Respect the Negatives

When doing any type of resistance training, the eccentric part of any motion, aka the negative, is well-known to be overlooked, despite decent evidence that it may be even more effective than concentric exercise for building strength and mass. People just like to pump out reps because it’s flashy, it’s an easy way to track progress and you don’t have to think too hard about where your strength may be lacking.

This applies to studying as well, though I’m not sure if there already exists language to talk about studying in these terms. Flashcards are like the concentric exercise of studying. You pump out quick answers without giving to much thought as to how you got to the answer, or to why you maybe gave an incorrect answer; you simply move on to the next card and try to remember the correct answer for next time. It helps me recall facts, but often more so out of pattern recognition than actual understanding. While I do think flashcards are valuable for rote memorization and have potential for effective study (if you slow down), as a concept aren’t conducive to taking advantage of the “negatives” and thus present a real missed opportunity for brain gains.

Case-based practice questions on the other hand provide do a meaningful opportunity to address the negatives. In order to choose an answer to a multiple-choice question you have to make a case as to why one answer choice is better than the others and why the other choices are wrong. When you get a question wrong you all of a sudden have content from at least 2 topics you can review, the correct answer and your answer choice.

Our education system has ingrained in us this crippling fear of multiple-choice questions, or any situation in which we feel like we are being tested or graded. Any situation that puts our pride on the line fills us with anxiety and dread, so we gravitate towards situations in which we don’t have to sit with that anxiety or confront our own deficits for too long. If I choose that path, what will I have to show for it?

What’s in the Basket

“Remind yourself that when you die, your ‘in basket’ won’t be empty.”

This is an idea from Richard Carlson’s Don’t Sweat the Small Stuff that I consistently come back to. In part because I think it’s a valuable idea to keep in mind… and also Mom always reminds me when I tell her I can’t come home because I have stuff to do for school.

I’ve written about this quote before, but my understanding of it and my perspective on it has changed over the years since first being introduced. It’s true the list of things to be done is never-ending, and in recognition of that I need to make time for the things that make life worth living. Sometimes though, some of the things that make life worth living are also in that basket. They may be tedious, time-consuming, and frustrating at times, but ultimately, they also give me purpose and a sense of fulfillment.

Carlson writes from a perspective that the in-basket things are those that we have to do. He is cautioning against the mindset that peace is found at the bottom of that basket, which is a valid warning. But what if the items in the basket are things I want to do or get to do? Surely Dr. Carlson would have no qualms with my savoring those right?

As an example, these days I have in my basket to go through 100 practice questions for my upcoming board exam every day. This experience has been… humbling to say the least, but as frustrated as I may get or as pitiful as I may feel at times, the experience also motivates me to move forward and gives me a vision for where I want to be. Sometimes I read the question and know exactly what’s going on. Other (most) times I go full deer-in-the-headlights, and only after (getting it wrong and then) reading the explanation am I able to piece it together and understand where my deficits are. I think, Damn, one day I may be able to just know this stuff, wouldn’t that be cool.

That vision is what I’m working towards, and the basket feels a little lighter when my eyes are fixed.

Just Eating

There’s this urge I have when I’m eating a meal to be doing something else. I’ll take my food to my room and watch a show, browse the internet, do some flashcards. I’m just trying to be efficient here.

The past few days though I’ve been trying to just eat. No distracters, no other activity, just me and my sustenance. Part of this was in an effort to stop eating in my room. Not that I’m a messy eater, but the smell of my food will often linger for a bit. And while the food I make always smells delicious of course, there’s something about having that smell in the bedroom that doesn’t seem right.

But I’ve been really enjoying this “just eating” thing, particularly in the silence of my apartment while my roommates are still out of town. It’s helped me grow in appreciation of my food and of this fortunate life I get to live.

“If You Expect Disappointment, Then You Can Never Really Get Disappointed”

So says MJ in Spider-Man: No Way Home.

**Just as a disclaimer, I’m going to be referencing the movie in this one, but there aren’t really any spoilers**

It’s a pretty good strategy. Disappointment sucks. It’s discouraging and sometimes embarrassing. So, if you can adopt this strategy, you can save yourself from a lot of anguish and frustration, and a bit like MJ and her posse (i.e. Peter and Ned), I became very good at it when I was applying for medical schools.

The problem with this mindset is that it makes you jaded and closes you off to possibility, which seems to be a point that the movie tried to make (whether or not they were successful is conversation for another time).

With the New Year coming up, people’s eyes are usually starry with the possibility of changing themselves for the better (whatever that means for them). But nowadays, or actually probably for a long time now, broken resolutions are a cultural meme; the tapering of gym crowds, the slow but progressive deterioration of a new diet that started off so strong! Commitments made and then broken faster than you can say February.

What is different about modern times is that visibility and access to other people’s lives is higher than ever. If you publicize your New Year’s goals, you are also publicizing your imminent failure. So rather than making a resolution, it’s much much safer to make memes about people who would be so bold as to have such ridiculous expectations of themselves. Everyone can relate and so everyone will give you the affirmation we all inherently crave via likes and comments.

I know intention-wise most of this is all in good fun, but like a lot of jokes, it’s funny because definitely there is truth to it. And so even if you know that it’s joke you don’t want to become the butt of it and will act accordingly. Jokes and memes create culture and culture defines our behaviors. The question is, what type of culture we want to bring into 2022?

All-You-Can-Eat

There is a word in Tagalog that I became very familiar with growing up; sayang meaning, “what a waste” or “what a pity,” usually used in the context of finishing our food, or rather not finishing it. We were taught not to be wasteful and to always finish all the food on our place and not throw anything away that could still be eaten.

As I grew up this mindset somehow transformed, at least for me, into eating as much food as possible to get our “money’s worth” or event just eating copious amount of food for the heck of it. I don’t think I’m the only one who grew up this way or at least somehow made it to this way of thinking because it feels like our society is obsessed with All-You-Can-Eat. Perhaps it’s the implication of a challenge posed by the restaurant (or by friends) or the allure of potentially having a very high calorie-per-dollar ratio, but people fuckin love AYCE.

Nowadays though when I find myself at AYCE restaurant stuffing myself to the point where it hurts just to get my money’s worth, I am often inspired with moment of pain-induced self-reflection. Did I really stick-it to the Hometown Buffet by eating those 3 extra slices of lamp-heated pizzas? Is the owner of Meat Love KBBQ really gonna rethink their whole business model because we smugly ordered one extra plate of brisket after everyone said they are full? Maybe what’s sayang is eating may more than I need to be satisfied and more than can be physiologically absorbed by my body.

The answer to these queries remains to be seen; perhaps all these restaurants are actually in crippling debt and the end of AYCE is close at hand. But I guess we just gotta keep consuming as much as humanly possible until we know for sure.

Review of Systems

One common practice in meditation (at least from the few apps that I have learned from) is the body scan. You go through your body head to toe noticing any sensations that exist or arise, not necessarily doing anything about them, but just taking note and moving on. I always thought of it like one of the futuristic body scanners that you may see in movies which shoot of plane of light at your body and evaluate your health status slice by slice.

The body scan is often one of the first things I do when I start my meditation, and while I always thought it valuable, I also thought it was tedious and would kinda rush through because (1) it’s not like there’s that much going on with my body as I’m just sitting quietly and (2) I want to get to some of the juicier parts of the mediation, or just be done with the meditation all together.

Recently though I’ve been starting to think of the body scan as review of systems and physical exam like I would do with a patient, basically a primitive version of that futuristic laser scanner, checking in with myself from head to toe:

Any fevers, chills, headache, nausea? How’s my vision (even though my eyes are closed at the time)? Am I smelling and tasting ok? Are hearing and balance normal? Any issues swallowing? What about swelling/ lymphadenopathy? Any shortness of breath or difficulty breathing? How’s my heart doing? What about my tummy? Any pain or discomfort? Issues with peeing or pooping? How’s the strength in my arms and legs? Any swelling, tingling, or numbness? Etc. etc.

Going through it this way as actually made it the body scan a lot more engaging (though perhaps overly thorough) and is also a nice way to review some of this stuff for myself.

Afraid to be Seen

Recently I’ve been particularly aware of a phenomenon that occurs when I go out to study with friends; we don’t talk or collaborate much at all. And if we do talk it’s always about something unrelated to school or just a brief question about what we’re learning. Working and learning in groups, to my understanding, is a great way to improve one’s mastery over the material. It requires us to think critically and understand the material so we can talk about it appropriately and it allows us to find flaws in our thinking and logic. And it’s for these reasons that I think I have an aversion studying collaboratively.

It’s the same reason why I don’t like getting cold-called to answer a question in class, or the same reason I don’t like to get singled out in any activity, even those I’ve been assured to be proficient in.

I’m afraid to be seen. I’m afraid to expose myself as the fraud that I know myself to be. I don’t belong here. Someone must have made a mistake.

Those are the thoughts that would play in my head, and having been around other med students for over a year now I know that a lot of other people have these thoughts too.

The thing is though, most of the people I’ve met here are brilliant and compassionate and definitely deserve to be here, and it’s low-key upsetting to me when I see them devalue themselves or be self-deprecating*, because if they saw what I see they wouldn’t be so hard on themselves, regardless of how ginormous their Anki queue is or the number of practice questions they get wrong on UWorld.

Recognizing this in others has helped me cultivate self-compassion and also has helped me shift me perspective on my imposter syndrome. It’s ok to feel behind, it’s ok to feel overwhelmed, it’s ok to feel like I am not enough, but I am here for a reason, and even if someone did make a mistake and I got in on accident, so what? Wallowing in that is not going to do me any good, I am here now and I will prove to them and to myself that I belong.

*I also think it’s a cultural thing to be self-deprecating nowadays ’cause no one wants to be seen as that arrogant asshole who thinks they’re hot shit, but we gotta find a balance ’cause this whole thing of competing about who is more behind or who has the most work to do is also a bit annoying and also ends up being a self-fulfilling prophecy.

Death of the Waiting Place

One of my favorite children’s books of all time is Dr. Seuss’s Oh the Places You’ll Go. As a young starry eyed lad, this book reinforced any ideas I had that I could be someone and make my mark on the world. At one point I had the whole thing memorized, and while those days are long gone (I maybe can still recite a few lines), there’s one part of the book that always stood out to me because of how starkly it contrasted with the book’s tone as a whole; “The Waiting Place,” for people just waiting… waiting for a train to go or a bus to come or a plane to go, or the mail to come, or the rain to go… etc etc. The way I interpreted it as a kid was, if you want to make something of yourself you can’t just wait around, you have to take action and just go!

While I wholeheartedly agree with this sentiment, I think we as a society, myself especially included, have taken this to unintentionally harmful extremes. Today it can feel like there’s pressure to always be doing something. A moment waiting is a moment wasted. When I’m eating lunch, I gotta be watching something or doing flashcards. If I’m in a lecture I have to multitask and write emails while I’m listening. If I finished a task early have some downtime I need to read that journal article about diabetes. If I’m stuck in a line I’ll scroll my phone desperately trying to find something to occupy my mind so I don’t have to deal with the existential dread or anxiety that comes with standing in silence with my thoughts. On the other end of this, if you’re anything like me, sometimes thinking of all the stuff I could and should be doing is paralyzing and I end up filling my time with unproductive things like video games to stay “stimulated” and feel like I am doing something.

The Waiting Place is empty, which if you’re familiar with Dr. Seuss’s version, would seem like a good thing. People are on the go! Taking action! Carpe Diem-ing! But is that really the case, or are we just making our brains feel that way? And even if people these days are being more pro-active, what’s wrong with a little waiting every now and then?

This is reminder to myself that it’s ok to be idle and to be silent. No that doesn’t include watching YouTube videos or scrolling through Instagram. It means savoring the moment, listening to things going around me and to myself, reflecting, being patient. Thinking back, the Waiting Place actually sounds kinda peaceful.

Us and Them

Having a community of like minded people is great. It’s part of what makes us human. It helps us promote things we believe in and move humanity (or at least our local society) in a direction that we choose. But as we’ve seen there is danger in community too. Just as communities can support justice and truth, they can also support bigotry and lies. Danger doesn’t come only from the latter though.

It also comes from when we start thinking of the world in terms of “us and them.”

We are just. We stand for good. People like us get vaccinated. People like us wear masks. People like us support this cause.

They are different. They are evil. They don’t do what we do or believe the things we believe know to be true.

We mythologize them, dehumanize them. That’s the dangerous part.

We forget that they are people (sacs of molecules), just like us. They weren’t born racist or ignorant; society and our broken systems made them that way. In no way should this absolve a person of wrongdoing, people need to be held responsible for their behaviors, but it’s important to recognize how the same systems that perpetuate oppression and violence, work at the other end to foster the ideologies that feed injustice on the individual level, which then contributes to those systems.

In fact I think subconsciously, or in some cases maybe consciously, we choose to outright reject people with discordant beliefs because we fear that if we actually get to know them, we might understand their perspective, or worse empathize with them. Justice is uncompromising and people with wrong beliefs don’t deserve empathy!! But there’s a difference between understanding where a person is coming from and condoning their actions and beliefs. You can learn how a person became who they are without supporting who they are.

Another reason we try to create divides between us and them is to protect our own egos. Because if we focus on the big evils done by others, then we don’t need to look at the small evils in ourselves. We put ourselves on a moral pedestal clearing ourselves of any responsibility to critically evaluate our individual actions and how what we do perpetuates hate or violence (of any kind to anyone or anything), because at least we’re not one of them.

I’m not trying to call anyone out here (if this is directed at anyone it’s mostly myself), but I will say that if you don’t think this is about you, it probably is.

Incomplete

It’s been a long time since my last post, and it’s not cause I haven’t been writing (well maybe partially). I have a lot of drafts that I just haven’t published ’cause I’m so afraid of putting out an incomplete thought without having a chance to fully explain myself…