Immersion Phase Update: Integrative Medicine (1/5 – 1/29)

January was a super rewarding month.  Working with one of the attending physicians I’d met on my PM&R elective in July, I landed a month-long elective at the Osher Center for Integrative Medicine at Vanderbilt.  Integrative medicine, also known as complementary or alternative medicine, focuses on holistic care of the individual–bringing together physical symptoms, behaviors, emotional health, relationships, and other aspects of a person’s life to promote overall wellness.  To do this, integrative medicine combines conventional medical care with interventions such as counseling, physical therapy, yoga, and acupuncture.  The chief complaint for most patients is some form of chronic pain–from migraine headaches to fibromyalgia–but they might also struggle with things like insomnia, anxiety, weight management, GI issues, or some combination of the same.

The philosophy of holistic care that clinics such as Vanderbilt’s Osher Center are founded upon is such an important one, but one of the unfortunate and sometimes frustrating observations that I had is that patients often arrive at this clinic as a “last resort” after seeing countless specialists in the community and considering myriad medications and procedures with no relief of symptoms.  Ideally, an integrative care model would offer a first look at the conventional and non-traditional options available to patients in order to deliver the best care possible for an issue, or perhaps it would facilitate preventive care before issues arise.  However, in the current health system, this is not the case.

Over the course of the month, I spent weekdays at the Osher Center and saw patients with physicians, nurse practitioners with medical or psychiatric focus, physical therapists (in exam rooms at Osher and in the heated pool at the Dayani Center on the main campus),  an acupuncturist, and a massage therapist.  I also participated in a few positive psychology/mindfulness meditation classes, tai chi classes, and yoga classes for patients.  There was even a workshop on sleep that I sat in on for a few afternoons.  I gained a lot from my experiences; I not only learned about how some of the recommended practices fit into patient care, but I also was able to take note of different styles of interviewing, educating, and motivating patients, which will no doubt serve me well later on in my own practice as a physician.  In addition to all of this, I discovered a few things–sleep hygiene tips, breathing and mindfulness techniques, and other little suggestions made to patients–that I want to actively incorporate into my own personal life.

Aside from observing and absorbing information from clinical experiences and the database of articles I’d been sent on day 1, I was asked to give a presentation on an integrative medicine topic of my choice.  So, during the last week of my rotation, I presented a short talk on how music can fit into the philosophy of integrative medicine.  It was well received and greatly appreciated by those who could attend, much to my relief (I guess oral presentations will always make me nervous).

As if this elective wasn’t enjoyable enough on its own…I had a pretty active life outside of clinic as well.  I got to sing with the worship team at church again, singing vocals with just two other people instead of being one voice in a full ensemble.  I was super nervous, as I’d never done this before, but now I’m hoping for the chance to do it again sometime if they’ll have me.  I also put a few new covers on my YouTube channel; one of them was even shared on Twitter by the original artist, which was super exciting!  In addition, I started to think about my rank order list for residency programs, meeting with people and getting advice from faculty both inside and outside of psychiatry.  I still have about 3 weeks before the deadline, but it’s quite a daunting thought just the same.

Now I am off for the entire month of February, taking one of my remaining “flex months.”  I’m spending most of that time in Memphis, keeping busy in a number of different ways.  Check back here at the end of the month for an update (hopefully)!

As always, thanks for reading.

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