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.

Welcoming 2021

It’s almost here, friends, a New Year!

What lessons and mementos will you hold in front, what light guides you?

Tonight I consider the landscape and path ahead.  What do I look forward to, and how do I want to be?  How will I approach relationships, media, leadership, projects, and health?  How will I challenge myself?  On the last blog post of 2021, what do I want to look back and be able to write about what’s important to me in the year past?

Relationships:  Always work to do here.  Some will require more vulnerability, which is scary.  In others I will work to overcome booth pride and self-doubt—maybe that is the ultimate paradox of imposter syndrome?  At my best I exemplify curiosity, humility, generosity, honesty, and kindness.  In the hardest moments I must cultivate non-judgment, empathy, and patience. I will scrutinize my inner narratives and assumptions, and look always to connect.

Media:  Ask. More. Questions.  What is the writer/reporter/source’s objective?  What is their bias?  What is mine?  Where/how can I access primary data in full context?  How should I be willing, and how willing should I be, to learn, change, and grow from what I take in?  How will this make me better, and to what end?  To practice thoughtful discernment—before, during, and after consumption—that’s the goal.

Leadership:  What do people need from me, individually and as a group?  How can I best also lead those who lead me?  In 2020 I completed a 360 evaluation; the feedback has served me well, and I review it often.  In 2021 I commit to stepping out of my default styles more often.  I will nurture my I, S, T, and J sides and attune better to those who live at these frequencies.  Goal:  To help my people and organizations advance toward our full potential, always aligned with and in service of our deepest core values.

Projects:  Assuming the invitations continue, this could be hard.  Every new presentation, paper, group, conference, and class, in my mind, is another exciting opportunity to learn, synthesize, integrate, and connect!  But I can’t do everything, and I must stop “screwing your future self,” as Ozan puts it, by overcommitting. 

Health:  Walk the talk.  Sleep, Exercise, Nutrition, Stress Management, and Relationships.  After all this time, defining health in terms of these five reciprocal domains continues to bring clarity and direction for both my patients and me.  I’m learning about keystone habits, which I bet will help all of us in the coming year.  Thankfully, not every domain goes to hell at the same time, and all behaviors are subject to change.  Goal for 2021 is to fortify healthy habits in each domain, especially the weak ones, to make them less susceptible to derailers.

Coda – Some last thoughts for the year

Books:  This week I started and finished Matthew McConaughey’s Greenlights on Audible in about 36 hours.  I don’t know if his hoots and whistles are written in the book, but they and he are a riot to hear on audio.  What a master storyteller!  And the life lessons are valuable, too, offered with humor and confident humility—highly recommend.

Since I shared my 2020 book list last week, friends have made myriad suggestions that are now in the queue for 2021:

The Naked Now by Richard Rohr

Upstream by Dan Heath

Nonviolent Communication by Marshall Rosenberg

Who You Are: The Science of Connectedness by Michael J. Spivey

You’re Not Listening: What You’re Missing and Why It Matters by Kate Murphy

Thinking In Bets by Annie Duke

Out of Our Minds: Learning to Be Creative by Ken Robinson

The Coddling of the American Mind by Greg Lukainoff and Johathan Haidt

The Long Game by Mitch McConnell

I’ve considered reading that last two for a few years now, and always avoided it.  Didn’t want to be uncomfortable.  In 2021 I commit to training in discomfort, to learn and broaden perspective.

Songs:  A friend solicited a playlist to bridge what has been to what can be.  Here are my contributions.

Do What You Can, Bon Jovi

May We All, Florida Georgia Line

Burn the White Flag, Joseph

Stand By You, Rachel Platten

No I In Beer, Brad Paisley

Days Like This, Van Morrison

The Mountain, Dierks Bentley

From Now On, The Greatest Showman Soundtrack

Dancing Queen, ABBA

What’s on your lists?

COVID Vaccine:  I recommend it.  After reassurance that my colleagues at higher risk than I who wanted it have gotten it, I got my first dose of the Pfizer/BioNtech vaccine yesterday.  34 hours out now, I have minimal, focal, and superficial arm soreness at the injection site and no other symptoms.  I did my usual HIIT workout tonight without limitation.  Read this concise and user friendly guide to the mRNA vaccines by Pfizer/BioNtech and Moderna, with references to data on safety and efficacy.  To see when you will likely be eligible to receive the vaccine, refer to this slide deck from the CDC, also concise and easy to read.  There are many months yet ahead to stay vigilant and mindful, though.  Cases and deaths will continue to rise before receding, especially with all of the people still traveling for the holidays.  Please continue all of your best COVID exposure precautions, for all our sakes. 

So much lies out of our control, friends.  And yet we all still have all kinds of agency.  We get to shape our future.  Let us all use our personal power for good, shall we?  At the end of each day may we look back and forward on myriad words and acts of kindness, generosity, humility, and connection, rather than judgment, ridicule, derision, and exclusion.  That’s how we can make 2021 infinitely better than 2020.

Books of 2020

Hello Friends!  HOLY cow, what a year…  What have we learned?  What do we hold in front as we enter 2021?  What do leave behind without hesitation?  And of course, what did you read this year?  I consumed fewer books than I had intended.  But I did manage to read or hear over 1.8 million words, the equivalent of over 25 books on Pocket, according to the email I got from the app.  So that’s something. 

Please find below the list of books I consumed (or attempted, or continue to engage with) this year.  Please make recommendations, if you have any, in the comments!  Read and write on, friends!

  1. Think Like a Rocket Scientist by Ozan Varol@   (@One of my favorites)  Usually I read books like this over and over.  But the ideas from TLARS stay fresh and live on Ozan’s private forum, the Inner Circle.  I’ve made some awesome new friends and had some of the most stimulating conversations of the year on this page.  What ties us together, aside from our Ozan fandom, is our shared resonance with the idea of challenging the status quo, thinking in possibility.
  2. Speak by Sally Lou Oaks Loveman*  (*Abandoned)  Just not interesting enough to keep my attention.
  3. The Weekend Book Proposal by Ryan G. Van Cleave#  (#In progress)  I’ll come back to this one in 2021.  Practical and humorous, recommended by friend, author, and fellow blogger Donna Cameron
  4. Talking to Strangers by Malcolm Gladwell    Another winner by another master challenger of status quo thinking.  Though not outright political in nature, the ideas explored in this book took on important socio-political relevance in 2020.  The fundamental tenets would serve us well to remember as we enter the New Year:  Our assumptions often operate without our conscious awareness, sometimes with destructive consequences.  It behooves us to talk to people and know them as individuals, rather than making assumptions based on group identity.
  5. Collaborating with the Enemy by Adam Kahane    A bit dense, and slow at times.  But another excellent reminder of the importance of cultivating relationships across difference, practicing empathy and nonjudgment, and exercising power always with love.
  6. Maybe You Should Talk to Someone by Lori Gottleib    I memoir by a therapist.  Touching, engaging, and reminiscent of my own personal experience as a clinician.  Worth a listen.
  7. American Dirt by Jeanine Cummins*    Well written and engaging, some controversy around race, the publishing industry, and ‘trauma porn.’  I abandoned when I could no longer ignore the call of my ever-growing pile of non-fiction books…
  8. Four Days to Change by Michael Welp@     A must-read for anyone working on self-awareness, and who wants to advance equity and inclusion by leading others in the practice.  Written with compassion and empathy, by a white man, for white men.   
  9. Leadership on the Line by Ronald Heifetz and Marty Linsky@    Another gem.  Concise, practical, and an excellent integration of abstract relational concepts with concrete leadership practices that help me move from weeds to vision and back again with more agility, grace, and confidence.
  10. Notorious RBG by Irin Carmon and Shana Knizhnik    A re-listen, with the family this time, on our summer road trip.  Short, funny, inspiring.  Highly recommend.
  11. Personal Leadership by Barbara Schaetti, Sheila Ramsey, and Gordon Watanabe#,@   Another deceptively simple and also richly deep and transformative book and program.  Thank you, friend Sharon Kristjanson, for your coaching and your class, where we get to play with this and other important concepts for Engaging with Difference.  I look forward to continued evolution in my personal leadership style and application.
  12. How to Be an Antiracist by Ibram X. Kendi#    Dense, a bit pedantic, also personal and important.  Will continue to work my way through, considering the larger picture of racism and how I both contribute and can help effect change.
  13. Mating In Captivity by Esther Perel@   Last year I heard Sex at Dawn; this was my sex book for 2020.  Irreverent, lighthearted, and also based on decades of clinical expertise; also attractive to nonconventional thinkers and experiencers.  Her Facebook group is also a fantastic place to learn about all the things you never knew people did in their sex lives.  Highly recommend both.
  14. Me and White Supremacy by Layla F. Saad   Much more practical and easier to consume than Kendi’s book.  Written as a workbook, each chapter grows a practice of awareness and action, grounded in humility and non-judgment. 
  15. But I Don’t See You as Asian by Bruce Reyes-Chow    Self-published and one of the only non-fiction books I could find written on racism from the Asian-American perspective.  Its purpose, much like Saad’s, is to enlighten white people on the impact of their cultural dominance, the way we might with our closest friends.  Worth the inexpensive print  read.
  16. Caste by Isabel Wilkerson@    No doubt you’ve read and heard about this book everywhere.  It’s every bit as amazing and important as everybody says.  Just read it.
  17. Caffeine by Michael Pollan    A fun and well-researched, short break from the heavy reads of summer.  Hasn’t change my habits…. Yet.
  18. Dear Girls by Ali Wong*   Funny, often heartfelt, and ultimately not engaging enough for this reader.
  19. What Unites Us by Dan Rather@   Read by Rather himself, an engaging and eloquent memoir that shines the warm light of hope and perseverance on the despair of today.  “Steady,” he says.  Highly recommend.
  20. The Alchemist by Paulo Coelho    Read by Jeremy Irons on Audible, such a treat!  An allegory, though I’m not sure I quite understand the lesson.  I’ll come back to this one, for sure.
  21. The Pleasure of Finding Things Out:  The Best Short Works of Richard Feynman ed. Jeffrey Robbins#    I bet Dr. Feynman enjoyed being thought of as kooky.  I like to read and hear kooky folks’ own words, but they require focus, especially when they’re talking about quantum physics.  So I’m getting through this one slowly, and enjoying it.
  22. The Courage to Raise Good Men by Olga Silverstein, Beth Rashbaum    Wish I had read this when Son was much younger.  Lots of gender stereotype stuff that I instinctively push(ed) against already, but with practical examples and recommendations that I could have used sooner.
  23. Fauci by Michael Specter (Audible exclusive)    I learned so much in this short book about Dr. Fauci’s early evolution as a clinical researcher and community liaison during the AIDS epidemic.  He really walks the talk of engaging with difference, professionally and personally.  We are so lucky to still have his leadership, and I admire him so much.  Learn about this humble and steady role model.
  24. Divided We Fall by David French    Follow this conservative Christian civil rights attorney’s newsletters and blog at The French Press.  I find he practices that dynamic balance of standing firm in his own convictions and core values, while maintaining an open and discerning mind for the value and validity of opposing views.  I thought his characterizations of ‘the left’ were often generalized and not totally fair, and his outlook is much more pessimistic than mine.  But I always appreciate his perspective, as it challenges me to query my own, keeping me fair and honest.
  25. Managing Polarities by Barry Johnson#    A concept I first learned halfway through LOH, which didn’t resonate deeply right away.  But thank God for the lesson, as it stands front and center as one of the most important concepts of 2020, right there with paradox and flexibility.    Polarities are necessary; they are not problems to be solved; they are relational phenomena that require keen awareness and management for ultimate success.
  26. Burnout:  The Secret to Unlocking the Stress Cycle by Emily Nagoski and Amelia Nagoski#    Humorous, well-researched, eloquent, moving, and personal.  It breaks down the physiologic, psychologic, and sociologic origins and consequences of stress and burnout, and presents an evidence-based process for coping with anything life throws with a lot more confidence, and less suffering. 
  27. Simple Habits for Complex Times by Jennifer Garvey Berger and Keith Johnston#    Unlike Changing on the Job, this book is written in allegory form, which I sometimes find tedious and distracting.  I should probably read rather than listen.  Will pick it up again and finish soon.
  28. Freakonomics by Steven Levitt and Stephen Dubner    Engagingly conceived and written, again joyfully stimulating to the contrarian in me.  Written 13 years ago, I wonder how it would be received today, given its sweeping generalizations and conclusions.  The authors proclaim themselves that the book has no real unifying theme (other than, perhaps, reminding us to regularly challenge conventional wisdom), and its ideas are not necessarily applicable in any concrete or personal way.  Reminds me of Gladwell—just makes me think.  I really want to ask the authors, “What are the most interesting and worthy rebuttals to your claims and conclusions so far?”
  29. A Promised Land by Barack Obama    I started this book in earnest today.  I’m on chapter 4, 3 hours in, 26 to go.  Read by President Obama himself, I feel soothed as soon as I tap ‘play’.  He uplifts me from my pessimism and burnout already.  My hope in the possibility and aspirations of our country swells again, despite the craziness I see all around me right now—the absolute, abject, unfathomable and enraging craziness

*sigh*  So many books, so many so many!  Here’s to the elegance and connecting power of words, in all forms.  May they hold us together and up, may we find in them comfort and solace, and may we always use our own for good.

No Wonder I’m Burned Out!

Once again, I ask my friends:  How are you? 

I am not great!!  Neck, back and head pain, insomnia, low mood, and the worst case of stress eating in a couple years—GRRRRRRRR!  *deep breath*  …So, like a good primary care doctor (she says with tongue in cheek), I evaluate and treat myself.

I ask patients to rate the stress and meaning of their work and then compare:  Is work overall more stressful than meaningful, or the other way around?  It helps me assess the sustainability of their work life, and gives me insight into their values and priorities.  In recent years when I’ve asked myself, the answer is consistent: moderate stress, HIGH meaning.  Today it’s high stress, less high meaning.  For the first time in a long while, work is not necessarily more meaningful than stressful.  Yikes.

Stress:  It’s COVID. 

Meaning:  I ask patients how they derive personal fulfillment and meaning from work.   I recently asked myself again.  It’s twofold:   Relationships and Efficacy.

Relationships: I am your primary care doctor. Sometimes I’m your therapist, your cheerleader, your drill sergeant, and your accountability buddy. I have always loved this, even on the hardest days. But this year, I am also a resolute public health advocate. Sometimes that rubs you the wrong way, because I tell you things you don’t like. I recommend against flying. Don’t eat at restaurants. Don’t gather with your family for the holidays. Don’t go to church. Stay home for 14 days after an exposure. I interrogate your COVID precaution practices. Then I dissect and judge them (not you), thank you on behalf of humanity, and admonish you to persist, longer and longer, for all our sakes. It kinda puts a damper on our relationship.

Efficacy:  I. Help. People.  It’s my calling!  Hemorrhoids?  No problem.  Back pain?  I’ got this (yer back, that is).  Viral gastro?  Migraine? Core instability, palpitations, paresthesia, GERD, thyroid nodule—even  depression and anxiety—I can make a good plan for all of these things.  I can walk you through it, reassure you, and help you feel better, even when I can’t fix the problem. 

Not so with COVID.  How did you get it, when you were so careful?  If the test is negative there’s still a 20-30% chance you’re infected if the scenario is high risk, but I can’t say for sure.  If you’re sick, how long will it last?  Will it get worse before it gets better?  How much worse?  Will you have lasting symptoms or long term health problems?  How long does immunity from illness or vaccine last?  I cannot lie:  I. Don’t. Know.  I will stay with you through it, but I can’t even satisfy your most basic questions, while you sit alone at home coughing, short of breath, unable to see or touch your loved ones, sipping ginger ale because you throw up anything else.  I can’t help.  And it kills me.

On top of that, I’m not doing any good as a public health champion, either!  Have I changed any of your behaviors?  Have I made even an iota of difference in my community to stop the spread?  All signs say NO.  I’m failing left and right.  No wonder I’m eating so much.

Burnout

Burnout is widely understood to have three key components: 1. Emotional Exhaustion, 2. Cynicism/Depersonalization, and 3. Reduced Personal Efficacy. Studies of physicians generally show that while we often score high on the first two, we do better with the third. I think not anymore. Burnout affected about half of all physicians in all specialties a few years ago, but had improved due to widespread research, awareness, and advocacy for systemic change led by professional societies such as the American College of Physicians and the American Academy of Family Practice. But think about 2020: Whatever emotional exhaustion my emergency medicine and critical care colleagues felt before, caring for the sickest of the sick, likely pales in comparison to the horrors of this pandemic. When their health systems ignored their pleas for PPE and then laid them off, making remaining docs work that much harder, and when they saw people partying and spreading virus all over the place, could you blame them for getting cynical? And though we’ve learned so much and fatality rates are lower now than in March, imagine going to work every day to watch patient after patient suffer and die alone, despite your and your team’s best efforts. We can no longer count on efficacy to save our morale.

Re-ignition

So how do we hold it together? Well DUH, it’s about connection! I had not felt this bad in a long time, but I’m better now, thanks to my peeps. They’re everywhere, and we hold each other up. Texting a meme here, venting (a lot) over there, and generally being present for one another, sharing, even embracing, the deep suck of the morass. Because this too shall pass… Like a kidney stone, as they say.

The only way out is through.  The best way through is together. 

I haven’t thought, said, or written that in a while.  It’s not that I forgot.  I got overwhelmed.  Happens to the best of us.