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Advent HOPE Sabbath School

Esteban Arevalo

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.

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From Surviving to Thriving: The Gospel Effect in Medical Training

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