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With butterflies in my stomach, I nervously entered Chehalis Family Medicine to complete my medical assisting (MA) internship. Stacey, an attractive woman with straight medium length hair and chestnut colored eyes, introduced herself as my preceptor. She quickly showed me around the clinic and pulled up the patient schedule. “Our first patient is in room 9. The most important thing to keep in mind is to not keep the doctor waiting. In and out.” I shadowed her as she moved quickly from room to room as if on roller skates. Chief complaint, allergies, medication list, medical/surgical history review, preventative health maintenance- immunizations, blood work, cancer screening, and vital signs were all addressed in under 5 minutes. She then popped out to give the doctor an overview of the patient visit. I watched as she threw a stack of consults on the desk and began updating patients’ electronic medical records. She called patients to relay imaging and blood work results at the same time. ‘’Stacey I’m going to biopsy the lesion. Please set up the tray,’’ Dr. Lee called out. I on the other hand, fumbled when placing the blood pressure cuff on patients’ arms, sweat dripped down my back as I prepared to give injections or venipuncture, and I slurred my words on the telephone. Everything was done slowly and consciously. It wasn’t too long though before I learned to pick up the pace. Stacey taught me how to be fast; after years I became what my instructor calls “seasoned.” This was my first glimpse of healthcare as I know it.

Slow Medicine The Way To Healing by Victoria Sweet has given me a new perspective on how medicine should be practiced. She begins by sharing about a time when her father received the incorrect diagnosis upon being admitted to the hospital. This clear error changed the whole course of her father’s treatment and almost caused his death. She goes on to distinguish between medicine and healthcare. Victoria states “What father had gotten was not Medicine but Healthcare-Medicine without a soul.” She defines soul as presence, attention, judgement, kindness, and responsibility. She explains that medicine deals with finding the true and right story. Victoria then brings attention to the different versions of medicine. She describes modern medicine’s view of the body as a machine. When I took courses for my MA program, the instructor also referred to the human body in this way. The doctor is the equivalent of a mechanic who must fix the broken part(s). She sheds light on an alternative model of understanding a patient, through the lens of pre-modern medicine. The body is like a plant and the doctor therefore acts like a gardener.

One of the major faults she identifies within the healthcare system is its fast pace. The medicine we should strive for is slow. This simple change allows the doctor to see the patient in a whole different light. She warns: “Don’t miss the obvious.” By this Victoria means that the diagnosis is written on the body. She proves this time and again. One captivating story she shares deals with a pediatric patient named Marcela Hernandez who was admitted for renal failure. With the help of fast medicine’s technological advances, multiple tests and work ups finally led to the correct diagnosis (neurofibroma). Victoria awaited for Marcela’s mother so she could share her finding. She is left stunned when she meets with the mother because she is covered in neurofibromas! Victoria recollects “All that effort, intelligence, and expense to get that brilliant rare diagnosis and all it had needed was one look at Mrs. Hernandez.” The diagnosis had been visible the entire time. Another clear is example is that of Joey Canaan, a pediatric patient who had drowned in a pool. He had survived but was admitted to the ICU and relied on a ventilator to help him breathe. Despite numerous tries, Joey’s body did not have the capacity supply oxygen on its own. The doctors thought he was a lost cause due to excessive scar tissue from the water and pressure of the vent. Before pulling the plug ,the pulmonologist instructed the attending physician to try decreasing the pressure and volume of the vent slowly. Joey began to respond and within three weeks was breathing entirely on his own. By week 6, he was discharged and went home to resume a normal healthy life. This goes to show that sometimes fast medicine isn’t enough-it’s the steady, consistent, and slowness of time that will allow one to heal.

Having already had a little bit of experience in healthcare, I can relate to many points Victoria brought up. I recall filling in for a medical assistant in internal medicine and pulling up the schedule to see patient appointments every 20 minutes from 8 am to 5 pm. All day long I weaved in and out of rooms doing my best to make sure we didn’t fall behind schedule. These were elderly patients most with complex medical issues. How did the doctor have time to fully address their needs? I questioned his model of patient care because being in a rural underserved medical area, my doctor and I struggled with even 40 minute appointments. Patients were asked to keep their chief complaint to a minimum of 1 but the doctor always ended up discussing 4-6 additional issues. As I resigned from my position, management was pressuring doctors to increase their patient panel, which would increase revenue. The turnover of doctors and nursing personnel has dramatically increased at my clinic as a result. I agree that not much is needed to make medicine better than it is. Everybody needs to just slow down.

The dynamic of gardener and plant approach to healing was very fascinating to me. Victoria describes the process as taking a step back and observing the patient in his own environment. The doctor asks himself “ What’s in the way of the patient’s own healing power of Nature?” It is then up to the doctor to remove whatever obstacle is impeding the patient from thriving. There are many who don’t realize or have forgotten how amazing the human body truly is. Oftentimes, people go into the doctor’s office with the expectation of being “fixed” right away. Many times that’s not the case, which leads to frustration and anger. Today I was reminded of the self healing capabilities we possess. All we need is a little patience and time.

With a higher education, I hope to help patients on a more personal level. Being placed in the patient’s shoes what type of care do I hope for? One of empathy, compassion, and support, which is what I have aimed to abide by from the start.The provider should be the patient’s greatest advocate. As I gain a deeper understanding of medicine,I hope to always keep in mind the integration of fast and slow medicine to help people heal. It starts with simply the slowing of footsteps and a listening ear.

Bill Arney taught Walking to Santiago De Compostela winter and spring quarter 2018. During our first meeting in the cedar longhouse, the class was provided with a program covenant outlining the student expectations. We reviewed this form and had the opportunity to ask questions. Each student signed the document agreeing to abide by the guidelines. He adhered to the program’s covenant precisely, which made the quarter go smoothly. In weeks 3, 6, and 9 students submitted a synthesis paper, which required individuals to reflect on his/her experiences in the program and show what he/she had learned. Assignment instructions and their due dates were organized clearly within the canvas module. Feedback detailing strengths and areas to work on was provided in a timely manner. Bill went out of his way several times to remind the class to “follow the form.” The reading list selection was appropriate and generally not difficult to understand. Before each Monday of the week, students were expected to have read the assigned book and portions of other complimentary text. Students led seminars were held Monday mornings to explore concepts within the book or ask questions about the text. Tuesday mornings were spent watching educational films about El Camino and other related topics. In the afternoon, the professor led seminar was held. Bill strongly encouraged everyone to actively participate and pushed students to think on a deeper level to understand the author. When the discussion strayed away from these key points, Bill was quick to redirect the conversation. He listened very intently and reminded the speaker to address the whole audience. At times his facial expression conveyed frustration because he wanted every student to be engaged in seminar. While I am still quite reserved, Bill has helped me be more open to sharing thoughts. Furthermore, on Wednesdays the class continued with seminar and had time allotted for guest speaker presentations. I was extremely grateful for these guests who provided education on various areas of travel-nutrition, gear, injury prevention etc. Bill also organized for a panel of prior camino walkers to discuss their experience and answer questions from the class. His organization of guest speakers was well thought out; I learned how to plan for a successful trip in this manner.

As we near our departure date, Bill has ensured that students have submitted all required documentation to Evergreen State College. He has also planned our itinerary for spring quarter and booked reservations for our stay as a group. In addition, he has collected each student’s itinerary/contact information and ensured each student is familiar with WordPress by geolocation oneself and posting in the blogsite. Whenever I email him with a question, he is quick to respond within the same day. His attentiveness to correspondence is excellent; he urges students of the need to check emails daily. Bill is an exceptional faculty member as he takes on the role of professor while also the responsibility of planning a studying abroad trip. His attention to detail and organization skills will ensure that our time abroad is spent in an enjoyable manner.

Upon arriving at the starting point of El Camino Frances, I was faced with an unforeseen situation; I was threatened by another pilgrim. I emailed Bill immediately to seek advice on how to handle the incident. He quickly responded to my email and was available to meet me in person the following day. Bill made sure that Evergreen State College administration was informed and kept updated as a report was made to the Spanish Guardia Civil. He was very supportive and remained near as long as I needed. The legal proceeding to obtain an order of protection was very stressful. I contemplated leaving everything behind before even starting my Camino. Bill listened attentively and his calm manner made me feel more at ease. He never hinted at what I should do but rather encouraged me to think things through carefully before making a decision. I was extremely grateful to have his guidance during my rocky beginning on the Camino. I also had the pleasure of walking with Bill and got to know him better as a person. We talked about many topics such as Spanish culture, education, and family. Walking the Camino was even more difficult than I imagined as it requires stamina. Seeing how Bill took on the Camino with ease gave me a newfound respect for him. He is truly a one of a kind professor.

Ten am had struck by the time my group set out from the city of Aviles. Aidan R, Anne, and I were one of the last people to leave the dormitory that accommodated 48 sleepy pilgrims. I recovered my shoes from the empty rack and propped down on a covered bench area outside of the albergue. There was an another more private dormitory directly across from the main albergue, and I was surprised to see another rack full of pilgrim shoes. I had expected the rest of my classmates, Aiden T, Annie L, Maddie, and Jacqueline to be long gone. While they had arrived late the previous evening, to my surprise they were greeted with a special accommodation- an entire private room to themselves! For this reason, they had not been awakened at 7 am on the dot like the rest of us. Almost an hour later, I saw Aiden emerge from his room. He smiled at us and said he would go wake the others. One by one, they recovered their shoes and made their way down the steps. We walked to the bar across the street for the usual breakfast-tortilla y Zumo de naranja. Then we parted ways with two classmates and set out for El Camino.

Shakira was blasting through my headphones for most of my walk today. The music carried me through the busy inner city, along the highway, through valleys, and ultimately to my destination, Muros De Nalon. There were a few steep inclines along the way and I took them on with full force. My calves were burning, sweat trickled down my back, and my feet were sore. I tuned out my physical weary state and focused on walking to the beat of the music. Once I reached the peak of the hill, a surge of energy ran through me. I felt as light as a feather and unstoppable. I was no longer walking, I was beginning to float. I reached a stretch where the Camino was level-adorned by a straight row of trees on my left side, a dense forest on my right, and faded leaves scattered on the ground. My mind began to wander and I found myself thinking about my loved ones back home. I missed them so much and couldn’t help but feel a little homesick. I looked ahead in the distance and saw a white figure standing still in the middle of the trail. As I got closer, I realized that it was a dog who was an older reflection of my dog Migaja (Spanish for bread crumbs). I got a little teary eyed at her sight, especially once I took a closer look at her. She had bloodshot eyes and her scruffy white fur felt coarse against my fingertips. Judging by her physical appearance, she had little interaction with people. She hesitantly wagged her tail and began to follow me as I walked on. I told her that she had to stay there and she obeyed. I looked back every once in awhile until she disappeared. Later that night, I asked my classmates who were trailing behind if they had met my furry friend. They had not.

My group and I reached albergue La Naranja Peregrina around 5 pm. We were greeted by Aidan and Anne. My face was sticky with dried sweat and my cheeks were rosy red but I was gleaming. We had been informed a few hours prior that the albergue was full but arrived anyways in hopes of being offered a spot, even if that meant sleeping on the floor. I spoke to the albergue host who unfortunately did not have any spare beds left. He kindly offered a tent and a spot in the backyard. I took the tent and thanked him. Maddie and I looked at each other and burst out laughing. Sometimes laughter is the only thing one can do to maintain composure. I was a little disappointed about not getting a bed but glad I wouldn’t be sleeping on the street. If I were placed in a similar situation only a couple months ago, I would have probably burst into tears. The Camino is teaching me to be more optimistic and to see the good in all situations.

P.S. I am sitting on Aidan’s bed writing this blog and an Australian pilgrim offered me his roll out mattress to sleep on. I accepted 🙂