Circle of Appreciation

Anatomy lab was bitter sweet.  I am pretty excited for it to be over in a few weeks but in a small way, I will miss it.  The bonding that takes place between lab mates is very unique.  A balance between curiosity and total disgust exists during many of the labs.  Some students dive right in and love dissecting while others sit back and watch.  I proudly fall into the second group.  Everyone in our group was very respectful and courteous of each other's needs.  When someone needed a break, somebody would step up and take over.  Everyone was included in one way or another.  

It isn't natural to dissect a cadaver.  When the inner voice in your head says stop, you have to find a reason to keep going.  We rationalize the situation by focusing on learning the structures we must uncover.  You cannot think about the person under the knife.  At times, I find myself wondering what he was like.  Was he a good person?  Did he have a family?  Was there a memorial service for him?  What did he do for a living?  Was he rich?  Poor?  Was he active and fit?  What were his hobbies?  These questions will never be answered.  The only answers we can get are from what we find under the skin.  It is then you find a detailed history of medical procedures, abnormalities, and unique structures only your cadaver has.  From this information you can understand a small portion of his life - particularly the pain he endured.  All the happy, pain free days of his life will never be known.  Our understanding of this person is quite simple and objective.  During lab, we had to identify with him beyond his dead body.  So, we assigned him a name, Herbert.  Why did we do this?  

I would suggest this is the only way we could move forward - by assigning a name to him, we allowed ourselves to think he was okay with us dissecting him.  A right of passage, perhaps.  At times we spoke directly to him, jokingly, by telling him what we were going to do to him during that day.  We even tucked him in to bed when we put him away for the day.  It is human nature to be caring and thoughtful to other's needs.  We felt compelled to treat him respectfully but still get the job done.  In the end, he will be cremated.  We will never know where his ashes end up or whether he will have a ceremony on his behalf.  At the end of the quarter we will have a ceremony of sorts - a circle of appreciation.  It is quite a sacrifice to donate your body to science.  Not knowing his reasons for choosing to do this is difficult to comprehend.  All we can do is honor his wishes and proceed with our weekly dissections.  When we wrap up the quarter with our final lab exam, we will tuck him in one last time and send him away to his final resting place.  

I will always remember him as the gentle faced man awaiting our eager minds.  He taught us many things that will empower us to help many, many people.  It is our duty to remember the sacrifice he made to teach us the details of  the human body.  His choice to help us in our education should never be forgotten as God was with him when he made it.  

Thank you Herbert

Greener Pastures...

Experiences come and go these days with such speed.  We must take ahold of every moment and extrapolate as much from the experience to get the most of what is given to us in this education.  Some complain the program is too hard and some feel it lacks depth.  Regardless of the viewpoint, we are given enough information to be competent doctors.  It is up to each of us to sink the information deep into our brains and perhaps, take it to another level.  The process of going to school merely presents experiences that allow us to program things into our heads.  We have to choose whether the information stays in there for the long haul, or passes by.  

I think the system is set up for us to merely pass tests - at least presently, anyway.  How do we get more from the program and pass each test with good grades?  I would guess the majority of the students, including myself, are trying their best to retain the information in it's entirety.  In so doing, they overdue it with studying and end up getting near average grades from going into exams mentally drained.  Some students study the day before an exam and get straight A's.  I tried this approach and it didn't work.  It stressed me out, big time!  I guess when it comes down to it, we have to get through school one way or another and when it comes time to actually treat patients there will be an abundance of information at our fingertips to help us along.  Being able to regurgitate information readily for an exam is a lot different than getting patients' good results.  I know that the education we are getting is top notch.  When comparing to other programs such as physical therapy, I think we get much more depth.

Today I visited Pacific University in Hillsboro.  I met with an admissions counselor to discuss the details of the doctor of physical therapy program.  The trip was mainly to see what the grass looks like on the other side and to compare our program to theirs.  The visit was essential to help me gain a complete understanding of what PT actually is.  I left feeling as if I chose the right path and that the hard work is worth it.  As many of you know, I have been on the fence for many years as to whether chiropractic is the right career choice.  I now believe it is 100% the right choice.  

The education we get as DC's is very similar to an MD or DO.  This is why we must force ourselves to understand the information at the level of our future competition.  The body is extremely complex and it takes time to master the processes and structures enough to help others.  When looking back, I am appalled at myself for working with clients and patients without the knowledge I should have had to be completely competent.  I never hurt anyone but my quality was so much lower than what it should have been.  After this program is complete and the DC degree is hanging on my wall, I know my quality will be at the professional level and my patient care will be stellar.  

As to looking for greener pastures to roam in, I assure you those days are over!  

Thanks for reading

Skippity Do Da

The Portland weather has finally shifted to gorgeous 70 degree days with minimal wind.  It is my favorite type of weather, for sure.  These nice days are taking a toll on those of us who want to be outside running through the hills or surfing in the ocean.  Instead, we must suffer through boring lectures about scientific mumbo jumbo that none of us really understand until the day before the exam.  Interestingly, I have fallen vulnerable to skipping class these past few weeks.  You can call it selective skipping.  Only once have I skipped an entire day and I can't say it was worth it.  

Our physiology class is taught by an instructor who tries really hard to make things more interesting for us.  He dances around all goofy and puts together slide shows that would amaze the designer's of Microsoft Power Point.  The material, for me, is already pretty darn interesting.  In fact, I sometimes read my physiology text for FUN!  Yes, I love knowing how things work.  But for some reason, when I sit in his lectures I lose interest quickly.  It isn't the material that is causing the loss either.  The sad thing is that he doesn't realize how his teaching style affects his students.  It is like he has been teaching this way for decades and doesn't care if we aren't getting it in his class.  Yes, you have nice power point presentations but your style has most of us so annoyed by the end of the lecture that we obtain nearly nothing from staying.  So, what do we do, we skip his lecture and he lectures to about 1/4 of the class.  There isn't much anyone can do to help make it better because he believes it is perfect how it is.  Whatever.

Here's to sunny days and skipping class!  It isn't about being in class and stroking the instructor's ego, it is about how well get the material down - not just for exams but for the long run.  When I think back to how much time I have wasted in class, it makes me want to puke or ask for a refund.  Not everyone learns by sitting in class, why force it upon us to be there?  In my opinion, if we do better at home or any other method of studying, by all means focus on what works.  I understand there is a workday component to having things structured like this.  This is because many of the students who go to our school haven't ever had do actually work for a living, so the program is focused on getting us used to a regular work week rather than helping us learn and become competent doctors.

Blah, blah, blah.  The opinionated mouth is fired up today!  Tomorrow is one of three final gross anatomy labs.  Oh, how exciting is that!  

Thanks for reading

Sweaty Day

Today was a bit tiresome and sweaty.  After having a long weekend with Memorial Day on Monday sort of threw my system off.  We started the day with a vigorous 5 minute step test in our physiology lab which got me all sweaty.  It doesn't take much to get the sweat going on me.  I think it is because I used to train around 15-20 hours a week on the bike just a few years ago.  You have to sweat all the time to stay cool when you are producing that much heat from training.  The problem is that if I do any physical activity nowadays, I start sending molecules to the surface.  And sometimes the surface they arrive to is embarrassingly noticeable, like today.  I will not elaborate on that.  People sweat, so what.  Right?  :)  All I know is that the workout clothes are coming out for adjustive skills - no more cotton!

Regardless of my overproducing sweat glands, I had a stellar day in adjustive skills.  I was able to set up my supine thoracic moves easily and efficiently today.  The more I practice, the better I get at setting up the move appropriately enough to cause movement before adding an impulse.  Supposedly, it is like taking "it" to the edge of a cliff then flicking it to move - it is all about setting up the proper biomechanics and torquing it just right.

I am a bit worried about our neuroanatomy test that is next Monday, June 1st.  I haven't read much of our new material and haven't been the best at paying attention to my fullest ability while sitting in lecture.  The material is too complicated to get the first time around.  The first lecture preps you for when you go through the material on your own.  And many times you have to hit the notes more than once to get it down.  There are no papers to write or projects to get down.  We study scientific information about the human body and try to remember every single detail.  The exams are mainly multiple choice and some true/false.  Trying to remember everything you read is a task that requires incredible patience and stamina.  

Try this, if you are reading this blog post and you are not a fellow student of mine, go to Wikipedia and type in; Cranial Nerves.  Look the list and see where they all poke out of the brain then take a little time to memorize the number that corresponds with the nerve's name.  See how long it takes to get the nerves down then try to memorize where they come from off of the brain itself.  This small feat will be taxing for most.  Now, to try and relate with what my colleagues and I endure on a daily basis, multiply the time you spent doing this activity by 50 (because I think the activity will take most an hour to accomplish) and you will have a rough idea what we go through each week.  Thinking isn't hard, it is the length of time you must think and the complexity of the thoughts you must think that makes our program challenging.  

Off to dinner then neuroanatomy until 11 tonight!

Good night

An Interesting Experience

This past Friday Sadie and I went to the Bonneville Hot Springs Resort for a little getaway.  I found a great deal on a package and decided to buy it on an impulse.  The package consisted of an hour mineral bath and body wrap as well as an overnight stay in a luxury suite.  We also received a bottle of Merlot.  I thought it was a great deal despite having to buy dinner and breakfast.  The reason I am sharing this is because I had a really cool/weird experience while there.

I haven't had a body wrap before and when I scheduled it I almost called back and cancelled.  Fortunately, I kept my appointment and went there a bit on edge.  I have heard of body wraps but usually it involved women trying to lose 10 pounds in an hour.  I had no clue what was going to happen and was a bit worried.

So, we arrive to the resort, check in and rush down to the spa to get our treatments.  Sadie is shuffled off to the women's bathing area and I am sent to the men's bath house.  I am greeted by a big man who's name escapes me and I am told to meet him in the back when I am ready.  When I am ready?  What the hell does that mean?  I walk back and he shows me where my mineral bath is.  It was a secluded area and completely private.  He tells me there is a bottle of mineral water and some grapes if I want them and that he'll come by to get me in 30 minutes.  

The water was really hot!  It took some time to get used to.  After a few minutes I was well on my way to relaxing.  The water was actual spring water from a hot spring in the area.  It smelled like sulfur and salt.  The guy came back about 30 minutes later and told me to meet him out in the massage area to get the wrap going.  I was still a bit on edge because I hadn't done this before.  I did as he told and met him out at the table - fully ready to fight him if he got frisky.  :)

He covered me with steaming hot towels, four to be exact.  I immediately began sweating.  It was dumping off me.   I thought I was going to have to bail out the treatment early but a moment later he brought an ice cold (literally) cloth and wrapped my head with it.  The man assured me sweating was the correct response. My body didn't know what to do or more precisely, my mind didn't know how to react to my bodies feedback.  My respiration rate skyrocketed, I was pouring gallons of sweat everywhere and oddly my mind began to calm.  

When I first got to the resort, a thousand thoughts were racing through my mind from school work, ambitions for the future, to relationships and the further I went with the body wrap treatment, the calmer my mind became.  I began to see things clearer and found that I was completely focused on trying to balance the hot and cold applied to my body.  By refocusing my mind onto these two simple things I was able to let all my worries go.  It was as if all the weight was lifted from my shoulders and I was free.

This was the first time I have had an experience like this in my life.  I didn't expect to have it and I sure wasn't seeking it.  It just happened.  Today, I feel energized, positive and completely satisfied with where I am at in life.   

I would recommend this spa treatment to everyone, especially if you are lacking clarity.  It made me think about possibly incorporating these services into my future clinic.  When you are sitting in silence and 'trying' to relax, it is amazing how much you notice racing through your mind.  We go through life like this without taking time to refocus on what really matters.   Try this, take a hot bath, close your eyes and try not to think about anything.  See what happens, I bet you'll find your mind is just as busy as mine and it will be challenging to stop the turbulence.  But, from merely taking time out, your mind will relax along with your body.

Thanks for reading

Guts and Round Robin Stress

Today was 'rounds'.  It was my turn to present our cadaver to the other groups.  Each group had five minutes with me and I showed them all that I knew about the corpse.  The focus wasn't on the entire body, it was over the abdominal cavity and it's contents.  More or less it was a presentation of the guts.

The presentation went pretty well.  I knew most of the specifics and answered questions somewhat intelligently.  When I didn't know something, I told them I didn't have the answer and moved onto stuff I did know.  Rounds are stressful because they force you to memorize the structures well enough to present it to the other groups.  Nobody wants to look stupid in front of their colleagues.  

The abdominal cavity is pretty nasty.  Our cadaver is quite messy still.  The celiac trunk was hidden within fatty, green mush.  It stinks too.  And to get to the posterior abdominal wall you have scoop up the intestines and move them over to the other side of the cavity.  You can't think too much when doing this because it looks kind of silly when grown men faint or vomit profusely when nobody else is.  Overall, I have had 3 solid weeks in the gross anatomy lab where I didn't feel overwhelmed at all.  There is only a few weeks left until finals which means NO MORE DISSECTIONS!  Thank God.

Today, there was a sense of exhaustion amongst our class.  People were yawning and deep dark circles surrounded the white of their eyes.  We are tired.  For the past few weeks our weekends have come and gone with literally no time to relax.  We worry about exams on Monday and spend endless amounts of time studying during Saturdays and Sundays to be ready and then sit all day in lecture halls trying to absorb all our instructors cram down our throats.  The lifestyle is one that would crack most people wide open and force them to think twice about the path.  It is brutal and only the strong survive.

You have to know damn well this is the profession you want to be in.  I know I am not alone when I say that I am not sure this is the best path for me.  I know others feel the effort might be too much for the scope of practice in the end.  Maybe not.  Maybe that is my opinion because I am exhausted and the grass is greener in unfamiliar territory.  It makes for good conversations and long thought provoking blog entries, nonetheless.

I will sign off and take a few moments to absorb some of the rare Oregon sunshine before crashing for the day.

Good night

Fundamentally fundamental

How do you define health?  Do you think you  can become well by going to a chiropractor and getting your back 'cracked' twice a week?  I hope not.  If you do go to a DC, why?  Is it for a problem you are trying to overcome or is it because your DC told you a straight spine will keep you from getting sick?  Hopefully, the answers to the above questions are based on logic and not another person's religious dogma.

My wife and I talked a bit about this very subject tonight.  I voiced my concern about the ever present religious dogma that plagues the 'profession' I am now representing.  It seems to me that some people lack the ability to see the world logically, as a scientist does, who call themselves physicians.  Since when did half-ass assessments of health become such a "need" in today's society?  If we were to put our scientific glasses on, we'd see that it isn't society who determines what they need, it is those who know how to sell an idea that need a paycheck who determine what society needs.  As new DC's we will be forced to decide whether to approach our role as a primary care physician this way.  We will struggle if we do it right and treat patients according to our objective findings and the actual needs they have.  Some of us will realize the small role we have in the health care market and we will try to 'stick it' to the 'man' by manipulating our patients in ways to grow our businesses, to go against mainstream medicine (rather than be true to our patients needs).  Some of us will get sued for doing this and some of us will realize our scope and follow the wellness "recipe" known by the academic world.  Some of us will push, forcefully, the kinesiological aspects of fitness and many of us will educate our patients about proper nutrition.  These folks are true, caring providers who go against self-centered desires.  In the long run, I truly believe that if you do everything possible to help your patient get better or live well, without selling them on a dogmatic principle you "believe in", your practice will thrive and people will love you immensely for all that you do.   

When we define what wellness is, is it a straight spine?  No.  It is a balance of social, physical, and mental health.  It is a proactive mindset.  Those who are well pursue life with vigor and always look for ways to improve their lifestyle for the betterment of their health and well being.  They look at the positive aspects of life and try to extract the goodness in each person they come across.  Some may think this is dorky or silly, but it is those who think this way that should be questioning what on Earth they are doing in a field dealing with others only real possession.  If a person is dorky, tall, thin, overweight, etc., etc., it shouldn't matter.  We must remember they are living a life different and unique from our own.  If we don't respect each individual's rare qualities, we do not deserve entitlement, we deserve nothing.

Practitioners who try to redefine wellness are doing so to make money.   From a scientific mindset, wellness has only one definition.

Thanks for reading

More on my mind

I think I think too much...  

There is so much excess thought that goes through my mind daily beyond the busy work school sends my way.  It is like swimming through sand, with a snorkel, of course.  My gosh is it draining!  

Everyday I sit and ponder what it is the health care system needs to be better.  I read about the major killers of our nation and think how pointless it is to approach health in this manner.  People die everyday from preventable disease.  Heart attacks, strokes, and cancer to name a few.  The list goes on and on.  If they only learned how to live more active lives with adequate intakes of nutrition.  What does it take to change unhealthy behaviors?  Personally, I think it takes a shock to your inner core.  Fear of the worst case scenario perhaps.  It takes guts to confront others on their poor behaviors.  In my ten year history as a personal trainer and coach I can count on one hand how many folks I felt comfortable confronting.  It is hard to earn that level of confidence in another person because it is tough for most of us to hear the things we avoid at all costs - the things you make excuses for and possibly lie about to save face.  To be honest and come to grips with exactly where you are in life is a difficult thing to do.  And to have another person point these things out to you can sting.  

I think fear drives most stubborn human beings to change.  For example, say you have a patient who is constantly getting sick.  You know they eat crap food, they don't exercise at all and they constantly come running to you for every little problem.  In your mind, you know they could take control of their health if they understood how their lifestyle was causing the problems.  So what do you do?  Do you tell them they are causing their problems by living an unhealthy life?  Or do you be their "doctor" and take care of their acute needs?  It is a tough question because nobody wants to lose a patient to another doctor.  How do you get a person's attention, scare the shit out of them, get them to change and keep them as a patient?  Well, I think it comes down to being passionate about your role as their doctor.  Showing them you really care about their well being might help them trust all the harsh things you confront them about.  People know when another person cares for them.  It is one of our unique human qualities that makes us human.  

If we don't learn how to do this, the thing that will end up getting their attention will be a chronic, debilitating disease.  That would suck knowing you missed the opportunity to get their attention by only worrying about their immediate needs versus their long term needs.  Now might a be a good time to start thinking about these things as we add more and more knowledge to our swollen brains.  

Something worth noting is how people in our class perceive my constant, never ending effort to increase the quality rather than quantity of our program.  There are some who speak the same language as I do and there are others who have no clue how to 'deal' with me.  It is not my intention to make people hate me or to be 'holier than thou'.  Quite the opposite, actually.  Some may feel my words aren't worth much and if I just shut my mouth or turned off my opinionated mind, their life would go back to the peaceful normalcy it once was.  Sadly, for them, I don't intend on shutting up anytime soon.  My intentions are to get people to think about things deeper than their notes spread across their desks.  The long forgotten world of antiquity used to suggest to be a physician was the top of the social pyramid.  The trusted doctor used to be one who was gifted in ways others are not, who provided services and education to those in need.  Their job was to think about things in ways the population was unable to.  It seems as if those values have been lost in the modern world's profit driven, self centered ways.  How many patients can I see per hour?  How can I hold onto my patients and keep them coming so that I can be a wealthy "doctor"?  I am sure you can see where I am going with that.

The point I am trying to make is that our profession lacks identity in modern health care.  There is a dichotomy that exists which keeps mainstream medicine from accepting us as equals or referring to us as physicians.  Half of the profession believes in magic and the other half try hard to be doctors.  We lack trust in the public's eye and DC's are notorious for going against mainstream thought.  Many times the technique systems out there are the real culprit for such behaviors.  Every patient gets the same treatment, and same advice.  I have personally witnessed this in action during a 1 year internship with a sports DC and technique system DC.  Guess who lost the most patients?  Not the sports DC, that's for sure.  One could argue that many folks who become chiropractors do so to make big money.  They have no intention to help the greater good.  The more money they can make, the better.  No matter what it takes or who it hurts in the process, the goal is to get rich.  Is it because that person lacks substance in their life and money is filling the void?  Probably.  One thing is for sure, if there is no biological plausibility in a technique systems' use, there must be another logical reason to use the system... MONEY, MONEY, MONEY!  Pathetic.  

If you are under care from a DC that adjusts you head to toe for no apparent reason or says you must come back twice a week for LIFE, run.  Run away as fast as you can.  It is very hard to make money as an ethical DC.  Chiropractors have to be businessmen and women because there are no hospitals with lots of patients waiting for them to treat when they graduate.  One DC I spoke with in Boise who graduated from WSCC said that he converted his practice to a 'subluxation' based system when he found out he couldn't make it being a "musculoskeletal doctor".  He is now a very rich man who lacks wealth.  

I share these stories because I have personally seen how hard it is for new graduates when they get out.  I strongly believe that if we focus on wellness through building fitness programs (or hiring trainers to do this) and guide patients through health education we will be deeply rewarded for our efforts and not just monetarily.  We will help them grow and become their best or at least help them avoid a debilitating disease.  Our role must be defined as first contact preventative care doctors.  And if we invest into fitness, nutrition and conservative primary care, our practices will blossom effortlessly.  

Thanks for reading. 

Ethics revisited...

Every Wednesday we have a philosophy and principles of chiropractic course hosted and/or taught (probably both) by Dr. Partna.  Dr. Partna talks to us about the issues related to the chiropractic world, many of which I have been familiar with for years now.  Some of the details we hear in this course are hard to listen to because they take the wind out of our sails, so to speak.  We all decided to go to chiropractic school for one reason or another (i.e., a different approach to health care, prevention versus sick-care, no MCAT's etc.) and when you learn there are deep ethical issues embedded in the profession it makes you stop and think twice about things.

This topic has been one that I have written about several times since beginning chiropractic school and will likely be one that plagues my blog space for many more posts, but I think it is important to address some of the issues from a student's perspective without being too cynical.  Remember, the definition of a cynic is, "a person who believes that people are motivated purely by self-interest rather than acting for honorable or unselfish reasons."  

Keeping the definition of a cynic in mind, I intend on chatting about what constitutes ethics in the health care environment.  I will try to tap into my long lost health science education from 2 years ago to see if our new profession is, in fact, breeding ethical doctors of chiropractic or a mixed bag.  From this context, what defines ethics in the first place?

I searched my Apple dictionary for a definition of ethics and this is what I found:  

Schools of ethics in Western philosophy can be divided, very roughly, into three sorts. The first, drawing on the work of Aristotle, holds that the virtues (such as justice, charity, and generosity) are dispositions to act in ways that benefit both the person possessing them and that person's society. The second, defended particularly by Kant, makes the concept of duty central to morality: humans are bound, from a knowledge of their duty as rational beings, to obey the categorical imperative to respect other rational beings. Thirdly, utilitarianism asserts that the guiding principle of conduct should be the greatest happiness or benefit of the greatest number.

To be ethical is a choice each person must make.  In our last philosophy topic, Dr. Partna spoke about whether to treat a problem such as gastritis or not with an adjustment of the thorax vertebrae.  My first thought was, absolutely not, there is no evidence to support such a treatment through research nor biologic plausibility.  The argument was that if there are no guidelines a possible "trial therapy" could be done to see if improvement occurs.  If the risk is lower than the benefits, then there is no reason not to give an adjustment for a visceral complaint such as gastritis.  

Why would someone get an adjustment for inflammation of the stomach you ask?  The theory is that a subluxed vertebrae causes impingement on a nerve and inhibits the function of an organ leading to pathology.  If the vertebra is pounded back into place then the nerves are restored to normal and allow for optimal function of the affected organ.  The problem is that this theory has yet to hold up under scientific investigation.  Schools looking to move the profession forward have left this theory behind to pursue other avenues of promise such as musculoskeletal care and conservative primary care.  Other schools hold this theory deep to heart and continue to preach subluxation theory amongst folks looking for an identity.  Their identity is found through the many profitable entrepreneurial "techniques" that give them all the answers to health and how chiropractic fits in the paradigm.  This is, of course, why the public has mixed feelings about chiropractic.  

There is a good side to chiropractic, mentioned previously, which focuses on relieving pain and even perhaps helping people move closer to the wellness end of health.  I think the motivation behind these individual's efforts is ethically based.  Their concern is the health of their patient population and not lining their wallets, which fits the definition of ethics.  I can not and will not give subluxation theorists and practitioners of this type any ethical credit.  It is a belief system, not a logic system that drives their every action.  They follow a set approach no matter what condition lands on their doorstep.  This is unethical behavior and unworthy of entitlement.  It is wrong to practice something that goes against all objectivity.  You can't just "hope" your adjustment does magical things.  Doesn't this violate the definition of ethics?  It goes against the "greater good" because the result from the action is unknown and the knowledge of the pathology (gastritis) is great enough to understand it is not caused by a subluxed vertebra.  Maybe it was a spicy meal, too much alcohol, too much coffee, etc., etc., etc.  My point is that there are DC's that believe a subluxation is the root cause for all health problems, no matter what the problem is.  They market their 'beliefs' and target unsuspecting consumers.  It is wrong and I can't believe they are going to be my colleagues.  

I will end by saying, its not all doom and gloom.  There is a definite place for chiropractors amongst the many HCP's.  I feel strongly that there needs to be a mass overhaul of the system and a new definition of what it is we as a profession are striving for.  End the useless, unethical practices of the profit driven subluxation theory technique systems that confuse the public.  To be good doctors we must keep our beliefs out of any decisions made on behalf of our patients.  

Please leave comments and tell me what you think.

Burned Out

I flew the coop today and didn't return.  It seems like I am burned out with school.  After making such a big deal about being professional and "physician" material, I lost interest in it all and went home after today's exam.  The only thing I wanted to do was play my acoustic guitar and take a long nap.  Of which, both were accomplished.  If you are wondering whether I felt guilty sitting up in my office strumming my guitar the answer is yes, unfortunately.  Even though I am burned out and tired that doesn't mean I can just skip class to act like a rock star.  Whatever it is worth, I feel better and ready to get 'serious' again.  Nobody is perfect.

During my little escapade I studied gross anatomy for 2 hours.  I even stenciled some drawings of umbilical folds and omentum.  So the time wasn't just full of goofing off.  

I think it is important to know when you have had your limit.  If I would have stayed for the remainder of the day I wouldn't have gotten much from doing so.  I may have fallen asleep in class or missed all the details.  Instead, I had some quality study time and some quiet-regrouping time which will help in the long run.

Today was tough.  We went into the weekend sort of stressed from a massive neuroanatomy exam and the lingering embryology exam watching over our every move.  Studied all weekend (most of the weekend) and I feel as if I need another weekend.  Fortunately, we have a 4 hour break tomorrow to rest or study if so desired.  Time flies by when you are this busy.

I am going to hit the hay and get rested for tomorrows labs.  We practice taking blood pressure tomorrow and we have another lab to learn how to use our opthalmoscope.

Good night

With regard to excellence and change

I was having a hard time figuring out what to write about next until I read a quote on my blog from Aristotle saying, "With regard to excellence, it is not enough to know, but we must try to have and use it."

This quote spoke loudly to me this morning.  The reasoning for this is that lately I have been speaking out in regards to the weaknesses the profession of chiropractic has.  In our philosophy and principles class Dr. Partna has addressed these weaknesses saying that our high velocity, low amplitude 'adjustments' are proving to be less effective than mobilization (gently restoring motion versus forcing things into motion).  Now, our entire curriculum is based on the HVLA mentioned above.  There are courses in soft tissue manipulation and stretching but the question remains, what makes chiropractic, chiropractic if the HVLA is becoming obsolete?  Why should we become chiropractors if research is showing better results come from less aggressive modalities?  My answer is, I don't know.  Honestly, I am trying to define why it is I am putting myself through this rigorous path when the professions bread and butter is losing its ground.  I don't think chiropractic will fold up and vanish but I do think we need to better define why our approach is special and unique.  What do we offer that western medicine does not?  Are we really taught how to integrate prevention into our future clinics?  

Many would say we heal with our hands rather than using pharmaceuticals.  There is some relevance to this argument but I am skeptical.  Some would go as far as saying we remove the resistance caused by the subluxation and allow the nervous system to restore health to the affected areas.  I can't say that there is much room for the latter argument.  We know there is something that allows our body to heal on its own.  Everyone knows this.  Some call it the "innate intelligence" or the "life force".  Whatever "it" is that allows restoration of homeostasis to occur is quite special and unique to life itself.  Modern medicine strives to figure out how to control this aspect of life by building molecules which inhibit a function that is overactive or restore a function that is inhibited.  It is quite amazing to think we know this much. 

Saturday I went to OHSU and checked out the campus.  What a massive entity it is.  There is so much concrete over there it is a bit overwhelming.  There was a nice feeling there though.  We rode the tram down to March Wellness and toured the facility while ending the day at a delicious Vietnamese restaurant.  We ascended back to OHSU via the tram system and checked out the buildings and architecture more.  It was an inspiring trip to see how a medical school feels while walking about it.

The wellness facility, March Wellness, is completely integrated into OHSU's program.  Cardiac patients and post rehab patients work with exercise specialists to get going on a new healthy lifestyle.  The cool thing about it was that the patients are fully monitored to assure they are safe while exercising.  And a physician is always on call for the facility.  It was an inspiring set up.  For example, they have a full kitchen where they teach patients ways to integrate good foods into their diets.  I felt like there was a very good effort being made to help the community live a more proactive life.  Unfortunately, many of the patients had to have health conditions occur before they began the program.  That being said, there were other patients who recently were undergoing chemotherapy for cancer and were looking for an increase in quality of life.  It seemed like the population that uses the facility is quite diverse and represents all walks of life.

All in all, it felt awesome knowing there are others who take prevention serious in the medical community.  We should be wise and follow suit because this is what our nation needs.

Thanks for reading 

Article Submitted and Published

A previous blog post of mine was recently published in our campus newspaper, The Axis.  Many read this post prior to submitting it to be reviewed for the paper and for the most part I received positive feedback.  In efforts to get this published I actually hesitated and backed out a couple days after the editor confirmed receipt of the article.  He promptly sent an email asking if I would reconsider and that he liked it a lot.  From the previous squabble I caused in December I gave it some time before deciding to okay it for publication.  Now it is fully displayed in our campus's newspaper!

It felt good to voice my opinion in regards to the constant battle within our profession, siding on the more science-based approach to chiropractic.  I do not know if there are any folks who disagree with me out there and quite honestly, I really could care less.  It is up to us to use our freedom of speech beyond talking behind each others backs or in our own social networks.  To get my voice out there on a subject I have rigorously studied for nearly 5 years was quite empowering.  Maybe the article will help a fellow student figure out why they are going to chiropractic school.  Based on the forum last week it seems as if there are a lot of students who haven't a clue what they are going to do with this degree when the get done.  I feel for them.  The last thing I would like to see is for a student in this decisive/vulnerable state to choose to believe in the 'other' side of chiropractic for no other reason than a lack of identity within the profession.  It has taken me years to figure out my path and until recently I was debating quitting the program!  So, hopefully I didn't just alienate myself even further by writing those words because my intention is to spark a healthy debate like one would find in a traditional university setting.  We'll see how it goes.

Time is ticking away and I am getting tired once again.  It is midnight and I am on a second night of insomnia!  There is a lot of pressure building with the program lately as there are a few exams rolling in that I am not ready for.  I wish I could just study this stuff on my own and get it down at my own pace rather than wake at the crack of dawn daily to sit through yet another boring lecture.  I think this is my main reason for imbalance.  If I could sleep in until 9 am or so, hit the books for a few hours, go on a run, hit the books again for a few hours then go to bed by 9 pm or so, that would be ideal.  But, we live in a world that is not ideal and unfortunately we must adapt to other's expectations to get ahead.  I better go to bed so the day isn't unproductive tomorrow.

All my best,

Nate

Thinking about Cadaver Class

For some odd reason, the further we get into our gross anatomy course the worse it gets for me. I think I am one of a few that do not enjoy dissecting human bodies.  It is disturbing.  I try very hard to think of it logically and focus on the day's work but I have found myself fighting to keep my cool during class.  

I wonder about the man we have been working on for nearly a year now.  What was he like?  Did he have children?  Married?  Happy?  Things like this crowd my mind when the scalpels come out.  I try to joke around with my lab group but I am certain they know I struggle in this course. It is pretty obvious - mainly because I publicly state this on my blog.  Go figure.  They are very kind and understanding... I think.  :)

We found a long suture along the inter-abdominal wall on Thursday.  Although, there were no signs of an incision on his abdominal skin.  The sutures were in his superficial fatty layer and traveled from his diaphragm to his umbilicus.  When we opened him up we found it to be quite disturbing.  His innards were green!  I think his gallbladder must have exploded during the embalming procedure and leaked bile throughout the cavity.  My dear colleague John Ng did the honors of opening up the cavity after I refused to do it.  I know, I owe him big time!  I intend on making it up to him by removing the liver perhaps.  The experience left me a bit drained this week.  To reach into a dead mans abdominal cavity with your hands and palpate his tissues is an experience of a lifetime.  I wish it was a bit more fun, that way I wouldn't stay up late writing in my blog about it all. 

Our cadaver has had several surgeries.  He has had an inguinal hernia repair, a knee replacement, a piece of bone tacked back onto his head with metal plates, he is missing both ring fingers, and as mentioned previously, we just found suture remnants in his belly.  To think about the amount of time he spent in hospitals is beyond my current ability.  There must have been days that were quite painful and miserable.  I am sure there were plenty of happy ones too.  It is fascinating to wonder about a person I have come to know so well.  His body reveals so much history - it is like a timeline of health.  We know for sure he died of cancer.  The type of cancer is still in question though.  My gut says something remains to be uncovered within the abdominal cavity.  The sutures we recently found have me thinking he had colon cancer.  It is just a hunch though.  We will soon find out and I will share it all with you.

Not many people are willing to share their struggles through an experience like this.  Many of the medically based blogs focus on the daily doings versus the thoughts that appear during the day.  To be cognisant of it all and to put it all into words is challenging.  I wonder if I offend others with my writings - if the words I send out there cause any affect.  It is not my intention to be holier than thou or too opinionated.  I do want to share this experience as well as I can and by sharing all that happens, good or bad, happy or sad, exciting or dull, the blog will uncover what it is truly like to take this path in life.  That being said, I plan to become more fluent with writing weekly.  

To end, I just want to say thanks for reading and have a good weekend.

Anxiety, EtOH and Caffeine...

Boy oh boy, this quarter is a' screamin!  My brain is full of new words, processes and body part details.  It is getting sort of difficult to manage.  Procrastination is definitely not the best idea when it comes to management of such a huge amount of information.  It doesn't stop either.  Once you get through a difficult set of new information a huge mass of new stuff gets poured on you.  So if the old material is still in need of attention you end up getting behind (like me).  Stress increases, sleep cycles get screwy and caffeine starts flowing in like oxygen from the lungs.  Of course this cycle is not one you want to be in for the long term because it leads to misery and greater than normal beer consumption.  As a result, anxiety sinks it's teeth in and the world begins feeling as if it is saddled up on your back!  The only way out is sleep and super productive study time.  All of which I am trying desperately to facilitate.

We will have to see how things pan out because I am tired, caffeinated, and longing for an IPA.  

To be continued...