Joy: It’s a Choice

choose to be joyful

Choose to be joyful, even though it’s an unnatural choice

Choose to be joyful?  How does one simply choose joy?

When I was about 11 years old, I remember my dad came home from a business trip.  Sometimes he would make a point on his business trips to buy some souvenir for my brother, my sister, and me.  

On this particular occasion, he and my mother sat down with us and told us that he had only bought one souvenir for one kid.  He hadn’t had time during the trip to go hunting for souvenirs for all of us, but while walking around he just happened to find a perfect gift for one of us.  

You can probably imagine the apprehension this initially caused.  We all silently asked ourselves, “Is it for me?”  

Dad went on to say that it was important for us to be able to experience joy and excitement on behalf of someone else’s good fortune, not just our own.  

It turned out that the gift was a book about sharks and it was for my brother.  That gift wouldn’t have meant as much to me, but my brother was super excited.  I got to experience joy at seeing his delight, and thus I had the opportunity to share in his joy.

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Choose to be joyful, even though its countercultural

Dad has since told me that when he shared that story with other parents around that time, they were horrified that he would ever consider buying a gift for one kid and not the others.  

His reply was, “So if I find something perfect for one kid, I shouldn’t buy it because I’m worried about how the other kids will feel about it?  That’s stupid.  Why punish one kid because the others might be so selfish that they can’t get on board with something good happening to him/her?”

He and Mom made a point of teaching us through that exercise that:

Something good happening to someone else doesn’t mean something bad is happening to me.

That was a tough lesson for an 11 year old, but it has been incredibly valuable in my life.  It has greatly enhanced my capacity to experience joy because I can share in the joy of everyone around me, not just my own.

Why is it important for physicians to choose to be joyful?

Medicine can be a joy-draining experience.  The burdensome regulations, insurance hassles, ingratitude, and lack of administrative support can weigh on us and really suck the excitement out of an otherwise amazing profession.  

As physicians, we have to find ways to maintain our joy.  Our patients can definitely sense when we’re mad at the world, which colors every interaction they have with us.  

Have you ever been on the phone with a customer service representative, and you can just sense that they’re in a foul mood?  It completely changes the conversation.  

Patients expect us to give them hope, and it’s hard for us to do that when we project misery.  Joyful doctors are better equipped to provide the high quality care patients deserve.  

When you’re not distracted or consumed by the distress associated with whatever is weighing on your mind, you’ll be able to focus on your patients more effectively.  

Choose to be joyful, but take caution

It’s important to note here that joy should not be considered a substitute for good clinical practice.  I’ve seen clinicians make this mistake too.  They take the “Patch Adams” approach too far.  

A few physicians I’ve worked with have taken the attitude that they will “just love their patients and get them better by listening to them and loving them and making them happy.”  

I’m all for that philosophy as long as people don’t use that as an excuse for shoddy medical practice.  It’s great to spend your time with your 5 year old patient making them laugh and putting them at ease.  But, if you never spend the requisite time to figure out how to do an ear exam properly, you’ll miss the ear infection they came in with.  

Fortunately, I don’t see this approach too often, but it’s important to recognize that it can happen.  Don’t allow yourself the excuse that joy can be substituted for sound clinical practice.

How do I stay joyful?

First of all, know that I don’t intend for this to be a one-size-fits all strategy for being joyful.  Everyone has their own way to unwind, de-stress, and recenter.  If you’ve got a method for retaining your joy, stick with it!  These are some of the top ways that I’ve found that help me choose to be joyful, even in times of great stress and anguish.

1. Learn to acquire joy from good things happening to others. 

When you share in the joy of others, you massively expand the number of potential “joy encounters” each day.  It’s easy to get excited about hearing when one of your nurses is having a baby.  But, what was your response the last time you found out a colleague was getting promoted?  

If someone else got a raise or a major financial windfall, would you be excited or envious?  

When you found out that someone got a nicer office than you, or got some new equipment that you felt should have come to you, how did you react?  

Sure, there are injustices in the world, but a lot of the perceived injustice is just envy.  Cultivate a habit of celebrating the wins that others experience.  When you can train yourself to share in someone else’s victory, it becomes your victory as well.

2. Train yourself to stop complaining unless it is directed to someone who can solve a problem.

Complaining and gossip kill morale faster than almost anything.  Complaining, especially in medicine, has become so common that it’s practically a sport.  

Someone will complain about something and then someone else says, “That’s nothing!  Did you hear about…?”  It’s really hard to stop complaining about every little thing.  

Heaven knows, there’s a lot of legitimate things to complain about.  But, when you spend your time complaining, you load your mind with negative thoughts, which is always destructive in the long run.  It’s garbage in, garbage out.  

So, spend your time thinking about positive things.  Find opportunities to comment on something that’s going well.  

If you have concerns or problems, voice them to someone who has the authority to help you solve the problem.  Otherwise, it’s just complaining.  

If you’re in a position of leadership, I also recommend you make an effort to quash complaining from others.  Set an example and cultivate a culture of positive conversation.  Coach your team members that complaints always go up the chain of command.  

Don’t complain or gossip to peers or subordinates.  Teach them to take complaints to people who are in a position to help.  

3. Have an attitude of gratitude

Grateful people have a harder time being unhappy.  Take some time each day to express appreciation to someone.  

Maybe you will have an opportunity to tell a nurse that she’s doing a great job.  Maybe you can notice your administrative team keeping the trains running on time and publicly praise them for it.  

The more gratitude you express, the more you find that your mind focuses on positive things, and joy will follow.  

Once a day, find something to be grateful for and thank the person responsible for making it possible.  Write an encouraging note to someone once a week and tell them why you’re thankful that they’re a part of your life.

4. Watch out for the “dark underbelly” of your specialty.

I talk about this issue often, because it’s underrecognized and very important.  Every specialty has a feature that tends to make physicians unhappy.  For GI, it’s irritable bowel syndrome.  Many GI physicians really hate taking care of IBS.  It’s a frustrating condition for patients and physicians because there’s no direct test for it and the patients experience real pain that has limited therapies.  

One of my attendings in fellowship coached me to learn to find IBS fascinating.  He said, “If you can’t learn to love IBS, you’ll hate gastroenterology, you’ll resent your patients, and you’ll end up miserable.  If you can choose to love IBS, the result is that you’ll choose to be joyful.”  He was right about that.  

Some (not many, fortunately) of my GI colleagues roll their eyes and sigh every time they have an IBS patient on their schedule, which is pretty much every day.  What a miserable experience for the physician and the patient!

I consciously trained myself to find the pathophysiology and management of IBS fascinating, and now I love it!  It keeps me excited to go to clinic every day, knowing that there’s never anything on the schedule I can’t stand to take care of.

Every specialty has this problem.  In cardiology, it’s “atypical chest pain.”  For neurology, it’s pseudo-seizures.  In OB/GYN, it’s false labor.  Whatever the specialty, you need to identify it and ensure that you find a way to make it something that you genuinely enjoy.  Decide that it’s fascinating and worthy of your attention, or it will suck the joy right out of your life.  

5. Look for ways to continually renew your joy

Every now and then, you may need a “reset.”  Take that extra time to just spend time enjoying your family.  Go on a vacation.  Take that family road trip you’ve been talking about.  Go see your cousins or grandmother whom you know you’ve been neglecting.  Find time to do that activity you keep having to miss.  

Don’t miss the opportunity to take that time to recenter occasionally.

Additionally, you should find ways to have little daily interventions that produce joy in your life.  For instance, I have a page-a-day calendar of Peanuts comics in my office.  My mother gives me one for Christmas every year.  If the page that day is particularly funny to me, I save it until the end of the month.  

At the end of each month, I write my mother a card, include the Peanuts calendar pages I saved that month, and mail it off to her.  I’ve been doing this for years, and it’s a source of daily joy for me as well as monthly joy for her.  

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Final Thoughts

You may have come through tremendously difficult circumstances.  Perhaps the season of life you’re currently experiencing is threatening to crush your spirit.  I don’t want to diminish the weight of your troubles, but I do exhort and encourage you to lift yourself above them!  

At some point, if we want to be happy in life, we just have to decide that we’re going to be happy.  Don’t let life steal your joy.  Don’t be victimized by a lousy boss or gossiping colleagues at work.  Choose to rise above all of that.  I want you to choose happiness.  

I want you to choose to be joyful.  

Further Reading

Leave a comment below and tell us what you do to maintain your joy when things get tough.

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