Gratitude: A Different Kind of Medicine

By: China Cox, MD

Our residency program recently experienced a tragedy. I think that word is so often in the same company of literally, awesome, and hilarious–misused and hyperbolic. It is exactly the right word, though, for the violent loss of a young, compassionate, bright, fun, and loving physician in a new home at the beginning of her career.

It has been a month since our co-resident, Sarah’s, murder. As I sat in our residency support group this week, I absorbed stories from some of my favorite people about how exactly they are grieving, processing, growing, stagnating, and surviving. There were a lot of tears and wavering voices. There was deep breathing and mindfulness. There was reassurance that still not being ok is, in fact, ok.

As I left that space, I wondered how I was really doing and how I could be doing better. I thought about the kind of advice I would give a patient. Physically, focus on diet and exercise. Mentally, allow room for your feelings and acknowledge them. Practice mindfulness. Write down three things you are grateful for . . . Gratitude journaling–that one seemed doable. Objectively, I do have hundreds of things to be grateful for. We practiced it twice before pediatrics rounds and it felt like a refreshing way to start the day. I’d even noticed a friend on social media practicing it daily, pointing to things such as family, faith, science, painting nails with her daughters, sunflowers, the commitment of marriage, the freedom to live life as she sees fit, waking up, hugs, belly laughs, and clean sheets. I’ve recommended it to patients before, but I realized that I don’t know if it actually helps or if there is evidence behind it.

A search brought me to, “The Science of Gratitude,” a summary of the data as we currently know it, prepared by the Greater Good Science Center at UC Berkeley. In it, Summer Allen presents a modern definition of gratitude: a two part cognitive process involving recognizing that you have obtained a positive outcome AND that there is an external source responsible for this outcome. She summarizes the origin of gratitude, different types of gratitude practice, and important research in the field. She presents evidence from primary studies that being more grateful can promote happiness, life satisfaction, optimism, hope, and positive affect, strengthen coping strategies, and heighten self esteem. Gratitude may make people more resilient after traumatic events, and it may help us cultivate other virtues such as patience, humility, and wisdom. Gratitude may also lessen burnout. There are even three meta-analyses that affirm gratitude has a positive impact on overall well-being.

This field of research is relatively new, and there is conflicting evidence about benefits. I think we can agree, though, that the risk is pretty low. I thought I would give gratitude a try, and you can check out my first list below! If you try it and find that it helps, let us know.

  1. I am grateful that Robin Brown, Zach Fredman, Anna Holman, Cole Hurley, Jess Petrovich, Cat Vanier, and Lindsey Yanke exist as people, physicians, friends, and co-residents.
  2. I am grateful for complex patients that challenge me and make me learn.
  3. I am grateful for straightforward physicals that allow me to catch up in clinic.
  4. I am grateful for our efficient medical assistants who know how things actually work.
  5. I am grateful for supportive and knowledgeable faculty.

China Cox, MD, is a second year resident in the Division of Family Medicine in the Department of the Family and Preventive Medicine at the University of Utah in Salt Lake City, UT. Her medical areas of interest include geriatric medicine, reproductive health, and alternative models of care.

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