Keep Showing Up

Posted on August 18, 2026 by Catherine Cheng, MD

“What mountain stands before you that you will climb with confidence fortitude courage and power?”

“You don’t get stronger by adding weight. You add weight when you get stronger.”
—Alec Blenis, Instagram

I love this quote. It feels a little counterintuitive at first, yet speaks to the fundamentally important understanding of skill building that keeps us safe, strong, and motivated in the gym: Keep showing up. Do the work. Get help if needed. It’s hard until it’s not, and then you level up. It also resonates in two domains outside of strength training:

Health Habit Change
“I know what I need to do, I just don’t do it.” I have written about this phrase I hear often from patients. For two years I met with one of the dieticians in our practice, feeling both hopeful and a little hopeless at the same time. Every week or two I both dreaded and anticipated the calls, knowing I had both attempted and failed to implement our action plan from the prior session. I muttered this statement myself how many times? We stopped meeting eventually; likely multifactorial but I think we both felt that further gains were unlikely. That may have been a year ago.

I felt a bit defeated at first, thinking my behaviors had not changed much, and I had not lost any weight. But looking back, those sessions served the same purpose as the years I spent with my personal trainer. Julianne was my nutrition coach. She made me better at executing the knowledge I already had, reflecting, investigating, trouble shooting, and brainstorming how to apply both basic and advanced nutrition principles in the various contexts of my life. I now eat more colorful plants, and I get substantially more fiber on a daily basis. I am much better attuned to hunger and satiety, I always fuel before workouts and make sure I bring a snack for after. I keep healthy snacks at the office and hydrate consistently. I eat a lot less dessert, and volumes are about half of what they used to be. I walk the talk of “enjoy every bite” much better now than before. My portions of everything are generally smaller. I estimate that I have shaved a few hundred calories per week from my diet, which should lead to very slow weight loss, about a pound every three months. That actually feels about right, and I can handle this. As I continue to train, both strength and cardio, I see my shape changing more than my mass, which I am happy about.

I keep showing up to apply, adjust, and adapt, and results emerge proportionally. Persistence pays off, and it’s infinitely easier with support from knowledgeable and supportive people like Julianne the registered dietician, my Ethos coaches, and my friends.

Civil Political Discourse
For some years now I have actively sought conversation and connection with my Red Voting Friends. Since 2017 I have supported Braver Angels, and now multiple organizations offer myriad approaches, strategies, and even education and venues to practice connecting meaningfully with people who disagree with us. Some even impact policy in a bipartisan way in local governments. We have come so far, and have very far yet to go.

How hopeless and/or hopeful do you feel about the state of political discourse, nationally, locally, at the level of your policy makers, in your social circles, in your family?

How do you impact those places and groups with your presence, your words, your attitude, demeanor, expressions? Bluntly: are you part of the civil discourse problem or solution?

It’s hard, I know. Uncomfortable, sometimes viscerally and distressingly so. And not everyone is a suitable counterpart for such conversations. Still, it is a learnable skill and more and more amazing people like Mónica Guzman and the folks at Braver Angels, Builders, and the Dignity Index provide support and education to help us do it better. We just have to keep showing up.

This weekend I will gather with one of my Blue voting friends for my first ever “Builders BBQ“. We won’t barbeque and I will not be actively bridging with any Red voters. But Blue Friend and I will talk about how we can do it better. We will practice curiosity, openness, self-regulation, and holding connection in front. We may even role play a little, who knows? It’s not exactly what the Builders BBQ is meant to be, but I have taken the liberty to show up how it works for me, and to keep iterating from here. I fully expect that there will be a Red-Blue gathering in my foreseeable future. If not, no matter.

I continue to invite and facilitate connection, unafraid and well-equipped to wade confidently into disagreement of all kinds with respect and good humor. I have trained for years and it has paid–is paying–off in spades. I keep practicing because while I am proficient, I still have a long way to go. Bridging work is a labor of love. It takes time to build trust, testing, building, and proving the strength of ties that start slim and tenuous, but have the potential to hold us together through the harshest storms.

Each and every one of us has the capacity–and I would argue a civic duty–to engage in building and bridging work, or at least to not contribute to derision and division. The nature of a democracy is that the power should lie with the people. We are the system. We get stronger as a collective when we exercise our power to connect.

Consistency beats intensity. Keep showing up, my friends, to all that challenges us in life.
We’ got this.

Listen to “Keep Showing Up” by Doctor Jose de la Rosa Mambo Town for some extra inspiration!

The Doctors Are Angry

Posted on July 27, 2026 by Catherine Cheng, MD

My friends.

People should NOT be tested for testosterone levels unless they have overt symptoms and are evaluated by a qualified clinician first.

“Peptides”, by which I mean some currently popular, non-FDA approved dietary supplements, have no reliable laboratory or clinical evidence for benefit in human conditions.

And now military service members will be screened for testosterone levels starting at age 30 and an FDA committee has recommended that compounding pharmacies should be allowed to create peptide preparations for clinical use.

The CDC website now includes verbiage suggesting that vaccines may cause autism, that the data is ‘unclear’, when myriad high quality studies prove soundly that they do not. The single paper published in The Lancet decades ago claiming the relationship was retracted when found to be falsified, and the physician author sanctioned by his professional governing body.

These decisions and many others fly flagrantly in the face of decades of rigorous academic study and painstaking medical and public health stewardship on the part of researchers, educators, and clinicians who have dedicated their lives to understanding the science of medicine and collaborating to apply it for societal good through thoughtful, responsible, and accountable public health policy. The United States has led the world in that time with breakthroughs in basic bench science, revolutionary pharmaceutical discovery and development, and technical surgical advancements. Diagnostic and therapeutic innovations were vigorously tested and monitored for safety, efficacy, and harm. We have rightly enjoyed international regard and status as a nation where science is respected and done with integrity.

No more.

Including the one physician whose ethics and clinical credibility were also roundly denounced by his former academic colleagues, the men in charge of the governmental health and medicine decisions above are about as far from responsible and accountable public policy stewards as we have ever seen in the posts they occupy. I cannot state strongly enough what a national disgrace this is. The least qualified and competent people have been elevated to the highest positions of power and authority in our federal government. Their actions exemplify hubris, ignorance, arrogance, and an utter lack of integrity or intellectual humility. They are exactly the opposite of leaders we need at the front of public health policy and practices that affect the health and well-being of our military service members and population.

It absolutely exacerbates the situation that our healthcare system is so profoundly broken that most people don’t have enough of a relationship with their primary care physician (if they even have one designated at all) to get qualified, thoughtful, caring, and informed advice about all of the confusing and conflicting information they encounter on every media platform.

This post is a week late for various reasons (jury duty [fascinating—more on that soon!] and travel). I had intended to introduce two clinicians whom I strongly recommend to follow for reliable, evidence-based medical information, as well as education on how to think for ourselves when we encounter such information, how to vet it effectively. But apparently I had to rant first. Introductions forthcoming. Thank you for your indulgence.

OH YES, the doctors are angry.
But we have not lost hope.
Far from it.
We persist and resist.

We lead.

Onward, friends. We’ got this.

Embracing Our Discomfort

Posted on June 7, 2026 by Catherine Cheng, MD

“How are you, my friend?”

Do you find yourself asking your people this more often lately?
It’s a heavier question today than in times past, no?
What are we really asking? What do we want to know (or not)?
I opened last week’s post by asking, and again today; the redundance feels important and necessary.

It’s Pride Month, and I’m seeing a lot less of the “Wishing all the homophobes a super uncomfortable month” memes now compared to last year, which I’m glad about. I thought about updating my dissent post today, but I think it still stands strong on its own:
“…The best intention of this message, I think, is solidarity and allyship. The impact may be very different. I can imagine someone who feels uncomfortable, for whatever reason, with non-cis/het identity feeling rejected, shamed, and even hated by this message. What response is this likely to engender? How does that make anything better for anyone? How does it advance the cause?
“…If we were all better at embracing our various discomforts (healthy eating, exercising more, being more honest with ourselves and others, having the hard conversations, etc.), at making it safe for one another to engage with and overcome them, how would that feel? How would our relationships and communities be? Right now we make it safe to respond to our discomforts with rage, blame, and dehumanizing. When I see people wishing discomfort on others, I’m disappointed.
“We can do better.”

A friend and I have exchanged messages about the value of discomfort, how it makes us stop and take perspective, how it shapes us and can make us better.

“A comfort zone is a beautiful place, but nothing ever grows there.” –unattributed

I still never wish discomfort on anyone. But I’m happy to encourage folks to embrace its inevitability and possibility for growth through it. Let us seek and engage with the worthy discomforts–those which move us through our stagnant assumptions and mental rigidities toward creativity, discovery, and deeper connection. And let’s do it together–mutually supportive and loving, striving always for better understanding, acceptance, and community through the joys and challenges of diversity and inclusion.

Embracing our discomfort often means acknowledging and facing our fears.
Fear is a legitimate and important emotion, required for survival throughout our evolution. Besides pain, is there a more uncomfortable sensation than threat and fear?
Can we recognize when our anger, righteousness, arrogance, disengagement, and even hatred are all founded on unacknowledged, limbic, or even existential fear?
Can we kindly, patiently, curiously, and humbly help one another explore and unpack it all?

How comfortable are any of us with any of this?
How much easier is it to declare categorical truths with certainty and authority, dismissing nuance and complexity, suppressing doubt, and rejecting earnest discussion and debate?

We each get to choose how we show up to our fears, how we cope with discomfort.
Sometimes all we can do is turn around and run the other way. We can deflect or armor up. They’re called ‘defense mechanisms’ for good reason, and the older I get the more I see and accept that we all have them. Each of us comes by our own honestly, and judging one another for them rarely makes anything better. Discomfort makes us squirelly at best, destructive at worst.

What if we shared our comfort with one another?

I messaged a friend last weekend:
“Reconnected with (a guy friend) recently, who is now a transitioning woman and agreed to take me to my first silent book club at a lesbian speakeasy this month! [Mentioned here last week–I’m very excited about this.]
“Omg dear one, our world is so chaotic and uncertain, and yet there is still SO MUCH GOOD in the day to day, face to face, in person connections of love and shared humanity. I hope you feel as surrounded by it as I do.”
Clearly, I feel very comfortable with gender transition.

But I know people for whom transgenderism is extremely uncomfortable, an unfathomable and existential threat to their core values and beliefs about humanity. I sense their acute distress, their stuckness, their utter helplessness to understand or accept the concept and get to peace with it–especially when a loved one discloses and transitions. I wish I could take away their sorrow and anguish. I know it’s not because they ‘hate’ transgender people or wish for anyone to repress their authentic selves. Their discomfort is not rooted in malice. And their experience far and away exceeds ‘discomfort,’ but I use this example to remind myself that humans come to any given issue or idea with a vast variety and complexity of attitudes, histories, and comfort levels.

The better we can tolerate, embrace, and process our discomfort, the stronger and more resilient we can be in the face of adversity and true threats to our survival, I think. And I wish for no one to have to do this alone.
Genuine human connection mitigates pain, suffering, and the extreme discomforts of fear, grief, and uncertainty. It is the most effective balm for what ails our hearts.

So this Pride Month and beyond, when we feel uncomfortable about something, anything, may we reach out with vulnerability and courage ahead of anger and antagonism. May our first instincts be to connect more than to judge. May we meet others’ discomfort with empathy, compassion, understanding, and patience. We can do this even in the smallest encounter, with few or even no words, with the most fleeting of looks. It takes practice. Thankfully, life presents us with the opportunity every time we meet another human.