WeekENDS in PDX

     I was watching TV recently and one of the characters had some sort of accent. Although I remember nothing else from the show I do remember enjoying that character but mostly loving the way the word "weekend" was pronounced. Most of us red-blooded Americans pronounce it WEEK-end but this, perhaps rogue, character pronounced it week-END. I though that was so much more fitting as it emphasized the "end" part which we all know to be so much more enjoyable than the "week" part.

     True to the weekEND pronunciation, Portland knows how to make the most of 48 hours. Pick a weekend, any weekend, and you will find any number of charity runs/walks/bike rides, farmer's markets and about a bagillion festivals.You're probably thinking, "Come on. Bagillion isn't even a real number. Surely you're exaggerating." I assure you I am not. As for bagillion, Portland is a safe haven for all things hipster, so naturally it has a bagillion of something before anyone else even knows about such a cool number.

     I realize photographic evidence is a must so here are just a couple of my weekEND adventures in PDX.

                                                                                 

This lovely Irish festival is touted as the only thing Portland does halfway. Complete with Irish music, Irish dancing, bagpipers, and costumed leprachauns, it's a perfect event for anyone looking for a dose of Ireland to get them through to St. Patrick's Day.

Portland just loves cultural festivals. I'm pretty sure that at some point throughout the year every single country gets some sort of representation including Djbouti and Lesotho. This weekEND it happen to be Fiesta Patrias. Nacho Libre wrestlers came to celebrate, although part of me thinks they were just wandering the streets in a "keep Portland weird" kinda way when they stumbled on to a festival where their attire happened to be appropriate.

         

 

    

 Next stop... Poland. You thought I was kidding about the cultural festival thing... but I wasn't. I attended a legetimate Polish festival. Luckily, I had a Pole to go with me to give me the inside scoop. Lucky thing too, because he was also quite helpful in translating what the vendors were saying about me in Polish... and ordering me the absolute best Polish food.

 In our fruitless pursuit of a funnel cake we stumbled upon this gem. It's an ice cream shoppe called Salt&Straw and we figured it must not be the worst ice cream ever since the line was out the door and around the corner... so we decided to get some.

In true PDX fashion this place only offers ice cream made with all natural, local, organic ingredients. I took a quick trip to the farm to make sure everything was above board before I placed my order and the cows seem quite happy there. This sign is also what distinguishes the line around the block as eager customers rather than picketing activists.

Then I saw the menu. Forget 32 flavors. This place offers pear with blue cheese ice cream along with malted plum, honey lavender, and brown butter popcorn among other flavors. It was then I realized the genius of this shoppe's proprietor. All natural, local, organic, homemade ice cream made in one of a kind flavors which after eating you can discuss amongst friends less hip than you... the PDX jackpot.

 Lest you think everything happening in Portland revolves around food (it does), sometimes I go to events where food is only half the reason people show up... Like quilting expos. Another great time, although I'm pretty sure my friends and I were the only ones there that didn't personally witness Neil Armstrong's walk on the moon... may he rest in peace.

 

 

 



 Aside from food and crafting, I would say Portland's third love is the arts. There are always tons of free concerts in whatever genre your little heart desires. What makes this even better is moving the arts outdoors because Portlanders go nuts when being outside is even an option. What better way to get hipster Portland excited about the opera than putting on a free outdoor opera sampling and following it up with an outdoor Marx Brothers movie projected on a giant screen? I suggest there is no better way.

 And last but most certainly not least...My all time favorite event in Portland is the annual Symphony on the Waterfront concert and it's exactly what it sounds like. It's a free Portland Symphony concert on the waterfront complete with performances by the Portland Ballet and finished off with the 1812 Overture and fireworks to the sound of cannon fire. It was one of the first events I went to when I moved to town last year and it felt like it was all for me. It probably was...Portland sure knows how to show a girl a good time.

525,600 Minutes

          I know, I know, I know what you all must be thinking. Desta, we've been sitting on the edge of our ergonomically designed computer chairs for months now just waiting for your next tantalizing update and you've been holding out on us. To all of you I must apologize. I'm not sure if I've adequately expressed it, but it turns out medical school is more than the average amount of work. As I plowed through midterms and then finals and rounded out my first year, I found myself with an extreme aversion to any and all things that even remotely resembled work and it seems blogging fell under that rather large umbrella. But fear not, all is right in the world... I'm back.

My brother is right. Prepare for the Golden take
over of the Millbrook High School alumni choir

          I recently received an invitation to a Facebook group. The group informed me that the high school from which I had been a part of the inaugural graduating class, would be entering its tenth year in existence and the choir director had a vision to assemble an alumni choir that consisted of members from that past ten years for a special performance. Aside from the wholly unoriginal "has it really been 10 years already" thoughts, the group elicited a few nostalgic memories. In particular, I recalled a song from the broadway musical Rent which we performed in competition and that I still find myself humming on occassion and belting in the shower. (From what I can gather, my neighbors appreciate the daily free concerts.)


          The song, Seasons of Love, expresses the myriad of ways a person can measure the length of a year. As I've recently hit the one year mark in my Portland life, I've reflected on all the ways I could possibly measure my last 525,600 minutes. It could be measured in classes attended, tests taken, and sleep lost... friendships forged, laughter shared, and tears shed... or even beets roasted, quinoa prepared, and urban farmed, better than organic, backyard chicken eggs collected. No doubt about it, this was a big year for me. But I must admit that whoever was responsible for the writing of Rent and its music got it right: my year is probably most appropriately measured in seasons of love. I love what I'm doing, I love the people I'm doing it with, and I especially love all the people in my life who've supported and encouraged me every step of the way.

          You know how everyone always says that a year seems so long but goes by so fast? Well in regard to this past year I would have to respectfully disagree. It was the longest, most challenging year of my life in every aspect and I earned every single minute of it... all 525,600.

 

Seasons Of Love
Songwriters: Larson, Jonathan D;
Five hundred twenty-five thousand six hundred minutes
Five hundred twenty-five thousand moments so dear
Five hundred twenty-five thousand six hundred minutes
How do you measure, measure a year?

In daylights, in sunsets
In midnights, in cups of coffee
In inches, in miles, in laughter, in strife
In five hundred twenty-five thousand six hundred minutes
How do you measure, a year in the life?

How about love?
Measure in love

Seasons of love
Seasons of love

Five hundred twenty-five thousand six hundred minutes
Five hundred twenty-five thousand journeys to plan
Five hundred twenty-five thousand six hundred minutes
How do you measure the life of a woman or a man?

In truths that she learned
Or in times that he cried
In bridges he burned
Or the way that she died

It's time now, to sing out
Though the story never ends
Let's celebrate
Remember a year in the life of friends

Remember the love
(Oh, you got to, you got to remember the love)
Remember the love
(You know that life is a gift from up above)
Remember the love
(Share love, give love, spread love)
Measure in love
(Measure, measure your life in love)

Seasons of love
Seasons of love
(Measure your life, measure you life in love)

         

Reforming Health

     As the debate on overhauling the nation's health-care system continues to be a political hot topic, complete with uncompromising bickering negotiations and partisan hubris, virtually everyone agrees on one point: There are not enough primary-care doctors to meet current needs, and the idea of providing health insurance to tens of millions more people would certainly threaten to overwhelm the already shaky system. The American Academy of Family Physicians predicts that, if current trends continue, the shortage of family doctors will reach 40,000 in a little more than 10 years, as allopathic medical schools send about half the needed number of graduates into primary medicine. The overall shortage of doctors may grow to 124,400 by 2025, according to a study by the Association of American Medical Colleges. And, the report warns, "if the nation moves rapidly towards universal health coverage," which would likely increase demand for primary care and reduce immediate access to specialists, the shortages "may be even more severe."

     The current solutions being discussed include easing the debt medical students accrue and amping up debt-repayment programs as incentive for those who choose primary care rather than higher paying specialties. As a medical student racking up an obscene amount of debt, I'm for it. However, I think there is another viable option being conspiciously overlooked; the inclusion of naturopathic physicians as primary care physicians in our health care model.

     Naturopathic physicians are primary care physicians. We attend four year, accredited medical schools, are trained and licensed to diagnose and treat patients from pediatric to geriatric, have prescribing privileges, and with additional education and licensure can deliver babies. In addition to the medical training received by our MD counterparts, naturopathic physicians also receive extensive training in botanical medicine, clinical nutrition, homeopathy, and structural adjustments. We focus on prevention to decrease the prevalence of chronic conditions such as diabetes, cardiovascular disease, and cancer. We facilitate healing by promoting and stimulating the body's immune system and removing barriers to health. Our interventions are less costly and less invasive and empower our patients to take control over their health and health care.

     As I mentioned in this post, naturopathic medicine is not defined by modalities but by six principals. These principals even further elucidate our effectiveness in primary care:

     The Healing Power of Nature - As naturopathic physicians, we work with our patients under the philosophy of a health-based model rather than a disease-based model. Under a disease-based model, the physician identifies a disease and prescribes a pharmaceutical or other intervention to remove the disease. Under a health-based model, illness is viewed as a suppression of the body's ability to counteract disease and by promoting a patient's health and wellness and removing barriers to healing, the body's immune system is supported and better able to remove the disease on its own or with fewer interventions. This model also decreases the likelihood of recurring disease and promotes the general health and vitality of the patient.

     First Do No Harm - As naturopathic medical students we study a wide range of treatment modalities, from homeopathy and clinical nutrition to pharmaceuticals and minor sugery. First do no harm exhorts us, as physicians, to choose the least invasive intervention for our patients. In a system where iatrogenic disease is the third leading cause of death in the United States, behind cardiovascular disease and cancer, I would say less invasive interventions that promote health are just what the (naturopathic) doctor ordered! Less invasive intervention also generally mean less costly.  In 2010, the United States spent $2.6 trillion on health care, over $8,000 per American. This is such an enormous amount of money, it’s difficult to grasp, but suffice it to say, the United States spends on health care alone what the 65 million people of France spend on everything: education, defense, the environment, scientific research, vacations, food, housing, cars, clothes and health care. In other words, our health care spending is the fifth largest economy in the world. And with this number only climbing it is becoming increasingly important to find less costly, yet effective solutions. Let's go ahead and chalk up another point for naturopathic medicine.

     Doctor As Teacher - Naturopathic physicians spend a large portion of each patient visit on patient education and counseling. In addition, our treatment style of less invasive and health promoting usually requires committment and active engagement from our patients. Taking a pharmaceutical or supplement alone simply won't do. This empowers our patients to be accountable for their health and health care and creates a positive atmosphere of change.

     Treat The Whole Person - I don't think it's any secret that we humans are complex creatures. So many variables are added, divided, sutracted, and multiplied to create who and what we are. Physical, mental, spiritual, emotional, genetic, environmental, social, and economic are only some of the many factors that contribute to pathology as well as well being. The most effective treatments (and physicians) are those that account for the multi-faceted way in which we live. Naturopathic physicians spend a great deal of time getting to know their patients in order to prescribe very individualized treatment plans and accomodate this idea. Not only does this make for more effective treatment but it also takes the doctor/patient relationship to a new level; creating a trusting and safe space that allows for optimum sharing and healing.

     Identify And Treat The Cause Not The Symptom - The naturopathic physician seeks to identify and remove the underlying causes of illness, rather than to merely eliminate or suppress symptoms and it is important to understand the difference. American society is enamored with the idea of the "quick fix." The $40 billions Americans spend each year on diet pills and supplements and gadgets seems to prove my point. However, these seemingly "quick fixes" often just negate symptoms somewhere downstream the physiological cascade and masks the underlying cause. This does not make for effective, long term health care. In fact, it does just the opposite: It turns patients into repeat customers as symptoms slowly return or new symptoms emerge. This type of dependence on the health care system isn't healthy, physically or financially, for anyone. In concert with the principals of Doctor as Teacher and Treating the Whole Person, naturopathic physicians aim to find the root cause of illness and symptoms and begin treatment there.

     Prevention - Naturopathic physicians emphasize the prevention of disease. This includes assessing risk factors, heredity and susceptibility to disease and making appropriate interventions in partnership with their patients to prevent illness. Our idea of prevention means so much more than vaccines and mammograms. Our goal is to increase and maintain health in an effort to help our patients live their best lives. This idea is immediately hindered when patients come to us with advanced chronic disease like obesity, diabetes, or carsiovascular disease. Don't misunderstand, we can, and will treat these things but a better model of health and health care would do its best to prevent these diseases before management and treament are necessary. I like to call this the "Smokey the Bear" principal because although well trained firefighters are vital, in battling forest fires and damage control in the aftermath, I think everyone can agree, people are better served by preventing those blazes in the first place. Naturopathic medicine is committed to prevention as this allows physicians to focus time and energy in more constructive ways.    

     With all that in mind, I would say as the urgent need for increased access to quality primary care physician increases, naturopathic physicians are a more than viable option, in fact we are necessary and uniquely trained to address this need. We are primary care. We should do primary care.

     So why is no one talking about this?

Cultivating the Practitioner

     My school year consists of three terms, each being three months long. Although I am only a little over half way through my second term I have quickly discovered a pattern. The first month of the term is nice as you're just getting into the swing of things, and you go to all your classes, and you feel motivated and invigorated. Then the second month hits you. And it's like a punch in the gut from someone you thought was your best friend. Suddenly, you're overwhelmed by exams and somehow you convince yourself that attending class is your "break time" from studying. As midterms approach, you begin to question every life choice you have ever made that has brought you to this point. Then, just as suddenly as it began, the second month is over. You enter the third month realizing that clearly you can conquor anything and actually look forward to finals week, even if only because it has become synonymous with Spring Break. That is where I am right now.

     Luckily, I'm quite good at picking fantastic friends and I owe much of the sanity I've retained to their unfailing support and cheer. Last night, as I was settling in for a movie night with one such friend, I ran across this poignant blog post written by another brilliant friend and was again reminded how blessed and grateful I am to have my village filled with such incredibly intelligent, provocative people.
    
     His post also caused me to reflect on something I've been meaning to blog about for a while now (blasted Second Month). I am taking a class entitled Cultivation of the Practitioner. When I first saw this course on my schedule I assumed it would cover subjects like motivational interviewing and the doctor/patient intereaction, and I suppose to some extent it has, albeit with a hippie healing twist I hadn't expected. What I hadn't expected was the intrapersonal component, where we delve into our deepest mental/emotional/spiritual recesses to see what we can find. The idea behind this is we cannot expect to heal our patients, physically or otherwise, if we ourselves are in a place of turmoil and uncertaintity. We must find a place of peace within ourselves before we can impart it to others. This doesn't necessarily mean we must be perfect or rid ourselves of every burden, we must simply be aware of our inner obstacles... as my professor so eloquently puts it, "know thy shit."

     That being said, I have really struggled with this class, which, of course, also has a lab component. Talking about my feelings and embarking on a path of emotional enlightenment is not my thing. It's not even anything close to my thing. I was even a little offended at what seemed to me, to be a bias towards emotionally driven living being a higher road. As I may have mentioned before, I was once described by a friend as a "hollow shell of a person" because of my lack of emotion-infused responses. This is not to say that I am completely emotionless. Of course I have emotions, everyone does. However, although I am aware of and acknowledge them, they are in no way my motivating force nor do they drive my decision making process. I'm much to practical and reasonable a person for that. I like things that are logical and make sense, two descriptives that can almost never be applied to emotions. So as you can imagine, being forced to dig deep and not only give my emotions the spotlight but also determine the source of those emotions can, for me, only be equated to nails on a chalkboard.
    
     In what can only be described as self-preservation, I have come to an agreement with this course and we have managed to coexist. I've managed to respect for the course for what it is and go with the flow. (Although yesterday, as we were sitting in a circle meditating and exchanging energy, I found myself alternating between nodding off and deciding what I would do if I won the MegaMillions.) I've even found myself looking forward to the class as a respite from the cerebral monotony that is medical school. It's become like a hug in the form of a class, which works out well because real life hugs often make me uncomfortable. If nothing else, it's given me a deeper understanding of myself and the source from which my motivation as a human being comes. By default, it has also provided me with an avenue for deeper connections with and understanding of those with whom I interact. It has enlightened me to different ways of living and perceiving the universe.

     As someone who self-describes as reasonable to a fault, I discovered something some time ago that has helped me cope when I can't seem to find a logical explanation for another's words or actions. The idea is that given my particular set of knowledge, experience, and opportunities, I am living my life the best way I know how. It would be unfair of me to assume otherwise of anyone else. We are all trying to do the best we can with what we have. Our vastly different backgrounds frequently guide us to make differing choices, which all too often lead to misunderstanding and judgement when viewed without context.

     Living in a city whose mantra is "Keep Portland Weird" has only solidified these thoughts. Portland is a place where every type of person can be found. The beauty of this is that Portland is not only accepting of both extremes and everything in between, it thrives on it. It has redefined, I suppose you could say "cultivated," my perspective on good and evil, better or worse, and brought clearly to the forefront the idea of different. There are an innummerable amount of paths to take in life, all equally sound... just different. And there is nothing wrong with that.

Studying with Flair

I have a big biochemistry test this week so studying has commandeered a ton of my time. I was starting to get a little restless with the usual flash card making, note reviewing, and textbook reading kind of studying so I decided to have a little fun.

Life Lived

     For those who don't know, I love to read. Everything about settling into a comfy chair, book in hand, with or without hot chocolate screams, "This is going to be awesome." And I can really tell when I've been reading a lot because my thoughts become a mental narration of my life, Not completely unlike Will Ferrel's experience in the movie Stranger Than Fiction... She walked absent-mindedly to school and as she passed the well-maintained homes and meticulously landscaped lawns she found herself daydreaming of the lives being lived behind each door; how glamorous they must be in comparison to her barely-there make-up and currently water-logged running shoes ... You know, that type of thing.

     I've realized that blogging has also changed my mental though process. I often find myself viewing my world in snapshots and story snippets that would come together to create the perfect post. That being said, I've now found myself with a phone full of photos and a notepad app overflowing with digitally scribbled thoughts and ideas. However, contrary to popular belief, my life is probably not quite exciting enough to justify bombarding you with posts detailing my every fleeting thought. So I've come up with a compromise. I'm going to do a weekly installment that I am going to call "Life Lived." I'll include a photo and a corresponding thought... a glimpse into my life lived.

     So here we go...

This is my friend Jam... during biochemistry lecture. This moment pretty much sums up everything. As a side note, Jam is from Bali... How cool is that?

Hero's Journey

     According to folklorists and other narrative scholars, the hero's journey forms the basic template for all great stories. The hero begins in the ordinary world, and receives a call to enter an unknown world of strange powers and events. The hero who accepts the call to enter this strange world must face tasks and trials, either alone or with assistance. In the most intense versions of the narrative, the hero must survive a severe challenge, often with help. If the hero survives, she may achieve a great gift. The hero must then decide whether to return to the ordinary world with this gift. If the hero does decide to return, she often faces challenges on the return journey. If the hero returns successfully, the gift may be used to improve the world.

     I can relate.

     At this time last year I was living an ordinary life, working an ordinary job, I had no idea I was about to stumble upon something amazing, something that would change the course of my life forever. A simple google search and I uncovered the world of naturopathic medicine. I had received my calling and was about to leave everything I had ever known to embark on a great adventure. I know I will undoubtedly face hard tasks and difficult trials, physically, mentally, emotionally, academically and everything in between. In some respects I already have. I know I will be pushed to the edge, but I also know I'll make it back... perhaps a little beat up, but who doesn't love a good scar story right?

     I think that's the beauty of the hero's journey, somewhere along the way an incredible transformation takes place and it becomes impossible for the hero to return in the same state in which she left. I can already see my own transformation taking place; I see it in my thought processes, I see it in my actions, and I see it in my relationships.

     The idea of the hero returning from her journey with a gift that will improve the world appeals to my inner Miss America... "world peace" style. I recognize and appreciate the importance and the power of the medical education I am receiving right now and am beyond excited to share everything I learn with anyone who'll listen but I hope that specific knowledge will only be a small portion of my gift. I hope my journey gives me the experiences and the wisdom to always try a little harder to be a little better. I hope my gift is everything that I am.

     Does that make me a hero? ... Heck yeah it does.