The Clinic as Workshop: Reflections on the New Year

Oil Painting by Henrietta Brown. A Girl Writing; The Pet Goldfinch 1870

I come across this beautiful 19th-century painting recently and am riveted to the image for several minutes. I absorb the peaceful setting, where the girl seems simultaneously unperturbed, yet inspired by her surroundings. I feel her dual experiences of taking something in, and yearning to express something out. It reminds me of an email from a dear friend, about the idea of a workshop and all the forms a workshop might take, where room is made to be present, capture a moment, and inspire creativity.

As a licensed naturopathic doctor for the last thirty-five years, I know that one of my favorite workshops is my clinic and my experiences treating patients.

In this Etch-a-Sketch time of year, when we all get a do-over, let’s-start-afresh chance, I consider what I might like to write about this year. I want to write stories about COVID-19 and what naturopathic medicine brings to the table. I want to write about healing from a difficult year. I want to write lighter pieces about people and places and art and nature. I aim to stay inspired by literal surroundings and my internal landscape, by the people I talk to, by the natural world, by things I read and hear and experience, and most essentially, by my patient’s stories.

Recently, a favorite older patient of mine asked if I believed in the power of prayer. I said, you know, I believe in the power of just about everything. Another young person asked bluntly, why I had taken chemotherapy when I had cancer some years back — if I was a naturopathic doctor, why didn’t I just use natural medicine approaches? A patient last week wondered my opinion about a drug she was considering to address her COVID-19-related anxiety and insomnia, or did I think naturopathic approaches would suffice? I love when patients ask questions that illustrate different world views, and allow me to learn, even as I try to answer as directly as possible.

I think about my patients’ biochemical individuality, about how each is made up of their genetic inheritance, lifestyle choices, experiences and relationships they cultivate, the environmental exposures they have. Every patient is different, a unique individual who makes their own decisions about habits essential to good health, and who chooses what kind of approaches they use for both preventive care, and to address symptoms or illnesses that arise.

There is no single right way to do most anything, including medicine. There is no one-size-fits-all, perfect approach. Part of what I love about being a naturopathic doctor is that by definition, I individualize care to each person I see, while working to address the whole person before me, their body, their mind, their feelings, their spirit.

I retain a strong faith in both my patients’ inherent capacity for healing and in the healing power of nature, in all her forms, from intricate human physiology, to the magic of plants, to the biology of nutrition, to the ongoing transformative power of exercise and mindfulness.

I remain inspired by the many people who find their way to my door who sustain determination through hardship, who stay strong when lonely, who are comfortable feeling all the feelings, even the uncomfortable ones, who keep supporting others, creating, giving back, even when the well seems nearly dry.

I am urged on in equal measure by people I do not help, as I work to find solutions for what ails them or to make an excellent referral to a better-for-them provider whose work I admire. I am a deep believer in the power of collaboration, how there is a time and place for many kinds of healing and medicine. It is the patient who benefits most with collaborative efforts among providers, so part of my job is to help my patients create their best team of doctors, therapists, and other pertinent healers. With regards to helping our patients, we doctors are limited only by a tendency to stay in separate silos and by our imagination.

I am sixty now, and hear many of my colleagues are starting to retire, or pulling back on their work. COVID-19 gave many people, doctors included, unprecedented opportunity to think about how things are going, is this work, in this form, good for me? Do I need to keep doing the same thing even if I don’t enjoy it? For some of my retiring doctor friends, it’s health reasons or burnout, or just too much stress of the in-person or telemedicine job. For others, it’s time to hear their heart’s yearning for deep rest or new adventure, or both!

But I don’t feel that way. I feel like so much of my knowledge gained, so many of my skills developed, alongside the comfort and presence I feel in the clinic, are coming to fruition.

My patients still grab me and make me want to help.

When I am in the clinic seeing patients, my work takes on the feeling of athletic pursuit. Listening to patients’ stories one after another sometimes requires a kind of endurance. I need to be comfortable in my own body. I need to be in the zone. Using my senses to observe and understand my patients is akin to an athlete developing court or field sense, reacting with adjustments, large and small. This is now more automatic for me in history-taking, or performing a physical exam, in creating a treatment plan, or in the follow-up visit setting.

I put not an insignificant amount of effort into getting into the zone with patients and creating ways to have predictable and easy access to that place. For every practitioner, finding that and keeping easy channels to it will be different. For me, it stems from the ability to quiet my mind, to close out distracting thoughts or needs. I take responsibility for being well-rested, well-exercised, well-hydrated, and well-fed! In other words, taking care of the controllables!

I make lists in the morning, that I add to during the day, of things I need to take care of, so I will remember the minutiae that make up being a doctor, mother, wife, and community member.

Before arriving to see patients, I keep close to the surface of my mind that this patient, whichever patient it is, has come to me for help. They are suffering or uncomfortable in ways, and it is my job to, without distraction, try to help. It is my only job at that moment. In ways, this process is very liberating, as it’s my only job at that moment, and though I multitask like all doctors while taking the history, by being observant, by allowing observations to inform questions, by being aware of interactions within the room, it is still much easier than say, running a household with three teenagers, which I did for several years!

So, I hope whatever you do for work or fun, for making a living or in your personal time, you have a place you can be from time to time, any kind of workshop in time or space, with some moments to reset your gears, look around for inspiration and find the energy and time to feel, to connect, and if you are so moved, to share in ways that are meaningful and satisfying for you!

With best wishes for a healthy, happy 2021!

American Association of Naturopathic Physician’s 2017 Physician of the Year. Teacher, writer and advocate for healthy living.

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