About Catherine Cheng, MD

I am a general internist in Chicago, Illinois, mother of two, almost native Coloradan, and Northwestern alum. I want to leave the world better for my having lived, by cultivating the best possible relationships between all who know me, and all whom I influence. Join me on this crazy, idealistic, fascinating journey! Look for new posts on the 10th, 20th, and 30th of each month. Opinions posted here are entirely my own, and in no way reflect the opinions or policies of my employer.

We Get to Invent It! 

You never know when creativity will strike or, more importantly, be called forth.

This weekend I’ve been feeling particularly melancholy, what with, you know, the world.

Thankfully Dan Rather et al over at Steady send a weekly email entitled “Smile for a Saturday”.  I needed a smile this morning, so I opened it and watched a video of Brazilian pianist Elaine Rodriguez conducting an impromptu performance in flexibility and good humor, when one of her piano pedals malfunctions.  I learned a bit about the literal mechanics of moving pianos; but more importantly, I saw how expertise, humility, and connection can save us in adversity.

While crew rushed to change pianos on stage, Ms. Rodriguez spoke to the audience.  She explained what was happening, got help, and continued to play music that did not require the pedal while she and the audience waited.  She chose pieces that sounded appropriate for the circumstances.  She looked into the audience and made eye contact, engaging them throughout.  She gave everybody, including me, the sense that we were all in it together.  Nobody knew what would happen next, how long it would take, and how the evening would turn out.  But I’d bet money that every person was glued to their seat, happily in it for the duration.

“We get to invent it!”  This may be one of my favorite sentences, and I have exclaimed it more often in the past two years than possibly in my whole life.  We thought we could not include telehealth in regular medical schedules.  We thought teams always had to meet in person, in the office, all the time to function.  We thought executives’ work necessarily required them to travel internationally over 50% of the time to lead effectively.  Maybe so, and maybe not.  COVID forced us all to reassess our default assumptions and practices.  Some served us well and proved their value through lockdown and beyond.  Some not so much, and now we get to invent how to be and do differently. Faced with adversity, we can play different songs.

My nascent idea and title for this post had just formed when YouTube autoplay began the next video, of Ben Folds composing a new song, on stage at the Kennedy Center for the Performing Arts in 2017.  Friends, you’ gotta watch this!!  He literally invents a song and leads the National Symphony Orchestra through its impromptu performance, beginning to end, in ten minutes.  Stop reading now and watch, and let’s debrief below, shall we?  I’ll wait. 😉 

See if you agree that this improvisation parallels our pandemic experience:

A Minor Key

First, the MC accepts an audience suggestion of A minor as the key for the piece.  Minor keys have a somber and ominous feel compared to major keys.  They grab my attention, make me slow down, listen more slowly and mindfully.  This makes sense because most music we hear is composed in major keys; it’s the default.  Okay, now I’m prepared for the Darth Vader theme (in case you’re wondering about the difference between major and minor keys, hear the Imperial March in a major key, and Chariots of Fire in minor).  This is the first constraint placed on Folds’s new composition:  Invent a song that everybody expects to sound solemn, foreboding, and sad.  Stay home.  Wear a mask.  Curtail your travel.  No more team lunches, boondoggles, water cooler chit chat.  Stress, stress, stress.  A minor sounds like the right key for inventing a song in the Age of COVID.

Upbeat!

Next, the MC asks the audience what tempo they want to hear, ballad or upbeat?  Immediate and loud spontaneous consensus: “Upbeat!”  What a fantastic challenge, how will this work?  As leaders, culture and morale start with us.  We get to choose how we show up, no matter the circumstances.  Maybe this correlates with taking a minor key and making an upbeat song—knowing to start slowly, from a serious, thoughtful place, AND choosing to uplift.  Minor key does not necessarily make a song sad, plodding, or a slog.  Rather, it makes our upbeat-ness necessarily more intentional.  To see and amplify the positive in a negative situation does not mean ignoring, repressing, or dismissing the bad.  It means accepting and embracing it, naming it, navigating it, making the most of all that is, and then moving forward with it all, in concert.  This is what leaders are called to do.

“These New Spaces Are All Designed to Be Flexible.”

The MC asks for a ‘an interesting sentence’ from the program book, perhaps as the unifying theme for the upbeat song in A minor—the mission, purpose, direction—the cause.  I kid you not, this is the sentence that emerged.  How cosmically prescient, this video, I have goosebumps.

“We Get to Invent It!”  In the wake of Battleship COVID, we now get to design our spaces to be flexible—all spaces!  That includes physical work spaces, spaces in our own minds for how and what to be, and spaces between us in relationship, whether at home, in college dorms, at work, at the grocery store, at concerts, or in traffic—everywhere, all the time! 

Confident Thinkering

Folds sits at the piano and starts noodling.  He smiles.  You can imagine his integrated brain gears turning, changing position while staying in contact, engaged and rotating for optimal efficiency and torque.  He hits a little rut and resets, still smiling.  He knows exactly what he’s doing, understands and embraces the process of creation, the necessary messiness and disorganization of initiating something meaningful.  He also has no idea what he’s doing; the product is not yet formed.  He is inventing in real time.  Isn’t that what we are all doing now?  What expertise and skill sets can we ground ourselves in, as individuals and collaborative (or competitive!) teams, that give us the confidence to invent?  How do we orient ourselves for maximal power to accomplish our goals?

Think and tinker.  Use your knowledge, expound on theory, do the thought experiments.  Then take the experiments from thought to piano, to conversation, to teamwork.  Try stuff out.  Pilot–thoughtfully.  Exercise both humility and confidence at once:  Go all in, get all out quickly if it doesn’t work, repeat.

Collaborate

Over the next several minutes he tinkers with baseline, progression, melody.  He starts sounding out with the cellos, then winds, then violins, violas, and finally basses and drums.  At each stage, he invents something, tries it, integrates with the previous section, and assesses.  Does it work?  “…Just to make sure I don’t suck…sorry, this takes a second to create a whole song.”  The song evolves in front of our eyes and ears, passing through organic adjustments of timing, notes, combinations of sounds and participation.  “…Let’s hear it all together, make sure it’s not crazy…”  The orchestra conductor follows attentively, providing seamless ancillary direction and guidance to the group.

Is this not what any team in transition needs?  Leaders recognize material constraints and requirements:  A minor key, upbeat tempo, These New Spaces Are All Designed to Be Flexible.  They take the first steps, feeling things out, listening.  They check in with the team at all levels—how does it sound for this group?  What about when we add other groups?  How’s the harmony?  Is it working for the whole?  If not, what do we need to change?  

Revel in the Awesomeness

The performance climaxes after all parts have rehearsed, integrated, and repeated.  Folks are comfortable in their brand new learned nerve pathways.  Now they get to really play together, to have fun, improvise, and enjoy their accomplishment.  What would happen if we celebrated our successes, even the smallest ones, more often and loudly (‘fivetissimo”)?

It occurs to me here that this performance works because of certain fundamental premises:  1) Everybody agrees to participate, and to follow Ben Folds’s lead.  2) Everybody speaks the same language.  Real time communication occurs cleanly and efficiently, with immediate feedback.  3) The leader trusts the team to do what they do best, giving appropriate instruction according to roles.  4) The task is brief, the goal is clear and simple, and the leader takes responsibility for the end product.

This video is neither a perfect nor a complete metaphor for creating optimal post-COVID environments and relationships.  Still, it inspires and activates me.  It provokes thought and creativity, and spurs me to enroll others in new ideas, experimentation, and shared accountability for our collective outcomes. 

Really, if you have not already watched, please take ten minutes.  You can even just listen.  I bet you won’t regret it, and it may even inspire you.

Check Thyself

More off the cuff than usual today, friends. It’s been a year so far, with few signs of relief upcoming. Breathing deeply:

Do you speak and act out of fear and a strong desire for control, in situations where you cannot have it?

Signs that this may be happening to you:

1. Your muscles get tense

2. Your chest feels tight

3. You feel your heart thumping

4. Your ears ring

5. Your speech becomes louder, higher pitched, faster

6. You feel ANGRY, especially if it’s sudden and intense rage

7. You interrupt people and start gesturing more

8. You feel self-righteous

9. You feel certain that everybody around you is stupid, ignorant, and/or either out to get you personally or totally corrupt and willing to destroy anything in their path to forward their own interests

10. You feel physically, mentally, and emotionally drained after a brief encounter

What else?

Words spoken and actions taken in the throes of active emotional hijack can wreak lasting damage on our relationships, social function, and collective culture. The emotions themselves, however, are temporary. They serve to call our attention to something we need to address, something important to our safety, security, and well-being.

How we address the somethings is key to our personal and relational success or failure.

Self-awareness and self-regulation are the core skills to train here.

Some tips (from dialectical behavior therapy [DBT] and elsewhere):

–Ride the waves of emotion like an expert surfer—balance atop them as they complete their natural journey to dissipate on shore, delivering you to the beach again and again

–Check the FACTS of the situation–distinguish between what can be observed and described objectively and what you assume/judge/project subjectively–recognize how you may have it wrong

–BREATHE. Deep breaths stimulate the parasympathetic nervous system, lowering blood pressure and heart rate, countering the activating effects of fight or flight. Slow, steady breathing grounds us and allows us to see, hear, and think more clearly

–Ask yourself, “How will what I’m about to say/do really make things better in the long run, and at what cost?”

–Slow down. Count to ten. Call a time out. Step away. If it’s worth saying or doing, it can wait this little bit.

More and more I see impulsive behaviors, in reaction to acute on chronic individual and collective stress, destroying relationships and shredding our social fabric. It’s so frustrating, mostly because I see it as so preventable.

Self-awareness and self-regulation:  The concepts are simple. The skills acquisition and execution constitute a lifelong pursuit of wildly imperfect mastery.

YES, things are shitty everywhere. YES, we are justified, if only partially, in our fear, anger, frustration, impatience, and dissatisfaction.

AND we can choose, at any time, to manage these intensely uncomfortable emotions in ways that either connect us in solidarity and cooperation or divide us in mutual denigration and destruction.

Recognize emotional hijack. Breathe through it.   

Let us speak and act from our core values ahead of impulsive, fearful, and self-righteous rage.

And let us thank one another for the effort.

Read more along these lines from one of my heroes, Brene Brown.

I See Myself In You

“I can’t imagine…”

“I can’t understand…”

“I can’t relate…”

“I would never…”

When you think or say these phrases, what is the context?  What message are you harboring, or trying to convey—connection or distance, or something else? 

Can you truly not imagine, understand, or relate?  What if you tried harder (or at all)?  How would it affect you if you could imagine, understand, and relate, or if you would ever, under certain circumstances?  How would this altered relationship to the situation (and person) feel?

I have written before about what happened when I said, “I can’t imagine” to a black classmate.  It was humbling.  I submit that we could all humble ourselves a little more these days.

Sylvan Dale Guest Ranch, Loveland, Colorado

My last pre-pandemic solo trip was to Loveland, Colorado, for the last retreat of Leading Organizations to Health, Cohort 11.  It feels cosmically fitting for my first solo trip since COVID to be a return for the first in person LOH alumni gathering in this time, last weekend.  OMG, friends, it was the next best thing to going home.  Other than our leaders, I had only met my fellow alums over Zoom these last two years.  And now I have 8 amazing new friends.  Though separated by occupation, specialty, generation, and geography, we all speak fluently the as yet rare and reverent language of relationship-centered leadership.  This is my tribe.

We start our sessions with poems.  Please Call Me By My True Names by Thich Nhat Hanh spoke deeply to me, especially these lines:

I am the twelve year-old girl, refugee in a small boat,

who throws herself into the ocean after being raped by a sea pirate,

and I am the pirate, my heart not yet capable of seeing and loving.

Whoa.

I have written on this blog many times about seeking, honoring, and really exercising our shared humanity —35 posts appear when I search the site for the phrase.  Even since I started blogging 7 years ago, though, it feels ever more urgent that we practice this every day.

This card hangs on my kitchen cabinet.

This week my good friend Donna asked me to re-articulate my Why.  Again, I’m sure it was cosmic inspiration that moved her.  Have I ever written my Why statement here?  It was ‘to optimize relationships with and between all people I meet.’  And by optimize I meant to make more understanding, more connecting, and more meaningful.  Today, I think I have to be much more specific:  

My Why is to help us all see at least a part of ourselves in every person we meet. 

I intend to practice and model this first myself—to really internalize the truth that I am myself and also every other soul—that we are all born with the same needs, the same aspirations, the same set of possibilities.  Each of our unique, complex constellations of birth circumstance lottery, serial life experiences, and intrinsic wiring shapes us in ways we can only partially understand in our thinking brains.  What we have not the capacity to think or speak, often can only be felt.  And when we contact another soul who has also felt what we feel, or who can imagine, understand, or relate in some way, WOW, how healing is that?  I bet we can all recall at least a few instances when those deep, meaningful connections occurred across apparently wide gaps of background, class, or other social construct.  And why do we remember?  Because we were moved, alerted, and maybe a little alarmed?  Or maybe we have forgotten, because to come too close to someone’s experience that makes us uncomfortable can trigger a distancing reflex—self-image-protecting, perhaps.

In recent years I have internalized the admonishment to never say, or really even think, “What is wrong with you?”  Rather, I remind myself to ask, “What happened to you?”  In every context, this one switch opens the door to curiosity, imagination, understanding, relationship, and connection.  It allows space for our deeply shared humanity to surface and teach me what I need to know, or at least to prompt humility ahead of blind judgment and dismissal.  Substitute “them” for “you” in these sentences, and see how easily and willingly we throw away whole groups of people with our in- and out-group identities and ideologies.

May we all see a part of ourselves in every person we meet, especially the ones who make us say, “I can’t imagine, I can’t understand, I can’t relate, and I would never…”  Let that seeing move us to put down our judgments and take up empathy, compassion, and connection instead.  We will all be better for it.