No one tells you gratitude and rage can share the same breath. On better days, when pain eases just enough for you to notice light, you might feel both at once, thankful for a friend’s text, furious that you need it. Most days aren’t better. Most days, “look on the bright side” feels like a small cruelty dressed up as wisdom.
I spent 30 years as a surgeon before illness taught me what my patients already knew. Suffering resists neat stories. The people who told me to “find the lesson” in 6 years of treatments and surgeries meant well. They also had no idea what they were asking. When your body becomes a place of constant bargaining, what you can eat, how far you can walk, whether you can sleep, gratitude lists can feel obscene.
Still, something else happens over time, something I didn’t expect and can’t fully explain. It isn’t acceptance. It isn’t peace. It’s more like an added room inside you, space where more than one truth can live. I can grieve what I’ve lost and still notice my wife’s hand on my shoulder. I can be angry at my body and get curious about a woodworking project. These aren’t contradictions. They’re how I get through the day.
Before I got sick, I spent 20 years meditating. I learned that presence doesn’t mean calm. You can be present with pain. That can be a kind of clear seeing. What meditation didn’t prepare me for was how chronic illness squeezes time. Past and future shrink. You live in the now, this breath, this nausea, this hour until the next dose. And in that tight space, small moments can feel huge. A morning with less pain. Your son calling just to check in. The way afternoon light lands on the wall.
I’m not saying these moments “make it worth it.” That’s the voice of toxic positivity, the idea that suffering must pay rent in meaning. Some suffering is just suffering. Some days are just lost. But I’ve noticed that meaning doesn’t always show up as a big insight. Sometimes it shows up as connection. Sometimes it’s the medical student I mentor who tells me I helped her see patients with new eyes. Sometimes it’s writing an article that might reach one person who feels alone at 3 a.m.
People find different ways to hold what hurts. Some turn to faith and find real comfort there. Others make art, or speak up, or raise money, or sit with someone in silence. Some choose, day after day, to show up for the people they love with whatever energy they have. I don’t think there’s one right way. I think we patch together what we can from what we have, practice, stubbornness, humor, spite, love, community, purpose, or simply the choice to see tomorrow.
Here’s what I’ve learned. You don’t have to make meaning from suffering, but you’re allowed to if it comes. You don’t owe anyone gratitude, but you can claim small moments of thanks without betraying your pain. You can be exhausted and still curious. You can want to give up and still find reasons not to. This is part of being human when life gets unbearable.
What does courage look like in a body that hurts? Sometimes it looks like getting out of bed. Sometimes it looks like telling the truth when someone asks how you are. Sometimes it looks like letting the dishes sit so you can rest. Sometimes it looks like taking the next pill, even when you’re tired of pills.
The hardest days still come. Days when meaning feels like a luxury you can’t afford. Days when reaching out takes more than you have. Days when the future looks like nothing but more of this. On those days, I don’t reach for gratitude. I reach for honesty. I tell Joyce I’m struggling. I cancel what I can. I remind myself that surviving today is enough.
I’ve stopped forcing myself to find a silver lining. I’ve started noticing when something real shows up, without trying to make it. A talk that matters. A paragraph that finally lands. The dog resting her head on my knee. These don’t fix anything. They don’t redeem the suffering or make it fair. They just sit beside it, small and true and mine.
That’s what I have to offer, permission to hurt without an assignment, and room to find meaning without pressure. Your suffering is real. What you make of it, or don’t, belongs to you alone.
