Nature or Nurture? Or Does Nature Nurture?
Modern day medical school involves an inordinate amount of time spent sitting inside staring at a screen. Quite separate from the volume and difficulty of the material I need to learn in my classes, this fact is what makes medical school mentally and emotionally challenging.
Last spring and summer -- up until the time orientation started -- I spent every day outside in nature. I hiked the Pacific Crest Trail (PCT) for 4 months until I had to be in Yakima for school. The transition was shocking and extremely difficult.
Months of walking all day.
Breathing fresh air.
Waking up with the morning light and the chirping of birds, and going to bed shortly after dark, keeping pace with the natural cycles of the day.
Covering vast distances on foot -- something our ancient ancestors evolved to be particularly excellent at.
From all of this... to sitting in a stuffy, hot lecture hall, basking in the glow of fluorescent lights.
On the PCT, there were occasionally road crossings. Every time I came across one I felt like a wild animal.
Warily merging from the trees, pausing, darting my eyes back and forth, and listening intently before quickly returning to the cool and quiet embrace of the forest. I had fully adapted to the pace and the rhythms of nature. I felt out of place in busy or crowded places.
This feeling of being out of place and restless was magnified when entering the polar opposite lifestyle of medical school. Being outside and exercising all day changed the way my brain worked. I lost the urge to look at social media or the internet. I became mentally completely in the moment and took every day (quite literally) one step at a time.
Being in nature has been shown to have benefits on mental health, apart from the benefits of exercise. The converse is also true, however.
Living in a big city increases your risk of mental health problems, such as anxiety. There is a large amount of research on the effects of nature on mental health, much of it focusing on certain types of thought processes that contribute to anxiety and depression. Many studies have half the participants walk for almost an hour in an urban setting, such as along a fairly busy road, to control for the effects of walking. The other half of the study participants walk for the same amount of time in a natural setting, such as a trail. The participants who walked in a natural setting reported much lower rates of what psychologist's call “rumination,” which is a maladaptive thought pattern where you go over a certain problem, or worry in your mind, over and over without completion. You're essentially thinking about something that is producing mental stress without resolving it in your mind. This negative thought process plays a role in anxiety. But, somehow, it is greatly reduced by even a short amount of time in a natural setting. From an evolutionary perspective, this makes perfect sense. Our brains developed in nature, where we are outside, surrounded by plants and animals and in tune with the natural rhythms and cycles of the natural world.
I was fortunate to find a house near trails I grew up using in Yakima. The hills right down the street from my house are interlaced with trails built by friends and anonymous strangers. Right now, the serpentine single track trails are partly covered with soft green grass and surrounded by dazzling fields of white, violet, and bright yellow wildflowers. The volcanic rock that lines the trails is covered in beautiful abstract formations of bright orange and yellow lichen. The trail winds through a patch of old forgotten flowering fruit trees, and towering sage brush that reminds me why Lewis and Clark referred to it in their journal as “Southern wood.” There are black-billed magpies gliding from bush to bush, quizzically watching me pass by. As I write this, robins, doves, quail, and bright yellow meadowlarks fill the air with the music of birdsong.
It sounds like springtime rejuvenation.
These trails wind through unprotected vacant land and connect up to the very top of the upland of the Cowiche Canyon trail system. This trail system connects with the Rocky Top trail system which then connects with the Snow Mountain Ranch trail system around Cowiche Mountain, where the former Supreme Court justice William O. Douglas used to head towards the mountains on his journeys from his childhood home in downtown Yakima.
I feel so grateful to live in a place where I have literally hundreds of miles of trails right outside of my back door. Being able to easily escape into the delicate beauty of the desert hills of Yakima has allowed me to clear my mind and feel mentally healthier. When I run on the desert trails of Yakima I am often reminded of this quote from William O. Douglas:
"I do not envy those whose introduction to nature was lush meadows, lakes, and swamps where life abounds. The desert hills of Yakima had a poverty that sharpened perception. Even a minute violet quickens the heart when one has walked far or climbed high to find it. Where nature is more bountiful, even the tender bitterroot might go unnoticed. Yet when a lone plant is seen in bloom on scabland between batches of bunch grass and sage, it can transform the spot as completely as only a whole bank of flowers could do in a more lush environment. It is the old relationship between scarcity and value, one of the lessons which the foothills of Yakima taught me."
The time commitment of medical school has made my nature experiences fleeting and brief. As they have become more scarce, they have become more valuable and intense. Even spending 45-minutes trail running allows me to enter a healthy mental state of being in the moment and simply observing the beauty all around me.
As I start the trail climb towards the conservancy, I often grab a piece of sage and let the pungent, yet delicate, scent flood my lungs. The smell of sage and moist volcanic soil wafts on the warm, friendly Chinook wind blowing from the West, blowing my cares away with the same ease it melts the mountain snow every spring, and reminding me why I’m grateful to go to school here in the Yakima Valley.
Osteopathic Medical Student - 2nd Year (OMS II)
College of Osteopathic Medicine
Pacific Northwest University of Health Sciences