How to Give Better Lectures: Some Tips for Doctors

Here's the slide set of the talk I delivered to colleagues from the Koronadal Internists Society last night, as part of the series on Continuing Medical Education.

To Doctors Who Write on Spotify

I sometimes listen to the Kwentong Callroom podcast on Spotify, that crazy show hosted by Ella and JB who have made a career out of talking about all things related to medicine and making sense of them. Ella Masayamor and JB Besa are doctors. Their friendly, laughter-ridden banter reminds me of slow, light, life-giving days in the call room—that small space one shares with one's companions in residency. The pressures of medical training can be crushing. The call room offers an oasis where one can decompress, rant, and share stories of victory and humiliation. 

When I shared the story of a consultant who called me stupid for ordering D-dimer for a severely ill patient with leptospirosis (I shouldn't have), the response I got was laughter. I laughed with them and at myself. What fun to have other people, who go through the same challenges as you, get what you mean. To be heard and better yet, laughed at, can be encouraging. That's why I enjoy Kuwentong Callroom so much. We must have sounded like this, too, but Ella and JB have, for the last two years, taken the form to a whole new level, sharing it with the rest of the world, sharing their wisdom and wealth of experiences. 

I enjoyed the episode, To Doctors Who Write. Written in the show notes are the words:

In the spirit of demystifying and humanizing medicine, doctor-writers Joti and Will tell us how they started writing, how they found their voice, and how writing helps them become better doctors.

Joti Tabula is a poet, publisher, and talent scout, with a nose for literary gift among doctors. He founded the Philippine Society for Literature and Medicine and leads the Committee on Humanities of the Philippine College of Physicians, with Dr. Noel Pingoy. Will Liangco is the award-winning writer of Even Ducks Get Liver Cancer, one of the most popular books in the country. His work got a National Book Award recently. Both are so talented and fun to be with. You'll hear them talk with Ella and JB in this wonderful episode. 

A few months ago, I was with Joti and Will, those two literary superstars, in Cebu during a writing workshop for medical oncologists. 

Dogs on the road

A woman hugs her aspin as she scans her phone at the back of a tricycle, the main public transportation in the city. The dog smiles, comforted by human touch, for what else does he need but tenderness? Photo taken at Alunan Avenue - Judge Alba Street intersection in Marbel. 

Riding on a Ford pick up truck, the husky, wears sunglasses, endearing motorcycle riders and cars passengers nearby as they wait for the green light. True to form, the husky howls at them, singing, it seemed, with joy, despite General Santos morning sun. I snapped the photo during my patient rounds.

The durian does not fall far from the tree

Spotted during my early morning walks: a small, premature durian fruit on the road. Meanwhile, Paul was approached by four mini pinschers, inviting him to carouse and jostle, but our aspin did not mind them and simply walked away, more interested, it seemed, in the grass than his fellow canines.

In sync

These blinking SUVs, likely government owned, remind me of women whose menstrual cycles are in sync.

Square

Trying out the square format of photos, inspired largely by Des's photos.

Ending the semester

I give quizzes in class to make sure my students did some reading before they listened to my lecture. I, and I suppose my students, find this approach good for learning. The concepts of biochemistry and molecular biology, the main subjects I teach, are best learned individually. The student reads the material, processes the concepts in his/her head, takes down notes, memorizes, understands, and applies it. The lecture serves as tool for the student to synthesize the concepts and to ask me questions, mostly for clarification. 

My students welcome my quiz announcements with nervous anticipation. We check the quiz together and discuss the answers. The quiz therefore accomplishes two major things for me: it helps me gauge their grasp of the subject matter and identify their gaps in knowledge. 

In a sense, I treat my students as Self-Deceived Rational Utility Maximizers, a concept I loosely borrow from Alan Jacobs, who teaches humanities. 

Students have many demands on their time, and they would also like to spend at least some of that time enjoying themselves, so when they look at what they’re supposed to do in any given week, they triage: What has to be done first? That is, what will I pay a price for not doing? Whatever would cost them the most to skip is what they do first, and then they work their way down the line. If you have assigned your students some reading but they pay no price for neglecting that reading, then students will neglect that reading. It’s as simple as that. When I was in college I thought in precisely the same way. I rationally maximized my utility, according to what was utile by my lights.

And this:

This is why I give reading quizzes: to move my assignments up in the queue, to force the practitioner of triage to reckon with me. And there’s another reason: We go over each quiz in class — I make them grade their own quizzes — and in the process I discover what they noticed and what they missed. That’s useful information for me, and not just when I’m making up future quizzes: I’m able in our discussion to zero in on those overlooked passages. “Why did I ask about this? Why is this passage important?” I also encourage them to tell me when they think a question is too picky — sometimes I even agree that it is, though whether I do or not it’s helpful to explain why I asked it.

Let me also just say: it's been a pleasure to co-teach biochemistry with this excellent gang of teachers the semester—Drs. Lyza, Nikki, Kath, and Junjun!

Music nib

I am using Sean's Sailor fountain pen with a music nib. The ink is Diamine Chrome. The nib transforms my ordinary handwriting into something calligraphic.  

Today is Tatay's death anniversay. It has been six years but there are days when I feel he is just right around the corner, napping in the other room.

Isidor, the siamang

Sean sends me this photo with a message from Australia, "Manong, kapangalan mo."

Tribulus terrestris

Yesterday, I saw these flowers (Tribulus terrestris, according to my Wiki search) carpeting the airport grounds. Let them grow freely. Nature does better landscaping than humans do—at least in this part of the country.

On Perfect Days

Who else has seen Perfect Days? It's about a middle-aged man, Hirayama, who lives his every day. He wakes up early and hears the street sweeper outside. He rolls his mat, brushes his teeth, trims his beard, waters his plants, gets instant coffee from a vending machine, plays a song on a cassette tape, and drives to work. He is a toilet cleaner in what looks like an upscale neighborhood in Tokyo. He has lunch in a park where he takes photos with a film camera. He looks up at the sky and trees and smiles. After work he goes to an onsen and eats in an izakaya, where he has a glass of beer. He goes home, turns on the reading light, and reads a book before he finally falls asleep.

Nothing much happens. Hirayama hardly ever speaks. There's not a lot of dialogue. Other than the wonderful American songs in he plays in the car, the sounds you hear in the movie are mostly background noises, like vehicles swooshing, the toilet doors opening, or the leaves rustling.

I can't quite explain why I like Wim Wenders's film so much. Is it because I am in that moment in my life when I live almost the same way—getting through the day but finding quiet moments in between? Is it because the film is set in Japan, which has recently become one of my favorite places to visit in the world? Is it because the film seems free from distraction and celebrates the analog in an increasingly digital milieu? Is it because the ending features Hirayama listening to music and tearing up, like it was catharsis and thanksgiving in equal measure, and I often do the same, with prayer and remembering, because work can feel heavy? Is it because it is quiet and contemplative—and freedom from noise is what we all need at this point? 

I suppose all of those reasons are true. 

Image credit: IMDB.

Intentionality

Deborah Treisman, fiction editor of The New Yorker, on Alice Munro:

Working with her on the last two dozen or so was both a thrill and a lesson in intentionality. Although her stories seemed to move organically, sometimes even to wander, often when I suggested cutting a passage that I thought was extraneous I had to erase my suggestion when the importance of that passage became manifestly clear a few pages later. Invariably, when I felt that something wasn’t entirely working in a story, she would send me a revision before I’d even had time to talk to her about it.

Alice Munro, 92

At 2 am, I woke to a text update about a patient. While scrolling, as I often do, I read the news that Alice Munro, one of my favorite writers, has died. I couldn’t go back to sleep. I sort of expected her passing, the way one does with old people. I knew Tita Alice had been frail these past years. She couldn’t even make it to the Nobel ceremony in 2013. But a part of me wished she would surprise the world with yet another collection of stories. No one else writes like her. You see, I had just been reading her, as I always do. No other modern writer speaks to my consciousness the way she does. Her prose is not elaborate. It is simple, deceptively so. There are no big words. But it is so sophisticated and complex and so well put together that I am always left in awe, even in the rereading. I don’t know what I feel—some sadness that I will not read a new story of hers, but mostly gratefulness for an impressive, moving, and extraordinary body of work that has stretched the limits of the short story, still my favorite form of fiction. 

Bic Cristal

I bought a few Bic Cristal pens abroad last year. I've been using one this past week. These pens are iconic. The design is simple and functional. 

Then I saw a video that calls it a pen that changed the world, significantly decreasing the cost of writing instruments through near-perfect design and engineering. The video is super cool and definitely worth your time. 

Mother's Day

1.

Before I would head off to work in the early mornings, Nanay sometimes asks me why I'm busy all the time. I tell her, "To sustain my mother's lavish lifestyle."

"Ano nga 'lavish'?!" 

2.

Here she is, on our last family trip, with her favorite: the firstborn son. She tells us, "Wala ko favorite sa inyo; tanan kamo favorite ko." But Sean and I know. 

3. 

Happy Mother's Day, Nay! You are the best mother God has given to us. 

The little bird

After rounds, I saw the little bird perched on top of my car. He looked at me, as if to say, "There you are," and ignored me for the next two minutes before he flew off. 

Website was down, but it's running now

For the last 4 days, this screen showed up instead of my actual home page. My apologies. There was a delay (not my fault) in processing the renewal of the dot com domain, but that has been fixed.