Hello Reader,
If you went into healthcare to help people — and somewhere along the way, forgot to extend that same care to yourself — this episode is for you.
I sat down with Dr. Carolyn Roy-Bornstein, a pediatrician, writer in residence, and educator at the Lawrence Family Medicine Residency Program, whose work sits at the intersection of medicine, narrative, and human flourishing. She's also a nurse of ten years before she became a physician — which gives her a perspective on healthcare culture that is genuinely rare.
What struck me most was how she talks about gratitude, resilience, and joy in medicine — not as aspirational concepts, but as skills. Evidence-based ones that we can actually practice, even in the middle of a brutal week.
The Difference Between Optimism and Wishful Thinking
Dr. Roy-Bornstein shared something early in our conversation that I haven't been able to stop thinking about. She referenced researcher Suzanne Segerstrom, who wrote that the difference between optimism and wishful thinking is elbow grease.
Thriving in medicine is work. It doesn't happen by accident or by ignoring what's hard. But the good news — and there is real good news here — is that the tools are more accessible than most training programs ever let on.
Tyler VanderWeele at Harvard's Human Flourishing Program has studied this extensively. Gratitude interventions, reflective writing, naming small moments of meaning — these aren't soft. They're evidence-based practices that have been shown to reduce burnout symptoms and improve resilience in physicians and nurses alike.
What Gratitude Actually Looks Like as a Leader
Let's be honest: gratitude has a complicated reputation in healthcare. A lot of us have heard 'be grateful' in ways that felt dismissive of real, systemic problems. Dr. Roy-Bornstein names this directly, and it's one of the reasons I wanted to have her on.
Here's the reframe she offered: gratitude as a leadership practice isn't about pretending things are fine. It's about consciously recognizing what's already present — and making it visible to others.
Some of the simplest, most low-lift ways to do that in a clinical environment:
• Start a meeting with a brief gratitude chain — what's one thing each person is grateful for today?
• After a particularly hard or contentious discussion, name what someone contributed before moving on.
• Send a quick follow-up note or drop by someone's office to acknowledge an idea or effort.
None of this is complicated. And the research backs it up: a Hong Kong study found that even brief, portable gratitude practices led to measurable reductions in burnout symptoms and improved work-life balance in healthcare professionals.
Dr. Roy-Bornstein also walked through Barbara Fredrickson's Broaden and Build theory — which shows that positive emotions like gratitude have a uniquely wide action range. Unlike fear (which narrows us to fight or flee), gratitude creates what Fredrickson calls elevation — the urge to pay it forward, to be kind, to look for more of it. It's contagious in the best possible way.
The Problem With How We Talk About Resilience
I'll admit — 'resilience' is a word I've wrestled with, and Dr. Roy-Bornstein helped me articulate why.
When institutions hand us a resilience workshop as the answer to an inhumane schedule, it's fair to push back. That frustration is legitimate. And yet — resilience isn't only a systemic responsibility. Even in the most supportive practice environment imaginable, we are still going to sit with patients as they suffer, grieve, and face the hardest moments of their lives. We are still going to need the capacity to hold that, and to let it go.
Dr. Roy-Bornstein describes resilience not as how much we can take before we break, but as something broader — creativity, flexibility, perspective-taking, openness to novelty. It's a posture, not a test.
One of the most useful things she shared: reflective writing can act as a filter. We learn, over time, to become porous enough to really hear our patients' stories. But no one teaches us how to release them. Writing — even just for ourselves, never for anyone else — can be that release valve.
Sacred Moments and the Permission to Claim Them
A study out of the University of Michigan surveyed more than 600 internists and found that over two-thirds had experienced what they called a sacred moment — a brief, deep connection with a patient. And when asked if they'd shared that moment with a colleague afterward, the overwhelming answer was no.
Dr. Roy-Bornstein's word for this is naming and norming. When we bring these moments into the open — when we say out loud, 'that was meaningful' — we give each other permission to notice them, to value them, to create more of them.
She shared her own sacred moment: doing a home visit on a newborn whose mother had been her patient as a child. They sat together, drank coffee, looked at this new little life. Nothing extraordinary happened. And the mother mentioned it for years afterward.
There's something important in that. The moments that sustain us in this work are often quiet. We don't need to manufacture them. We need to slow down enough to recognize them.
Self-Compassion Is a Clinical Competency
Research by Kristin Neff at UT Austin shows that self-compassionate physicians manage stress more effectively, and self-compassionate leaders pivot more easily when circumstances change. This isn't soft — it's functional.
Most of us got into healthcare by holding ourselves to a near-impossible standard. That drive matters. But it also isn't sustainable. And the antidote isn't lowering the bar — it's adding common humanity to the mix. We all fall short. We all make mistakes. Recognizing that we're not alone in our imperfection doesn't diminish our care for patients. It protects our capacity to keep showing up for them.
One Thing to Take Away
Dr. Roy-Bornstein closed our conversation with this, and I keep coming back to it:
"Don't wait for someone else to give you permission. Take your own permission — to be imperfect, to be messy, to claim small moments of joy. Because that can feel like real agency when maybe nothing else is."
That's not toxic positivity. That's a survival skill we were never formally taught.
🎧 Listen to the podcast sneak peek episode below and listen to the full episode on YouTube, Apple, Spotify, Podbean, or Amazon Music.
What's inspiring us this week:
This past weekend was Easter for those who celebrate, and it was warm and sunny (finally!) in Pittsburgh. Small things like sunshine and getting outside is enough!
The Practice: Celebrating Wins
We get more of what we focus on. The practice of gratitude and celebrating the goodness of life is the first step in changing our brains, mindsets, and circumstances for the better.
Spending time learning is so nourishing and gratifying. Finished 8 of 14 days of an Outskill AI Generalist Course (it's intense!) Just making the commitment to continued learning and seeing everyone all together. What commitment to learning just to learn are you putting into your calendar this week?
Stay mindful and keep leading,
Lillian
Founder & CEO
| We are planning workshops for the fall: What would you be most interested in attending?? |
|
|
|
|
Ready for More? Join our FREE Community:
This is our free community where we host:
our quarterly Book Rounds book club,
monthly live streaming webinars,
and resources related to leadership and wellbeing.
If you're looking for like-minded support and real growth, this is your space.
Prefer personalized support?
Book a Call to explore how we can support your unique journey in healthcare.
To make sure you never miss an update, please:
- Move this email to your Primary inbox (see steps above).
- Add us to your contacts.
- Click and reply to let your inbox know you want our emails. Plus we love to hear from you!
If you want to update your preferences or unsubscribe, just click the link below.
