We get a break! By break I mean a week (5 whole days!) without classes. Exams are three weeks away, meaning that once we return from our class-free Thanksgiving we have one week of class and then finals. Inasmuch as there will be no class, there must be studying over break if any sort of sanity is to be maintained during the final two weeks of the term. Alas.
This week has been good, anxiety-provoking, relaxing, tiring all together and at once. We covered lung exams, both in theory and practice – anxiety provoking. I did some reading, had some spare time to see my partner – relaxing. We had an exam on Wednesday of this week – all the above. And, for the highlight, I joined a gym!
Never have I ever had a gym membership, the gym culture has always seemed a little to intense, a little to meat-headed for me. Not to mention music on loudspeakers and screens on the machines and TVs around are sensory overload for me. However, given the Portland cold and rain in addition to my recent lack of good running space (i.e. I am to tired to run but the time I get home) I have not been exercising. So I decided to check out a hospital associated gym – and LOVE it.
Let me explain a bit about this gym. Unlike the more popular chains, my gym is associated with a hospital, which means that there is a wide variety of people in a wide array of circumstance. Some are fit, focused, and well put together (medical students, hospital employees, etc). Others are not. Patients of the hospital are prescribed exercise routines, depending on where they are in their particular stage of illness or recovery. Trainers work with some others come in to do their prescribed time and exercises on their own. Regardless, there is an atmosphere of striving for health, whatever stage you may be in. There are also no cell phones allowed, and no music or common television. It is a haven.
There is some truth to valuing what you pay for. I pay a fair few bucks for the privilege of an unnecessary use of electricity via a treadmill, to be able to pick weights up and put them back down, and to do yoga with a teacher who actually knows what he or she is doing. Not to mention to use the sauna and/or hot tub and pool as the mood may strike. Money is going in, I for damn sure will be showing up to make use of the service.
Stress wreaks havoc on the human body. We are not made to be in constant, unending stress. Exams every week, practical labs sans shirts (not stressful for everyone, but certainly for me… and yes, we do have gowns), piles of studying for the ever impending avalanche of exams, work (albeit only a few hours per week), family, children, social lives – it is just too much. My own stress symptoms range from nausea, excessive appetite, no appetite, erratic bowel movements, gas, bloating, diarrhea, abdominal rash, muscle tension, inability to sleep, exhaustion… In short, I’m a mess. I’m tired, blotchy on my belly, may or may not be excessively gassy. This with weekly therapy and acupuncture. And so – to the gym! The beautiful thing about exercise is that it burns up the stress hormones, makes concrete use of overstimulated sympathetic nerves, helps the bowels move, enhances blood and lymph flow, which in term enhances detoxification and immune function. It is a win, win, win. And happily, just a few days in, I am winning!
I confess, this is not only due to the exercise (though the benefits here cannot be overstated). It is also due to the fact that the gym is a place where I do not have to talk to anyone, think about anything, or appear any particular way. I show up in the morning, messy and disheveled. I exercise, sweat, completely and utterly disconnected from every obligation and responsibility I have, present only to whatever questionable music choice I have made and the wonderful feeling of moving rather than being seated in class. GLORIOUS. The sauna has become my after-workout cone of silence. I sit in the heat and meditate and breathe in so much joy and thankfulness to just be.
Of course I shower and dress, leaving much more put together than when I rolled in. And I feel as put together as I look by the time I walk out the door. Certainly the upcoming week will bring a welcome respite from 8:00AM classes and unending lectures. My hope is that, moving forward, keeping moving will help me cope with the chaos of it all.
Riding in the back seat I flipped through an abandoned Reader’s Digest – the cover had a headline about a man that wanted me dead. At the time, a child, I wondered how someone I never knew had any awareness of my existence and why, if they didn’t know me, they would want me dead. The article must have been about Osama bin Laden, and I don’t remember any of the details, other than the intense fear and confusion I felt.
Much of my upbringing (and therapy) is focused around fear – intense anxiety around so many things. Fear of being home alone in the evening, having conversations with people (known and unknown), of failing out of school, of having people see the person I am, of letting go of the person I was, of growing, of making mistakes, of going crazy, of being out and about at night in the dark, of missing the bus, of fatal car accidents, of cancer…
It is no surprise or secret that the climate of fear is cultivated by the media in our country – it is how outlets keep people coming back, how they sell newspapers, how they get people to listen or watch. Many parents teach their children fear, over-cautious and over-concerned for safety and well being. We are a nation of adults who are consistently afraid and unable to differentiate the real threats from those imagined.
I also do not participate in a good deal of media, and was surprised when my mother told me what had happened in Paris. More than surprised, I was anxious and afraid. Will my holiday travel go alright? Will my family and friends be hurt, living so close to DC? If it can happen in Paris, it can happen anywhere… On my Facebook feed there were posts about #prayforParis to be sure, but there were also a great many about prayer for the world. Many to bring awareness to the bombings in Beirut just a few days prior, to the fact that Muslims in Paris were killed alongside white people (whose religion we neither know nor care to know, their skin color being their alibi).
In the midst of the gut-clenching fear and deep sadness for what appears to be an inescapable human condition of violence, the quiet thoughts that rises to the top are about those people who carried out the acts of violence. An unpopular stance I’m sure, what compassion might we find for those living the violence. Local gang violence comes to mind, perpetrated by individuals in deep poverty, who may or may not have ever known what it is to be accepted until joining up.
Fear is not meant to be a constant state of being – it is unhealthy and contributes to the wide array of stress-associated diseases and subclinical conditions: hypertension, hypercholesterolemia, diabetes, obesity, headaches, impotence, insomnia, generalized anxiety, depression, OCD, difficult menopause, cancer, etc. Conditions resulting from excess stress and poor diet and no exercise – the body, mind and spirit do not grow well in such soil.
Love bears out in the opposite way. When we love and are loved, we know we are well and safe. Fear does not exist in a state of love. The archetypal earthy mother’s love when we are newly of this world shows us we are provided for, cared for, that all is well in this world. Ideally, we are actually welcomed into our mother’s arms, our co-parent’s arms, and that love translates and transforms as we grow. Translates into an ability to love and care for ourselves, transforms into love we exude for other people, compassion for life such as it is.
Too often, people do not experience warm, nourishing love. Experience tells that there is not enough, will never be enough, that safety does not exist in this world. An exceptionally simplistic view perhaps, this is the root of violence. Not meeting of basic human needs, of teaching and learning scarcity ongoing threat. We are made to live, and threat to life naturally leads to lashing out in self-protection. This comes out as blatant violence – killing self and others, domestic violence – and in more subtle ways. Harsh words, bullying, excessive criticism (of self or others), overconsumption are all symptoms of fear.
It can be challenging to shift from a state of fear to love. Fear is, after all, easy – it is programmed into our DNA for self-preservation. Lions are scary – how about we don’t go near them and continue breathing. Love requires much of us – it demands care and awareness and responsibility and accountability for ourselves and those around us. Love asks us to show up in ways that are uncomfortable and vulnerable, to open ourselves down to the depths. It demands trust and faith at every level: in ourselves, in others, in the universe at large, in God.
Whoever you are, wherever you are, I invite you to cultivate love as best you are able. Curiosity is a good vehicle for this practice. Instead of harsh criticism or anger, ask questions and get really interested in what it is you are experiencing. The best place to start is within your body – ‘I wonder what this headache is about?’ ‘My gut just clenched really tightly a minute ago – I wonder what that’s about?’ With practice and in time, it is possible to harbor curiosity at every turn, to wonder at where someone’s actions come from (this does require inviting a bit of naiveté into your life).
Practically speaking, peace is cultivated on an individual scale, in daily and mundane choices. It lies in every moment of every day: waking, cooking, driving, childcare, self-care, errands, eating. Peace requires we face our discomfort, that we invite it in to sit with us. That instead of lashing out against others or ourselves, that we have compassion for whatever it is we are experiencing. There are many great resources for beginning this practice – one in particular is Thich Nhat Hanh’s book True Love. Practical and simple, it offers ways to practice love every day – in fact with every breath. Dancing with the Ten Thousand Things by Tom Balles is another life-changing favorite. Mystics have ever so much writing on love: Julian of Norwich and Rumi are two of my favorites. Victor Frankl’s Man’s Search for Meaning is similarly helpful in understanding the condition we humans are living. Sri Mati has wonderful meditation resources, and as of next month a podcast for living in ways that facilitate compassion and peace.
Whatever the global political climate, we determine our local climate, be it one of fear or love. What is happening in your home? To whom do you express love and compassion? Anger? Fear? How is it with your soul? If there is change to be made, and you are not sure how, you need only ask for help with an open heart – you will be supported. The pursuit of love is always supported by the universe – it is a universal force, after all.
~ In love ~
Two thirds of the term are finished, and I am struggling. Struggling keeping to the grueling schedule of study I need to keep in order to get so much information firmly embedded in my mind. Struggling to eat healthy foods, to keep my body running well and my mind focused. Struggling to find a balance, which, although I know is a falacy, is terribly important to me. Struggling with the deep Portland winter dark. And struggling to make decisions that are the best for me and my education and my future at large.
My most cherished possesion was broken this week: a shell given to me by my mother that belonged to her now deceased partner, Susan. It was a slow motion moment, hearing the shatter, turning to see pieces on the floor, and feeling the familiar dark grip of grief on my heart. Shock came and left quickly, replaced by incredible mourning. Through my mind ran, in amazingly quick succession, a lifetime of memories – of Susan, of her death, of trecking all of my things across the country, this one carefully wrapped up the whole time… I wept, muscles tense and full with grief. In a suprisingly short span of clock time, I relived my life’s most profound loss, surrendering completely to the depth of my emotion.
Breaking such a shell, you can see the beautiful pearlescent inner layer. Depending on the shell, the outside may or may not be so stunning – typically not. The outside reveals the beauty of spiral form, perhaps, or earth tones interestingly arranged in stripes. The inside, though, is amazingly beautiful, the moreso given its mystery.
That said, I’ve spent the week thinking about three things: things, my attachment to them, and the necessity of breaking open.
‘Stuff’ has not been a huge deal for me in a great while. An entitled millenial, I lust after things to be sure. Over time though, I have been wearied by too much stuff – not only while moving, but also in the day to day. The less stuff I have the less time it takes to care for my space. Having lived in a micro-apartment I have some practice living with minimal excess. Even now, living in a house, I crave divestment, to lessen the burden of things. Things require storage, cleaning, maintenance – I`d rather give it all away. My books I am highly attached to, along with a few select kitchen gadgets, and the clothes I regularly wear. I hadn`t considered myself particularly attached to anything until that shell broke. In that moment (and those following), any attachement I had to my other things disappeared – what do they matter? The most important is gone – take the books, my favorite pans, my juicer, my favorite socks and jacket… none of it matters.
From there I moved to thought about why that shell was so important – because Susan picked it, touched it, carefully selected it. Because my mother gave it to me to take across the country, away from her, a selfless gift on her part. Because it represented the time of my life when my family of origin was whole, when nothing bad could happen to me, when I was surrounded and steeped in love every minute of every day. Along with that shell shattered the last physical remnant I carried with me of the time before my loss of innocence, before my relationship with loss and grief began.
And so, now, living a different life entirely, integrating and broadening my family in new ways, I have put a good deal of thought of how to commemorate what has passed without the things. Susan being from New Orleans, I decided to take a friend to brunch at a cajun restaurant in town, in memory of Susan. I ordered Cafe du Monde coffee and chicory to have for my morning coffee, integrating memorial and memory into a cherished daily ritual. This is a new and ongoing question for me, how to nourish and honor the memory of time and people past.
Dismemberment, in some schools of spirituality and religious practice, is considered necessary. It is only when we are altogether broken down that we may be made new. The military uses this practice, initiating recruites into new ways of living, harsh and unknown, breaking them down completely in order to make them new. The universe (God) too breaks us open and apart with loss, chaos, unknowing. Changes burrow up and through the foundation we thought solid, destroying the base of the life we thought we made for ourselves. Turns out we humans have even less control than we thought we did. Marriages implode, careers fall apart, illness takes hold, and it is all we can do to draw one more breath. Existence is reduced to a moment to moment experience, becasue anything more is simply excrutiating.
Collective experience from those who successfully make it through these moments is that coming out on the other side we somehow find ourselves in a place of beauty we were sure could not possibly exist. The dark night of the soul somehow, and mysteriously leads to a new dawn. Breath is renewed. We were reduced to ash and in mystery made new. It is a mystery to me how this happens, why it must happen… and my sense is that it must. My intuition is that this breaking apart, including the incredible difficulty and pain and discomfort, is critical. I don’t know why, and perhaps never will. Tremendously I wish there were another way around transformation than complete annihliation of the familiar and comfortable.
On starting school I was sure that my period of profound unknowing was finished, at least for a year or two – it turns out I am being broken down and rebuilt day to day. So to my struggles – practices – I add surrender. And compassion, care. Leaning into discomfort as best I can.
In one day I had the most stressful event I’ve had this far in med school (registration with 100 other over-achieving type-A personalities), and the most awe-inspiring.
We are doing our first swath of heart physiology and learning the associated physical exams: chest exams and blood pressure. In labs, we partnered up, got gowns on and listened to the hearts in the room.
Truly, how many people listen to your heart over the course of your lifetime? Your mother, perhaps your father. If you are a woman, your children know your heartbeat, having developed under its cadence. Maybe your spouse lays his or her head on your chest, or your children, a sibling. Only those closest to you hear the beat that moves your blood and enlivens your organs.
Surprisingly, many doctors don’t listen to the heart, unless they are cardiologists. It has been years since I’ve been to a doctor myself – I think the last visit was in 2013, to the gynecologist, who, specializing in other anatomy, did not listen to my heart. The last time a doctor listened to my heart that I remember was when I was a child, likely younger than 10.
As naturopath and a primary care physicians, we are taught this dying physical exam. Listening deeply to the rhythm of another human being is amazing. Through the stethoscope can be heard the steady opening and closing of a healthy heart, the ongoing movement of a seemingly tireless muscle. The sounds from each set of valves may be heard, sometimes affected by the breath. Subtle sounds that take time and attention to decipher. Having only listened to a grand total of 4 hearts I have much to learn. What an exciting endeavor, to learn to listen and decipher the beating heart.
Monday two weeks ago, at the beginning of week 6, I took a spectacular fall, substantially injuring my left foot- I’m not sure I didn’t break it. Not wanting to take the time to have an x-ray or see a doctor, needing to get to school via the bus, to which I walk, and being an enterprising herbalist and first year student, I took matters into my own hands. The wonders of homeopathic arnica had been touted to us just a few weeks before, and having some on hand for an assignment, I decided to go full on, topically and internally at regular intervals, to see if it would help me so that I could at least walk to the bus stop without wanting to cry with each step.
Let it be known that I am a skeptic. If I have not seen something work that does not make logical sense, I withhold judgement until I’ve had some first hand experience. Homeopathy does not make good logical sense to me – even in lower dilutions, the amount of plant material is barely detectable. At high dilutions, there are no molecules of the original plant in the remedy. It seems like a bit of magic, and no small trick at that. And yet, so many use homeopathic remedies habitually to keep themselves well, with excellent results. Many naturopaths primarily use homeopathic remedies with their patients for a wide array of conditions and symptoms.
At any rate, as you might have guessed, it worked. Within 24 hours, the swelling in my foot went down, a nice bruise showed up, my range of motion increased dramatically, and I could walk, with minimal discomfort (!!).
Before my fall, I decided to try my hand at fermentation by way of sauerkraut. Ever a favorite, reading through the process of salting and pounding a cabbage I was skeptical. Yes, I know plants have a good deal of water, and I know the mechanism of salt bring the water out, helped along by breaking the cell walls with vigorous force. But the book said there would be enough water to cover the plant material. No… Surely not. I had a huge cabbage, slightly larger than a basketball. Maybe sometimes that works, if you have just the right cabbage, but no…
So I did it- I chopped, pounded, salted, chopped, salted, and pounded some more. And I’ll be damned if there was not enough water to cover the cabbage! This may sound terribly elementary and simplistic – really, I am in awe of the fact that it worked at all. It has been a beautiful reminder of the wonder that exists in the world, the everyday processes we take for granted, being as they are part of us. Osmotic shifts from electrolytes, innate healing capacity… The stuff of which we are made.
This past week I learned to take blood pressure and do a heart exam – and wouldn’t you know, the heart works. Again, this sounds dumb in writing – yes, of course the heart works, we would be dead if it didn’t. But think about it – there is a marvelous and complex interplay between electrical current, ion movement, and protein binding happening during every heartbeat (!!). For your entire life. It doesn’t stop, it keeps plugging along, beat after beat, compensating as best it can for any mishaps: contractility may be adjusted, stroke volume, pressure, coronary circulation… And sure enough, in the 5th intercostal space, I’ll be damned if there isn’t the apex of the heart, and the point of maximal impulse, the seat of the rhythm of the body, clear and palpable if you know where to look.
The majority of the time, if we can get out of the way, it all works! Mysteriously, amazingly, simply and effectively. Do you understand how simply amazing that is? That a remedy made of sugar and a molecule or two can help heal a nearly broken foot, that water can be removed from cabbage, and then made to ferment, generating, among other things, beneficial bacteria and B vitamins?! That your heart has contracted countless times from your conception to this moment, allowing for your vast life experience, no thanks to you? This is the part where, were I the jump up and down type, I would squeeze your shoulders and jump up and down – it all freaking works!!! It is just all so terribly exciting.
Certainly it is best to be prepared, to put in the time and energy to pull together information or resources for a particular endeavor. This might be camping, athletics, a party, a presentation, an exam, a meeting – anything that requires some forethought and planning. Certainly there is a great deal to learn at medical school: the obvious anatomy, physiology, physical exam, philosophies of healing and patient interaction. Something I hadn’t counted on having to learn is to fly by the seat of my pants, off book altogether while appearing as if I were perfectly prepared. It is a phenomenon I have noticed all around me, increasing with the progression of study.
Certainly, moving along and gathering knowledge as we go, there is more leeway for improvisation, simply due to a broad base of knowledge. In terms of patient care, new remedies or protocols may be tried with confidence, given a certain history and knowledge of both the patient and effective remedies. Scholastically there is no way to fit everything in – unless we adopted the life of a hermit, foresaking food and family, and even then it still would probably not all fit into the hours of the day. And so those things with which we are slightly more familiar get set aside, or an assignment is forgotten, and off we go, all improvisation, and let’s see what happens.
A good deal of emphasis is placed on appearing confident – we are graded on our confidence in both presentational classes and physical exam classes. How much do we look as if we know, regardless of what is actually consciously retained. The purpose of this I see as twofold. As physicians, we must instill confidence and trust in our patients – if we are shaky in the face of what may be a terrifying experience of illness, on what ground will a patient be able to stand? Secondly, subtle remedies require unwavering knowledge that yes, this will work. This is part of healing – having and holding unwavering faith and confidence in our abilities as healers and in the effectiveness of our remedies.
Confidence embodied comes only after a certain amount of experience, seeing what does and doesn’t work and fully integrating the knowledge. One of our professors commented we could borrow his confidence until we had enough experience to have our own, an offering I anticipate relying on as I move into the role of clinician. In the meantime, alongside confidence, we work to cultivate humility, knowing that people are vast and complex – unexpected effects come and go, people change where we thought them once firm.
Overarching the whole endeavor is faith in a system of healing that has endured despite the best efforts of technology and convention to eradicate it. Nature thrives in predictable rhythm- so too do we humans. Botanical compounds have reliably predictable effects on patterns of symptom. This, if nothing else, I know and trust. The rest will come in time – until then, I prepare as best I can, and when all else fails, improvise.