Compassionate Consistency

Posted on June 30, 2025 by Catherine Cheng, MD

Chojun Textile & Quilt Art Museum, Seoul, South Korea

Am I walking the talk?

It’s been a week, friends—I shall spare you the details. Suffice it to say that somewhere along the way I started to ask myself the question above. As I prepare to kick off a series of wellness presentations based on the idea that we Lead from Any Chair—that how we show up for ourselves and others has power and impact whether we intend it or not—I must check in on my own integrity. How do I show up?

I jotted notes for an “Impact and Impairment” post a few days ago:

Progression of stress: What are the first signs, when and what do I notice? Are they thoughts? Body sensations? Moods? What are the smoke alarms, and can others detect them before I can? What do I do in response to awareness? How am I impacted by this stress right now—sleep, workouts, eating? And how is my function? Am I getting everything done that needs doing and would I notice impairment soon enough and have the resources to recover? What does the housefire look and feel like?

Lazy Susan unicycle: I can’t remember the last time I thought of this image, which I wrote on this blog many years ago. Sometimes life feels like holding a lazy Susan in each hand, loaded with life things and spinning in opposite directions, while unicycling through traffic wearing a scratchy pant suit. That it came to me this week felt like a sign that I felt the impact of everything, no question—volume, intensity, risk—all my stress management skills and mantras called forth and tested:
ODOMOBaaT
Goals and trade-offs
Do what you can
Do what works
Commit and Flex

After my last commitment on Friday I could finally breathe and relax. All I wanted to do was cut and write jar smiles. It was positively meditative and recharging, for hours while listening to romantasy in the most delicious voices—that was all day and night yesterday—ready to attack today! Then the WiFi crashed at home (fixed now, thanks Hubs). No problem, there’s a café down the street, I could cram all internet-requiring tasks into a single time window and crank through. I’ got this!

I started to wonder how constraints like this could make me more efficient in general, which led me to question my own capacity for discipline. I estimated it as moderate, and the words ‘good enough’ emerged with force. How do we define ‘good enough’? Looking back, I compared my grades in high school to college and med school, and realized that what mattered was not the grades themselves, but whether I thought I was showing up to my full potential, and whether it mattered to me. Whatever grade I got was ‘good enough’ as long as I had done the work that was worth the costs to me at the time. In retrospect, I have always had a strong intrinsic sense of the value of my energy and effort. Except for some parts of residency, I have rarely self-sacrificed or burned out in any pursuit that I can recall.

I found the lower limit of my half-assedness in college, when my life task balance seesaw hit the ground with a resounding thud. It was the first quarter of physics—mechanics. I hate physics. Hubs and I were just starting to date. I chose to hang out with him rather than study the week of the second midterm and failed the exam spectacularly. I got a C for the class; that did not feel good. I have studied enough and not failed another exam since.

Morning pages. Exercise. Blog writing. Patient care. Parenting. “Yes, I am disciplined and also flexible,” I journaled today—in the morning but not formally as Morning Pages. “Consistency…80/20? I am consistent enough to get the results I want—mostly…” I don’t have the body I want (very ambivalent relationship with my body at the moment—more on that another post, perhaps); yet I put forth all the effort I can muster each day in that direction. “For now, I feel ok with my body the way it is because I know in my thinking brain that I am strong and healthy… And in my feeling brain I still kind of hate how fat I am now compared to before… But would I rather be that shape and weaker? Hmmm… I think given the choice, I might actually choose me now.” That felt good, and I’m glad I took the time to write it out.

“All or something,” says The Betty Rocker

I concur.

When I look at the long arc of action in the domains that matter—exercise, patient care, relationships, and even nutrition, where healthy habits are still such a struggle—I show up consistently and reliably with my core values, highest goals, and integrity in front. When things get heavy and stressful I feel it, as we all do. It’s very uncomfortable and I don’t like it. I think it’s fair to question my responses, to assess whether I do what I recommend to others in such circumstances, and what I have written every week on this blog for the past decade.

Our culture pressures us to be perfect. Impossible. Traffic gets heavy, the suit gets sweaty, and things fly off the lazy Suzan. Sometimes we must put it all down and reset. Then we get back on, maybe with lighter loads on smaller roads. We get to decide. Slowing down and taking time to look behind, here, and ahead can help ground us in perspective and confidence that we are indeed showing up how we want—compassionately and consistently.

This Moment

Posted on June 15, 2025 by Catherine Cheng, MD

5 talks to prepare in the next eight weeks.
Blog post to write.
Dinner to cook.

But all I wanted to do is write to my friend. Not just jar smiles, but a letter. Connect in long form, right now. Because this was a big week and weekend and I wanted to share it.

Daughter graduated high school and turned 18 on the same day. Family came and went from my house for six days in a row; I woke up each morning having to run the list to keep track of everybody. Our family has been through things over the years; getting to this point of pending empty nest was, at times, not guaranteed. We got through it all together, one breath at at time. This moment is a big deal in our family. This moment is a big deal for our country. All of this on my heart, I wanted to do nothing but write to my friend, before any of my other tasks and obligations. I’m getting better and braver at letting my intuition guide me, and I have yet to regret it.

Turns out I want to share what I wrote with all of you, too:

“…I write to you today because this moment in life feels important. The No Kings protests marched all across the country yesterday as most of my family were basically offline and absorbed in ourselves. We read about the two political shootings in Minnesota and I felt a little guilty not participating in any larger demonstrations of my values. And I reconciled it by attending to the connections in my own tight circle. We have disagreements and friction within my own family and I see my navigating and mediating these peacefully and mindfully as an important contribution to society–small and mighty. 🙂

“There are so many calls to ‘fight,’ so many adversarial, us vs. them, good vs. evil narratives surrounding us right now. And while I abhor so many actions taken by ‘leaders,’ I still resist to call them evil and dehumanize them… That feels antithetical to the ethos of love and connection that I wish/strive to live by… But OMG it is challenging to resist that ad hominem train! *sigh*

“…This weekend I begin creating five new talks for this summer, to be delivered to [XXX corporation]… As I consider how to address their wellness challenges, many of which are relational, I come back, as I so often do, to core principles of humility, curiosity, empathy, and connection. My intent is to light the spark of togetherness, mutual caring and uplift, and collaboration, starting with the premise that we all matter, and that no matter what chair we occupy in the orchestra, we can and do lead from exactly where we sit. Each and every one of us matters to the whole–WE ARE THE SYSTEM–and embracing that fundamental first principle changes everything–don’t you think? If we all matter, then I need to know how I affect you, and vice versa. We need better self-awareness, self-regulation, and effective communication skills to get the work done and not burn out doing it! And having talked to people and learned how we operate individually and in groups my whole career, I feel qualified to help here! And who knows–this could be the start of something that grows; I could possibly help more people than just my one patient at a time! SO many possibilities!”

This moment, my friends.

We get to decide how we show up, and for what, over and again, in resilient, optimistic learning and persistence, in love and connection, in faith and confidence that we can do what is needed to heal the ragged tears in our social fabric, one encounter, one conversation, one relationship at a time.

Movement In Community

Posted on June 9, 2025 by Catherine Cheng, MD

“I think you can do it.”

Sometimes all it takes is a few little words from a coach or friend and suddenly we can do so much more than we thought: Lift more weight. Pull harder and faster on the rower. Dead hang longer. Try a movement that reveals a fun and challenging new world of training potential. Two years into regular group strength training at Ethos, the benefits continue to multiply, both physically and psychologically. I’m stronger now than I’ve been in my whole life (that I know of—I never tried deadlifting 185# in high school); I feel confident now that I could lift my parents if they fall, without hurting myself. Suddenly I feel a surge of confidence and empowerment to be bolder and braver in other domains of life. And it’s all because I love training at Ethos.

Over a decade ago, Melissa Orth-Fray taught me the five factors that keep kids in sports and adults in a fitness routine:
1. It’s fun
2. Your friends are doing it
3. You feel like you fit in
4. You feel like you know what you’re doing
5. You feel like you’re getting better at it

Like many such lists, the factors intersect and overlap, no? I’m much more likely to find exercise fun if I do it with my friends, I fit in with the group, and I feel like I know what I’m doing—these factors all speak to psychological safety. These are limbic, back-of-the-brain factors, hence they are ‘feelings’ and not ‘thoughts.’ Decision making is more often more limbic than cognitive in origin, and discipline is much easier to maintain when action aligns directly with something that rewards an emotional drive—in this case, that innate drive for connection and community. At Ethos, I get my fixes of dopamine, serotonin, and oxytocin, and it’s all because of the people.

The 5am crew at Ethos has gathered regularly since the gym opened in 2019. The core group has persisted through a pandemic and moving to a new location last year. I queried them about their experience, and without fail the strongest responses spoke to the bond of camaraderie that could fairly be described as love. Folks drive long distances to show up and train, to be accountable for themselves and one another in health and well-being. They report mutual uplift not just in the workouts but in their personal lives, too. They use words like support, trust, and belonging to describe their tight relationship. They share their struggles and triumphs in life, not just their personal records (PRs) in the gym. They are part of one another’s emotional support networks.

When patients tell me they exercise alone, I must check my immediate desire to suggest otherwise. It all depends on our goals and preferences, and solitary movement has its benefits. The main benefits of coached and group settings are programming and presence.

Programming: Left to our own devices, we often avoid movements that we don’t enjoy and don’t feel competent at or comfortable with. Over time this can lead to insidious asymmetries that put us at risk for injury not just in the gym, but moving around in life. Over a year at Ethos, three weeks at a time, training blocks are designed to improve strength and conditioning in iterative fashion, each block building on preceding ones. Sprint and endurance, power and isometrics—it’s all included in the program and all we have to do is show up. We get to learn the rationale and distinction between various movements and relate gym exercises to activities of daily living. When injured or limited in some way, coaches can always modify or find alternative movements to keep us active; at home we might just quit, not knowing what else to do. I recently noticed I barely use my chair at work anymore —I can stand at my desk all day with minimal fatigue. I attribute this to two years of consistent training, though it was not a goal on my radar whatsoever. I highly doubt I’d see this result just working out on my own.

Presence: I can hear heart murmurs and abnormal lung sounds. My coaches can see unpacked shoulders and caved knees. They observe and correct, making us all safer to lift heavy loads with confidence. Their encouragement and assistance further stoke our courage, allowing us to push and prove ourselves more capable than we could do for ourselves. And it’s not just the 5am crew that bonds; my 9 and 11am friends and I cheer and celebrate our PRs together. Movement in community is the best example of freudenfreude (joy at another’s joy) I can think of. There is just something about sharing space in person, all of us working to better ourselves and supporting one another in doing so physically, morally, and otherwise.

Strong Old Ladies and Gentlemen. This is my goal for us all. We can get there many ways, and movement in community is my first recommendation for its myriad overlapping benefits. Exercise benefits body and mind. Exercise in community benefits the whole person. It’s about relationships, of course; those cultivated in health are what save us.