Almost a year ago, I logged onto a Zoom call. Being the chair of the meeting, I was a little early, and happy to see another member, a dear friend, had also joined early. After we greeted each other, I asked them, how are you doing? With a smile, their response was authentic, “I’m fine, trying to stay relevant!”
Not the response I had expected or ever heard before! Before I could respond or even have time to unpack their response, other members started joining and our conversation shifted. For some reason, their comment has stayed with me, prompting much thought and reflection. I have also shared it with my father and close friends.
What does it mean to be relevant? Who am I relevant to? Who determines this? Does it matter?
My reflections on these questions brought me back to another one of my strong convictions: I need to be intentional to reflect on what gives me meaning and purpose.
This realization did not come to me easily. I remember those hard days, more than a decade ago, when I was questioning my purpose, both professionally and personally. Externally to the people looking in, it might have appeared that all was well. However, that was not how I felt. I always felt inadequate. The imposter phenomenon, well, I had a bad case of it! I was irritable and snappy when I was not at work. I didn’t like who I was, and the nights were lonely and scary.
Why was I feeling like this? What were my fears? Why was I questioning my purpose, especially as an internist twenty-five years later? Why did I feel unfulfilled in my work each day, what did I need to feel fulfilled?
I had to pause to review and reflect on these very questions, ones that I had refused to surface for fear of my own answers. What really helped me was the listening of a trusted circle of family and friends and the courage to share my own fears and vulnerability. I found the courage to explore these hard questions both through self-reflection and in open, honest conversations in the safe space created by my family and friends.
I needed to remind myself of—and refocus on—my why, what gives me meaning and purpose, not just in my professional life or personal life, but for me, my core being! What was it that gave me the reason to get up and go each day? What was it that made me feel fulfilled, that gave me a feeling of self-confidence?
The answer: When I feel that I’m truly living a life of meaning, not just doing the tasks assigned by a role or influenced by the stage of life that I was in.
Five Answers to What Gives Me Meaning
Reflecting on meaning and purpose has been and is an ongoing journey in my life, one I continue to explore, redirect, be surprised, amazed, and even humbled by. This reflection is hard because it forces me to look in the mirror, even when what I see can be often harsh and judgmental.
Claiming My Gifts: Through open, honest conversations, I was reminded of the importance of accepting and recognizing that each of us have gifts that we are meant to share and utilize in each of our roles. This reflection forced me to claim my birthright gifts, something that was hard because it felt selfish, self-proclaiming and prideful.
Being Wise Selfish: I also found my answer in a beautiful book by Sogyal Rinpoche, The Tibetan Book of Living and Dying. There is a paragraph (I paraphrase) which speaks to the innate nature of humans as one of being selfish. However, we have a choice of which kind of selfish we want to be, foolish or wise. The foolish selfish person thinks only about themselves even at the cost of harm to others, whereas the wise selfish thinks of others and themselves and works towards a greater good.
Acts of Service: Living a life that gives me meaning and connects me to my purpose requires when I can use my birthright gifts in service of others with humility. In other words, I must experience a deep sense of genuine care and concern for another living being, human or animal or even plants (I do not have a green thumb and accept this as my limitation) and fulfilling my roles by intentionally engaging with a greater good in the focus. This service requires me to ritualize this practice and comes with courage and sacrifice, however it feels so fulfilling.
Following My Thread: What also gave me meaning and purpose was revealed by a poem, “The Way It Is” by William Stafford. This poem is truly very meaningful to me and I also share this in my book, Resilient Threads. The poem speaks about a thread that goes through the journey of our life, also through the world around us, even when both our personal world and external world seem to be falling apart or changing. As long as we hold onto that thread, we are okay. For me, I realized that many threads of different textures and colors make up the tapestry of my life, and they all are rooted and connected to the strong thread of faith. This faith more importantly provides me with hope for the future! Faith in the future with hope gives me energy and enthusiasm. This allows me to act!
Reigniting My Inner Flame: There have been times in my life both professionally and personally where I felt the future was dark and hopeless. I remember the feeling of disengagement and apathy, not just physical, but emotional and spiritual too, and the feeling of being so drained and depleted in every way. I am grateful for the learned ability to now have the insight to recognize and reframe when such thoughts arise, reconnect and remind myself of the meaning and purpose that is not dependent on any external force but lies within me, in my core. It is the flame that never extinguishes, yet needs intentionality and hope to be reignited!
What’s at Stake When We Lose Hope?
I remember a story that my father shared when I was a junior faculty member. After my own journey of self-discovery and in an attempt to create a safe space at work where we could all show up as our true authentic selves and build community, I had started hosting reflective sessions called RRRnR (Relaxing, Rejuvenating and Rejoicing in Residency). I personally looked forward to these and so did others. Once when my father, a practicing surgeon, was visiting, I invited him to one of these sessions. This evening we were speaking about our experience and journey as physicians, meaningful moments, lessons or relationships, and the role of patient autonomy.
My father shared his own experience of being a junior registrar in London during his early career, soon after his surgical residency training. His consultant was on vacation and had entrusted the care of his private patients to my father. During his rounds, my father went to see a pleasant lady who had been operated a few days prior. In his conversations my father disclosed her diagnosis to her, while also reassuring her that she was okay; however he used the words breast cancer. He came back the next morning to find her bed empty, the nurse sharing with him that the patient had passed in the night. Only later did my father learn that this consultant had not shared her diagnosis with her.
My father shared with our group the lesson he learnt: how we have to be extremely mindful about our patients, their frame of mind, and most importantly make an attempt to understand the thread they hold, how they cope, what are their support systems. This allows us to be present in an authentic relationship and attentive to the needs of each individual patient.
It is not an uncommon belief in India, and other East Asian countries, that sharing bad news can lead to bad outcomes. Thus, family members and caregivers will often request physicians not to share all the prognosis or diagnosis with the patients. I too had abided by similar requests during my training outside the USA. This was contrary to the tenet of patient autonomy in the USA, which was then a new concept to me.
Frankly speaking, I was a bit embarrassed initially when my father shared the story, fearful that he would be viewed as violating this ethical responsibility. However, only later I realized his wisdom when he shared his own vulnerability, and his regret for sharing the diagnosis and how that helped him.
Science has also proven the close connection between the state of the human mind, human courage and hope, and their effects on the immunity of our body. We are paralyzed when we have nothing to look forward to, when we lose faith and hope in our future, when we lose our connection with our meaning or purpose, when we are not valued or even allowed to fulfill this meaning and purpose. Our body, mind and spirit fall victim, we can lose the will to live, and this can even have a deadly effect. (see References below).
Indeed, a common feedback I receive from healthcare members during my listening tours is the feeling of not being seen, heard, cared for and most importantly not feeling valued. On the contrary, they expressed the feeling of being a commodity rather than a human being first with gifts and skills.
#REFLECT: What gives you a sense of meaning and purpose? How might you encourage others to reflect on their gifts in the coming year? How might we ensure we see and affirm each other as valuable human beings? How can we be intentional to maintain and provide hope?
As we ring in the New Year, let us to attempt to reflect on our why, our thread of courage, of meaning and purpose and be intentional to invite those in our circle to share theirs as we together connect to our common purpose. Let us strive to co-create safe and brave spaces, providing hope and helping each other to feel fulfilled, and to engage in a collaborative community united around our common unity, our common purpose.
We all have something innate in us that the world needs. Let’s remember this with faith and hope and spread this shared hope with faith and action!
Blessings for 2023!
References
Annick Shaw, Stephen Joseph & P. Alex Linley (2005) Religion, spirituality, and posttraumatic growth: a systematic review, Mental Health, Religion & Culture, 8:1, 1-11, DOI: 10.1080/1367467032000157981
Wagner AC, Torbit L, Jenzer T, Landy MS, Pukay-Martin ND, Macdonald A, Fredman SJ, Monson CM. The Role of Posttraumatic Growth in a Randomized Controlled Trial of Cognitive-Behavioral Conjoint Therapy for PTSD. J Trauma Stress. 2016 Aug;29(4):379-83. DOI: 10.1002/jts.22122. Epub 2016 Jul 19. PMID: 27434598; PMCID: PMC4988872.
Löffler S, Bogausch A, Knappe R, Joraschky P, Pöhlmann K. Wachstum oder Wunde? Sinnfindung und Traumabewaltigung bei Patienten mit posttraumatischer Belastungsstorung [Path to growth or open wound? The quest for meaning and coping with trauma in patients with posttraumatic stress disorder]. Z Psychosom Med Psychother. 2012;58(2):192-204. German. DOI: 10.13109/zptm.2012.58.2.192. PMID: 22786848.
Frankl, Victor E., Man’s Search for Meaning, Beacon Press (1946).
As 2023 unfolds, how do you tend to well-being, community and resilience? I will post reflections on these themes and invite you to join in the conversation here or on Twitter or Instagram with your thoughts or what you are doing for self-care and care of others. My book explores such ideas too: Resilient Threads: Weaving Joy and Meaning into Well-Being.