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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.

Better Angels:  Why I Have Committed

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Friends, what is your WHY?  Mine is to cultivate the best relationships between all people, (here comes my spiel [I prefer to call it a mantra—winking emoji]), “because our relationships kill us or save us, and relationships themselves live and die by communication.”

How are you affected by the current political climate?  Are you separated from friends?  Do you feel restricted in your conversations?  Do you self-edit more than before?  Or are you emboldened to speak your mind, finally freed from the social muzzles of more repressed times?  How have politics in the 21st Century affected your relationships?

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I first learned of Better Angels when I read David Blankenhorn’s article, “The 7 Habits of Highly Depolarizing People,” written before the 2016 election.  I was intrigued by the organization but could not figure out how to get involved.  Last year I asked my Facebook friends which charity they thought I should fundraise for—I support so many causes in theory, but could not decide where to focus my efforts.  One insightful friend suggested Better Angels.  I did not end up fundraising for anyone, but I started following Angels on Facebook and signed up for the newsletters.  This May I participated in a skills workshop and wrote about it.  The objective in these workshops is for attendees to learn and practice listening and speaking skills, to facilitate mutual understanding and connection between liberals (Blues) and conservatives (Reds).  The workshops are brilliantly structured to make engagement safe and productive.  I decided I wanted to be part of this solution.

In August I attended my second workshop, “Depolarizing from Within,” aimed at helping us help our own ‘side’ combat the 4 Horsemen of Polarization that we unleash on the other side:  Stereoptyping, Dismissing, Ridiculing, and Contempt.  I took notes on the moderator’s methods this time, as I had committed to training to become a moderator.  Like in teaching, he had to set clear expectations and ground rules.  He had to control the session and politely but firmly interrupt people’s monologues and keep us on task.  This was harder than I expected—many of us wanted to depolarize from the other side rather than our own—self-scrutiny and –regulation is hard.  Going against group think and calling out our peers feels scary and vulnerable.  But we can do it if we have the skills and motivation.  It is essential if we want to reconnect with our loved ones ‘on the other side.’

I read the moderator training materials and watched the videos over the summer.  When I found myself feeling triggered watching a Red/Blue workshop online, I wondered if I’m really up for facilitating such an event.  Moderators, after all, must exude sincere neutrality and make all attendees feel welcome.  We are the leaders in the room; we set the tone.  For the sake of the work, we cannot afford to get emotionally agitated by anything any attendee says.  That means not only in our words, but our body language, facial expressions—people must feel us being professional at all times.  So to test myself, I registered for the next Red/Blue workshop in my area as a participant.

The event was almost cancelled because not enough Reds had registered.  Chicago and Evanston are very Blue cities, and I’m learning how ostracized and unwelcome my Red peers feel among us progressives.  So I’m so grateful for Red folks who came at our organizer’s behest—her friends who did it as a favor to her.  More than once during the morning, we heard how apprehensive some of them felt, not knowing what to expect, and not used to feeling free to express their views.  This makes me so sad, and I feel strongly that we Blues have to own our part in it.  Regardless of how badly we feel our conservative counterparts anywhere behave, it does not excuse our own ad hominem.

About a week before the workshop, we found out Van Jones and his crew would come to film the whole thing and then interview some of us afterward.  With very mixed feelings, I agreed to wear a microphone and appear on camera.  He told us at the beginning that of the 4 hour event, 4 minutes would be aired.  So we could relax.

Not only was I relaxed; I felt positively uplifted and encouraged.  Throughout another set of wisely structured exercises, Red and Blues explored not only our strengths, but our flaws—both ideological and behavioral.  The stage was set for safe self-reflection, and the vulnerability required to practice it.  How often in your conversations, even with people you love, do you feel safe to acknowledge the weaknesses of your ‘side’ and where your group could act better, without someone pouncing on you?  Has it been so long that it doesn’t even occur to you to consider it?  At the end I exchanged contact information with two Reds and another Blue, and I really hope we can continue the conversation.  I will invite them to the skills workshop I will co-moderate next month, my first attempt.

The Better Angels segment aired on the Van Jones Show last night.  It’s about 9 minutes.  I thought the show did an excellent job of highlighting the objective of the organization, and showing perspectives from both sides, as well as an observer, whose notes are worth pausing on and reading, at about 7 minutes.  Please take a look and share your reactions (civilly) in the comments.

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In preparation for Thanksgiving, Better Angels is holding skills workshops across the country in the next weeks.  Find one near you and bring a friend or loved one!  And check out the blog and podcast to read and hear civil, respectful, even friendly Red and Blue perspectives and discourse on issues like gun control and education.

We have so much work to do, my friends.  It feels exhausting and discouraging at times, but not during Better Angels events.  Here the goals and vibe are openness, curiosity, learning, understanding, and above all, connection.  It’s the perfect place for me and my WHY.  So I’m going to stay a while.  I’ got something to contribute here.

 

Help On the Path to Better

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Okay, let’s talk about your eating!

What about your eating habits is already good, that you want to maintain, that you’re proud of?

And where is there room for improvement?

Sometime in the last five years, I started querying my patients about nutrition this way.  It seems to put people more at ease talking about their eating habits, for some reason.  Culturally, we are so judgmental and defensive about food and eating, weight and appearance.  So one day, I decided to start with the positive, and it makes the conversation easier for everybody.  Fascinating!

I did not realize until the past week that this is my personal version of appreciative inquiry (AI).  I have started including AI in my presentations this fall, which is very well received so far.  I got feedback from the talk I gave to my design friends two weeks ago.  They liked focusing on the positives of work before problem solving.  This week I presented to a mixed audience of physicians, from all specialties, early career to retired, on burnout.  I chose to make it similarly workshop-like, a very ambitious undertaking in 45 minutes, but we did it!  In the last segment I invited audience members to identify the first step they might take to address their own sources of burnout, or improve their self-care.

One generous physician shared her plan, initially stated as, “Just commit to doing it,” talking about exercise.  After a few more questions, we arrived at her actual plan: figure out what she will do (treadmill); decide how long she can carve out (30 min); find time on the calendar; write it on the calendar; know how she will be held accountable.  Turns out she had already succeeded at executing–5 times a week for 20 weeks this year—STRONG WORK, MAMA!  I wonder if there are other arenas where she applies this same, stepwise approach to making something better in her life, or the lives of her patients.

When I ask patients what needs to happen to improve their health, we inevitably start at the abstract (“Just Do It”) and must work to get to the concrete, granular action steps that will actually result in successful behavior change.  It’s gratifying for both of us to arrive at a plan that the patient him/herself has an active hand in creating.  Then s/he feels ultimate ownership and agency to execute.

These days I also always ask about help.  Who else can keep you on track?  Can your spouse eat healthier with you?  Can your assistant eliminate junk food from lunch meetings?  Can your kids be your food police?  My best friend in college agreed to do this for me our junior year, and I lost all of my freshman fifteen, God bless him (and yes, we are still friends).  When we go shopping and I look tempted to buy yet more of something I already have piles of, my daughter asks, “Do you want me to be your conscience?”  Usually I reply with a hedonist, “No,” but I’m always grateful for the offer, and it does make me think twice.

Often patients return the next year living healthier in one way or another.  Sometimes the plan works; many times they find another way.  Sometimes plans are executed and then derailed.  So we get to work on a new plan, asking all the same questions over again.  It doesn’t have to be a slog!  It’s just what we’ gotta do—keep getting help on the path to better.   It’s my privilege to serve as helper.

These last two weeks (months?), I’m definitely not sleeping enough.  Exercise is hit or miss.  Eating is pretty erratic and unhealthy.  Stress ebbs and flows with travel and events.  But my relationships are thriving and I’m doing some seriously fun and amazing sh*t.  Next year maybe the eating and workouts will be on autopilot and I’ll have to lean on folks to get through rough times.  The path to better always gets blocked, takes detours, and makes us reroute.  Those twists and turns are so much more fun, and we notice so much more beauty that we might otherwise miss, when we take them with good friends, no?  I’m so grateful to have such loving help on the journey, and also honored to offer it.  Onward.

 

The Mark You Make

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Friends, Ozan has written another book!  I know it may seem like it, but he’s not paying me to promote his work, really!  He has offered perks for Inner Circle members, however, like an advance digital copy for preordering, and signed copies when the book is released next April.  In considering what I would ask him to inscribe to my friends in the books I will give them, I realized yet another evocative dimension of my relationships.

If you were to describe your friendships to a third party, or make a meaningful introduction in service of connecting two amazing people, what would you say?  I call it ‘connecting fellow Awesomes,’ and it’s always a pleasure and privilege to serve in this capacity.  I thought to ask Ozan to write to one friend something like, “Cathy thinks the world of you—happy to make such a positive new connection!”  Then I thought, this friend has really made a mark on me.  Then I thought of the mark Ozan has also made, in just 9 months of virtual contact.  And then my mind was blown with the realization of my cosmically marked-up self—the finger, hand, and footprints of all those whom I have contacted.

Years ago I attended the orthopaedic surgery resident graduation dinner with my husband, a happy and fun annual event.  At the end, mingling with faculty and trainees, one of the graduates looked at me and his eyes widened.  “You’re Dr. Cheng!  You were my teaching attending during my third year medicine rotation [7 years prior] at [the hospital where I used to work]!”  I was gratified that his expression was cheerful, rather than distressed or awkward, surprise.  He went on to tell me that I held the team to a high standard of discussion, and that he appreciated my presence and teaching.  I will always remember this encounter with pride and appreciation.

In the past year three patients from my past have resurfaced and told me the positive difference I made it their lives.  I remembered two of them so clearly, both their faces and their names (after 20 years and thousands of patients, I can usually only remember one or other).  Talking to each of them reminded me of all that we had been through together, and I was glad that I had done my job well.

But what about those for whom I have not been a great doctor?  I have had my fair share of patients who left me, for various reasons.  I know I have been seriously disappointing for many.  I wonder how many times I have contributed to patients’ negative overall experience of medicine, and further widened the divide between doctors and patients in our fraught and flawed healthcare system?  Sometimes I look back on my early years of practice and cringe a little—all the writing I do now on empathy, compassion, curiosity, openness, and humility results from years of lessons learned in real time, on real people.  I’m definitely much more adept at it all now than in the beginning.  And I’m still learning—I still get triggered, still fall into old, counterproductive thought and behavior patterns.  Sometimes it feels like I will never be good enough, or enough in general.

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I also think about the people whose marks on me were/are hurtful, dismissive, and otherwise wounding.  It reminds me of carvings I see in the trunks of the beautiful aspens I walked among this weekend.  Did the folks who made them set out to harm the trees?  If they thought the tree might die from their knife marks, would they think twice?  Maybe they were overcome with their profound experience in nature and just wanted to mark it in some way, especially if they shared it with someone they loved (so may initials with plus signs and hearts)?  Sometimes we just want or need to be right, competent, respected, and acknowledged.  So we mark our encounters with stubbornness, aggression, or even violence (in its many forms, overt and cloaked).  Like the strong and flexible aspens, I bear scars from such encounters and still continue to thrive.  Such marks have taught me how to care for myself, and also how not to be toward others.

In the end, how do I reconcile these relationship phenomena?  Sometimes we can see and know the mark we make on others.  Many times we cannot.  Nobody is perfect.  My whole life I will scrape and nick those around me, hopefully never with malicious intent.  I can only hope for their generosity and grace, and forgiveness.

Sister Brené Brown, once again, helps me continue.  In her book Rising Strong, she describes a choice, a mental attitude, that can help us all suffer less.  If you have not read or heard the book, I highly recommend it—it’s my favorite of the 5 of her books I have read.  Assume, she says (with the help of her pediatrician husband), that we are all doing the best we can.  That’s it.  We are all imperfect.  Our circumstances mess with us, our patterns mess with each other, and sometimes it can feel like a strange and inexplicable miracle that we have not all killed one another already.  But choosing to give each other this one, simple, and at times colossally difficult benefit of the doubt, could be what saves us all.

We simply cannot extricate ourselves from each other.  So we can just do your best to take care of one another.  And be prepared to apologize, early and often.

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