On Digestion

As expected, working in the GI unit of the hospital is very different than working on a farm. I was excited to finally see the ways medical nutrition therapy was implemented in clinical settings - the tube feedings, the TPN - all stuff I'd read about, studied and heard about in lecture but I'd never seen them, nor spoken to patients who were relying on tubes for sustenance and life. Different indeed.

Early in the week my fellow intern and I tailed the doctors on their morning rounds for a few days, listening to the medical students, interns, residents and attendings hash out their diagnoses, treatments and prescriptions, and tried our hardest to keep up with the jargon. We then chose patients to follow, ie. to conduct assessments and chart using nutrition practice guidelines. It was all very intellectual and I found myself philosophically drawn back to my time at Bastyr where much of the focus was placed on digestion as the foundation of health. The gastrointestinal tract is a path for foreign objects to move through our body. When we ingest foods they technically remain outside of our selves until we digest them, break them down, absorb them into our very being. Digestion allows us to process that which is outside of ourselves and internalize it in a healthy, discerning matter. Finally, it is transformed into matter that serves us, creating energy and enabling life affirming pathways. In theory, anyway.

A reminder of the major organs involved in digestion

I've been thinking about this process all week - digestion, absorption, transformation - as I hit the two month mark of my internship. Somehow it feels like a real change. Maybe it was beginning my fourth rotation, transitioning from cold to hot cereal for breakfast, switching from running shorts to pants or leaving my house early enough in the morning to catch the moon still shining that it feels like summer is really gone and fall is here to stay. And while I look forward to the spectacular Michigan foliage I've heard so much about, to the abundance of honey crisps, winter squash, root vegetables, to wearing jeans and sweaters, I still find myself struggling with the start of the fall season as I do each year. I dread the inevitable extra curves on my body and roundness in my face, the result of less activity with the shorter, colder days and an increased appetite for warming, grounding foods. If summer is about expansion and openness, then fall brings contraction and retreat, a turn inward in preparation for the winter months. I'm finding it all a bit hard to digest.

Catching sunrise on my walk to work

And yet. Eventually I will make my peace with this transition, as I always do, with this new energy and space, this opportunity to reflect and re-evaluate my life course, a process facilitated by the onset of the High Holidays, the Jewish New Year and Day of Atonement that demand introspection and contemplation. Some years the holidays, based on the lunar cycle, fall earlier in September when the weather has not yet turned and they seem to appear suddenly, catching me off guard, unprepared to admit to my weaknesses and areas in need of improvement, to examine my relationship with the divine and with my fellow man and set an intention for the year ahead. But with another week and a half until the holidays begin, I find the change in weather, the change in my diet, the change in my mood appropriate for the start of a new year.

So what am I thinking about for this coming year? Most immediately I have career concerns. Re-entering the workforce this winter during this uncertain economic state is daunting and more and more I think about the importance of non-traditional entrepreneurial ventures. I've read, heard and been involved with many formal and informal debates lately about the relationship between education and employment. While a college degree may still vital be to getting a job, having one no longer guarantees security. Nor does a graduate degree or even two. Furthermore, tonight I was listening to a report on bankruptcy and in the past five years there has been a 20% increase in college grads filing for chapter 11, which honestly, came as no surprise.  Still, it is also an opportunity for incredible creating ways to (professionally) enact your beliefs in the world suggested by Peter Sellars who taught at UC Berkeley's Edible Education course (streamed here on YouTube). He posed this question to the audience: "What does it mean to put your belief system into your body? And actually live based on what you believe most deeply? Not at some future time, but now."

So for now, I try to focus on the task at hand: helping those with compromised digestive health achieve optimal nutrition status. And in doing so there is a reminder for me to measure my own digestive health. How well am I processing the information that is all around me? Am I integrating it into my mind and my body in a constructive way, or am I getting bogged down by the all the change, frustrated by the challenges and the dread of winter and all it brings? How can I optimize my spiritual and emotional digestion so that I can have a strong foundation in the year ahead? These may not be competencies I need to complete for my internship, but they are worth devoting some time toward nonetheless.