I got my grades in the mail yesterday. I passed everything, and was pleased to find that I rated honors in both Immunology and Hydrotherapy. I wasn't even really going for honors, I was just trying to pass. That is a hopeful thing. Having passed all my first year classes, I am now officially an ND2.

Study Questions:
1. Does having an immune response to a colon tumor preclude you from getting lung cancer? Why or why not?
2. What happens if you systemically and non-specifically turn on all of your T cells at once?
3. What are TSAs?
4. How does a DC vaccine for cancer work?
5. Why can people often fight off virally induced tumors but not spontaneous tumors?
6. Name one way that viruses that cause tumors evade the immune system.
7. Which cells of the immune system have receptors for neurotransmitters?
8. What effect do glucocorticoids have on the immune system?
9. Name 3 problems that make it difficult to do PNI studies.
( answers and some info about unconventional cancer research and treatments )

The woman who cheated on her biochem exam in first quarter, the woman I turned in for cheating, she is still in my program. She knows that I reported her, and since then we have not had honest words. She has avoided me, or been syrupy fake. I have waited for a chance to begin to speak openly with her again, because I like her, because I respect what she has done in life. I even tried to call her but her cell phone number has changed. So I have waited for my chance. Today she gave a presentation on alternative cancer cures that I was particularly interested in, and I asked her if I could get a copy of her powerpoint. She said yes and took my email. I said thankyou. She said "You're welcome bitch" as she turned away. I did not react. We continued to interact inside the same group of people for the next 10 minutes or so and she would not meet my eye or speak to me. I would like to be open with her. I understand that she is holding a grudge, that she thinks I was wrong to turn her in. I do not know if she understands that it was not personal. I like her. I would have done the same if ANY other classmate of mine had been cheating. I'm sure she had reasons that she was not prepared for the exam. My choice to report her was about the principle, and I stand behind that principle. I wonder how long it will take for her to cease being so angry and be willing to speak with me again. I am grateful that I am able to understand her grudge and not take it personally. For the most part. A part of it still stings, and that is my work to do.

Today was the last exam....and it was pretty easy. In fact, all the finals seemed easy to me this time. Last quarter I was worrying about merely passing, and this time I'm thinking I should have fought for a few more points in a few more classes and maybe got some H's (for honors, instead of P for pass) on my transcript. But it is not the time to worry about such things. I have let go of my old habit of going for the A+ (since there isn't one to get...). I'm going for comprehension.

I made it through most of my notes and index cards from this quarter, integrating them into my ever-evolving filing system. I want to be able to lay my hands on any piece of information that I need. Some my files are destined to become chapters in books. All of them will help me as I dig deeper into each aspect of medicine. The beautiful thing about medicine is that each layer builds on the last. It's like learning a language, and we need a certain fluency to pass the boards, and another kind of fluency for each possible specialty we might take on. And then there is the language of human compassion, which is the core of the practice of medicine.

So much has been happening lately that I can't even come close to keeping up with my journal. This weekend I'm attending a conference at NCNM on "Transforming the Mind" and the presentations today were fascinating. I think the most interesting one for me was this wild mathematician guy who has decided to represent aspects of dynamic living systems in three dimensional moving lines as drawn by his computer. But I don't want to write about this too much now. There will be more of this conference, and I'll have more insight after I finish the whole thing.
( long and rambling, about movies, studying, Governor Kitzhauber's talk on the future of healthcare and the Archimides Movement, and a couple of vocabulary words (grok and transmogrify) )

I just finished taking the 4th exam in organ systems, on the digestive system. I thoroughly enjoyed studying the GI, and look forward to the next round! Gut health is a modifiable key to overall health. I did OK on the exam, there were a few questions (as usual) that I answered by deductive reasoning, and because my knowledge base is spotty, my deductions can lead me to quite wrong answers. No worries. It is all beginning to plug into the big picture.
( random notes )

Homework for week 8
Doctor-Patient Communication
Liz Sutherland, ND, teaching
( here's my homework for tomorrow morning )

GENERAL
--affects the skin and joints
--we have 25 square feet of skin, weighing approximately 9 pounds, with 32 million bacteria per square inch on it, 20 feet of blood vessels and 72 feet of nerves (per square inch, still)
--red scaly patches on skin = psoriatic plaques = inflammation and excessive skin production --> silvery-white appearance
--common locations: skin of elbows and knees, palms of hands and soles of feet, on the scalp, inside ears, butt crack, etc.
--not contagious
--can be INSANELY ITCHY!!!
--chronic recurring condition
--fingernails and toenails frequently affected
--10-15% of people with psoriasis have psoriatic arthritis
--often associated with food intolerances and multiple chemical sensitivities that are often the result of dysbiosis or an imbalance of intestinal flora that causes yeast overgrowth --> systemic effects
--clinically associated with a deficiency of zinc, magnesium, essential fatty acids
--indicates a high degree of toxicity in the body
--associated with cardiovascular disease
--Annual treatment cost exceeds $3 billion, in 1993 was btw 2-3 billion
( long )

What are the inputs and outputs from the amino acid pool?
--Inputs: diet, stomach digestion, pepsinogen, pancreatic enzymes, intestinal processing, absorption, turnover of endogenous proteins
--Outputs: excretion, protein building in fed state, aa catabolism during a fast
( more )

I'm at school, and we have an hour after our last lecture, not because we're supposed to have an hour but because Brons didn't want to lecture embryology to a group of students completely distracted by their upcoming microbiology exam.
( more )

petechial rash = little red spots on the skin caused by broken capillaries. Widespread petechiae and ecchymoses are signs of sepsis (meningococcemia). They also may indicate various causes of thrombocytopenia, and leukemia.
( more )

Just finished my first test of the day, palpation. On my patient I located the 7th thoracic vertebra, the manubrium and quadratus lumborum, and did passive flexion motion palpation of the cervical spinous processes. Pie. Easy, that is. The next test is in organ systems, on the four segments that I posted about last night. That one will be harder.

Well I could have gone to school early this morning in order to go to Mamie's free yoga class, but instead of practiced a little yoga here at home and then made a big eggy goat cheese peppers and onions and cilantro burrito. Now digesting and posting for the first time in a day or so. It's nice to be home. I like home.
( more )

Kitten just pulled another tack off my corkboard, causing important things to do lists to fall into the dark behind my desk. She loves to play with tacks, and leaves them lurking in the carpet when she is done. But her very favorite thing is a desk drawer just slightly open, with a hair tie in there. She'll play and play with the desk drawer, and when she finds the hair tie she will snatch it up as if it were a live bird, and run off to play with it on the slippery livingroom floor. That's where she is now, batting a hair tie around and pawing at the walls.
( more )

The assignment is to interview, and be interviewed by, a classmate, and to reflect on the experience. I interviewed Dustin Dippin, who asks really astute questions in class. I wanted to meet him and to know him, so I jumped on the opportunity to interact with him at this level. I will not write his personal details here, except to say that at age 26 he is highly advanced for an American male, and I am pleased that he is here at NCNM. His experience validates my own.
( more )

Came into school for an 8am class and discovered from a sign on the door that it was cancelled. Would have liked to have still been in bed.

Starting a new subject with a brand new teacher, and for once, I think the teacher is more nervous than the students. I hope he calms down enough to finish his sentences, and wait for that flash of awareness or recognition before he moves on to the next slide. I was left behind for most of his lecture, which was scattered and incomplete. The notes, furthermore, were incomplete (lacking images) and wildly disorganized (repetitive but without logic to the order). Welcome to NCNM.

But this study of microbes is very important, so I need to keep up with it. I have never taken microbio before. The closest I've come is learning about all the causes of food poisoning as part of becoming a Coconino County (Arizona) approved Food Manager (certified to supervise Food Handlers). So I will begin the process of transcribing my notes and looking up everything that I didn't get on the first run through.

First, a quiz:
A. What was the leading cause of blindness prior to 1800?
B. When was the first report of Helicobacter pylori, the bacterium now known to cause stomach ulcers?
C. What was the first commercial antibiotic, what was it for, and when was it produced?
D. What is the ultimate microbial symbiosis (from the human perspective)?
E. What specific state of infection contradicts Koch’s 3rd postulate?
F. What specific person has historically been used to contradict Koch’s Postulate?
( answers and notes )

Today is Day 1 of Quarter 2. Behind me already is my first class in Medical Ethics (since my undergrad in philosophy in the 80's) and my first clinical correlates class. I'm feeling considerably more settled than I did last quarter. At least now I have a stable place to live, a relationship that has withstood a test or two, and an idea of how things work (or don't work) around here. I passed all my classes from last quarter (didn't find out until I checked my mailbox this morning) and even got honors in one. Woo hoo. Next stop: the bookstore to get a book on microbio for idiots.

I've been making a list of the classes that I would like to see added to the offerings at this school where I attend. I am sure this list will expand, but for now I want to get it into a post so I can throw away the scrap of paper my notes are on. These are my suggestions on how to improve NCNM's Naturopathy Curriculum:

Classes or Requirements

Reduce or Lose
--4 quarters of required homeopathy is too much. One quarter required would be appropriate, to introduce us to this modality without requiring us to adopt it. There are many other modalities worth considering.

Increase or Add
--supporting infant and childhood health
--more than one emergency medicine class
--intro to microbiology
--public health courses, managing a quarantine? pandemics? vaccinations? history?
--add traditional North American tribal medicine, esp herbs but also ritual
--add dance therapy, sex therapy, color therapy, scent therapy electives
--add yoga
--add meditation instruction
--add hypnosis instruction
--we have Ayurveda electives, how about Tantra?
--one more quarter of biochemistry just before the summer of boards

I'm glad there's:
--two quarters of minor surgery
--one required quarter on obstetrics, the basics of birthing, plus an assortment of additional obstetrics classes