How to reconnect with your spouse

Last week was a funk for my wife and I. We didn't get to see one another very much and when we did, we mostly talked about planning items and little specifics. We spoke little of feelings or experiences. What made it so weird were a few things:

• Jackson was diagnosed with Pneumonia on Monday (which is another completely different story about how bad I felt for not being thorough when completing a little physical exam on him on Sunday)
• Rachel got a sinus infection on Tuesday
• I had a test the following Monday, so I was super busy
• Jackson wouldn't take his naps, so Rachel was exhausted
• Jackson wouldn't eat his dinner, so we had no meaningful dinner conversations
• My wife and son were in the house all day...infecting our living quarters...so I didn't want to get too close to Rachel or Jackson, or be home very often...I think you get the point

After the week passed, we had a Sunday. I love Sundays. Jackson went down for a nap and Rachel and I talked. She simply asked me if something was bothering me. Aside from the lack of communication, sickness all over the house, and a test on Monday, I did have some personal things that were bothering me. I told her all of what I was feeling and then she told me how she was feeling.

Thesis

So what's my point? Communication is pretty much EVERYTHING in a marriage relationship-- ESPECIALLY when balancing very busy schedules and not seeing one another very often. Rachel told me of an article she read which outlined three levels of communication:

1. Superficial--schedules, weather, gas prices etc
2. Personal--interests, dreams, passions, beliefs, goals, fears, inadequacies
3. Validating--praise, complements, nurturing, listening then comforting

When we're so busy with life and don't have a lot of time with our spouse, it's easy to remain in the 1st tier of communication. But that is the pitfall of medical school/busy lives. We need to get into those deeper levels of communication, putting our emotions on the line, trusting and validating one another. The article states, "'A marraige that does not provide nurturance and restorative comfort can die of emotional malnutrition.'  Communication that validates is edifying, healing, nurturing, and complimentary." (Read the article to learn more on how to validate your spouse.)

Putting it into practice

For weekly planning this week, Rachel and I carved out 30 minutes in 3 nights this week where we are planning to engage in meaningful communication to talk about feelings, experiences of the day and making each other laugh (that comes naturally for me...those of you that know me are rolling their eyes). I look forward to this opportunity of getting to know my spouse on a deeper level and getting closer to her through the process.

Try it out, I'm sure you'll like it...and you're spouse will appreciate it, too.

How to make and set family goals?

I was talking with my brother-in-law just the other day. He is living in Chicago and is working for a surgical center that has offices in major cities throughout the US. They manage surgical centers in major cities around the US. He said he and his wife (my sister) were having dinner with the CEO and really got to know him better. One of the biggest things that my brother-in-law noticed about him was how deliberate he is in both his business and home life. The CEO knows what he wants in his job AND at home, and he goes out and gets it.  If we want to raise our children successfully, and have a successful family life, while balancing Medical School or any other time consuming persuit, we need be deliberate about it.

Success isn't serendipitous, it's deliberate

How are Rachel and I deliberate?

We Set Goals:

-Ever since we've been married, planning has been an ardous and painful task. For some reason, I really hated it for the first few years. Then, one day, I was helping my brother move from his college dorm room back to home for a summer, and he had this big white board. I asked if I could have it, and with it, I created a family goal board. Since Rachel and I have been using this goal board, life, planning, and working towards our goals, has been more joyful and engaging. I might even say that this goal board has turned in our wishful hopes, into concrete plans and goals. Here's how it works...

The Goal Board:

Each year we identify our 4-5 key priorities. This year they are: 

• Service
• Missionary Work
• Unity
• Spiritual
• Jackson

Under each of these priorities we chose a scripture that is somewhat our theme. For example, under Jackson we chose Proverbs 22:6, "Train up a child the way he should go: and when he is old, he will not depart from it." That helps us keep our vision for the priority/goal. Next, we identify 2-3 specific tasks we want to accomplish each month, or in the year. For Unity we have: Weekly dates, Have one family activity to learn about our ancestors each month.  That's it. 

Planning

Monthly planning: The first Sunday of every month, Rachel and I sit down and plan out the month. We created an outline of all the things we've found are good to discuss, and we just go down the line.

Weekly planning: Every Sunday we sit down and see how we're doing on our goals for the month. We plan our week according to those goals and fill one another in on what's going on, dinner times, gym times, dates, things we need one another's help with, etc. 

Get out there and do it!

We have our goal board hanging in our bathroom. Sometimes while brushing my teeth I like to turn around and look at the goals we've set for the month. Sometimes I realize we're struggling with something, or that we are doing well with another thing. It always motivates me and focuses my efforts KNOWING what I want to accomplish. And another thing, it is incredibly unifying as a couple to know what you are striving for as a family and seeing one another working hard towards it. When we kneel down together to pray at night, it feels good to feel like the Lord knows what you're working towards and why. It's important to let Him be a part of your goals and plans because with God, all things are possible!

I hope this helps.

What's the best way to mark Pathoma?

(Currently working on this post:)

How to create a USMLE study plan

Around 6:30 this morning, while coming up with my revised game plan for Step 1 prep, I remember thinking  how fun it would be to be a step1 coach. I think it would be so cool to sit down with a student and help him/her create their personalized step1 study plan. Perhaps one day I could do this.

How I created my plan:

This morning I had a deep self evaluation (while pacing the medical school halls). I asked myself:

• What tests did you do best on?
• How did you learn during those blocks? Lectures, First Aid, Books, Youtube, Goljan?
• What was your mind frame while preparing for those exams?
• Did you use flashcards? Did you use books? Did you draw concept maps and/or pictures? 
• Who did you study with?
• How did you feel when you were learning your material?
• How much time did you take to study?
• Was there anything in your personal life that was contributing to these behaviors/practices?
• How do you retain information?
• Flashcards, pictures, mind-mapping, drawing things out, talking things out, and/or teaching others?

After asking myself these deep questions (because learning is hard work and sometimes it's easier to take the simpler route and the route commonly traveled), and after answering these questions honestly, I began evaluating what others did to prepare for step. From A&M's 2015 class, I learned what they read, what helped, what they wish that had done more and came the conclusion that:

1. I need to read through First Aid many times.

2. I need to learn the material. 

Let me emphasize this, actually LEARN it (not just memorize facts associated with it)!

3. I need to do as many flashcards, memory tricks, and questions as I can!

Having gone through the question exercise, determined the exact goals of what I want to accomplish and by what specific dates (which I've done), and creating an accountability checklist-tracker, it's time to go to work. 

My specific Step 1 study plan (Jan 28th-March 31st):

Just for those that are curious... My specific plan is 3.5 hrs. of step prep a day. 

1st hour: 20 pages of First Aid while marking things that I want to find and answer the whys.

2nd hour: Answer the areas I've marked by looking up Physiology questions in Costanzo book, big Robbin pathology, and/or Marks and Lippincott's biochem and pharm.

3rd hour: Firecracker flashcards on those subjects or 10 Kaplan study questions.

4th 1/2 hour: Picmonic card reviews while creating flashcards/memory checklists, to review in the future.

Goals: 500 questions by March 31, two reads of FA, all of Picmonic reviewed. I sure hope this helps my Step 1 score!!

How do you deal with defeat? Bombed GI test 2 and USMLE practice test

How do I start this? I'm feeling pretty defeated right now. I took my 2nd Gastrointestinal test today and felt like I was guessing on half of the questions. Many of the questions were directly asking percentages of how likely a disease was or the most common causes. There were also many questions with general symptoms of Jaundice and epigastric pain and then it asked what would be the most likely cause...I don't know about you, but it that sounds pretty vague to me.
I know I didn't prepare well enough for that exam. I only listened to a quarter of the lectures and simply read the handouts, pathoma, and first aid for the rest. I also did Picmonic for the molecular biology clinical correlations. On top of getting rocked by that GI test today, I also got back my result from a practice USMLE exam. I scored in the 10th percentile. To put that into perspective, if I were to take the exam today, I would not be allowed to be a doctor... that's a defeating feeling.
How do I deal with that? Well, ironically, right after our test today I had a scheduled meeting with two of my medical school colleagues. We are all in a "spirituality in medicine" selective/class. We were meeting as an out-of-the-class assignment to discuss our spiritual life with one another and determine how our spiritual life/religion might require healthcare professionals to deal differently with us to provide optimal care. The reason for this exercise is to view one another as potential patients and learn how we can cater our medical administration in such a way as to take into consideration the spiritual needs of the patient.  One question that we were supposed to ask each other was, "Do you deal with stress in a spiritual way?"  My answer to this is a resounding, "Yes!" What do I mean by that?
I try to always keep looking forward with hope, setting goals, and never stop working.

I look forward to Sunday

There is a quote by one of my church leaders where he says, "Sunday will come." He emphasized that the Savior of the world, Jesus Christ, went through the deepest of all pain and suffering, bled and died on the Cross, and then--Sunday came! The day of the magnificent Resurrection. Here are the words of hope this leader shares:

"In the darkness of our sorrow, Sunday will come.  No matter our desperation, no matter our grief, Sunday will come. In this life or the next, Sunday will come."

There is much more to be understood of these words and this doctrine, but as for me in my life right now, I have a profound respect and gratitude for Sundays.  I respect how others to use this day, I do not judge them for their choice.  I have felt that it is important for me to set aside school on Sunday, and use this day to be together as a family and worship the Lord. It represents a day of service, and teaching, and being with others of our faith...and not of our faith. It represents a BEAUTIFUL day of rest from the relentless rigors of Medical School. I am so grateful that God gave this day, the seventh day, to rest from our labors. He created this day for man, NOT man for this day.

Another reminder why I love Sunday
Today, Saturday, I woke up at 5:30 and went to the school to study until lunch. For lunch, my family and I had an opportunity to be with some medical school friends for a little birthday party. I had so much fun being with Jackson and Rachel. When lunch was over, my son Jackson looked up at me and said, "Daddy home now?" My heart just about broke. He wanted me to come home with him. He just wants his dad to be home on a Saturday. I sadly had to tell him that I had to go back to school to study. Yet, I knew that Sunday would come and it is finally here.

Helping your wife understand what a preceptorship is

So, today I came home from preceptorship drained and exhausted. I don't know what the difference between drained and exhausted is. Anyway, Rachel was still making dinner and I got on the floor with Jackson and began playing a card game with him. Rachel naturally asked me how my day went, and all I could think about was my preceptorship.

Today, for preceptorship I got drilled time and time again by the family medicine doctor I was working with. He had me go into patients' rooms alone, interview them, try to think about what they might have, and organize all my thoughts and notes in the precise manner that the doctor wanted. I found it extremely difficult and intellectually taxing. He continued to tell me how I could shorten my response, where I needed to elaborate, or how I could be more efficient. After he told me what I should fix, he told me to type it up and he went to see the patient himself. He did this a few times that day. I found myself in an intense study mode trying to remember the best way to present information, remember the kinds of questions I should ask, think about the many types of diseases it could be etc. etc.

So, once I was home, it was difficult for me to explain this to Rachel because she was continually trying to make dinner, Jackson wanted to play soccer and cards, I needed to set the table and we never had some focused time to talk. So, I came up with an analogy/example of what preceptorship is like. I think all you wives of Medical Students will understand quickly:

What a Preceptorship is like: a kitchen analogy
Trying to ask the patients the right questions, organize the data, and present in the perfect manner is like:
having someone come into your kitchen, throw everything out of the fridge, freezer, and cupboards, and you have to ask them what they wanted to make. But, the problem is they don't know what they want to make! All they know is that they have all of these ingredients everywhere in different places all over the ground, and not in the order you need. You are then supposed to see what ingredients you recognize and that it is a recipe that you vaguely know. Then, you are supposed to rearrange all of the liquids and solids and powders and spices together in the precise order. Then, a head chef walks into your kitchen and you are supposed to present to him the ingredients in such a manner and organization that you lead him to the recipe before you are even done presenting. On top of that, you are supposed to tell him incognito, 10 to 20 other recipes that it is not, by eliminating or telling him the ingredients you don't have. And that is how I would describe a preceptorship.

So, a long story long, I now know how to describe a preceptorship to my wife. Some fun facts on top of that example are that there are thousands of recipes, and we are supposed to know the recipes simply by knowing one or two key ingredients. It may sound easy but the problem is that when we see a patient we don't even know what types of ingredients they have. Through appropriate questions and doing the right labs, hopefully, we can learn the recipe that patient has.… And then tell our head physician what we think… And most likely we are wrong anyway. Yet, I believe that one day I will learn more than I know now.

That is all for tonight.