Maybe There is Something to The Struggle

Question: what's the best way to study?

As I'm spending the vast majority of my waking hours (that photo is of some un-waking hours, but the books are not too far away) these days studying for the first Test of All Tests of the path of a physician - Step 1 of the Boards - I had about five different people send me an article about how best to study/learn that showed up in the NYT this week.

So much of medical school is learning how to learn most effectively - both efficiently and completely - because there's Just.So.Much information that doctors are required to (and should!) not only know, but be able to synthesize and connect and process and USE to help people regain or keep their health. It's also the first time where everyone has their own way - when I look around at my classmates who are also studying most of their waking hours, some are listening to review lectures, some are flipping through note cards, some are reading and re-reading every review book they can get their hands on.

Somewhere along the way in medical school, I realized that I could learn things as they were being explained to me if they were immediately followed by questions reviewing the main concepts. Since this is not normally the approach of most lecturers, and I could only get friends to create questions for me so much, I started making up my own. So how I would study for basically all of medical school was to take the material we were learning and create a question that got at the main concept or an important detail.

Now that we have this big test coming up, I would try to do the same thing, except that there's just too much material. Luckily, one of the main study tools that most people use is a "question bank" which is basically > 2,000 questions created to touch on all the material that could be tested. It's basically my study dream come true (as strange as that phrase just sounded) - so that's mostly what I've been doing these days. It's great, except that it's like taking a test ALL DAY every day, which can get pretty exhausting.

However, this article in the New York Times this week by Pam Bullock (that so many of my favorite people so kindly sent me) seems to support my style of learning. whooohooo. But because this is my style of learning, I thought that the most interesting part of the article was when Bullock discussed how the struggle inherent in being forced to recall something helps to reinforce it - that there's something about the struggle that's good for solidifying knowledge.

“The struggle helps you learn, but it makes you feel like you’re not learning,”“You feel like: ‘I don’t know it that well. This is hard and I’m having trouble coming up with this information.’ ”

By contrast...when rereading texts and possibly even drawing diagrams, “you say: ‘Oh, this is easier. I read this already.’ ”

right now I really appreciate anything that supports "the struggle" being a good thing.

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"you gotta be bad, you gotta be bold, you gotta be wiser

you gotta be tough, you gotta be stronger,

you gotta be cool, you gotta be calm, you gotta stay together,

all I know all I know is love will save the day"

-desiree, you gotta be

idiosyncratic rejections

Question: what sorts of qualities are make or break in looking for friends, romantic partners, places to live, whatever, in your life right now?

this skiing photo is from a week or so ago, but I thought I needed more photographic reminders that sometimes I do fun things! hopefully to create more soon.

after a 3 hour practice test this morning, I decided to take a mid-morning break and sit down with some tea to read the newyorker - which I feel like I never get to do enough lately (thank you, Boards studying).

there are lots of times when I laugh out loud at new yorker articles, but this article by David Brooks on current research in social interactions ranging from how attachment patterns of children predict graduation from high school to why the professions that correlate most closely with happiness are social (examples include hairdressers and corporate managers). It also echoes the sentiments he expressed in his response to Amy Chua's article on parenting - mainly that learning social intelligence is really important.

It actually reminded me a lot of this blog that a friend recommended I start reading (also clever and laugh out loud funny) where a woman in her 20s waxes on relationships, careers, life moves, etc. Here's one of my favorites on whether something is totally awesome or rock bottom (since the two are more closely related than you might think - which I want to add to the theory of Type 1-3 fun)

you should read the Brooks article and Rachel's blog, laugh out loud, and tell me what you think.

Best line from David Brooks?

"...Erica used her powers of observation to discard entire categories of men as potential partners, and some of her choices were idiosyncratic. She rejected men who wore Burberry, because she couldn't see herself looking at the same pattern on scarves and raincoats for the rest of her life. She viewed fragranced men the way Churchill viewed the Germans - they were either at your feet or at your throat. She would have nothing to do with men who wore sports-related jewelry, because her boyfriend should not love Derek Jeter more than her"

(also cool that the name he uses is Erica, obviously) and because the high today is 0 degrees, I might brave the weather for some very short snow shoeing, but the rest of the day will be study, study, study.

but what KIND of smart are you?

Question: What kind of smart are you? And maybe more importantly, what kind do you want to be/your kids to be?

First, a rebuttal from David Brooks to Amy Chua's Tiger Mother approach, called "Amy Chua is a Wimp" here. The essence of his opinion is that learning how to most effectively function in a group is one of the most important types of intelligence - because it leads to the best collective intelligence, and collective intelligence is how we actually solve problems today. Best line?

"Practicing a piece of music for four hours requires focused attention, but it is nowhere near as cognitively demanding as a sleepover with 14-year-old girls."

This is even more interesting to me because on a run with a friend yesterday we talked about the 7 (or 9, depending on the source) types of intelligence , including: spatial, linguistic, logical-mathematical, body-kinesthetic, musical, intrapersonal, interpersonal, naturalistic, existential - and which ones we appreciate in our lives right now, both in a success in medical school and in a more holistic way. Each type of intelligence has careers associated with it - for example, naturalistic intelligence fits well with farmers and guides, body-kinesthetic intelligence fits well with professional athletes, logical-mathematical fits with engineering, etc. Physicians, however, seem to need all of them (including musical, if you read any Oliver Saks, or have any interest in heart or respiratory sounds, which most physicians do).

One of the physicians I admire the most in my own life once said that she thought her best talent as a physician came from this "sort of sixth sense about people" - meaning, whether they had something serious going on or not, how to ask questions that would bring out relevant information, etc. Having more experience in the clinical setting, I can see how that might be THE most important type of skill for a physician. A common phrase in medicine is that "90 percent of the diagnosis is in the history", meaning that if you just listen to your patient, they'll tell you everything that's wrong with them. But the unsaid things are A) you have to ask the right questions, and B) you have to know what you're listening for. These are things they teach us the basic framework for in medical school, but there are some physicians who have a seemingly innate feel for it, while others have to work really hard or have to use other skills to compensate.

in my life, I just completed our end of all classes EVER assessment of if we can do a full physical exam on a mock patient - and they look at all the nitty gritty. I always get a little lost in exam and forget that the person is a mock patient, but maybe that's all for the best anyways.

and now, a few hours of studying before trying to do some yoga to stretch out those cranked study muscles, and get to bed at a somewhat decent hour for the first time all week (heyyy late night ultimate winter league)

and for fun, and because I've somewhat started watching Glee, check out this new cover.

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Medicine is learned by the bedside and not in the classroom. Let not your conceptions of disease come from words heard in the lecture room or read from the book. See, and then reason and compare and control. But see first.”

-William Olser

woman riding dinosaur

Question: what art have you found lately that inspires you?

new favorite artist? check out more here: http://hiroshitanabe.com/

lost in a kiss (or a mogul or a room full of friends)

Question: what moment have you gotten totally lost in lately?

since my life is now mostly studying, I'm hanging onto every outside of studying moment and trying to truly suck the marrow out of each moment. Being so fully "on" and absorbed in the things going in and out of my own head forces me to have to think more in interactions with other people (because I'm doing so much less of it, it feels strange - in a good way). But I think is it's allowing me to notice different things. how soothing the sound of a friend's voice, how your body seems to warm from the inside out when you sit next to a fire, the change that comes with the slight buzz from one very infrequent glass of red wine, the feel of powder under your skiis, how awesome it is to wake up in a room full of your friends sleeping and to know that in mere moments, you'll all be awake together again.

This past weekend was full of some blissful moments - read: skiing moguls ALL DAY on Friday until I was seeing visions of moguls every time I closed my eyes, ending the day with all you can eat pizza at a cute little shop in town discussing the ways different religions teach us to see God in each other, ourselves. more on this when my mind works again.

followed by (more studying, then) snowshoeing in southern VT, making delicious feasts, and hanging in an outdoor jacuzzi with 3 of my closest woman friends in med school, topped off with a few episodes of Alias to vicariously be badass women. LOVE that show.

But mostly it's been studying. There's only a month left. Which makes me feel nervous (ONLY a month!?!) and excited (because after that month...) - but enough of that. let's talk about bliss again.

to fill out the blogpost - because you definitely don't want me to start talking about lung function tests, and because there's something about a really good kiss that puts all other moments to shame, an excerpt from one of my absolute favorite poets, Saul Williams' book, "Said the Shotgun to the Head" (a book introduced to me by an old friend):

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"Have you ever lost yourself in a kiss? I mean pure psychedelic inebriation. Not just lustful petting but transcendental metamorphosis when you became aware that the greatness of this being was breathing into you. Licking the sides and corners of your mouth, like sealing a thousand fleshy envelopes filled with the essence of your passionate being and then opened by the same mouth and delivered back to you, over and over again - the first kiss of the rest of your life. A kiss that confirms that the universe is aligned, that the world's greatest resource is love, and maybe even that God is a woman. With or without a belief in God, all kisses are metaphors decipherable by allocations of time, circumstance, and understanding"

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From The Battle Hymn of the Tiger Mother

Question: which parenting techniques of your parents will you use and which will you definitely definitely not?

An article on the (superior?) tactics of Chinese Mothers sent by a friend on different parenting styles. The author, Amy Chua, a professor of law at Yale, has a few theses that made for great discussion.

One is that children don't think things are fun until they're good at them, so it's the role of parents to push their children through the learning process (when it's not fun) until they become good at something (and it becomes fun). Chua states that the Chinese Mother style is often seen as extreme:

"For example, my Western friends who consider themselves strict make their children practice their instruments 30 minutes every day. An hour at most. For a Chinese mother, the first hour is the easy part. It's hours two and three that get tough."

I'm not quite sure I agree with how that manifests in her parenting style, but I think there's a lot to be said for parents pushing their kids to stick with things that aren't fun because they are not good at them when there's a) potential for them to be very good at the activity (e.g. guitar) or b) a good reason why they should be motivated to be good at the activity (e.g. math).

I'm torn because while there are some things I am glad my parents pushed me to do (piano, however brief, science competitions starting in middle school), I'm even more grateful for their sharing in my excitement for things we both liked (political science, travelling internationally), and I feel like most things I love, I found mostly on my own (medicine, for one, is not a popular profession in my family of virtually all lawyers and judges).

Friends and I ended up having a really fascinating discussion about our own parents and what aspects of discipline, support, and direction we liked, appreciate now, or will never re-create ever. The ways in which parents motivate children ranges from shame (somewhat the Chinese Mother way) to guilt (maybe the Jewish mother way?) to affirmation (the Western way) to rewarding the process (maybe also a Western way? an example of which would be getting paid for grades, more the better they are).

The second is that Chinese parents believe that their kids owe them everything. Yet what they ask for is that they do everything they can to be the most successful at whatever endeavors they are pursuing. But in this definition is not that they also be happy, or socially adept, or fulfilled. This is in contrast to the US, where parents are held responsible to their children - for their children's happiness and success. Where it is more than acceptable to be in therapy because of something your parents did or didn't do (but, often these are really important things to process! affecting current relationships, priorities, or life goals.)

The third is that Chinese parents assume strength, and their parenting style reflects this. "Western parents are concerned about their children's psyches. Chinese parents aren't. They assume strength, not fragility, and as a result they behave very differently." By this she means that while it may seem like Chinese mothers are harder on their children, it's because they know their children can take it and will be better for it.

One of the best pieces of advice about parenting that I have received was from a friend's aunt (who is a pediatric oncologist, has read every book on child development, and has 2 sets of twins, all under the age of 7 to prove it). She said that having 2 sets of twins made her realize that children are really their own people, and as parents, your job is really to help them cultivate and use their strengths as well as acknowledge and address their weaknesses - but not to change who they are as people. I think that means assuming strength, but not ignoring fragility - if that's possible.

Check it out for yourself (here) and let me know about your thoughts on parenting styles!

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"You don't really understand human nature unless you know why a child on a merry-go-round will wave at his parents every time around - and why his parents will always wave back."

~William D. Tammeus

Women's Tears = Cold Shower??

Because with studying for the boards, my blogposts are about to get really short or non-existent, check out this NYT article on how women's tears actually decrease arousal in men. if I had extra brain space, I would love to think about the evolutionary basis of this - it sounds straight out of Louann Brizendine's the Female Brain.

Homo Ludens

Question: why do you like games? (or why not?)

Nope, it doesn't mean what you think it does. It roughly translates to "man, the player" and is the topic of this blogpost. Over the holidays I had a little bit of time to catch up on some NewYorker reading (yay, trans-continental flights!) and read this awesome article on, of all things, Nintendo. It's a profile called "Master of Play" about Shigeru Miyamoto, the first artist of Nintendo video games - who, interestingly, grew up spending his time entirely outdoors.

The article is fascinating not only because it reveals crazy secrets like Mario was wearing a hat and had a moustache because the designers didn't know how to draw mouths or make hair move when you jumped yet, but also because it dissects not only what makes a successful game, but what it means to play.

The author, Nick Paumgarten, discusses the work of different researchers of play, including Johan Huizinga, a cultural historian who wrote a book called "Homo Ludens" in 1938 created 5 qualifications for "play". These include: 1) it's voluntary; 2) it has unserious consequences (in other words, it does not end in death); 3) it is unproductive, at least in the money sense; 4) it follows an established set of parameters and rules, requiring artificial boundaries of time and space; 5) the outcome is uncertain, and this uncertainty creates room for improvisation and discretion. As Paumgarten says, "In Hyrule [a game created by Miyamoto] you may or may not get past the Deku Babas, and you can attempt to slay them with your own particular panache"

I think I like rule 5 the best. And I think Miyamoto would agree with me, as he is quoted in the article saying that he prefers games that favor chance over skill, giving each player equal advantage. Which I thought was interesting, coming from someone who has created games that now have international tournaments.

Another author quoted in the article, Roger Callois, responds to Huizanga by saying that games can be placed on a continuum from ludus ("taste for gratuitous difficulty") to paidia, ("the power of improvisation and joy") The author contends that Miyamato's video games sit right in the middle. I'm trying to figure out where to place all the games I like to play - and also the personal tastes of the people with whom I like to play games.

My favorite part of the article is where Miyamoto is quoted describing the feeling of learning to play a game. He is quoted comparing it to learning the F chord on the guitar (maybe I like this because I just learned the F chord not too long ago and can relate). I have to directly quote because it's so well written:

“Take the guitar,” he said. “Some people, when they stumble over how to accurately place their fingers in an F chord, they actually give it up. But once you learn how to play an F chord you become more deeply absorbed in playing the guitar.” The F chord, as he sees it, is a kind of bridge between indifference and pleasure. “If the bridge is too easy to pass by, it’s called ‘entertainment.’ If it’s rather difficult, it can be called ‘hobby.’ ”

Where do your interests fall on the continuum of ludus to paidia? What are some of your favorite games (not necessarily video games)?

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"it's supposed to be hard. if it wasn't hard, everyone would do it. the hard is what makes it great."

-Jimmy Dugan (played by Tom Hanks) in a League of Their Own