Chapter two: Gratitude is strong medicine

Hard things

I’ve had to do hard things before cancer, but I haven’t always done them well. Here’s one example. I have a genetic condition called epidermolysis bullosa simplex in which the layers of my skin don’t stick together correctly. Friction or heat often create blisters, especially on my hands and feet.  As a kid, normal activities like walking to school or playing outside could be really painful.  I often did what I wanted to despite the blisters (like a 12-hour dance marathon in high school) but over time I avoided more things that would have painful consequences.  I knew I was missing out but sometimes it was easier and safer to sit on the sidelines. 

Unfortunately, that became a part of my life pattern. Shy away from things that might be painful, engage tentatively, do what seems easy and painless. That strategy worked to a point but didn’t provide a lot of traction for creating a meaningful life. And it didn’t prepare me for dealing with hard things I couldn't avoid. So hard things sometimes opened up into dark rabbit holes of depression. 

When I learned the details of my recent cancer surgery I worried about how I would respond. Having half of my tongue cut out and replaced with tissue from my arm would mean being disfigured and having to learn to swallow, eat and speak again. Questions swirled. “How would I deal with the pain?” “Would I ever speak normally again?” “Would I be able to eat again?”  “If I did, would I be able to taste food?”  I worried that despair over these problems would sink me into one of those dark rabbit holes.  

Gratitude as service

In pondering this I was reminded that Jesus Christ taught “whosoever will lose his life for my sake shall find it.” He taught that the way to be happy is not to focus on our own needs, or obsess over our problems, but to reach out and lift others. And he didn’t just say this, he did it.  He devoted his whole life to lifting, healing, and blessing others—even when it meant intense suffering.  “True enough”, I thought, “but what can I do for others lying flat on my back in a hospital bed?” The answer came: “be grateful”.  It occurred to me that the people who would be taking care of me--doctors, nurses, aides, lab technicians, therapists of all sorts and custodians--have a hard job. They help people who are hurting and not at their best all day long.  I could serve them by always being grateful to whoever came to my room to provide something I needed and always expressing that gratitude--no matter how I felt at the time.  

So, I did. Over eight days in the hospital, if I was awake when someone came into my room I said “thank you” for whatever they came to do. Whether it was a doctor checking on me, one of my wonderful nurses giving me another pain-relieving shot in my bruised belly, the hourly vital-sign check by a CNA, a lab technician coming at 4 am to take yet more blood, a custodian coming to clean, or whatever else, I said “thank you”.  It didn’t sound much like “thank you” during the first few days after surgery when I was learning to push sound out of the tracheostomy tube in my throat.  And it wasn’t fun when my throat burned from having feeding tubes scratch it raw.  But I did it.

Three rather remarkable things happened that I think were linked to this practice. The first was that I was never overwhelmed by pain. To be sure, I was getting pain-relieving drugs 24/7, but in my past surgeries these drugs tended to just take the edge off the pain, not knock it down completely.  In this case, with procedures that cut me more deeply and in far more places, I never felt more pain than I could handle. Second, I never felt dark.  Frustrated, yes.  Impatient yes. But not even a whiff of self-pity or despair. The rabbit-hole never even appeared, let alone entice me to jump in.  Third, my care-givers were always happy to see me and take care of me. They often remarked about how “low maintenance” I was. This surgery was a hard experience, and some days the emotional demands were overwhelming, but I was happy.

Gratitude and human psychology

As a psychologist, I am also aware of the research showing the overwhelmingly positive effects gratitude can have in our lives.  “Positive psychology” researchers study the effects of gratitude both in lab experiments and real-life studies.  In both settings they find that gratitude enhances many aspects of our lives. According to Harvard Health Publishing:

In positive psychology research, gratitude is strongly and consistently associated with greater happiness. Gratitude helps people feel more positive emotions, relish good experiences, improve their health, deal with adversity, and build strong relationships.

It turns out that people who live in gratitude feel less pain and stress. They have stronger immune systems so they get sick less often. They enjoy happier relationships and are less prone to emotional and psychological distresses.  Developing deeper gratitude is the single best thing we can do for our mental and emotional health.

So what am I learning?

Clearly expressing gratitude is a simple thing, but it's not always easy.  I have learned that I take a lot for granted, and I have to be intentional about seeing the things I should be grateful for. That’s harder when I’m in pain. Or in the midst of losing things that I value and that allow me to function in my world.  But that is also when it is most important. 

And I am learning to do it better in my normal world. It's been challenging to devote the same level of attention to feeling and showing gratitude at home as I did in the hospital.  As the days of recovery and rehabilitation wear on, I have found myself occasionally drifting towards the rabbit holes. I find myself focusing on my new deficits or asking dumb questions like “what will cancer take next?”  When these dark clouds appear I realize I have to take responsibility to act or the rabbit hole will win. I focus on the things I have to be grateful for, do something productive or help someone else.  

While I can’t honestly say I am grateful for cancer, I am grateful for the opportunity to learn and to be refined, even if that refining comes through some fire. One consequence of that refining is that I am more aware of the pain and suffering others experience and try to be more mindful of them.  I still have a lot to learn, but I’m getting better.  I recognize the need to ask questions like “what else should I be grateful for?”, “what am I taking for granted that I should notice and appreciate more?”  Recognizing how fortunate and blessed I have been has led me to think more about related characteristics. In my next post I’ll be writing about one of these: the quality of being gracious.

Final word: Top ten things I’ve been grateful for since my surgery

1.    Tasting food.

2.    Speaking well enough to be understood, which has happened far faster than expected.

3.    A job with insurance that largely paid for the procedures that removed the cancer.

4.    Doctors, nurses, aides, therapists and others at Huntsman Cancer Hospital.

5.    Sacred music that helped me sleep and find peace on long nights in the hospital.

6.    The prayers and faith and positive thoughts of hundreds of people on my behalf, many of whom I don’t even know.

7.    Family members, friends, neighbors and work colleagues who have supported me with prayers, visits, food and general goodness.

8.    A body that mostly functions as it was designed to, despite my recent difficulties.

9.    My wife who was with me every day of recovery at Huntsman, carefully prepared meals I could eat and dispensed medication once we got home, and still reminds me to do my crazy exercises every day.

10.  A patient, loving, mighty God who blessed me with both comfort and healing.

More on gratitude

https://www.psychologytoday.com/us/basics/gratitude

https://www.youtube.com/watch?v=6yFbsB4VvQg

https://www.healthline.com/health/benefits-of-gratitude-practice