Cultivating Joy in the Journey of Medicine - Awareness

We are on a blog journey about finding and creating joy along our paths in medicine. Last week, we defined joy for the purposes of this blog - at two levels - a broader affective state and a momentary emotion. This week, I want to turn our attention to awareness - where wonderful things start to find their way under our agency. Awareness of the Trap, the Current Joys, the Gap, and Possibility of finding joy in the journey. 

The Trap. Let's recap and take a deeper dive into a trap common to physicians. We, for the most part, are goal-oriented, task-driven individuals. This can be a wonderful thing. However, we often delay gratification and tolerate many difficult circumstances to make it through the process and to arrive at each goal. This is how the arrival fallacy grows strong. Our expectations go unmet and we keep moving the goal posts. Somehow, it's never how we pictured. Often, when life unfolds in this manner, we can feel disillusioned.

Not only can we be disappointed that reality looks very different from our initial romanticized version of life as an attending physician, but we likely have missed out on engaging fully in life until that point. We can become trapped in resentment. We then set a new goal that will help us feel better – when we pay off the student loans, when we can get out of this contract, when we cut down our hours, when we can own our own practice, when we retire or leave medicine.  We continue wishing the current days in which we are living away. And then what? While I haven’t quit medicine or retired, I do have friends and family who validate that the arrival fallacy is still in effect – even then!

The Current Joys. So now that we have a bit of awareness of the common trap. Let’s spotlight some of what’s going well - harnessing some good from a self-reflective appreciative inquiry.  

Spend a moment – where do you experience the most joy currently? If it’s outside of work, bask in a bit.

Next ask, in what situations do you experience the most joy at work? What makes those areas/situations pleasurable?

Where else? What makes them so?

Don’t be alarmed if it takes you a minute. Our negativity bias is strong, especially when we are tired, overwhelmed, and stressed. This is the time I like to remind you to point your brain in the direction you want it to go, and then get out of its way. Think of a time that epitomizes joy in medicine for you. Relive it, savor it a bit. Write down what things you notice.  

This can be a powerful reflective time. Recently having walked a resident through this process after she started the coaching session saying she felt she had made a mistake choosing medicine, it opened up a world to her. She had been overlooking those moments of joy. They were hidden gems under the rocky surface of stress. It gave her hope and re-kindled her purpose in medicine.

The Gap. Now, I suspect you, like most of us physicians currently, have a bit of a gap between how often you experience those joyful moments and a deeper sense of lasting joy despite circumstances. (If not, please take a few minutes and celebrate!) Nothing is wrong with having a gap. We just want to think though how to begin to close it. That brings up awareness of the last component:

The Possibility of Joy in the Journey.  So, how can you start embracing and loving whatever point of life you are in currently? There are multiple approaches. And I doubt my list will be an exhaustive one.  

The approaches are much like varied classes of medications for a given condition. Think of seasonal allergies - you can target the allergy pathway with antihistamines of two varieties, intranasal steroids, leukotriene antagonists, immunotherapy - etc. Not everyone needs all. And some people can't tolerate certain ones. But most of them build on one another, creating synergy, toward the outcome we desire.  

Similarly, I will offer you a menu over the coming weeks. Pick only those that resonate with you. Take one and begin to work on it until it seems settled. Then move on or add on as needed in an iterative process to find your best milieu of interventions for your current stage of life. (Maybe down the road, I'll work on "First Line" interventions and "Secondary" – maybe a whole algorithm! – a bit aspirational, ha). For now, you can just begin with what makes sense from your previous experience to what intrigues you and seems doable).  

A couple of years ago, I reflected upon this journey vs destination idea when my daughter and her spouse took a 2 ½ -hour car ride followed by a 3 ½-hour flight to Alaska with 2 toddlers during a pandemic. They had cute snack compartments, games, a little rare screen time, stories, comfy clothes, and their favorite stuffies. They had a blast on the way to Alaska. It was part of the adventure.  

In many ways, it wasn’t too dissimilar to my own childhood 8-hour car rides to visit cousins. The awareness that the journey not only could be made bearable but even enjoyable was the initial step needed for a successful, memorable trip - filled with a variety of activities. For me, those long car drives as a kid are some of my fondest memories - snacks, license plate games, memory games, singing, waypoints, and family chats. Finding Joy in the Journey. 

Reflecting on those who exude joy - despite the circumstances can help you become aware of the possibilities. Who do you know that exemplifies that? Read a book, such as Rough Sleepers by Tracy Kidder which allows for a broader explanation of that true deep joy despite a range of less pleasurable emotions given the circumstances. 

So, that’s what I offer you this first week – start with awareness - the trap, the current joys, the gap, and the possibilities.

Reflect on your planned destination in medicine and life as a whole. How much are you savoring the time along the way? What would it be like to enjoy the process of moving toward your goals as much as the anticipated joy when you achieve them? I know your brain is likely saying, "but, this and that" to all the reasons for not being joyful - and that's okay. Let's just notice and play with imagining - even with your current circumstances – that you can enjoy the path itself. 

Over the next few weeks, we will unpack the various strategies. I look forward to unpacking Expectations next week.  

Have a Joy-filled week! Tonya 

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Original post 5/2022, updated 3/2024