Courtesy of Dr. Marnie Loomis, at NCNM, I learned a lot about burnout today. And as suspected, I score very high on the I-have-it scale!

What are the stages of burnout, you might ask.

1) Emotional and/or physical exhaustion. This might characterized by fatigue and cognitive weariness.
2) Depersonalization (cynicism). Symptoms include lack of empathy, mocking others, and loss of altruistic feeling.
3) Low sense of personal accomplishment. This may include a sense that you can’t do anything right, and worthlessness.


“But Ash, isn’t it a little early in your schooling to get burnout?” you might say. Yes, I think so. But the trouble is, I started this way.

Don’t get me wrong, I had an amazing summer! Whales and mountain goats and bears, oh my! But transitioning from farm life on an island where my favorite thing was watching lambs play, to a summer on a small boat with 10 new people per week that it was my job to entertain and serve all of my waking hours… well folks, that just aint easy. Naturopathically speaking, it would’ve behooved me to bring along some sort of adaptogen or other support product, as well as cultivate emotional and mental sanity in my minuscule time off. Hindsight, 20/20, and all that.


Stress does more than cause tension. According to Dr. Loomis, you are literally more brittle under stress. This is because each day your body is replacing and rebuilding cells and tissues. Stress changes the chemistry of your body, and each day you rebuild in stress-conditions is another day of reduced flexibility and less-than-optimum building conditions. So while fight or flight is an appropriate response when a herd of wooly mammoths is stampeding through, it is less than idea in a long-term stress situation. Like medical school!


So what can we do about this? Many things! Depending on how far down the 3-stage pathway we find ourselves, this might vary. For instance, I find myself between a 2 & 3, so my first step was to seek out available resources for assistance. On campus at NCNM these include the student association and student life departments, student counseling center, tutors, student mentors, faculty mentors, and a program called Careteam, where we can actually seek help for classmates we are concerned for as well. Amazing.

If you’re not so far down the continuum and/or are more of a help-yourself type, other suggestions include:
Personal quiet time
Spend time with family/friends
Spend time in nature, or if you can’t, with plants!
(seriously. an office study showed people around plants were 30% happier)
Get more (better) sleep
Eat regular meals
Take breaks!
Start a mindfulness practice
And many more…

Things to avoid, that may contribute to burnout include:
Alcohol or drug use
Skipping meals
Wishful thinking
Financial stress
Housing stress
Poor health

In the 6 hours since this presentation I have done these things to help myself:
Went to yoga (love Friday night yoga!)
Planned 2 study sessions with classmates
Planned a night of dancing to move my body and relax my mind
Spent time talking to friends about topics other than school!


I have a ways to go, friends, but I am paying attention to where I’m at and taking steps to improve. Other things I have in the works are: cooking at home, seeing a counselor, establishing care with a naturopath, taking adaptogen supplements (Gaba, Opolopanax, and kali-phos), and cultivating a mindfulness practice. I will report back on progress.

If you are feeling signs of burnout, I urge you to take steps to reduce/eliminate stress and cultivate a stable state. Find resources, talk to family and friends, and direct your energy to things that will support your sanity and your health! We don’t have to correct everything at once. Promise yourself you’ll try something new for a week, and at the end of that week check in and see how you feel. Was it beneficial? Do you feel any better? Do you want to continue or try something else? Listen to your body and trust your intuition.

I’m going through this now, and if you are too, feel free to comment, and we can share difficulties and successes. I’m so glad I went to that talk to, this week has been a huge shift into gears for my self-care! I hope you can help yourself too.


Why being present > worry

Howdy friends. ┬áToday it occurs to me that I can legitimately count down without thinking about it! Numbers are my thing, amazing magic poetry that always resolves if you know how to manipulate it, with constants┬áthat plug into diverse formulae. What’s that about?! Okay, but I digress. The countdown!


Today is April 26th, 2013. Gasoline is $3.69/gallon. Apple blossoms are on the trees, and the cherry tree is snowing on the front porch. My broccoli starts are ready to go into the garden, and the dahlias uncovered from their over-winter blanket. Gay marriage and marijuana are legal in Washington State. And today is 28 days from my last day of work. A few days short of a month away from hoisting sails for Alaska. Less than 4 months from my first day of medical school!

So many things to do, so much to sort out and accomplish over the next 4 weeks. Hire and train a new office manager at work. Sort out and pack things to move, separate from the things to bring with me for summer. Paperwork for school while I’m still around internet. Logistics and formalities for my summer job. My mind is scrolling in lists. Each day that I cross something off, one more “big” stress that I can finally set down, it feels like gaining back 5% lung capacity, 5% mood elevation, and 10% heart. I am highly stressed in the most beneficial ways.

Every couple of days I let my head fall back and thank the Universe that I’m not a worrier. This is usually half a moment behind my becoming aware that I’m worrying. As funny as it sounds, I’ve already done this a handful of times lately. Worry is something I have seen so many of my friends, family, patients, and colleagues do, sometimes to a debilitating degree. It can become so ingrained and ubiquitous in a person’s character that they are described as a worrier. As to say that’s what you would notice about that person if you met him/her. Aren’t people amazing creatures?! This soul’s ride through a human body can so easily dwell in cerebral hemispheres! Self undoubtedly included! Worry is not something we see in other species to a fraction of the degree in humans, and yet so many of us adopt it with every cell. Worry becomes a conditioned response. Pavlovian. Incredible! These sorts of things usually get me asking questions about this mind-vehicle we’re all in, most especially, are we riding or driving? Observing a person’s most apparent traits, what they are most comfortable representing to others, and trying to see what light that sheds into their deeper self, I inevitably find these traits in myself as well. Worry is no exception!

Of course I’m not free from worry. I’m not that zen. Yet.

I aim to be. Worry doesn’t serve me. I don’t wind up ahead when I over-think things. In grade school I recognized that I miss more questions on multiple choice tests when I second guess myself and change an answer. Trusting my gut (which has a mind of its own) usually leads me forward, and if I’m listening closely, rarely leads me wrong. So why should I worry?

But then the list gets long and the time gets short. Tasks stack up, responsibilities call, and plans being to form as vague outlines with blanks that can’t yet be filled. This is when I start to worry.

Most often these things build up gradually over time. So slow sometimes that I don’t recognize the worry building until I don’t recognize myself. I start to feel uncomfortable in my own skin. Worry takes over. But you know what’s cool? Usually being consciously aware is all it takes to reverse the process. Sometimes that’s all it takes.

Being present is shockingly hard and surprisingly easy. Nights like tonight I can sit in the yard feeling mellow, eating my dinner, watching the sunset and be perfectly happy to sit feeling the warmth. Other nights (especially when waiting for an acceptance letter) it’s hard to keep from being a passenger in the mind-car, getting whisked away sudden and often, feeling out of control.

Like I said, I’m so happy I’m not a worrier. I have not mastered this grounding presence, and am still prone to getting caught up in the whirlpool of my mind. Fortunately, this is not a prevalent tendency for me. Details of the day come and go, each moment replaced by the next, new information to process and feel. With so many experiences to be had, I’m not the type to spend a lot of time evaluating and re-evaluating each and every one. I look for the good ones. Savor them.

And when the stress builds, my goal is to savor those too. Balancing the pull with visions of the big picture. And maybe someday I’ll hop in the drivers seat, and steer my way into bliss. :)


Breathing the Tuesday air

Stress, stress STRESS!

First practical exam in osteopathic evaluation coming up a week from today, with the second one in osteopathic tutorials a week on its heels. Today I sat in on the class I missed last week due to travels, and so glad I did. We learn new things all the time, with very little class time spent on review, and while that seems totally reasonable, practical skills can be much harder to pick up than memorization. Somehow, even after two years, I still have trouble counting spinal vertebrae and palpating transverse processes in the neck. Does it even make sense that I can feel nerve and artery tensions and not bones? Hmmm…. something more to learn there.

Trying to clean house, create some space for my roommate who arrives Thursday bright and early. Two more classes, two more nights sleeping, and then taking the train to London for another epic airport moment. It’s funny, no matter how many tear-jerking airport scenes you see in the movies, it’s no less real when you get there. Never knew I’d get to partake, but no complaints! In the meantime there’s laundry to put away, floors to clean, bathrooms to sanitize, groceries to shop for, and maybe some new decor as my horoscope suggests.

Wish me luck as I clean/organize/study/transition/cohabitate/try to maintain stability! :)

Such great heights

Long distance relationships are hard. Take something awesome, throw in 5044 miles, and see what you get. Sounds like a recipe for loneliness. How are some people are able to sustain relationships over the distance, across land and area codes? Even if you talk everyday, it doesn’t replace the physical contact.

Touch is a key component of my relationship with my partner. We are both very hands-on people, our love language is touch. Right away we had a strong chemistry without words, and that has only grown over the time we’ve been together. A hug, a squeeze of the hand, a kiss; we know so many ways to communicate with each other non-verbally. Snuggling is high on both of our lists. There’s nothing like coming home to read more