The Flow of Friendship

30 years this October.

Janet and I met at our white coat ceremony in 1995, sat two seats apart, alpha by last name. Walking home from school days later, I learned her family lived in Denver for a while when we were kids. We exchanged parents’ names and went home to call our respective ones. And get this: Her dad was my grandfather’s student, and stayed at the Cheng family home in Tainan, Taiwan one summer while studying engineering. He was one of Yeh-yeh’s favorites. We went to their house for dinner once (neither Janet nor I remember). When Ba recounted the evening, he got most animated about the concrete foundation that Janet’s dad had laid for the playhouse in the backyard (both dads are civil engineering PhD’s).
Positively. Cosmic. Sisters.

We were joined at the hip in school. We sat at the back of lecture halls, Janet doing crosswords and I writing letters. As anatomy partners we created mnemonics with gestures to remember the cranial nerves and their exit points from the brain. We learned interviewing and physical exam skills together, went to the gym, cooked, and basically grew up together in the final stages of adult brain development. Some of our teachers could not tell us apart. We rotated on pediatrics together when she met her now husband, an intern then, eating French fries and drinking ginger ale on call every fourth night. We attended each other’s weddings (I got to stand up in hers). Our kids are similar ages.

As an executive health internist and academic neonatologist, our professional worlds overlap little, yet we still speak multiple languages in common (including American English-accented Mandarin). As we, our parents, and our children have all aged these three decades, contact has fluctuated and our bond remained intact. This weekend Janet came to Chicago and we spent three days together cooking and yapping, our longest in-person time in fifteen years. We made a menu in advance and headed to the grocery store on her arrival. These three days we cooked Vietnamese spring rolls, green onion pancakes, fried rice, potstickers, and curry beef pastries, all steeped in nostalgia and yumminess. Doctoring, momming, daughtering, wifing, teaching, leading, citizening–we covered it all while mixing, rolling, wrapping, frying, steaming, baking, and of course eating.

Our class stays connected on a What’s App chat and we are impressive, I must say, many of us leaders in our fields, making an impact. And yet when we gather, we still meet as the people we knew then: eager, optimistic, young students. We reach out with news, requests, and just to say hi. That easy connection is just so special. How have 30 years passed already? Will we still be around to celebrate another 30? It’s possible, and I will revel in every year we get with one another in the interim.

Dear readers, I wish for us all to have friendships like this–the ones that persist with easy and steadfast confidence, that we trust implicitly, that validate and support, that endure and mature in mutual respect, admiration, growth, and evolution. It’s these meaningful relationships that will hold us up in life, no matter what happens.

Chengerisms and NaBloPoMo 2024

“Hey friend, favor?
“When you think of me, what things do you hear me say all the time that signify to you who I am and what I’m about? 🤔
“…Collecting ‘Chengerisms’”

The compulsion overtook me Thursday evening, when I should have been finishing clinic notes and packing for LA. I texted a slew of people in a flurry with the question above, intending to assemble their answers into backbone for National Blog Posting Month in November. For those who don’t know, NaBloPoMo challenges bloggers to publish 30 posts in 30 days, all written in real time. It coincides with NaNoWriMo, National Novel Writing Month, a sprint to write a 50K word manuscript in the same time.

This will be my tenth consecutive NaBloPoMo challenge–BRING IT, I say!

My “Chengerisms” query, I see now, was actually me gathering validation and support for showing up all me, all in, BOOBS OUT at the Writers Rising retreat this weekend. My subconscious intuition knows what I need; I sense, trust, and follow better with age. Replies rolled in with speed, earnestness, and so much love it positively bowled me over. Highly recommend!

The strongest messages I perceived throughout the conference reinforced all of my highest writing and living values:
Let loose your curiosity
Take risks
Tell the truth
Honor your Central Self
Own Your Shit
You are enough
Assemble your pit crew
Connect, connect, connect!

How tightly these correlated with the Chengerisms my friends mirrored to me:
What is that about?
How fascinating!
Tell me more…
Hey friend
How did that feel?
Love you love you
Yaaaay!
One breath
Walk the talk
BOOBS OUT (apparently catching on in my small circles–yaaaayy!)
Tribe
Sooo human.

This spontaneous, subconscious-driven exercise shows me the profound importance of good, loving feedback and the absolute value of meaningful relationship. My response to almost every reply was a sincere and heartfelt, “I feel seen!”

While I continually noodle on content and structure of Book (I’m getting closer, really!), I feel a limbic and visceral certainty about how I want readers to feel throughout and especially at the end–seen, validated, inspired, empowered, and convicted. This NaBloPoMo, I aim to color in and sharpen that vision, saturate my thinking and writing brain with it.

At the end of an executive physical, I want my patient to feel thoroughly understood. I show that I know them, even if I only see them once a year, by reflecting their stories back to them, interpolating and extrapolating what’s not said, checking in, and providing what I know patients need from their doctors: personal connection in service of self-efficacy for health. So this year for NaBloPoMo, I commit to the theme:

What I Wish For You

Thirty things I want patients, readers, or anyone, really, to experience after encountering me in person or in print. Chengerisms in action. I will resist wallowing in guilt and shame when I notice how often I fall short of these aspirations. When I see perfectionist self-loathing approach I will divert it to the nearest off-ramp. All part of the process.

This could be both fun and enlightening! Let’s see what happens, eh? Ready, set, let’s go.


I Just Want to Talk to People and Write About It

WAIT—I already do this! 

All day, every day at work I talk to people.  I query their perceptions about their health, their habits, relationships, and leadership.  I ask about their families, challenges, and struggles.  We get as personal as they are willing, and it is always a privilege and honor to be allowed into people’s lives like I am.  Between the pre-call, the morning interview, and the debrief, I spend about two hours with each patient during their annual exam, reviewing the year past and anticipating the year ahead.  The best days end with me feeling joyously spent, having attuned and attended to each patient intently while mining all my cumulative expertise, both personal and professional, to compile the most collaborative, relevant, and holistic action plan I can muster.

I have saved face sheets from these annual exams for the past year, all the encounters that felt meaningful to me.  Each paper bears my notes from the interview, essentially a list of ideas/concepts, resources, and recommendations to include on the action plan.  It’s a set of organic notes for myself, a record of how I know each person, what stands out about their life today, the most salient aspects of health and relationships this year.

Internal Medicine is a ‘cognitive’ field—we don’t do procedures.  “I think, therefore I.M.” my American College of Physicians mug says.  I literally talk to people for a living.  And then I write about it.  Each clinic note reports my patient’s state of being, in the context of their life at the time.  Every year I add on to the cumulative ‘social history’—work, eating and exercise patterns, sleep, stress, and relationships.  Reading through that section of the note, I can see how many years I have known the patient, and how each of these aspects of their health has evolved over time.  They rise in the ranks of work, change jobs.  Weight fluctuates.  Kids grow up, graduate, leave home and go to college, get married.  Grandchildren accumulate.  My annual exam note is the record of a person’s life as I hear it.

Each encounter note’s ‘Assessment and Plan’ is essentially a problem list with my description of each active medical issue, interpretation of potential causes and implications, and plan of care.  It serves to guide anyone who cares for the patient in the future (myself included) and to inform patients themselves, so they may know the rationale behind my recommendations.

This past week, I started a new journal to document each encounter for my own benefit—to recall and reflect on each interaction and log my own perceptions (intellectual, relational, visceral, and otherwise) and insights.  Each entry ends with the heading “FEELING”—my attempt to articulate how the encounter affected me personally, what meaning I derived from it.  I LOVE this new practice.

Similarly, I have often journaled feverishly after conversations with my best friends—the deep, philosophical, and bonding ones wherein I grab my journal in real time to jot ideas, insights, and epiphanies.  My days off fill up with calls and coffee dates well in advance, and I now set aside time after each of these encounters to make similar recordings to those after my patients’ annual exams.  Between friends who have known me decades (‘stem cell friends’, as I have named them this week) to lovely new ones who may be decades younger or made in specific contexts (‘tissue friends’), the connections made of late flourish as if doused in Miracle Gro concentrate.  And I’m writing it all down!

This blog will be ten years old in April.  This is the 630th post.  It all started because I wanted to write a book on physician-patient relationship and how to save it.  And yet the focus, content, and organization of Book has eluded me all this time.  But it’s okay; I’m having so much fun with the process, feeling my way through, attending to and reveling in each twist and turn of the journey.  I’m getting closer.  I have no deadline or expectation, no goal other than fostering and honoring what emerges from the most organic and authentic places within me, for no other reason than to connect with people for whom it will be meaningful.

I talk to people.  I listen.  I connect.  I write about it for all our benefit, so our bonds may hold strong long after each encounter, cumulatively, in the most intersecting and inclusive ways.  I do it for a living—not just for an income, but for my very livelihood—I traffic in the spoken and written word to make the highest, deepest connections and meaning in life.  Wow, what a duh-HA! revelation.  And how lucky that my life calling and profession should align so perfectly? 
Book will come eventually, I am confident.  I can feel it. 
Onward.