Esteban Arevalo

Advent HOPE Sabbath School

God Cares About Your Dreams

You know, the Bible has a very famous verse in Psalm 37, verse 4, that says, delight yourself also in the Lord.

And I would like for the purpose of today's message to say that dreams is the desires of our heart.

And today we are going to speak about God caring about your dreams.

And I don't know when was the last time that you had a very big dream in your heart, or maybe accomplished a dream, or maybe gave up on a dream.

But I think that dreams are something that all of us have in common at some point in our lives.

And I think it's special to see what God thinks about it.

So before we start, I just want to make a small disclaimer that I am just a sinner.

So as I share my testimony, all the mistakes and things that you can say, oh, he didn't do it very well, is because I'm just a sinner.

So if there is anything that you think, oh, actually that was not bad, it's because of Jesus.

Now when I was a child, I thought, why should we share a testimony in front of the church?

We are supposed to share about Jesus, not about us.

And I still think that we should share about Jesus.

But through the Bible and quotes like this, God changed my perspective, and I still think Jesus should be always the center.

But it's interesting that the Spirit of Prophecy says in messages to young people that we are to acknowledge His grace as made known through the holy men of old, as we see here in the Bible, but that which will be most effectual, what is it?

And I love when I hear your testimony, and I'm here and I will be very glad if you tell me your story.

And I've heard some of your testimonies and I have been really blessed.

And I was called by the Lord and Josie to share my testimony.

So, today's message will be like a meal, a three-course meal for you from the Lord.

I'm married to a chef recently, so for the last 4 months I have been thinking a lot about food.

So the appetizer for this morning is called Unlimited Possibilities.

The main dish is my weakness and righteousness by faith, and the dessert will be called love.

You know Chile is a beautiful country for tourism.

How many of you either are from Chile or have any Chilean connections.

That's why this church looks so beautiful.

And of course, the rest of you make it look even more beautiful.

So You know, Chile is nice to do tourism, but the average Chilean family is a very humble family.

And those of you who are from Chile will agree with me.

It's not like a rich country with fancy things where you can do whatever you want because you have the money, the resources, and the opportunities.

And I was born in a very average, very humble Chilean family.

And this subtitle of unlimited possibilities was the opposite for me from a human standpoint.

I was born with many limitations, if you want, from a social standpoint, from an educational standpoint, from a financial standpoint, even from a language standpoint.

You know, if you are born speaking English, you already have a lot of opportunities.

And it was interesting that I didn't know any of that.

So I just thought everybody's born in kind of about the same type of family when I was a child.

But something that was special is that my parents instructed me on this special book called Santa Biblia in Spanish and my grandmother gave me that little lion and I really liked it and she handmade it if I remember correctly And I think that some of us maybe were born with a lot of possibilities and some of us maybe not.

And if you are here, maybe you can identify with me.

We are all here in Loma Linda, which is great and we have a lot of opportunities, but maybe even here there is some limitations to us.

Maybe it's not financial or maybe it is or maybe it's social.

It's interesting that this book was written for everybody.

I really like that and we will build a little bit more on that later.

For the first 4 and a half years of my life, regardless of those limitations, you know when you're a baby, you don't know about that, I actually don't have not even 1 sad memory for the first 4 and a half years of my life.

Only memories of a Christian mom and dad that really loved me and that in a very simple but special way just did the best for me and taught me about Jesus.

And I have been always very grateful to my parents for that, but then after my 4 and a half years of life, I decided to go to school.

So this is 1 of my very first days in kindergarten, and things changed radically actually.

So I was happy about learning, but I came from this very Christian loving family with very interesting principles.

And please don't think about Loma Linda when you hear my testimony.

Think about the opposite side of the world, where being Adventist, plant-based, and not having TV, and having a very particular lifestyle, was very unpopular and different to your surroundings.

So when I got into this public school that was right across the street from my rural town.

I really liked the learning, even though my mom had already told me everything I was learning, but I didn't like the atmosphere.

And so much so that I started to cry every day.

You know, my parents didn't know so much about homeschool and it was very expensive and the legal issues of that in my country, it was something that they didn't know so much, so they just sent me to the school that was closest.

And the Adventist school, which was like an hour away, didn't have any places for me.

So, I really didn't like school to say the least.

So much that after a little more than 1 year, I couldn't handle kindergarten, I couldn't handle the first year of elementary school, and I basically self-kicked me out of school.

So I don't know if the med students are here or not because I know we are coming back to the academic year.

If you are having struggles in your college or school, I had struggles with elementary school and kindergarten.

And you know, I did homeschool for a little bit, and it was great, but it was very expensive.

And I wanted to go to the Adventist school, and finally God allowed me to be there, and it was a blessing too.

In the big city closer to my town there was an Adventist school and they accepted me there.

But even over there, of course you have classmates from across society, I decided to be very lonely.

I wanted them to listen to the same music that I was listening at home.

And when they asked me, who's your favorite singer?

And everybody looked at me and laughed and nobody knew about it.

And when they would say about the movies and about the actors and about the things that they saw on TV, I didn't know anything.

I didn't know any movies, I didn't know any actors.

I couldn't talk to them, even though I really wanted.

And all the things that were interesting to me were not interesting to them, or to a lot of them.

So I became very lonely, but I thought that sacrifice my little house principles and these principles for that was not worth it.

So I was like, well, I guess Jesus will have to become my friend because it's not possible to live with no friends.

At least you need to have 1 friend, even if it is Jesus.

But then I thought, well, I guess in this world, we won't be able to accomplish much, because if we are this different in society, and this lonely and almost discriminated, I guess my life probably won't be super exciting, but I will try to be faithful to Jesus and someday I would like to live with Him in heaven.

So I had kind of my expectations going down and even my dreams in a way, until my parents gave me a book called messages to young people.

But I said, OK, I'm going to read this book page by page from cover to cover.

So I went to my room, and I started to read this book.

Balanced by religious principle, you may climb to any height you please.

I was like, wow, that's a very interesting and powerful quote.

Those who are satisfied with low attainments fail of being workers together with God.

And it says things like this, Dear youth, what is the aim and purpose of your life?

And I know you know these quotes, but please imagine a child in the other side of the world reading the same quotes that you know.

From Surviving to Thriving: The Gospel Effect in Medical Training

I would love to pray 1 more time, if that's okay with you, so please let's bow our heads.

Dear Lord, thank you so much for the opportunity to be in this very special place, and we just want to thank you for being here with us.

And we want to ask that this room can be literally filled by angels today.

That you can be so close to us that at the end of this sermon, each 1 of us can walk through the doors with the biggest smile on our faces.

I echo Michael's comments that I love the view.

Unfortunately, I will be on the opposite side, but you can enjoy the view.

The mountains, La Malinda Medical Center.

You also have a view of Costco and Panera, which is very interesting.

And then you have screens on the side, so if you want during the presentation, you can look to your right or to your left to follow the slides.

Today we'll be speaking about a topic that we have named From Surviving to Thriving, The Gospel Effect in Medical Training.

And you know this is a very interesting time of the year for trainees, it's not the beginning of the year and it's not the end of the year.

So usually at the beginning of the year everyone or most people are very excited and also at the end of the year because it's almost done.

But in the middle of the year it sometimes gets challenging because you have your examinations, because you may be applying for a residency or another program and you have your interviews in this season, like Anthony Baca for example, please pray for him and for all of us that are going through the interview process.

Not so much here in Southern California, but when I did my residency, it was pretty evident that from now till February were the saddest months for residents.

And also, for some reason, patients seems to get sicker and they come more to the ED, so the ICUs are full, the emergency room is full, so everything is a little bit of a chaos.

So I thought that it was very interesting if we could just for some minutes meditate and enjoy how amazing it is to receive encouragement from the gospel in the midst of this little chaos that we have at this time of the year.

So I was thinking if I could say 1 thing to any of the participants of this meeting that is a little bit discouraged today.

You know you have 2 types of people in the world, encouraged people and discouraged people.

What could I say that everybody, every single person, whether you are in medical training or not, could relate with?

And God inspired me with a very interesting idea that I hope it encourages you very much.

So I'm going to come here and show it to you.

So I think that 1 of the most encouraging things that you can know in your life and that every Advent hoper should know or should hear at least once in your life, is what happens in your own body in a single heartbeat.

And then I'll explain why that is encouraging.

So, if you don't mind, buckle up your seatbelts, and for the following couple minutes, listen to a simplified but semi-detailed version of what happens inside your chest in 1 heartbeat.

It's a very complex interaction that has a molecular, cellular, physiologic, electrophysiologic, and anatomical explanation.

But it starts somehow between a communication between your brain, the central nervous system, between the sympathetic, the parasympathetic nervous system, and the actual structure of the heart in 1 tiny little location of the heart in the right upper chamber of the heart called right atrium in a little dot inside there called sinus node.

So as those electrical impulses come from your brain and also some things happen inside the cells of that little tiny dot, the membrane of the cells that has sodium and calcium outside and potassium inside starts going up and down in different ways until the electrical threshold of that little tiny membrane changes enough for you to start the heart impulse, and that is called action potential.

And that goes very, very fast from that little sinus node to both of the upper chambers of the heart called right atrium and left atrium, and they squeeze.

And that, on the right side, means that all the blood that was coming from all your body, deoxygenated blood, goes from the right atrium through the tricuspid valve to the right ventricle.

And at the same time, on the opposite side, the blood goes from the left atrium through the mitral valve to the left ventricle.

But that is good healthy blood that came from the lungs through 4 pulmonary arteries that came into the left atrium.

Now, on a more cellular level, you see on the right bottom corner of the screen, you have in the heart about 5000000000 tiny little specialized cells that are called cardiomyocytes.

So that electrical impulse goes through the entire heart from the top to the bottom and gets spread cell by cell through very interesting connections called gap junctions so that the entire heart gets the electrical impulse and finally the bottom chambers of the heart also get this very interesting interchange of ions between sodium and calcium and potassium, and they also squeeze, and that is called systole.

And on the right side, the bad blood goes to the lungs so it can get oxygen, and on the left side of the heart, the good blood, or the oxygenated blood, goes through the aorta to your entire body, and it goes at a speed of about 4 to 8 liters per minute.

And then, after that happens, the ions go in the opposite direction so the heart relaxes.

And in that diastole, there is a little tiny period where the heart almost doesn't move.

And that gives rest to the heart for like a fraction of a second.

And then in that exact moment when the heart's kind of resting, the blood goes to the coronary arteries of the heart so that the heart can get blood for itself.

And all of that process happens in 1 or less than 1 second and is called, ladies and gentlemen, 1 single heartbeat.

So that, in a 70 or 80 year old person, will happen 2 to 3 billions, again and again, times in your life.

So, as you were listening to me, that same process, much more complex but I simplified it, happened inside your chest about 200 times.

And I don't know if there is another thought that comes to your mind that you are really wonderfully made.

And the creator, the king of the entire universe, designed each 1 of the microfibrils that compose 1 cardiomyocyte inside your heart, and there is 5 billions of them at least in your own heart.

And he took so much care that I would say probably most of you right now are having a normal sinus rhythm in your heart, like a normal heart rhythm, and that happens again and again in a fraction of a second by God's grace.

And I just wanted to reflect, if God took that amount of care and detail on this that gives us life or allows the life to circulate, however you want to say it, how much more will he care about our worries, about our big and little problems, and about whatever we are facing right across the street for some of us, amen?

So I would like you to take your phones for a second and open your cameras and scan this QR code that is going to show up on the screen in a few seconds.

And we are going to answer a very simple question.

So if you have your phone, please scan that QR code.

You don't have to create an account, give information or anything.

And just give it a few seconds on your phone and leave it open because we have more than 1 question.

And you can answer, start answering any time.

Thank you for the people that are already answering.

If you are in a sabbatical year, you can answer yes, because it's part of the training in a way.

But if you are completely done, you can say, I'm done.

So, so far, thank you, we have a great participation, almost 50 people, and about a little more than half so far of the answers are, we are in training, so majority will say are in training, and also a good amount are already done.

Congratulations for the ones that are done, and I hope that This message actually can somehow connect with both groups this morning.

Wow, almost 100 people answered actually.

For the people that are in training, are you undergrad, grad, or post-grad?

So it should show up in your phone and you just click and then click the icon that says send.

And we can see what is happening with our audience.

So I see that So far, almost 50 people have answered, and most of you, or most of us, are in graduate school.

Some undergrad, and some of us post-grad.

This is just for the, I just wanted to know, for the people that are specifically in medicine, where are you in your medical training?

Are you in med school, in residency, in fellowship, or you are already an attending?

I thought I would put a dollar sign in the attending answer, but then I decided not to.

Med school, residency, fellowship, or are you an attending?

I love this audience because 45, 40 to 45% are in med school, and then we have residency and fellowship, and then the other big group is attendings.

AMEN Conference 2025: Touched By Grace

Medical

Adventist Medical Evangelism Network (AMEN)

Navigating Spouse Satisfaction During Medical Training and Practice: A Case Report and Review of the Literature

Welcome everyone to the, I guess, first breakout session of this afternoon.

And I want to thank you for making the effort to have lunch over there and then walk here and be here on time.

And I want to start by asking the Lord to help us today in this meeting.

Dear Lord, thank you so much for the opportunity to be here together.

Thank you for the medical ministry, how it is in Jesus, and also thank you for the marriage ministry.

And I want to invite your Holy Spirit to be with us to speak through me.

I want to thank you for all the participants that are here gathered together, and I pray that we can all support each other and be blessed today.

So for those of you who don't know me my name is Esteban and I'm coming from Loma Linda from the cardiology fellowship and I am very excited about cardiology and I remember some time ago I told my wife Annie that the reason why I'm doing cardiology fellowship is to get to know her heart better.

And I don't consider myself an expert on this topic, but I'm very interested in this topic, which is, as you can see on the screen, navigating spouse's satisfaction during medical training and practice, a case report and review of the literature.

So I have a very short case report, very short experience, as you can imagine.

But I hope that the review of the literature and other cases can add some strength to the presentation.

I do want to go over some actual scientific evidence on this topic.

I also, in the context of course of an AMEN conference, want to identify some ways in which this topic relates to the medical missionary work.

As you know, the theme for this year is Touched by Grace.

So that is an amazing, I think, reality to grasp and apply to this topic as well.

And then I want to share some practical insights from both personal experience and experience of some mentors and people that I appreciate.

And then I will love if all of us can finally grab some concepts or some ideas that we think we could implement in our own personal experience.

And before I move on, I wanted to say that everybody is welcome to be in this meeting or listen to it through audio verse, whether you are married or single or any of the, both, I don't know how you could say that, but if however is your journey on this topic, whether it's very exciting or very more on the painful side, I want to be very sensitive and hopefully that everyone is blessed and somehow can be encouraged by the presentation.

Before I go into the scientific part, which may be sometimes slightly heavy after lunch, I wanted to make you smile with a picture of our puppy.

And if you have time, this actually is a good time, like our friends are doing in the back, to scan the QR code, either now or at the end of the presentation, because if you are interested in getting CME credits for watching a puppy, you need to scan the QR code.

Okay, so to make this CME credits a little bit stronger, I wanted to share with you a very interesting article.

There is a number actually of articles regarding physician or medical marriages throughout multiple years.

I just try to limit myself to year 2024 and 2025 because depending on the year you study, different things were happening in the world and in the medical world, so the statistics can be a little bit different.

So I'll just give you the maybe the latest statistics that I was able to find.

So this is a group from University of California Irvine that had a genius idea of collecting emails from US physicians across the country and sending a survey to as many as possible so that they hopefully could get a representative study of the US physician Mary's situation.

And the topic was center around marital satisfaction factors.

These were the demographic characteristics of the people that responded the survey.

I don't know if you responded the survey or not, but there's a number of physicians that responded it.

40% male, 60% female, so pretty good female representation on this study.

Majority of them were MDs followed by DOs.

And then majority of them were attending physicians followed by residents and then retired and fellows.

Majority of them were in academic practice and some of them in private practice, and those were their specialties.

So this is an interesting figure that they came up with.

According to this, of course it's not a comprehensive statistics and has some limitations, but at least what they were able to gather in 2024 was that 86% of physicians are married, at least with this sample.

And some never married or some not currently married.

From the ones that are married, about a quarter of physicians are married to another physician.

And about 75, 1 is doctor and the other is a non-doctor.

1 out of 9 ever married physicians married multiple times.

And then the physicians that are not married anymore or that ended their first marriage, 7 out of 8 ended the first marriage because of divorce rather than death or another reason.

And then how old are the physicians when they get married, at least on our age?

That's the average of the first wedding for a physician in the US.

OK, so they came up with a list of distressing factors and also strengthening factors for the marriage of these physicians that answered from across the country.

So the distressing factor number 1 from all these physicians was stress from job.

And you can see them also identified between female and male physicians that were responding.

Very similar distribution between male physicians and female physicians.

For example, female physicians tend to consider more the stress from the spouse's job as a distressing factor.

So for male physicians, that was not as much problematic, apparently, as for female physicians.

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Presenter

Esteban Arevalo

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