Grit and Your Health



Angela Duckworth is a bit of a hero of mine.  Her book at TED talk on “grit”  has dramatically changed the way I look at myself and whether or not I’m “good” at something.

“Grit” is a funny word to stand in for tenacity, perseverance, determination and belief in oneself.  Before I came across her work, when I heard the word “grit”, I would think of sand in my swimsuit when I was a little kid, not a positive character attribute.  Now as someone who is trying to become “grittier”, the part of the word that implies an abrasive surface has become lessened.

As I’ve been thinking of grit recently, I’ve started to wonder about other applications for it than simply achievements.  What about grit in terms of health and healthcare?  What can patients, doctors, and other practitioners do to cultivate grit in the face of health concerns?

It’s easy when we’re told we have a health problem by a doctor or other medical provider to feel discouraged.  Why did it happen, we wonder, could it have been prevented, did we do something wrong?  It may feel like an affliction and cause us to feel depressed, or become an irritant that we try to ignore.  This may be part of the process of coming to terms with a health problem, but how can we as patients and practitioners shorten that time of grief and start building grit?

The way I’ve been thinking about it, “grit” in terms of a health problem is a steadfast determination to not remain limited by whatever condition you’re diagnosed with.  A condition like chronic pain can be extremely difficult to live with, and may lead people to depression and, as we’ve seen with the opioid epidemic, drug abuse.  We don’t want to have to deal with it, we want it gone.  However, this may not be realistic for everyone.   The road to minimizing pain in daily life may be long and arduous.  To deal with this optimally, multiple changes in how the pain is thought of may have to occur.  It may no longer be realistic to think of being entirely pain free.  Instead, days of minimal pain need to be appreciated for the relief that they are.  Multiple modalities of therapy may need to be consulted–physical therapists  and yoga to build up strength, massage and acupuncture for relaxing areas of tension and pain, and possibly even nutritionalists to make sure the body is being nourished in the way it needs.

Most of all, the spirit needs to be fed.  This may sound hokey, or possibly even new age-y, but it’s something essential in cultivating the belief that we as people in our bodies are worth working for.  In whatever spiritual context that fits most with an individual’s world view and paradigm, we need to tell ourselves that we can do it, that we have what it takes to make the most out of our lives whatever obstacle comes our way.  If we don’t have something that nourishes our spirit, it’s so easy to flag, to start off strong only to wind up feeling defeated.  To combat this, we need to find ways to inspire ourselves and keep our motivation going.  It’s a hard prescription, as its so individualized, but a necessary one.



I think there is a general misconception about the state of happiness.

Here in the US, written into one of our founding documents, we find the phrase : “We hold these truths to be self-evident: that all men are created equal; that they are endowed by their Creator with certain unalienable rights; that among these are life, liberty, and the pursuit of happiness.”

These words have had a profound effect on the psyche of our country.  While originally, as the phrasing implies, the word “happiness” meant more the pursuit of wealth and a good situation in life, it’s meaning has morphed as time has passed.  Now that many of us take finding a decent situation for granted, the meaning of “the pursuit of happiness” has become something less tangible, more of a state of mind than anything else.  We should be joyful, we think, it’s our right to feel happy most of the time.  We want to follow our bliss, find endless affirmations around us, employ positive thinking to attract what we want in life.  After all, “happiness” is our right.

The thing is, life in the world isn’t a streamlined experience.  If you expect conditions that are conducive to your happiness to be present all the time, you’re going to be let down.  Crappy things can happen out of the blue, “ruining” what may have started out a good day/week/month/year, regardless of the positive thinking you’ve employed.  Nature is not predictable, and rarely is thinking things will continue on as they are indefinitely a good long-term strategy.  I don’t mean to sound bleak or like a downer.  If you look at it scientifically, a static system is a dead system–we’re all meant to exist in a continual dance of finding equilibrium.

In less obvious ways, I think this “pursuit of happiness” can affect the way deal with our health, physical and emotional.  Rather than a long hard slog to feeling mostly alright with a few crappy days every now and then, we want our pathological symptoms to go away, the sooner the better.  We want to be cured from what ails us, to overcome our flaws and endlessly improve ourselves.  Then, maybe, we can start getting down the the business of being happy.

But what if happy is learning to work with those symptoms, of accepting our limitations, and within those confines, appreciating, if not loving, our strengths?  What if happiness is that moment we stop trying to be this glowing, radiant magazine cover version of ourselves and reinvest that energy inward to taking a good long look at ourselves and being ok with that, however messy?

I’ve lately started to re-work what I consider to be “happy”. Maybe this is odd, but personally, I’m not a big fan of feeing giddy happiness–it feels too fragile, like sumptuous dessert to be enjoyed only every so often.  I much prefer to feel a calm sense of resiliency, the feeling that regardless of what happens, good or bad, I’ll be able to assimilate and adapt as needed.  Happiness as an appreciation of inner strength.  That way if today happens to be a cruddy day, or if illness befalls me, it becomes less of a catastrophe or set back than something that I can deal with, moment by moment, without feeling like I’ve been pulled away from my previously happy state.

This is a work in progress, an aspiration, but it feels useful.  It gives the sense that, bar anything horrible, I’ll be ok, and that’s a good place to be.  And the thing is, most of us are already there, if we just let ourselves appreciate that fact.  We’ve got this.


Philosophy of health and healthcare

I’ve been thinking for a while about what the word “health” means.  As always, when wondering what’s behind a word, I consulted the dictionary for the first interpretation.  Mirriam-Webster defines health as: “the condition of being sound in body, mind, or spirit.”  The Oxford English Dictionary takes a slightly less holistic approach and defines it as: “The state of being free from illness or injury; A person’s mental or physical condition.”  The root of the word is of Germanic origin, having migrated over to the English centuries ago as “hǣlth”, and is related to the word for “whole”.  This seems more like it.


The thing is that like defining “happiness”, it becomes a little dicey when applying it to individuals.  In college I took a lot of philosophy, and one day in class we were discussing happiness or the good life in terms of the Epicureans.  The modern usage of the word “epicurean” is often used to mean someone of cultivated tastes who appreciates the finer things, especially as pertaining to food and drink, and can run close to hedonism.  This is far from the intention of the Greek philosopher Epicurus, who, while placing pleasure high on the list of what constitutes the good life, also preached a gospel of everyday temperance, advocating that his followers drink watery beer and porridge as their main sustenance.  This would make it so that when one did have good food or drink, it would taste all the better.

My argument in the class was is that this isn’t the good or happy life for all people.  Some people might be miserable eating porridge every day, and the rare occasions when they didn’t eat it they might be even unhappier for thinking that they would have to go back to porridge.  For whatever reason, my classmates weren’t buying it at the time, but as I’ve gotten older, it seems all the truer.  Each person has their own life paradigm: their core set of beliefs, what makes them happy, and how they choose to live their life.   What I’ve realized as a healthcare provider is that this extends to what constitutes “health”.  For some people, it’s worth it to do something typically regarded as “unhealthy” because of what it brings to their life.

Going back to the root of the word, what makes us healthy is what makes us whole.  Healthiness is being at peace with your body, mind and spirit.  Whatever brings you more in alignment with that should be taken in mind as a key component of your health, even if it’s outside of what a more common definition of “healthy” looks like.  If it’s something that isn’t good for your body to function long term but it brings you joy, the pros and cons should be carefully weighed out without value judgement.  It’s better to examine carefully what is going to bring us closer to an individual feeling of wholeness rather than dismiss it because it doesn’t fit into the mainstream paradigm.  It is up to both patient and provider to hold that seeming paradox, and to make a plan for wellness that is realistic and aims to optimize the patient’s overall health while accommodating for their life paradigm.