor is emotionally entangled with a patient based on predispositions. For example, a doctor may show protective feelings over a female patient, and then realize through discussion that it was actually because the patient reminded them of their little sister.

   Transference and counter-transference are automatic processes that cannot always be controlled, but the important things as a clinician is to be aware of them when they happen. If you are not aware that they are happening, then that is where the negative effects really come into play. So once again the topic of mindfulness came into discussion during our small group talk today, and I really liked a new point that Dr. Ragbir brought up. There seems to this distinct connotation of the word meditation in which you imagine a person sitting in a quiet room with their eyes closed, maybe with the lights off, just breathing, maybe even doing some sort of humming or chanting.

                                                 Pretty classic looking meditaton here right?

    Now of course there is nothing wrong with that picture of meditation. In fact it is a very healthy way to relax and bring oneself into their mind and awareness, and to pull away from the stresses of their life. However, this does not have to be the only way to be mindful and meditate. Dr. Ragbir talked about a Buddhist monk named Thich Nhat Hanh, one who has been compared to the Dalai Lamai. He explained that when asked about what he does to be mindful, Thich said that he is always mindful. He is always aware of himself in all ways, because you really don't need to get into that quintessential meditation practice in order to be mindful. All it takes is practice and most importantly, removing any judgement upon yourself in the journey to mindfulness. Again there is this belief that to be mindful, you need to have completely unwavering thoughts, focused just here on the present moment (I should know, that's why I thought I've been meditating wrong all along). But in reality, it is not the way that you meditate that makes you mindful, it is just the awareness of what you do. Whether your mind is focused solely on the tides of the ocean, or if your thoughts drift to your schoolwork, and then traffic, and then what you want to do next weekend, they can all be true mindfulness, IF you are aware of what it is that is going on. Practice awareness, remove the judgement, and just do it for yourself and you will see the benefits that mindfulness brings.

     On another quick note I just wanted to mention that I did end up going all out for the Halloween costume yesterday, wearing the thing 2 costume (wish I'd thought to bring thing 1 and share it with a friend; oh well, maybe next time). It was pretty fun though laughing with others about being really silly (not to mention Dr. Terzic said to me, "Noah, I thought you were a serious student" --> I think he was kidding, after all it's okay to let loose sometimes). Not to mention Bonus! I came in third place and won a Starbucks gift card! Can't wait to top it next year.

There's me on the right, my friend Alex as batman on the left, and someone I don't know in a really sick scarecrow costume in the middle.

                                               

Midterms

    Finally finished midterms yesterday. 5 midterms in a week was pretty intense, especially because my brother came in from North Carolina for Thanksgiving and that really cut into weekend study time. Oh and not to mention that three of my exams were basically in another language (Botanical Medicine, Homeopathic Medicine and Asian Medicine). Overall they went pretty well though, and it was nice finally getting to relax last night after studying every day for the past 15 days! I'll do a quick recap of what the exams were like.

Tuesday morning --> Anatomy
Dr. Terzic wrote a pretty fair exam. It was 85 multiple choice questions, 3 questions were matching but the rest were just straight up. Overall it wasn't so bad, I just had a little trouble remembering exact locations of some ligaments and muscles. The practice midterm questions someone put up on facebook were really helpful.

Wednesday --> Botanical Medicine
This was a pretty hard exam. All multiple choice (I think 50 questions). Quite a few questions about specific actions or names of phytochemicals. I think knowing the specific classes well would definitely help with this, also knowing some specifics from the safety stuff (especially about how to affect specific parts of liver detox, not just phase I or II) would've been good.

Homeopathic Medicine
This was a pretty tough exam with 50 multiple choice questions, just because knowing the remedy pictures was so hard for me. The stuff not related to remedies, like philosophy and terminology was actually not bad, I knew most of it pretty well. So just knowing the remedies better would be good; there was lots of questions about specific cases and what remedy should be used. The really tough questions asked "what would be the best question to ask to determine the correct remedy?" To help with this, it would be great to determine key difference between remedies.

Thursday --> Asian Medicine
Having past midterms was really helpful for this exam, but also it just wasn't so bad overall, with 60 multiple choice questions. Asian medicine seems daunting at first, but the more you study the more everything makes sense. There was a lot of questions just giving you symptoms and asking what pathogen is involved and stuff like that. There was also 3 full case studies, but then he gives specific symptoms from the list and asks questions about them, so you don't really need to read the case studies. As long as you know elements, pathogens, patterns and vital substances well, there really isn't any tricks in this exam.

Friday --> Biochem
This exam wasn't too bad because I've taken biochem already in undergrad, but also because it really followed our assignment closely. If you did well on the assignment, or made an effort to ensure you understood the stuff from it well, then it should be okay. The only real curveball of a question was about epimers and anomers --> kind of random stuff from our first lecture, but aside from that just following the assignments and past midterms on google drive was really helpful. The whole exam was short answer which was a bit of a change, but it really wasn't so bad since going over all the material and assignments made it pretty easy to talk about. And fortunately you can write point form so you don't have to kill your hands.

So that's it for the first set of midterms, 5 wasn't so bad, though 8 during finals will be interesting!