Elena Vavassori is an Anaesthetist-Rianimist at the Fondazione Poliambulanza Istituto Ospedaliero di Brescia. She has been involved in narrative medicine for a number of years and has recently taken an interest in traditional Chinese medicine, in a combination of knowledge and interests always in search of contact with the human.
A few days ago I attended an event at which a small book was presented entitled With One Foot in Paradise, written by a young priest whose leg had been amputated as a result of road trauma. More than the title, I was interested in the subtitle: Suffering is not an end in itself.
Don Luca (that is his name) has tried to make sense of his suffering through writing, feeling a strong need for meaning and truth. In the meeting with the public, he said that ‘the miracle of healing my foot did not happen, but I gained more awareness than before’, and again ‘I was granted the grace of being so close to Jesus’.
He also felt grateful to his friends, family, and all the people (he called them angels) that the path of the illness allowed him to meet. As a man and as a priest, he embraced the gravity of what happened to him by expressing gratitude to his missing leg because this absence led him to ask himself “who am I?” and not “what am I capable of doing or not doing in this condition?
This posture towards a serious and unforeseen event in one’s life reminded me of what Oliver Sacks, a neurological doctor who was diagnosed with cancer, wrote. He wrote: I am grateful that after the initial diagnosis I was given nine years of good health and productivity […]. In the last few days I have been able to look at my life as if from a great height, as if it were a kind of landscape, and with an ever-deepening perception of the connection between all its parts’. Don Luca and Oliver Sacks, two people far apart in time and space, but close because they both experienced illness.
The great doctors of the past have said and written that patients are the best teachers for a doctor. Not only do I fully share this thought, but I experience it as true. Illness teaches the doctor, but every patient, if listened to, teaches something that goes beyond the symptom: it teaches suffering and commits you to look at it.
My gratitude goes out to the patients, even when unforeseen events occur: the so-called ‘widespread death’ during the Covid pandemic taught me that doctors are not omnipotent and that heroes can (perhaps must) mourn. In that hard and tiring time I certainly received more than I gave, which already seemed like a lot.
Gratitude for me is a concrete feeling: it is being there in order to be able to give and it is being in touch with a world, that of the anaesthetist-resuscitator, in which every awakening (and a pain-free awakening) after surgery makes you feel grateful for what good you have done; a world of stressful events, in which asking a colleague for help in case of difficulty makes me grateful for my asking and for his presence. Awareness therefore of one’s own limitation and, at the same time, accepting in help a point of view different from one’s own.
You can be grateful for having experienced error, because even this takes you further than you thought you were, further than your presumption of knowledge. It opens up a new awareness of you and your profession, the medical profession. You can be grateful for having experienced love, with the joys it brings and also the troubles it is capable of.
The word gratitude contains many other words: a feeling of gratitude towards people or circumstances we have experienced, but also the memory of what we have received. Through memory one can express gratitude towards people (family members or friends) who are no longer with us but who remain important in our lives. The memory of a bereavement is transformed into a positive emotion.
I believe that gratitude is an essential component of our humanity, a disposition of mind that can only make both intrapersonal and interpersonal relationships better. Precisely for this reason in health care it is, in my opinion, part of the soft-skills to be integrated with technical skills. The feeling, the act and the gift of being grateful as a way of relating to others by rediscovering the capacity for empathy in the care pathway with sick people and with colleagues; the feeling of gratitude to enrich oneself, to nourish encounters and relationships with emotions and to achieve better self-knowledge, being able to govern one’s own feelings and recognise those of others, without shame.
Gratitude as an aspect of emotional intelligence: learning and practising gratitude develops cognitive and emotional benefits that can improve relationships and the approach to everyday life. In the world of work, incorporating gratitude as a soft-skill in organisational design (in healthcare but not only), with the capacity for a vision that gives meaning and truth to the fact that we receive something of value from others and that this is recognised, to open up new channels of relational communication. Conceive in a new way what we call leadership and increase people’s well-being.
Gratitude stems from an attitude of openness towards others and in this space we must be able to acknowledge their benevolence with joy. Not just being able to say ‘thank you’ because one is polite, but gratitude as a form of social recognition and a prerequisite for relational energy: less sikness and more resilience.
Can gratitude be learned? In my opinion yes, through training in emotional intelligence, with acquisition of cognitive, intrapersonal and interpersonal skills. Gratitude is a complex feeling: if seen as a debt of courtesy or help, it can be embarrassing. As a sign of inner strength if experienced as gratitude and as genuine reciprocation for what has been given to us. Gratitude as a space where encounters rich in humanity and brotherhood are possible. Where everyone feels free to question their conscience and listen to their words. Because words are sensitive beings.