In the middle of my second year of medical school, I began noticing early signs and symptoms of burnout. The stress, anxiety and diminishing joy terrified me because I wondered: How could I already be burned out when I had not even studied for Step 1 or started rotations at the hospital? Were there any remedies to what I was experiencing?
In hopes of addressing my looming burnout, I chose to cultivate gratitude by writing down at least five things every day for which I was grateful as my 2018 New Year’s resolution. I somehow followed through with this daily exercise; 15 months and 2493 entries later, I thought I would share what I’ve discovered in the process in hopes that it might encourage someone else.
First, there are always things for which to be grateful. Some days were easy, but other days I had to reflect a long time in order to come up with five different things to write down in my notebook. Some days, the exercise stretched my creativity, which led to some entries I look back now on with laughter:
I wrote that I was grateful for scoring greater than forty-five percent on a UWorld quiz on an otherwise tedious and discouraging day of studying. I celebrated the existence of tea and DayQuil when I was fighting a bad upper respiratory infection. I rejoiced that I somehow was not late to rounds when my alarm failed to sound one morning. I was appreciative that the surgical technician trusted me to help her tie her gown on an otherwise thankless day of standing in the operating room. I delighted that I found a clean white coat when my lunch exploded on me.
Even on bad days, I was able to find highlights, and the days when it was hardest to find five things to be thankful for were the days I needed to choose gratitude the most.
Second, deliberate gratitude shifted my internal narrative. By choosing gratitude over my natural instinct to complain about slow progress in my studies, illness, long hours, demanding superiors or even just minor inconveniences, deliberate thankfulness became both habitual and easier over time.
What started as a somewhat academic exercise became more natural and instinctive as the year progressed. Instead of gratitude being a chore I put off until the end of the day when I pulled out the journal to write five things down, it became an impulse throughout the day.
Finally, gratitude protected my joy. Now that I’ve acclimated myself to the habit of being grateful for small blessings, I find myself quickly noticing ordinary occurrences worth celebrating and being more resilient towards setbacks and disappointments. People find joy in different sources; I find joy in my faith and in being able to use my skills to serve others.
By orienting my heart and eyes to the bigger picture, gratitude protects my joy from erosion by a thousand small discouragements. Since starting the exercise fifteen months ago, the moments of feeling burned out and discouraged are far less frequent or intense.
I guess you could say I’m meta-grateful. I’m grateful for the gratitude that has been growing in my heart over the last fifteen months and for how it has shaped my experience as a third year medical student. I’m grateful for the change in my internal narrative that this experiment-turned-habit has created. I’m grateful for the joy that I am able to experience in the midst of even my more difficult rotations. And I’m grateful to be able to share that joy with patients and colleagues alike.