For some unknown reason, I get sappier at the start of a new year, perhaps because of the whole renewed hope that the new year brings. Or maybe it’s the darkness; I like it dark and cloudy having been raised in Oregon and Washington. Perhaps, it’s because I usually get to see friends and family more around the holiday season and I’ve got some real gems in my friends/family category. Or, perhaps, it has to do with my job.

I work with patients with addiction, some of whom struggle through the holidays hoping to just close their eyes and wake up in February. Some of my patients have very little and battle every day to find food, clothing, sobriety, housing, and peace. Working with them is a gift. One of the things it teaches me is to be grateful for the things that I am lucky enough to have including a house, relatively good health, a spouse of the highest magnitude, and a job that I love.

I try to sprinkle my semi-cluttered office with signs of gratitude, both as a signals to my patients and to cue me to think about how lucky I am. One of my very favorite reminders hangs on my wall, occupying a special place next to stethoscopes belonging to my late brother, who was a nurse.

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Between 2011 and 2012, I spent some time on the faculty at the University of Washington (UW) Department of Anesthesia. I loved attending the early morning grand rounds weekly meetings, which usually featured compelling lectures, many about the most complex issues in anesthesia that were a bit over my head.  I offered to lecture on implicit bias, a topic near and dear to me and something I have written and spoken about over the years. I was a bit surprised to get the okay but thrilled, to say the least. What an opportunity to stand in front of the faculty of a world-renowned anesthesiology department, the home of cutting-edge pain medicine advances!

My talk, however, was a bit of a calamity. There were supportive medical residents from all over the world on one side of the auditorium, asking good questions and really tuned in. On the other side sat the cowboys, the hot-shot physicians with their feet up on the seats in front of them who scoffed at the notion that they could be biased.

A few practically heckled me, saying things like “so now we’re politicians?” or “so you’re saying we have to treat everyone exactly the same, what kind of medicine is that?” I got through the lecture but it was upsetting.

The next day I found a little Post-it note tacked to my board in my small cubicle among the physicians from the department. It was from an anesthesiologist whom I didn’t really know very well. She is a senior faculty member with a kind face, we always smiled at each other and said hello. Her name is Gouri Sivarajan, MD, and she still works at UW.

The little Post-it note simply said “Jim, I enjoyed your talk yesterday. Thank you. Gouri Sivarajan.”

When I read it, I almost started crying. I had been having so many feelings about the lecture, thankful for the obvious support of the medical resident section but still puzzled over the somewhat hostile response by some of the more senior faculty. For Dr Sivarajan to have taken the time to do this meant so much to me, indicating it was likely that she knew I needed some propping up after the lecture.

I’ve always kept that Post-it note close and recently I framed it. I’m not the most skilled keeper of little memorabilia but somehow it survived moving in boxes, being stuck inside books, and finding the light of day over a decade later. When I feel tense at work, worried, stressed, or otherwise lacking of reserve, I just give a quick glance at the note and it brings me back to a place of gratitude and thanks for what I have now and the wonderful luck I’ve had throughout my life.