I have only had to replace one earbud, and now the diaphragm twice. Somehow I feel really good about this, like we have both survived and thrived, and continue to serve at our highest capacity. 😊
My stethoscope is 22 years old.
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Author Archives: Catherine Cheng, MD
Love You Into Being
A couple of weeks ago I met my new medical students. These 10-12 trainees will be my small group for the next two years. We will meet monthly to discuss the soft stuff of medical training—hierarchy, tribalism, death and dying, medical errors, difficult patients, etc. Some call it “third year medical student support group.” This is my 6th year of the pleasure and privilege (I inherited my first group halfway through, when their previous preceptor moved out of state).
With each successive group I am ever more amazed at the students’ level of insight. They articulate compassion, humility, and maturity that I don’t think I had at their level of training. Or maybe it’s because we did not have classes like this to explore such things when I came up (or maybe I don’t remember?). More and I more I see my role as facilitator more than teacher. I am not here to impart medical knowledge. Rather, it is my job to stimulate exploration, conversation, and meaning. It’s so freeing, really—there is no standardized test to teach to. And yet I see it as my responsibility to help prepare these gifted young people to face the greatest challenge and reward of the profession: human relationships.
I feel no fear or trepidation. We cannot ‘fail’ at this class, any of us. Because the point of it is simply for everybody to participate, contribute, consider, and learn—myself included. Each month the students are given questions to answer in the form of a blog post. For example, “Recall an example of inspiring or regrettable behavior that you witnessed by a physician. Describe the situation, and its impact on you, the team, and/or the patient.” I read them all and facilitate discussion, tying together common themes and asking probing questions. My primary objective is to help them maintain the thoughtfulness and humanity that led them to medicine in the first place. Medical training has evolved in the past 20 years, for the better in some ways, not so much in others. One way we do much better nowadays is recognizing the hidden curriculum, and shining light on its effects, both positive and negative, through classes like this.
We all have those teachers who made a difference in our lives—or at least I hope we all do. I have multiple: Mrs. Cobb, 4th grade; Mr. Alt, 7th grade math; Ms. Townsend (now Ms. Anna), 7th grade English; Ms. Sanborn, 7th grade social studies; Mrs. Stahlhut, 9th grade geometry; Mrs. Summers, 10th grade English; Coach Knafelc, varsity volleyball; Dr. Woodruff, primary care preceptor; Dr. Roach, intern clinic preceptor; Dr. Tynus, chief resident program director. My mom is one of these teachers, also. She leads nursing students in their clinical rotations. I have seen her student feedback forms—they love her. And it wasn’t until I heard her talk about her students that I realized why they love her and what makes her so effective—she loves them first. Teaching is often compared to parenting. Our parents, at their best, see our potential and love us into our best selves. They cheer us, support us, redirect us, and admonish us. They show us the potential rewards of our highest aspirations. If we’re lucky, they role model their best selves for us to emulate.
All of my best teachers did (do) this for me. I’m friends with many of them to this day, and I still learn from them in almost every encounter. I love them because I feel loved by them. They held space for my ignorance and imperfections. I always knew that they knew that my best self was more than the last paper I wrote, the last test I aced, or the last patient encounter I botched. To them, my peers and I were not simply students. We were fellow humans on a journey of mutual discovery, and they were simply a little farther along on the path.
This is my aspiration as a teacher, to live up to the example of all those who loved me into the best version of myself today. This kind of love allows for growth and evolution, from student to colleague, to friend, and fellow educator. This is not something attending physicians typically express to medical students, positive evolution of medical education notwithstanding. But when I met this new group, I was overcome by love for them. So I told them. “If you take away nothing else from our two years together, I want you to have felt loved by me. I wish to love you into the best doctors you can be. That is my only job here.” Or something like that. It was impulsive and possibly high risk. But it was the most honest thing I could say in that moment, my most authentic expression of my highest goal for my time with them. I only get to see them once a month, and I want them to be crystal clear about what I am here to do. We have lots to cover these two years, so much to learn and apply. And love is the best thing I can offer to hold us all up through it.
Support for the Inner Work
Things were a little crazy this week. I have an idea for a post and still have not sat down to write it out. But I want to share something that came out on my Facebook page (of course) tonight. One of the reasons I love writing is that insights pop out when you least expect them. Writing exchanged with others is even better, because those insights are then shared, and their meaning amplifies.
I posted this article from the Washington Post yesterday: “Nearly half of liberals don’t even like to be around Trump supporters.” It’s a summary of a recent Pew Research Center survey, which finds that 47% of liberal Democrats “say that if a friend supported Trump, it would actually put a strain on their friendship.” It posits, among other things, that liberals are less tolerant of dissenting ideas because they are clustered in urban areas, lending to louder echo chambers. By contrast, only 13% of Republicans answered that “a friend’s support of Hillary Clinton would strain their friendship.”
From the survey report: “…Nearly nine months after the election, most people (59%) say it is ‘stressful and frustrating’ to talk about politics with people who have a different opinion of Trump than they do; just 35% find such conversations ‘interesting and informative.'”
I consider myself a socially heavily left-leaning, fiscally centrist Independent, but I identify more with liberals than conservatives, by a large margin. This article made me sad, that my ‘tribe’ shows itself to be much more intolerant and judgmental than I would like.
I posted this comment along with the article:
“Ooohh, so much data here, so much potential for blame, and also for self-exploration. Humbling, no question.
“Be extra kind with your comments on this one please, friends. No need to reopen barely scabbed wounds. I mean for my page to be a safe place for all of us to engage. We are all in it together, and the sooner we *all* figure out how to deal with 45 and one another, the better we will all be.
“Also, I’m bummed that Asians are always left out of the data set.”
I got some comments from my liberal friends about how hard it is to talk to Trump supporters, so much so that they avoid talking politics with those friends altogether. But one friend exemplified my aspiration for all of us. She wrote:
“… I recently had dinner with a very close friend who voted for Trump. Typically I think I’m a really good listener, listening with curiosity and a desire to raise the conversation and all involved to a higher level. However, when our conversation turned to politics I found myself cutting her off, getting defensive and bordering on being critical of her. I was horrified by my own behavior. I think this article hits on it – the support or opposition of Trump feels like less of a political stance and more of a statement of a person’s values and morals. I don’t think that’s necessarily true- I think a large population of Trump voters (my friend included) were actually voting against Washington more than for Trump. While I can’t get behind Trump I can get behind a vote to change the system. I wonder what might happen if more of us looked for what we can stand behind together?! Thank you for continuing to be a voice for this movement!”
Exactly! Immediately I felt connected to my friend in a higher calling, and a shared struggle. I replied:
“(My dear friend), I derive so much of my strength and curiosity from you. How many of us can own up publicly about our own flaws and failures, like you did here? And I know you know I use the word failure in the most empathetic and loving, mutually understanding way. I think that is the first step–complete humility and openness to our own imperfection. It’s so fucking hard. And I’m so lucky to have friends like you, (these four other dear friends), and others… I know now, better late than never, that we cannot do this work without unwaveringly reliable support, no matter how motivated we are. And for those of us who are already well-supported, I think it’s our responsibility to look outward and support others. You never know when or where someone may be standing on the edge of openness, and when your small gesture of encouragement may nudge them on. Thank you for your loving support, my soul sister!”
It really is true, we cannot dig deep and bring out our best selves by ourselves. We are meant to hold one another up and accountable, to bring out the best in each other. It breaks my heart when I interview patients, and learn how sparse and frail their emotional support networks are. There is no stereotype for this scenario, it can happen to the best of us. Past experiences, circumstances, timing, life events—they can all combine to undermine our relationships, thereby weakening our capacity for self-awareness and exploration. So we fall back on default modes of defensiveness, righteousness, denial, and blame. Whether it’s quitting smoking, sticking to a healthy eating plan, or elevating our political discourse, we are truly stronger together.
I share this tonight because I so admire my friend for owning her whole self. I am so grateful to her for sharing her imperfections and vulnerability with humility and hopefulness. She gives me strength to keep going, despite how fucking hard it is. And I hope I can do the same for many, many others.
Healing Through Connection 