How Gratitude Changed the Course of My Life
I celebrate Thanksgiving nearly every night. Before I go to sleep, I write down and savor five things that I am grateful for in this world. Sometimes they are as silly as setting a new personal record on my squat or deadlift that day, and often they are as important as my loved ones and health. I started this habit since I read research in college showing that this simple exercise can significantly increase psychological and physical well-being. But I kept this habit since I learned first-hand that gratitude can have far more powerful effects, such as changing the course of your life. Here’s how it changed mine:
VENI:
This is the anniversary of my attending the Stanford Quest Scholars program. During my junior year of high school, I was one of 21 kids selected to attend a special college-prep summer program at Stanford University. Coming from humble beginnings, going to a place like Stanford or Harvard never seemed like a real possibility. So when I was accepted to the program, whose graduates usually attend Ivy-League universities, it seemed like a dream come true. I vividly remember the first time I arrived to Stanford’s campus: my parents and I drove down Palm Drive, the main road that leads to campus. I was in awe of the gigantic palm trees, imported from the Canary Islands, that lined both sides of the street. They looked like something out of Jurassic Park, and made me feel that anything in the world was possible if I just proceeded on this path that lay before me.
Though the curriculum at Quest was nominally focused on preparing for college, it was really about personal development and building the momentum to achieve social change in the decades to come. Before graduating, I was encouraged to write a postcard with advice to my ‘future self,’ based on what I learned at Quest. I learned more life lessons that summer that I could never get from any textbook, so I tried my best to encapsulate that spirit. Quest kept my postcard and mailed it to me a year later, just before I went off to college. Among the admonitions, I instructed myself to “never forget to be grateful for how far you’ve come when you’re stressed about the little things in life.” That postcard travelled with me for years as I moved to 7 cities, and would foreshadow things to come. Just not in the way that I had anticipated…
After graduating from high school and becoming an ‘adult’ at 18, I left home for the next eight years on my academic odyssey to make something of myself. I attended #1 ranked college and graduate programs: four years at Harvard, four years at UCLA… four degrees, and a “Dr.” in front of my name later, I felt accomplished, but also tired of my transitory and future-oriented way of life. I found myself longing for something more: to find my ‘Ithaca’ once again: to return home to San Diego, start my career, and settle down. Thus, I turned down the opportunity to do my internship/residency at the top Harvard & Stanford-affiliated programs. I was done with pursuing prestige; I figured my resume was good enough at that point and no longer felt a need to prove something to myself. I ended up matching at my first choice program in my hometown at UCSD Medical School/San Diego VA, and loved it.
After years of being a ‘perma-student,’ complete with that requisite sense of guilt whenever I was having fun instead of being ‘productive,’ I enjoyed finally being in the working world. I relished slowing down to a normal workweek (with free weekends!), spending more time with family, pursuing interesting personal projects, including entrepreneurial ones. I thought that my odyssey was over and had moved on to a more mellow phase of life. But just as Odysseus thought he was heading home before he was cast out to sea, I had not yet learned all the lessons I needed to learn…
VIDI:
After finishing my residency in San Diego, I received an offer to stay for fellowship, and was basically guaranteed a full-time staff position afterwards. I was happy to be home, well-liked by my colleagues, and in a budding relationship with another doctor. The complication was that before we had met, she had matched to a residency program in Chicago for the next three years. I had no desire to leave San Diego, but I also realized that I had spent my adulthood prioritizing myself. At this stage in my life, success meant more to me than my career, I wanted to invest in someone else and a potential life together. Ironically, when I graduated Harvard and was getting ready to go to UCLA, I literally sold my winter coat and gloves, expecting never to leave California again. So despite finally returning home, I decided “to go out into that dirty gray turmoil to follow love and pride” in Chicago as F. Scott Fitzgerald romantically put it.
Because we had not been dating long, I knew that going to Chicago could be a mistake. But I knew I would never regret following my heart. So I rolled the dice — I turned down the path in San Diego that I had spent 8 years preparing for — and moved to Chicago. Soon after arriving, I came to the realization that this would not work out, and I was devastated. I remember that night clearly, walking out into the freezing night air in a daze, and sitting down on the gritty sidewalk to think. I had already signed an employment contract and was stuck there for at least a year. I couldn’t just go home, and remember thinking: what have I done?
I called my best friend to talk it through, and I shared with him the plan I had just devised: since I had no choice but to be here for a year, I would take this opportunity to better myself. Figures I had looked up to, like Martin Luther King Jr., Gandhi, and even 2pac used their time in exile to reflect, write, and formulate their visions. I took inspiration from Bruce Wayne in “Batman Begins,” who trained himself physically and psychologically to become a hero before returning home to help Gotham. Chicago would be my Himalayas, and its cold streets and gyms would be my training grounds. I told myself that the gauntlet has been thrown down for the year ahead, and I will return home to San Diego stronger for it.
However, I also had enough psychological insight to realize what my mind was doing. This mission I created for myself was a defense mechanism to protect me from the pain of failure. But even so, I made a conscious decision to delve into the fantasy, because it would help me find positive meaning from a difficult situation. I had learned this lesson from working with some cancer patients, who concluded that getting cancer was the best thing that ever happened to them, because it forced them to prioritize the important things they had been ignoring in their lives. If there’s anything I’ve learned, it’s that few beliefs are inherently right or wrong, it is more important whether they are effective.
So that winter, I sublimated my energy and went on a rampage. I completed extra projects at work, earned my license 8 months early, and physically trained with a tenacity I hadn’t felt since my competitive athletic days. I kept a journal of my progress in the gym, and documented every time I set a new personal record… 250, 275, 305 lb. The weights kept going up and up, and I was also feeling mentally stronger in preparation for my homecoming. It felt therapeutic to channel my angst productively.
But in the moments of quiet, pangs of self-doubt would creep back into my mind — feelings of regrets and worries about the future. One of the things that sustained me through that time was keeping my gratitude journal. On a particularly cold Chicago night on November 14, I wrote down five things I was grateful for that day. And as I closed my eyes to appreciate them, a vivid image of a palm tree from Stanford’s Palm Drive spontaneously came to mind. Somehow I knew that I would come back to California one day to see it again. I drew it at the bottom of the page because although I did not know how I would do it, I just had faith that coming back to Palm Drive would mark my ‘nostos’ (the Greek word for ‘homecoming’ in the Odyssey, has a second meaning, ‘the return to light and life’).
So when I finished my fellowship, I sold all my possessions, packed up what was left in my little 2-door car, and drove back to California with one of my best friends from high school. I wasn’t sure of my next steps, but I knew I was heading in the right direction…
VICI:
As I drove across the country, I reflected back upon what I had learned professionally in Chicago. I had completed a fellowship in Behavioral Medicine and set up a Diabetes Management program in the VA Hospital there to help Veterans with uncontrolled type 2 diabetes. I saw the devastation that the diabetes epidemic wrought upon my patients first hand — I’ll never forget the patient that told me that his goal for treatment was to avoid having his remaining leg amputated.
But the man that stuck out the most in my memory was Joe, the Veteran that had been coming to my group sessions regularly and had made great progress in significantly lowering his blood sugar levels. He came up to me after group one day, and said “Hey Doc, I can’t come back no more”. When I asked why, Joe replied, “Well, I share my car with five family members, and I can’t take it every week.” Though I normally felt confident to treat the most challenging of conditions, in that moment I was utterly powerless. That was the sobering reality of his life, and financial/environmental issues were beyond my capability to fix. When I left work that day, I asked myself: What good is the best health care if a person can’t even come to get it?
That experience triggered a powerful paradigm shift in me — instead of continuing to convince my patients to come to treatment in a hospital, I realized that technology should be used to bring treatment to patients wherever they are. I had already been seeing patients in satellite clinics using telemedicine and using digital devices like home blood pressure monitors to trigger a call by a clinician whenever patients went out of range. So while researching innovative new models of care, I heard about some people starting a digital health company. I called them and found out that they were doing exactly what I had been developing with my diabetes management program, but in a way that was more accessible and scalable to help prevent these patients from having to come see me in the first place. This was solving a real clinical pain point that I experienced firsthand, and I wanted to help.
While there was nothing more that I wanted to do than move back to San Diego, especially after having left my family and a job offer there, I was no longer concerned about taking risks. I was used to the nomadic life by now, all my possessions fit in a car, and most importantly, and I knew that I could pretty much survive and thrive anywhere if I put my mind to it. So despite the fact that the company was in San Francisco, I drove there soon thereafter and joined the founding team. In retrospect, if I had never taken the risk of going to Chicago, I would have probably been too comfortable in San Diego to be willing to take the risk of starting a company.
Not too long after starting, the President of the company and I drove down to Palo Alto to pitch what would become one of our first enterprise customers: Stanford University. As I drove towards campus, I took a left turn and suddenly realized I was on… Palm Drive! The memories of those iconic palm trees came rushing back to me: the last time I had seen them in person was when I was 17 years old, and the last time I had seen it in my imagination was when I was in Chicago and homesick. And here I was now, driving down Palm Drive once again. Dreams really do come true…
FIN:
A psychologist supervisor of mine once told me that though incidents like this can be coincidences, it can be more useful to not treat them as such. “You learn more that way,” he told me with a wink. And so though I know I found myself back at Stanford through serendipity, I treat it as an important lesson in self-fulfilling prophecy. Back on that cold Chicago night, I did not consciously know what I would do next, but I did subconsciously know where I wanted to be. It even turns out that the stamp I put on the postcard was a special edition promoting Diabetes Education — foreshadowing my future career!
I still read that postcard from time to time, in moments of nostalgic reflection, and I am always amused at the wise words I penned at age 17 (which, really is more of a reflection of having wiser mentors and books). I think sometimes youth has its own intrinsic wisdom, since personal growth is really less about learning new lessons, but more about unlearning the bad habits like cynicism we pick up along life’s path. Perhaps ‘growth’ is actually a positive regression — returning to our childlike sense of wonder and regaining the ability to find the joy in the simplest of things.
Now at 17, I didn’t know very much, but I did know what was important to me. As ambitious as I was, I didn’t want to conquer the world, I wanted to conquer myself first, as I wrote about in that postcard. I am still as hungry as I was back then, but hungry to continue to grow as a person and contribute meaningfully to the world. For as Plato said: “For a man to conquer himself, is the first and noblest of all victories.”
I believe the seeds of who we will become are inside us, planted at a young age, and they are destined to grow if given the right conditions. Practicing gratitude in my life was the soil that allowed me to stay grounded to what is important to me and stay true to my path even when I strayed. I now write this from my family home in San Diego for Thanksgiving. While I never quite made it back here permanently, I have never felt more at home.
— — — — — — — — — — — — — Postcard — — — — — — — — — — — — — —
“On this last day before graduation, I’m sending this post card to you as a memento of your experience at the Quest Scholars Program at Stanford this summer before your senior year. I want you to use this to never forget some of the lessons learned from this experience:
Don’t let your emotions get the best of you, because you’re only hurting yourself. So take a deep breath, take two steps back, and realize what you’re doing. It’s your life, live it happily. Never forget to be grateful for how far you’ve come, when you’re stressed about the little things in life, for they’re really trivial. Never forget how far you still need to go.
Remember to maintain your passion for life and learning, because without it, you’ll be lost. Be happy, be optimistic, find the good in every bad, and most of all, smile. =) Never forget to be genuine and sincere, and to be warm and open to others, for that is the only way to build deep and worthwhile relationships: by trusting others with your cares and concerns. Live your life, it’s the only one you have, so never have any regrets.
Lastly, find what you love and go after it, it is the only path to happiness.”
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