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.

Here’s How We Can All Help

How do we stick with something when it’s hard? 

I queried my Facebook friends this weekend.  My favorite answers:

“Doing it with friends/family.  People you like spending time with.”

“The alternative of not doing it is worse… and how it helps in the long run.  Knowing it helps me feel better about my life.  …Also, hope matters a lot.  Gotta have hope or else it’s hell.  Finally, helps a lot if you love the subject matter or the work, even if it’s hard.  Or you care about the person for whom you’re doing it, if it’s not for you.”

Most people thought about exercise and other personal habits.  But I’m thinking about those hard conversations about racism, bias, and prejudice.  It’s a whole other ball game, and yet similar principles of practice, persistence, and resilience apply.

This week I had a heartfelt and enlightening conversation with fellow physician leaders about addressing racism and bias at work.  It was the first prolonged, frank conversation most of us had had on the topic with colleagues.  I came away feeling connected and also frustrated, with three conclusions:  1) We all see the problem and we all care; 2) Too often we don’t know what to do or how to help; we feel like deer in headlights—because it’s hard—so we stay silent; and 3) What I want most is for us all to keep trying anyway, even though it’s hard and we don’t feel totally competent—yet.

I see parallels to counseling I do for patients about lifestyle habits.  So many people tell me that they don’t bother trying small habit changes because they never stick.  They believe they are ‘all or nothing’ folks—full on angels or devils of habit—no incremental change possible.  Psychology research tells us that this is not an intrinsic or immutable trait; we can overcome it.  But it’s hard.  We forget that learning, competence, and mastery take practice, time, and persistence.  Sounds a lot like communication skills, no?  In lifestyle counseling, we take a very concrete approach to habit change.  After work, I often overeat in a fit of stress and desire for reward/relief.  I always regret it.  I can delay and diminish my mindless vacuum eating, however, by changing small things in my home arrival routine, like bypassing the kitchen and going upstairs, drinking some water, and breathing deeply, to re-center for a mindful dinner.  I can take small steps—not all or nothing, rather all or something

Obviously, addressing bias and racism at work is different from managing eating habits. But we can still take small steps to build confidence and competence. A lot depends on the culture at work—are hard conversations even safe to have? We must also consider relationships and context—sometimes it’s better one on one, other times you can talk about it as a group. There is no substitute for active awareness practice—attunement to self, others, and environment. Moments of potential connection and understanding can be fleeting. How can we develop an effective skillset, one that builds confidence and agility so we may recognize, seize, and capitalize on those moments? Repetition is key for entraining any skill, and it’s our small daily practices that can cumulatively improve the psychological safety of our work cultures, and make the hard conversations easier. Below is a list of small steps we can all take. With regular exercise and training, we can strengthen our upstander and allyship muscles. If we find workout buddies (like my physician leader forum group) and support one another by sharing challenges and iterative victories, just like at the gym, it’s easier and more successful for us all.

How are you already holding up marginalized people in your world?  How do you stick with it when it’s hard?  What and who holds you up?

* * * * *

Learn and Use People’s Correct Names

My first name is spelled with a C, and my last name has an E and ends with a G.  It matters to me.  Allison goes by Ally.  ‘Chien’ could be pronounced with a ‘ch’ sound or a ‘j’ sound at the beginning, depending on where someone is from.  It’s okay to ask someone how to pronounce their name.  It shows that we care to connect and acknowledge their identity and whole personhood.  Hear or read this short article on how this simple practice can make a world of difference in how we include one another in the workplace, and for tips on how to do it effectively and easily. 

Don’t Laugh at Racist (or Sexist, or Any ‘Othering’) Jokes

And for sure don’t make them.  Psychologists call this disparagement humor:  “any attempt to amuse through the denigration of a social group or its representatives… (It is) paradoxical:  It simultaneously communicates two conflicting messages.  One is an explicit hostile or prejudiced message.  But delivered alongside is a second implicit message that ‘it doesn’t count as hostility or prejudice because I didn’t mean it—it’s just a joke.’”  Such expressions perpetuate a social norm that marginalized people and groups should ‘just lighten up’ as others devalue and dehumanize them.  Read how it affected one East Asian woman when she internalized her own white friends’ ridicule, and how she overcame it.  If you see a marginalized person participate in denigration of their own group, ask yourself how that came to be; then recognize and consider the complexities of assimilation and survival.

https://www.diversitybestpractices.com/sites/diversitybestpractices.com/files/attachments/2020/06/upstanding_against_racism_-_a_practical_guide_final.pdf

Upstand When You Witness Aggression of Any Kind

What will you do the next time someone makes a racist, sexist, or otherwise denigrating joke or comment?  Or when someone starts abusing another person on the bus?  How can you help?  You don’t have to be a hero or put yourself in harm’s way.  And you can still respectfully and firmly disrupt aggression, and signal your support to a targeted person.

Learn and Share—Find and Be Peer Support

I’m so grateful for friends and colleagues who have committed to this work.  We validate one another’s experiences, fears, triumphs, and learnings.  We exchange resources like everything linked in this post.  I keep articles in my Pocket app, so I may share them readily and widely.  We acknowledge that the work will not finish in our lifetimes.  And yet we persist, because we believe we can contribute.  We work to leave the world better for our children, and to lead them by example so they may carry the torches after us.  We hold one another up in hope.  Please, join us.

How to Support Your Asian Colleagues at Work Right Now:  1. Reach out in support if it’s appropriate to your relationship.  2. Consider your intent—is it really to help them, or are you just making yourself feel better?  3. Don’t invalidate or diminish their feelings.  4. Listen to understand, not to fix.  5.  Just don’t stay silent.

InclusionLabs Fellowship Program:  For a deep dive of inner work in service of effective action, check out this program to connect to others who have also made the commitment. 

We Can All Relate

Happy Spring, friends!  How are you doing?  The world is still such an intense and often painful place, but somehow the warmer, lengthening days bring hope and solace.

I find myself still immersed in exploration of tribal experiences… Talking, reading, writing, thinking, connecting, reflecting, learning. What’s on my mind tonight:

Comparative Suffering Is Counterproductive

I have known about abusive and violent acts against Asian Americans since the beginning of the pandemic.  I have felt increasingly self-conscious about my Asian-ness for the past five years—more so than at any time since elementary school.  So it was somewhat gratifying to see anti-Asian hate crimes get more press in recent weeks.  But even as I add my own voice to the call for awareness and action, I hesitate.  All violent acts deserve attention and reckoning.  But part of me feels sheepish ‘complaining’ when anti-Black racism feels like such a more endemic, urgent, and severe crisis.  Even as I read more articles on anti-Asian hate this week, the trial of Derek Chauvin progresses in Minnesota, and so many of us hold our breath, knowing that the outrageous possibility of acquittal is real.  But staying quiet about anti-Asian hate helps no one.  I’m part of an out-group, too, and our needs are not less important than anyone else’s.  It is precisely when we start comparing and ranking the value of one group’s suffering against others that we all lose our collective power and potential to drive positive change for all of us.  When I speak up on behalf of the AAPI community, I remember that we are ‘othered’ in different ways and with different consequences from our Black brothers and sisters, but the shared experience of white supremacy binds us together.  I will do better to point out that the empathy, education, connection, and solidarity that I want people to foster in themselves must be applied to all marginalized people, not just Asians.

Leadership Matters

Looking back at summer 2020, I wonder if I did enough to address the concerns and well-being of everyone on my team, but especially my Black coworkers.  Did I foster a psychologically safe environment where people could express their concerns and emotions?  Did I encourage enough self-awareness in thought, speech, and action?  Do I continue to do so?  As the leader, how much should I bring up anti-Asian hate, does that center myself too much?  How do I maintain a balance of attention and integrate our awareness so as to include the concerns of any and all who feel oppressed?  As I face outward to encourage system leaders to speak out, have I done enough on my own team to connect with my AAPI and Black colleagues in support?  How will I know I’m doing enough?  In the end I submit to the assessment of those I lead.  I can solicit feedback and accept it with humility and honesty.  And if I falter, I can ask that people look not only at my impact, but also at my earnest intentions to cultivate connection between us all, and keep doing my best as I learn from mistakes.  I can also continually work with fellow leaders to develop initiatives to improve diversity, equity, and inclusion—to hold us accountable to tangible results, and not just give lip service.

We Can All Relate

How are you “othered”?  I mean based on the tribes in which you claim membership, or certain personal traits, how can you be identified and ostracized by others?  Consider a scenario:  White woman verbally attacks elderly Black man with racist slur.  He retaliates by fat shaming her.  We all have our vulnerable parts, those things we fear being called out and held against us, that we cannot necessarily control.  Even members of the dominant culture have them, though they may or may not be as readily visible as race, gender, or ethnicity.  The fears and anxieties we carry around these soft spots cause varying degrees of personal and collective suffering and social consequence.  When we dig deep and recognize our own vulnerabilities reflected in others, then we can truly relate to all who suffer, and we are moved to act on their behalf—because advocating for one of us is advocating for us all.

I finished watching the PBS series “Asian Americans” (which PBS has apparently made free for streaming since the Atlanta shootings) this weekend, which I highly recommend.  From it I learned how Asians and other marginalized groups have come together in American history to advocate for one another.  Filipino and Mexican farm workers formed the United Farm Workers in 1965.  Asian, Latinx and Black students at San Francisco State University joined together and succeeded in creating America’s first ever ethnic studies program in 1968.  Jesse Jackson spoke out on behalf of Asian Americans after the murder of Vincent Chin in 1982.  And since last summer, I’m happy to see increasing solidarity again between Asian and Black communities.  From a recent article in TIME magazine:  “’We’re not safe until all people of color are safe. Safety doesn’t come in the form of heavier policing calls or of carceral state oppression of poor communities,’ Dao-Yi Chow tells TIME. Chow, who is Chinese American, was one of the organizers of Running to Protest’s ‘Black & Asian Solidarity’ rally. ‘That’s only continuing to align ourselves with white supremacy. And if we continue to do that, those are anti-Black acts that’s only going to continue to drive divisions in between our communities,’ Chow says.”

Call to Action on the Periphery

I’m currently reading Change by Damon Centola.  Hear him discuss the central tenets with Shankar Vedantam on this episode of “Hidden Brain”.  He asserts, with evidence, that social movements and change originate in the periphery of social networks, through strong and overlapping ties.  This means that we each and all have a role to play in making the world more equal for marginalized people and groups.  It all starts with the conversations we have in our daily encounters, and the cascade effects they have on our friends’ friends, etc.  On my work team, if I’m hearing the same message of solidarity from my manager and my medical director, and then my colleague from another practice, and then my fellow committee member, then I’m more likely to accept and adopt it, and then promote it myself.  Whether or not I had a formal training or participated in some system-wide initiative, I’m influenced by those around me whom I respect and care for—and vice versa.  That is why no matter who I am, what I say and do also matters—we all lead by example. 

The journey is long and arduous.  The path winds through caves of uncertainty and adversity.

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

#TalkAsianHate

YouTube: Eugene Lee Yang of the Try Guys

When someone is unfriendly to you, how often do you attribute it to your race? How often does the possibility cross your mind?

Since I was a kid this has always been in the background, and it was worst in elementary school.  Second and third grade stand out:  Kids would pull the sides of their eyes up and down, chanting, “Chinese, Japanese, dirty knees,” or make fun of my name: “Ching-Chong-Cheng.”  In high school one boy in particular referred to me as “Cheng,” and always said it with a sneer.  It could have been innocent—I found him generally sarcastic and antagonistic in the most annoying way.  When I told him how it made me feel uncomfortable his demeanor changed immediately; he apologized and never did it again.  Looking back, he and his friends referred to one another by their last names, and often in that competitive, confrontational, adolescent male way.  So maybe that was actually his way of including me?  I think he harbored no specific malice, but his impact strayed far from any benign (ignorant?) intention, I think based on my own past experience.  I remember the encounter vividly, and to this day appreciate both my own courage to bring it up, and his willingness to accept the feedback and change.

I think my family and I experienced minimal direct racism as I grew up. But I have always felt self-conscious whenever bad news comes from China, like when babies were dying from melamine-tainted formula, and when thousands of dead pigs floated down a river in Shanghai. I hesitate to even mention these stories here, for fear of negative stereotypes they may incite or confirm in readers’ minds about Chinese people. We humans generalize about and denigrate groups we perceive as different from ourselves, often based on minimal information (and these days, more and more disinformation). When these events occurred I asked my friends, and they reassured me that the news was inconsequential.

Not so with coronavirus.  A close family member was verbally assaulted in the mall a year ago, by a white adolescent girl.  She just walked right up to him, two generations her senior, and started yelling, “This is all your fault!”  How entitled, how arrogant, and how brazen—to think you can just attack an elder stranger like that with no fear of consequence.  That is the privilege of membership in the dominant culture.  Hard for me not to feel defensive and alert to threat, not to mention rageful, after that. 

For the past several years, and especially the past year and the last two weeks, acute awareness of what makes me visibly different, and thus a potential target of prejudice and racism, occupies increasing space in the front of my mind.  Our family just road-tripped to Colorado and back.  Driving through the rural Midwest, I found myself thankful that Husband wore his university hospital, orthopaedic surgery logo jacket into the gas station stores.  I spent as little time inside as possible, made sure to be friendly, and felt noticeable relief every time someone smiled and treated me with kindness, or even just common courtesy. 

This hesitation–the vague and disconcerting paranoia I feel–is justified. It’s not debilitating, but I’m frustrated, annoyed, and angry about it.

* * * * *

How important is it to you that all people, including people of color, women, LGBTQ, indigenous and other marginalized groups, feel accepted and welcome, and treated with respect and dignity, everywhere they go?  How can you help?  Below are my suggestions.  I’m tired, friends.  Whatever you can do in your spheres of influence is much appreciated.

Educate yourself.  See links below to multiple articles and a very well-done video (I recommend the video most) to familiarize yourself with current and historical aspects of the Asian-American experience(s).  Talk to your Asian-American friends, if you have that kind of relationship.  But understand that they may not want to rehash their experiences just for your benefit.  Look for published stories to foster your empathy.  Then, if you can muster it, find ways to tell your friends and any other marginalized folks, “I see you.”

Seek diverse perspectives.  Asian-Americans are not a monolith.  Despite some overlapping aspects of culture, Chinese, Korean, Thai, Vietnamese, Indian, and all other groups have divergent histories in and out of the United States, and each individual in any group manifests their own unique experiences.  If you’ve met one of us, you’ve met one of us.  Resist the urge to oversimplify and overgeneralize.

Look at your own biases with self-compassion and accountability.  Biases are human.  We all have them.  It does the oppressed no more good for you to self-flagellate over yours, than if you ignored them altogether.  What matter are your awareness and self-management of your biases, and then your ability to help others do the same. 

Commit to doing the work.  This does not mean expecting perfect words and actions from yourself all the time.  We will all open mouth and insert foot; we will all fall into old habits of thought and assumption.  But we must persist; abandoning the work helps no one.  Every failure teaches us, if we let it, and this helps everybody.

Find a supportive community to hold you up and accountable in the work–friends, tribe members who love you through your struggles to reckon with yourself.  These will most often be people who have committed to doing the same work themselves.  Hold them up in return.  This is a group project; we all depend on one another to succeed.