may i just say…
i luhuhuhuv STARBUCKS VENTI ICED SHAKEN BLACK TEA WITH GRAPEFRUIT AND HONEY minus the sugar syrup!
yum!
and i have crossed over.
i don't drink coffee anymore because i have gastritis.
and i have crossed over some more!
i can't fall asleep when i drink coffeee!
far cry from med school!
chronicles the adventures of an out of training nephrologist who tries to master real life just when everybody else has a huge head start…and finding lalalaughter and awesomeness in the most mundane of real-life events.
Wednesday, May 3, 2017
WANTING TO LEARN WHAT I WANT TO TEACH
I remember that much of the failure I got in medical school was with
the renal modules. In first year until
the end, I got a complete renal failure in all of the examinations. As much as I tried reading and absorbing it,
and thinking that I understood it, I failed the examination.
As such, I made it a career to become a nephrologist partly because I
wanted to conquer these failures. But a
bigger part why I became a nephrologist despite the failure in the basic
sciences is that I loved the way the patients responded to renal treatment in
the clinics. Ang the biggest reason why
I went into Nephrology is that during the last year of my residency, my mother
went into chronic dialysis.
Theoretical Nephrology was never easy for me. I failed all the written examinations in
medical school, residency, and my first Nephrology Board Examination. I excelled in seeing the patients and did
well in the oral examinations and revalida given by consultants. However, I believe I have prevailed and am
happy with my career because of the following:
First, I really want to become a general physician and a nephrologist
particularly because I want to be able to provide care to other patients the
way this care has been provided for my mother.
I think that this very deep and desire helped me to finish this
difficult path where I met a lot of mini failures along the way. Also, prolonging life and improving the
quality of life of the patients was very important.
Second, the environment was very supportive. Although the topics were very hard, the
people who were teaching were very kind and encouraged me to persevere. Each of my mentors told me of the challenges
that they faced. When they finished
training, they are very generous to share the benefits that they have reaped
and promised that once we finished, we will be able to reap the same
benefits. Currently, my then mentors who
are now colleagues are very helpful in helping each one advance in one’s
career.
Third, the topic was something I really liked. I was fascinated by renal physiology, and how
it affected all the systems. Though
difficult to explain (until now), I was fascinated by the electrolytes, the
logic and the mathematical part of the theory.
Fourth, I enjoyed how nephrologists are also educators. They are very active in wanting to improve
curricula in their respective societies.
They are trainers in their institutions.
And this is similar to who I think I am.
Lastly, I believe that I endeavor to teach nephrology to the residents
and the students because I think it is beautiful. Since I found the topic to be very difficult,
I want to make a way to find it easier for other students. And also, I want to serve as an example that
I have failed so many times at each level, yet I am where I want to be.
As such, I find myself in the training institution of my hospital and
the head of the continuing medical education committee of our society. I am utilizing camaraderie with other
nephrologists and trainees to facilitate learning as well. However, this motivation is not really
selfless. I endeavor to teach because I
don’t want to become stagnant in what I know.
I think that ultimately, teaching is a way to keep sharp and learning
some more.
Teaching is a way for learning never to stop, and as a closet nerd,
this is how I want life to continue to be.
It is very exciting! J
GUSTO KONG MATUTO, PERO HINDI OK MAGAWA
When I was a child, my learning opportunities came by very easily. I distinctly remember when I was in nursery,
I had a made-up classroom in my home where I would “do homework” with my
sisters who were eight and nine years my senior. Early on, I was adding and subtracting in my
little classroom. It was fun, not
terrible. I loved doing the problems,
was persistent until I got the right and answer and reveled at the good
feelings I got when I did. As such, I
brought this on continuously until high school.
Because of this, I believed that elementary and secondary school
learning was effortless.
I wanted to share this love for learning and to teach early on. A fresh psychology graduate, I decided to try
my hand in teaching by coming back to my high school and becoming a biology
teacher. This decision was easy for me
because I had the most inspirational biology teacher when I was in second year
high school. And I wanted to be just
like her.
I set out to make this learning effortless and fun for my students. As a young teacher, I think that it was easy
for me because I could easily relate to the students, utilize examples close to
our young hearts and laugh with them while learning. However, these were not enough for all the
students. My theory that learning was
easy was tested by two students. Let us
call them Iris and Loren.
Iris had a failing mark in biology in the first quarter. As such, I had the dreaded job of speaking to
Iris’ mother about her performance. She
asked me how to better motivate Iris.
She saw that Iris would spend a lot of time doing computer games and not
reading. In retrospect, it was very
difficult for a then 22-year old teacher to explain to a mother the
answer. I believed I was a kid myself
and she knew her daughter better. I went
into a very unconfident answer that I would just work with Iris after school
and see where that would take us.
Looking back on the experience and reading these motivational hand outs
and notes, I realize that Iris was not interested in Biology. She excelled in sports and was looking to go
into athletics where Biology would not serve any utility. I told her that this may be so, but the
school system was trying to instill the discipline of being able to study
different topics. Persistence was also
key in success. So every day, after
school, I would create practice questions for her to answer. If there was a long test, I would review the
questions with her once the feedback was given.
We would go through the books slowly and repetitively.
I saw that for Iris, the goal was just the performance standard instead
of the learning standard. I just wanted
her to pass the course at the end of the year so that she could be elevated to
the next year level. She was there with
me through the recommended time, but the time was not well spent as she did a
lot of self-handicapping, and was debilitated easily. I persisted, but in a slower pace. In the end, we did succeed for her goal in
biology. She had barely passing marks at
the end of the year. However, she failed
in two other subjects and the school lost her as a student as she transferred
to another learning institution at the end of the year. This was difficult for me.
Loren, the other student, was a very excellent dancer in the school’s
dance club. However, she had a difficult
time in biology. During the first
Parent-Teacher Conference, I also had to deliver the sad news that she failed. The mother asked me one question: would she
ask Loren to quit the dance club. I
replied that when I was in high school, a big part of me wanted to come to
school because of the school choir activities and that I would not be motivated
to come to school if the choir were not there.
Loren was already competing in the inter-school dance competitions. Although this took time away from studying
science, I thought that this was a good motivator for her to improve her
science grade because one had to be in good standing in order to continue
competing.
In this case, I used what she really loved as a reward to continue
studying for biology. I told her that we
were not necessarily aiming for high marks, but passing marks. But by continuing to encourage her, calling
her out in class and affirming her, I saw her draw out of her shell. Though she did not get A’s or B’s, she improved
and passed her course and moved on to the next year.
I had not read the theory of Maehr at the time. Looking back, both students lacked direction
and persistence for biology at the onset.
However, when explained that they needed to pass the subject for
different reasons, like passing the year level or continuing to dance, they
prevailed. For Iris case, though, her
performance was barely passing because I think passing had no effect on
her. For Loren, her grades improved as
she had more opportunities to dance and as the teachers and club mates
constantly reminded her that she had to do well in her academics as well. Loren possibly attached meaning to biology as
that ticket to continue to dance.
Loren was more systematic in her trying to improve. She would come to me when she had a difficult
task and I saw her interacting more with her seatmates during class regarding
the topic. She had taken more of an active
role because of her goal. This worked
out for her better than it did for Iris, who I had to constantly push.
Looking back, I would have probably asked them, rather than directed to
them, what their goals were in their life and related the subject to that. Perhaps that would have been more powerful. I would have pointed them to the right
direction, been more persistent.
Persistence may have entailed my efforts and my encouraged their
classmates to encourage them as well.
Perhaps I would have included more activities like groupings rather than
just sticking to didactics and answering of sample questions. I would have included their friends in the
review, making it fun and designed tasks with clear objective endpoints per
activity instead of just aiming for a passing mark.
I hope that these experiences and study will help me with my next
students that will have difficulty in being motivated. I also hope, moreso, that this reflection
will help me in the times that I am also unmotivated. J
TRY TO REMEMBER
Ever since I was a young student, I always excelled in Math and
Language because I never perceived them as subjects that you had to do
“memorization.” I favored analysis over
rote memory. I learned the
multiplication tables not by memorizing them but visualizing multiple groups
instead.
As a result, I passionately disliked Social Studies because of the
memorization of dates, facts and events.
I did not like Physics and Chemistry because I did not understand the
concepts and had to memorize the formulas.
This dislike extended to even shifting my course from Biology to
Psychology because of the fear of memorizing the different taxonomic
groups. However, I was not able to
escape memorization because…I WENT INTO MEDICINE!
Memorization is indeed a part of becoming a doctor. I had a very difficult time in the first and
second years of medicine proper during the basic sciences. In fact, I think I repeated the Nephrology
Board Examination the first time because of this failure to memorize. Given these failures, I summarize how I coped
with trying to remember by the following steps:
First, I had to put myself in the mindset that I do HAVE to study, to
do the active memorization and repetition.
I had to devote my time to the memory work. This state of readiness, I believe, made the
difference of whether I would prevail in learning a new topic and making it a
new part of me.
Second, I had to repeat, repeat, repeat and repeat! The Medicine Board Examination was a constant
example of this. I remember studying
from literally sunrise to sunset and patiently repeating all the terms and
concepts. There had to be acceptance of
this need to repeat in order to learn.
Third, I had to build on what I already knew. I noticed that I had to master basic concepts
before moving on the advanced ones. In a
sense, the concepts had to be a part of me and just not rote. In order to do that, I had to utilize
examples. For the initial concepts that
had much detail, I had to use mnemonics, make up stories, remember patients in
order for me to remember.
Fourth, review was always imperative!
There is no assumption that “I already knew that!” For every new test, every new patient, I had
to go back to the concepts in order to make sure that I already knew everything
by heart.
Fifth, and most important, I realize that I am a group and an auditory
learner. I study best when I study with
others in order to pace myself and focus.
I integrate much of the new knowledge by discussing cases with my
friends, telling stories of physiologic concepts to my colleagues, and teaching
my students. I think in large part, I
want to become a teacher. In teaching
others, I am forced to simplify the concept, teach in my own words instead of
copying data from the book and integrating what I know.
Currently, I really live on my fifth memory rule. I really want to teach so that I will be
forced never to stop learning. J
MAYDAY!
two weeks ago, i had a melt down. imagine your 75 year old father wanting to get married to an 18 year old.
well, it wasn't really something like that, but kind of something like that in intensity.
imagine getting a piece of news of that magnitude while you are alone.
thankfully i wasn't.
the time i received that message, i was in the company of friends. friends who laughed with me, cried with me, got surprised with me.
i was in the SMS company of siblings as well.
and just like that, everything was bearable.
as such, for the first time in a long time, i posted a single liner Facebook status update: friends, siblings, thank you. you know who you are.
that post got very few likes.
but the response of my real close friends was overwhelming. they realized, before i did, that i was actually sending out a mayday!
Mayday is an emergency procedure word used internationally as a distress signal in voice procedure radio communications.
i got dinner invites.
i got lunch invites.
i got text messages.
i got offers to print and submit my homework.
i got classmates handling my schedule for me.
i got fake phone referrals which are really disguised "how are you?"
i got long distance calls from london.
i got pizza parties.
i got coffee meet-ups.
all in a week. all in that hell of a time. in order to help me through it. it was a miracle.
they knew me well.
and i realized, that sometimes, when my family cannot give me what i need, God gives a surplus of love via my family from other parents who never allow me to feel alone.
Lord, thank you for my friends and siblings.
now, if only i could go to a road trip or a plane ride with any of them…
that is another story!
well, it wasn't really something like that, but kind of something like that in intensity.
imagine getting a piece of news of that magnitude while you are alone.
thankfully i wasn't.
the time i received that message, i was in the company of friends. friends who laughed with me, cried with me, got surprised with me.
i was in the SMS company of siblings as well.
and just like that, everything was bearable.
as such, for the first time in a long time, i posted a single liner Facebook status update: friends, siblings, thank you. you know who you are.
that post got very few likes.
but the response of my real close friends was overwhelming. they realized, before i did, that i was actually sending out a mayday!
Mayday is an emergency procedure word used internationally as a distress signal in voice procedure radio communications.
i got dinner invites.
i got lunch invites.
i got text messages.
i got offers to print and submit my homework.
i got classmates handling my schedule for me.
i got fake phone referrals which are really disguised "how are you?"
i got long distance calls from london.
i got pizza parties.
i got coffee meet-ups.
all in a week. all in that hell of a time. in order to help me through it. it was a miracle.
they knew me well.
and i realized, that sometimes, when my family cannot give me what i need, God gives a surplus of love via my family from other parents who never allow me to feel alone.
Lord, thank you for my friends and siblings.
now, if only i could go to a road trip or a plane ride with any of them…
that is another story!
WRITING RECORDS OF LIFE BEFORE MEMORIES GET SWEPT AWAY
I have a lot of thoughts today.
i wish to write them before i lose them.
So now i am busy pasting away my papers written for school.
So now i am busy pasting away my papers written for school.
it's sooooo hot.
the thoughts are gone now.
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