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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.

We Are Really Bad At This

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Sylvan Dale Guest Ranch, Loveland, Colorado, March 2019

How many truly meaningful and fulfilling conversations do you have in a day?

How many such relationships do you have?

Though I wrote my Pit Crew post almost a year ago, its ideas recur regularly.  I have linked to it on multiple subsequent posts.  I share it with patients and reference it in conversations often.  My patients are leaders of large corporations and organizations.  My colleagues and I lead teams in the hospital, the medical group, and the medical school.  My friends lead their families and communities.  When I think about our health and its consequences, it’s about taking care of those for whom we are responsible, ourselves included.

Are you generally the one who always takes care of others?  How does this affect your style and effectiveness as a leader?

Who Takes Care of You?

I estimate that about 20% of the time when I ask this question, my patients say that nobody takes care of them; they do it themselves.  They don’t mean that nobody cares about them.  It’s that they don’t really depend on anyone for counsel and/or support.  They hold everything together themselves.  I always have mixed feelings when the conversation takes this turn.  On one hand I feel admiration and respect, especially when they seem generally healthy—apparently unaffected by physical, mental, and emotional dysfunction.  On the other, I get curious.  How do they sustain this Lone Ranger method?  And what does it cost them?  I believe we all need tight, vulnerable, and safe connections through which we can get raw and real, and work through life’s ultimately messy sh*t.  We need others, even if it’s only one or two, to help us truly hold it all together.  My default assumption is that if we don’t have such connections, we are not living into our full potential.

And today I feel cynical.  I think we are getting really, really bad at taking care of each other.

Driving to work this week I wondered to myself, why do we feel the dearth of mental health services so acutely these days?  Is it that more of us are living on the psychological razor’s edge of mental health and illness?  Are we not diagnosably mentally ill but simply, profoundly, stressed to our limits of sanity and function?  Is that why none of my patients can get in to see a psychiatrist or therapist for weeks to months?  Is that why physicians are increasingly leaving the profession and killing ourselves?  Why do we feel so hopeless?

It’s easy to blame social media.  And I do, partially.  The cruelest irony lives here.  My non-evidence based impression is that cyberbullying bears equally life-threatening consequences as face to face bullying.  If you know of evidence to support or refute this premise, please share.  Negative interactions on social media, which rage so easily like wildfires, are now understood to contribute significantly to the rise in loneliness across the country.  Worse, cultivating truly positive relationships via social media is much harder and more complex, even deceptive.   So on balance the risks and harms of social media may far outweigh the benefits.  There simply is no substitute for personal, physical contact, for sharing the same space, breathing the same air, experiencing another’s full presence.

Worse yet, too often we can’t even get that right!  Ozan Varol wrote about this in his last post, “3 Ways to Be Insufferable In Coversation.”  They are:  1. Always turn the conversation back to yourself; 2. Pretend to listen; and 3. Ask no questions.  How many people have you already met today who do this on the regular?  If you’re honest, how many times today have you committed these relational sins?  It’s okay, we all do it sometimes.  As GI Joe says, knowing is half the battle.  The other half is doing something about it!

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Smart Museum of Art, Chicago, July 2019

So what do we do?

First, Attend.  Pay attention.  How much time do I spend on social media?  What do I get out of it?  When does Fear Of Missing Out (FOMO) drive my scrolling?  Am I really connecting?  Or am I stalking, comparing, judging, flaming, agitating the echo chamber, and otherwise wasting time and energy?  How can I set alerts and redirect my routine?

Second, Intend.  What is the best use of my time?  If I want to see how my friends are doing, rather than check my Facebook feed, why not call them up?  Send a text, photo, or—gasp—a handwritten note just to say hi, I’m thinking of you?  It may cost you time, energy, and $0.55 in postage.  But aren’t your real friends worth the investment?  You can do it on social media too—if you slow down and think about it first.  Consider the return—brightening someone’s day, feeling that personal connection.  Dopamine drives FOMO, and is also associated with addictive behaviors.  Bonding behaviors elevate oxytocin, the hormone that mediates empathy, safety, and connection.  There is even evidence that higher levels of oxytocin correlate with increased longevity of romantic relationships, or even a person’s own life span (could not find a reliable, peer-reviewed source for this claim—I just believe it intuitively).

Third, Get Curious.  This was the first skill I (re)learned in life coaching, ‘way back in 2005, and it serves me well every single day.  If we let go of the competitive, scarcity-based thinking that surrounds us, what more could we learn?  What novel and inspiring stories could we hear from anyone we meet, or even our closest friends?  If we listen to understand rather than to reload and refute or one-up, what vexing problems could we solve, together?  Just wondering about it makes me feel lighter and more optimistic, what about you?

Subscribe to Ozan’s newsletter, the Weekly Contrarian, to get his list of solutions to conversation insufferability this Thursday, 9am Central Time (I have no financial interests in Ozan’s site; I just really admire his work and the community of critical thinkers he has convened).  And today, I challenge us all:  Monitor our attitudes and facial expressions.  Manage our self-absorption for a few minutes at a time.  Look strangers in the eye and smile as if they’re already our friends.  Ask a Facebook friend what they did this weekend that really made them feel alive and well.  Let’s all get our caring on, shall we?

 

On Labor Day

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For a New Position

May your new work excite your heart,

Kindle in your mind a creativity

To journey beyond the old limits

Of all that has become wearisome.

 

May this work challenge you toward

New frontiers that will emerge

As you begin to approach them,

Calling forth from you the full force

And depth of your undiscovered gifts.

 

May the work fit the rhythms of your soul,

Enabling you to draw from the invisible

New ideas and a vision that will inspire.

 

Remember to be kind

To those who work for you,

Endeavor to remain aware

Of the quiet world

That lives behind each face.

 

Be fair in your expectations,

Compassionate in your criticism.

May you have the grace of encouragement

To awaken the gift in the other’s heart,

Building in them the confidence

To follow the call of the gift.

 

May you come to know that work

Which emerges from the mind of love

Will have beauty and form.

 

May this new work be worthy

Of the energy of your heart

And the light of your thought.

 

May your work assume

A proper space in your life;

Instead of owning or using you,

May it challenge and refine you,

Bringing you every day further

Into the wonder of your heart.

 

–John O’Donohue, from To Bless the Space Between Us

 

I know Labor Day is not about doctors, but I’m thinking about all workers and how we each relate to our work.  I discovered the poem above earlier this summer and loved it.  Rereading it this weekend, it resonated even more deeply and I shared it with some friends.  Since taking on a new leadership role about 20 months ago, it feels like I have really lived into these aspirations, as if the cosmos has held this blessing for me a while already.  I was primed for the call; I summoned every skill and insight I already possessed; still the learning curve has proven steep.   And no success is achieved alone!  The steady, honest, and loving support I enjoy from so many humbles me beyond expression.

Our practice recently welcomed new physicians and staff, and I will soon share this piece with the whole team.  Even for us veterans, it never hurts to look at our everyday work with new eyes, as if approaching it for the first time.

I hope O’Donohue’s words above speak to you in your chosen vocation, even if your occupation does not fulfill all of these lofty ideals (it’s kind of a lot of pressure to put on a job).  I wish you work that is much more meaningful than stressful.  If that’s not the case, I hope for you an effective and peace-giving way to reconcile this and find great meaning elsewhere in life.

And I thank you for the work you do, whatever it is.

 

 

Birthday Sock and Washi Love

 

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What’s the best birthday gift for you?  How do you feel when you get it?

I turned 46 last week; I am now officially in my late 40s, YAY!  It feels pretty awesome—what a great age!  I am a seasoned clinician, at a point in my career where I have earned some respect and status, and still have plenty yet to accomplish.  My kids are maturing, getting wise; we have fun and deep conversations.  I am, finally, understanding how to do this complex thing called marriage.  I know what I will tolerate from others and what I will not, and I stand up for myself better than ever.  I know who I am.

Apparently others know, too, and they showed me this week in the most loving celebrations.

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I used to wear the most boring socks.  I worried whether they matched my outfit or my shoes.  Then one day my manager gleefully wore the loudest, brightest striped socks to work.  Suddenly hosiery became the easiest mode of self-expression that I could exercise daily, with abandon!  Soon I discovered mismatched sock trios, launching my sock loving life to the next level.  Thereafter my socks did not match; they coordinated (but I did it less expensively by just mixing regular pairs).  These days I wear compression socks, but even they come in fun styles (I have no financial interests in any of the businesses linked here)!  It just brings me that little bit of joy each morning pulling them on, and then seeing them all day—a splash of color, a flourish of design.  On Thursday, in honor of my birthday, colleagues came to work sporting fun socks of their own.  We gathered briefly and bonded with exuberance, took a picture, hugged, and went, a little more joyfully, back to work.

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The next day, at the other office, I was greeted with a big printed sign, shiny streamers, and a delicate, hand-decorated, washi tape banner.  My newest colleague brought a huge box of assorted donuts.  Hugs abounded from all over.  And one friend wrote me a lovely birthday note—on one of a stack of washi tape cards I had made and left in the office for folks to use on each other.

I have a friend who always feeds me when I go to her house—whatever she has around, often that she has made—and she always has something awesome…  It’s usually sweet.  This day she went to special trouble to make a perfect dessert, which we enjoyed with coconut green tea while catching up on work, relationships, life.  We sat in her beautiful front room, afternoon sun streaming in, surrounded by books, leather, and special papers—all of my favorite things.

 

It was the best birthday yet, I must say.

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I wrote recently that we have 5 fundamental needs:  To feel seen, heard, understood, accepted, and loved.  Over these two days and in the past week, so many people in my life have not only met these needs for me, but fulfilled them in the deepest, most touching and poignant ways.  Simple gestures.  Heartfelt words.  Slow, quality time.  They may seem small.  But make no mistake, their impact and resonance cannot be adequately measured.  I felt absolutely lifted, and my heart was—is still—warmed, through and through.  “Gratitude”, even rendered by the eloquent and wise David Whyte,  just doesn’t quite capture the whole experience.

Gifts like these—conceived from an intimate knowing, presented joyfully, and shared in generosity and love—make birthdays, both mine and my friends’, some of my favorite days of the year.