Early in his medical career, Mark Greenawald, MD, a family physician at Carilion Clinic in Roanoke, Virginia, had the honor of caring for a patient with cancer. While the course of treatment was agonizing, the patient remained upbeat even though he knew he was going to die. When Dr. Greenawald asked what allowed the patient to be so upbeat, the patient noted he has lived a good life. It was the practice of gratitude that helped enhance his well-being.

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“I found a letter from this gentleman and inside, his message was very simple and it stirred me to tears at the time,” Dr. Greenawald said during an AMA webinar. “It said, ‘Hey doc, you also won the lottery when you were born. Don't wait until you're dying to remember that and be sure to pass it forward.’”

“We see things not as they are, but as we are, and this patient demonstrated that so clearly to me early on in my career,” he said. “We have the opportunity to see things differently often just by changing our perspective a little bit.”

Here are ways physicians and other health professionals can integrate the habit of gratitude into their daily routine.

“What we know about gratitude is it’s a gift that you can give yourself,” said Dr. Greenawald, adding that it can improve relationships, physical symptoms, and “our capacity to cope with the stress so it can help make us more resilient. All those things are part of the gift that you can give yourself by having regular gratitude practice.”

By following three good things or the three blessings practice, physicians can practice daily gratitude. This means, “once a day, take five minutes to write down three good things or three blessings that happen in your day,” he said. Then “go one step further and reflect on what it is about those things that you're grateful for or made those so good for you.”

“Doing this regularly—even over the course of two weeks—once a day will allow you to begin to recalibrate your gratitude lens so that you will start looking out and seeing more gratitude because that's what you're looking for,” said Dr. Greenawald.

Read about six ways to address physician stress during COVID-19 pandemic. 

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“It's easy to say, ‘Wait a minute, the COVID blessing? What could possibly be wonderful about COVID? What could be good about this time?’” said Dr. Greenawald. “Yet, when people step back and think about this, they come up with things immediately that have been blessings for them.”

This might include more time with family or learning new hobbies. For physicians and other health professionals, this might also be seen in “stepping back for the first time in a long time and just taking a breath,” he said. “Certainly, that's not happening for many now, but even in the midst of so much going on with COVID, blessings come up.”

Discover how Dr. Greenawald’s peer support program strives to ease distress during pandemic.

While caring for a new patient who just moved to Roanoke, Virginia and was immediately hospitalized, Dr. Greenawald asked why he moved here. The patient noted that in September his doctors had told him he had four weeks to live. That was two months ago.

The patient went on to explain that what he “realized is that every day for me now is a gift because I was supposed to be dead a month ago, so everything I do could be for the last time.”

“That’s what the last time meditation is—it’s an opportunity to step back and say, ‘If this was the last time I was doing this, how would I be present differently than I am right now?’” said Dr. Greenawald. “It's not something you want to do all the time, but I promise you, if you try this, you will be present in a very, very different way.”

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“The second practice that I found very compelling is called the life of your dream meditation,” said Dr. Greenawald.

This means that there are “billions of people on this planet living right now for whom your life, my life, is a life of their dreams,” he said. “Just having that shift in perspective and realizing how incredibly fortunate we are, allows us the chance to step back and live in that perspective.”

“It's important for people to be appreciated, but gratitude can ring hollow if we don't follow through by hearing, preparing, protecting, supporting and caring for those people who are doing work in this challenging time,” said Dr. Greenawald. “Making sure that that gratitude translates into listening and then action becomes just as important as the expression itself.”

Learn more from the AMA’s Professional Satisfaction and Practice Sustainability webinar series, which focuses on physician well-being, practice redesign and implementing telehealth during COVID-19.

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