Author Archives: Catherine Cheng, MD

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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.

I Wish I Was Better For You

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Dear Person I Knew Before,

Looking back, I wish I had been better for you. When you knew me, I was young in the work. I was well trained and I understood the task in my thinking mind. But I had (still have) a lot to learn about relating to people who are different from me, people whose behavior I don’t understand easily, who rub me the wrong way at first.

I wonder if you felt disliked by me? I hope I was professional/amiable enough, but I know I wear my feelings on my face. My tone and words can be terse and even cold when I feel disconnection. I hope you still felt respected, attended to, even cared for. If not, I own it. I remember you because I knew it at the time–knew I was not my best with you, and yet I could not help it. I had only yet begun the inner work journey that has brought me to today.

I know so much better now. I am so much more self-aware, humble, honest, and accountable. I withhold most judgment now, unlike before. I engage with difference now in openness and curiosity, and take few things personally. I am so much more peaceful inside. Even when I get triggered these days, it’s much less intense and lasts minutes, maybe hours, instead of days. I am far better at asking direct questions to clarify meaning, calling out disrespect, and connecting better or amicably exiting a poor relationship. I don’t let things hang or fester like before.

If/when we meet again, I welcome the chance to reconnect and apologize. I want to show you how much I have learned and grown since you knew me, since I had my potentially negative impact on you. I was doing the best I could, with what I had, at that time. I still am. There is no substibute for experience and time.

Please know that my relationship with you, through its challenge and difficulty, has been the pebble in my shoe making me more mindful, more intentional. I thank you for crossing my path, showing me my deficits and calling me to address them. I hope my future relationships will show my progress, so that even if I cannot make direct amends to you, I can avoid doing similar harm to others. You have made me better.

Wishing you peace, and people in your life who show up better for you than I did. I will stay on my path, and if we meet again, I will smile.

I Just Forget

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“I know what I need to do, I just don’t do it.”

I hear this from patients regularly.
Translation: I don’t want to talk to the dietician or exercise physiologist; they’re just going to tell me what I ‘should’ be doing and I’m just going to feel bad that I’m not already doing it.

My colleagues and I talk all the time about judgment and how to avoid and manage it in our practice. We are human and thus subject to social norms, pressures, and biases of weight, physical appearance, etc. And yet I know of no other group of people who practice self-awareness and self-regulation more consistently and humbly. Our objective is always to meet you wherever you are, and help you get to wherever you tell us you want to go, with realistic, sustainable suggestions and support. Still, we cannot control anybody’s response to our consults and feedback.

It feels defensive, the ‘I just don’t do it,’ and ‘I don’t want to talk about it’ responses. Maybe people judge themselves harshly, and also anticipate judgment from us? Who wants to bring that on themselves if they can help it? It makes me wonder, when I get defensive about something, what’s behind it in me? How am I filtering an otherwise benign or even benevolent message? My colleagues and I understand the myriad extrinsic barriers to ideal habits, and how thin the threshold can be between doing something healthy and not. For example, a bowl of whole fruit may sit on the kitchen island for days, untouched. Cookies and candy are much easier to grab and go. But when someone cuts the apples and peels the oranges, they disappear in minutes. Where can we each find our cut fruit equivalent for health habit (or any habit) change?

As I completed another amazing conditioning workout at Ethos this weekend, lying on my back feeling where my paraspinals were tightening and recalling some knee swelling of late, I thought back to the one stretching session I did at home in the last week. DUH, my back felt better in subsequent days. Coach Ryan taught me how to do knee CARs months ago, and it always helps. It occurred to me there, recovering on the floor, that I just forget to do these very helpful things. It’s not that I don’t want to feel better, it’s not that I don’t care about my health; it’s not that I don’t believe that stretching and rotating will reduce pain and swelling. It’s just that I haven’t yet made them into a habit. I do cat-camels and CARs before every workout at the gym and at home, just not at any other time. I might do a few standing quasi-knee CARs in the elevator on the way to the office in the morning–why it only occurs to me to do it then, I have no idea. But it occurs to me sometimes, yay!

This realization came with no shame or guilt, no self-flagellation or judgment. “Huh, that’s interesting,” was my main takeaway. And now I’m wondering how many months of aches and pains I could have saved myself before now. So as I write tonight, I consider how I might create cues to get on the floor and take care of my body in this way more regularly. I can make progress, and that’s what matters. Even once a week will be better than what I’m doing now, and I know I’ll feel better after only a few sessions.

Tomorrow when I see and talk to patients, how can I show up so we can all stand in the ‘Huh, that’s interesting’ perspective, and brainstorm together, with curiosity and possibility, how to bridge the ‘know what to do–actually do it’ gap?

We’re all here doing our best. Assessment of current state–what’s already good and what could be better–can be done without shame, guilt, judgment, or negativity. And everything doesn’t always need to be better! Satisfaction and reveling in what’s already great today has absolute value. So if someone tells me they’re good where they are, I’ll stand with them and bask in the goodness. And we can always reassess later–or not.

Off to stretch my back and rotate the knees, my friends! Have a great week!

NaBloPoMo 2023 Debrief

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*sigh* All done, my friends.

She sits back, breathes deeply, and looks around in satisfaction.
The house is no more of a pigsty than usual.
Meals were planned and cooked, laundry completed, child chaufferred, workout routine maintained (other than during travel). AND SHE GOT TO BED ON TIME MOST NIGHTS. That may have been the greatest accomplishment–the first NaBlo in 9 attempts that did not cost 30 days of sleep and physical health. WIN.
Another month of daily extemporaneous writing in the books.

Observations, Learnings, Applications

After all this time, I can finally admit and embrace that I am a Night Writer. I can put down anybody else’s advice to get up early and do it in the morning, or even during my days off. That’s just not me. All-nighters are not me, either. My ideal writing time seems to be around 9-11pm. Looking ahead, this feels like a doable schedule for the book. Like workouts, I can aim for 5 nights a week and plan ahead each weekend, so there is routine with flexibility, and long term consistency.

I feel self-conscious writing too much about myself–my own stories, thoughts, feelings, ‘musings’. Navel gazing. Who wants to read that every day? But this desire to connect my own experiences to others’, to make meaning and touch on a larger, more resonant scale–where can I start but with my own lived history? And the ‘lesson’ parts can really come across as pedantic, no? So, I can look for ways to improve my storytelling and delivery, be both personable and knowledgeable–relatable. I want the book to feel like the best clinical encounter–query, intake, reflection, suggestion, action plan, follow up–connecting, learning, empowering, and always forward moving.

Practice makes better. The words are in there, and they don’t have to be fully formed or organized before pulling them out to the page or keyboard. Like icing out of a squeeze bag, ideas and expressions will take shape depending on temperature, pressure, movement, and tip. But regardless of the conditions, output is needed. It can be reshaped later; I just need to sit down regularly and squish it out in the first place. I’ got this.

Though I chose the 30 NaBlo topics a bit haphazardly, they were all meaningful, and the order in which some of them emerged felt organic as I wrote each day. If I were to continue, I’d add curiosity, kindness, and generosity to the list. Redundant, I know. The longer I write this blog, the more times I repeat myself and refer back to pieces I wrote years ago. And it’s okay. It’s just taken me this long to convince myself that I have something useful and relevant, something timeless to contribute, a thing worth amplifying. I had to build up the confidence, make it strong and solid. Now I’m ready.

Writing a book will be different from a blog, and now I have accumulated enough of both discipline and surrender to let some good writing flow from the deeper places. An image of volcanic magma emerges–not spewing in great explosions with atmosphere-darkening ash clouds, but a slow, burbling ooze, hot a pliable, soft and layered, unstoppable yet unobtrusive, solidifying over time to create new islands, smooth and round rather than jagged, places where we can stand together quietly in wonder and explore, from whence new perspective and understanding may grow.

Many thanks to all who have followed along this month. Could the post titles have been more boring? Overall it was not my best published output, but the intent all along was to use this month as personal and public writing lab for book work prep. It feels to me like time and energy well spent, worth the effort, and work I will refer back to often. Now to find the new routine, book and blog juxtaposition/integration? A fun new fork on the writing trail, yay! Or ooo, maybe a convergence. I trust it will all work out, unfold, and emerge in good time and space. Can’t wait.