From Hardship to Healing: The Power of Gratitude

This is my journey of previvorship in a nutshell: In a span of six years, between ages 26 and 32, I welcomed two children within 19 months, worked a full-time job during early motherhood as a palliative care physician, served on the frontlines during the COVID-19 pandemic, and underwent multiple breast cancer risk-reducing surgeries in 2020.
When people hear my story, I often get asked the same question repeatedly: “How did you handle all that?”
When I reflect on my journey, one tool stands out as a lifesaver: gratitude.
What Is Gratitude?
Gratitude is one of the most powerful positive human emotions that is often overlooked. It is the act of expressing appreciation for what we have, whether big or small. It could be gratitude for our health, relationships, or even something as simple as a beautiful sunset. Gratitude is not about ignoring or denying hardships and challenges in life, but rather choosing to focus on the good things that exist amidst them.
I've been fortunate to work in palliative care, which has given me a very unique perspective on life. Challenges that others may see as difficult, I see as hidden blessings. An example of that is my BRCA genetic mutation that raises my risk for breast cancer.
I have always looked at my genetic mutation as a privilege that empowered me to make proactive choices for my health and life, choices that my mom and many of my patients never had the chance to make.
2020 was a turning point in my life. It stands out as one of the most challenging years I've faced so far. That year, I served on the front lines of the COVID pandemic as a palliative care physician and witnessed an overwhelming number of deaths. I was married to a critical care physician who was also serving on the COVID front lines, and was mom to two kids under 3. I went into my risk-reducing mastectomies (surgery to remove the breasts) alone, and had a major complication after surgery that made me dependent on others for many of my basic needs.
That year was filled with immense fear, and yet it's when I encountered the most resilient version of myself. It’s the year I found the true gift of gratitude, and it’s what ultimately saved me that year.
Gratitude is the antidote to fear; you can't feel grateful and fearful at the same time.
Here are three simple ways to embrace gratitude.
Write Your Gratitude
The Gratitude Journal
I had a journaling practice that was simply writing down three everyday things I am grateful for. Because of my work in palliative care, my gratitude often centers around the little things that are actually the big things in life: waking up in the morning, the ability to walk independently, the ease of breathing and eating, and simply being with the people I love.
These are things most of us take for granted since we don't have to consciously think about them. I've gained this perspective by hearing stories from thousands of my seriously ill patients who would give anything to have these basic abilities back. It taught me to appreciate and be grateful for even the most mundane things in life.
Gratitude Manifestation
Leading up to my surgeries, I had a gratitude manifestation practice where I wrote out all the outcomes I hoped for during and after surgery. I did this every day for a month and read them every night before bed. This gave me hope in the face of uncertainty and fear as I headed into surgery after having seen so much death in the hospital that year.
The Gratitude Jar
My family and I have a weekly Sunday gratitude ritual where we each write down something we are grateful for that happened during the week and put it in our gratitude jar. On December 31 of every year, we pour out the contents of the jar and reflect on all the moments of gratitude we experienced that year. It has been a truly heartwarming tradition for us, and I highly recommend trying it!
Visualize Your Gratitude
Meditation
I started a gratitude meditation practice as my surgeries approached. I did this multiple times a week before my surgery and a couple of times a day after surgery. I would place my hand over my heart to ground and center myself. Then I would vividly visualize three things that I am grateful for and three things I am looking forward to experiencing once I am recovered.
After surgery, this was especially helpful for my emotional and mental well-being when I couldn't take care of even my most basic needs and couldn't hold my children.
Vision Boards
I created a bright colorful vision board with pictures and words representing my gratitude and wishes for after surgery. Looking at this board everyday was calming, uplifting, and a gentle reminder to myself of all the things I had to look forward to.
I recommend to the families of my palliative care patients that they set something up like this in their room for the same reasons.
Express Your Gratitude
Gratitude to Others
This one is probably the hardest for most people to do, but expressing gratitude to others is powerful: It strengthens and deepens relationships, makes everyone feel good, and spreads ripples of positivity. Try sending a text, email, or gesture of appreciation, love, and gratitude to the people you love. This was especially powerful during the pandemic and after my surgeries because I got an outpouring of love and support from my family and friends.
Gratitude to Yourself
The one person I wasn't so good at expressing gratitude to was myself. Learning the power of self-love and expressing it to myself was one of the biggest lessons for me that year. It’s important to appreciate and love ourselves before we can truly express gratitude to others. Being able to look in the mirror and say, “I am grateful for you, without breasts, with scars, and all,” has been a game-changer for my self-confidence and well-being.
The practice of gratitude may seem simple, but its impact is profound. Gratitude has not only helped me through tough times but has also made me appreciate and relish in the magical moments even more. It has the power to shift our perspective and allows us to find joy and beauty amidst the challenges.
We experience the life we focus on, and gratitude is what shifts that focus to the things worth living for.
So here's my challenge to you: Try incorporating one or all of these gratitude practices into your life for one week and see how it changes your outlook and overall well being. You might be glad you did.
Important: The views and opinions expressed in this article are those of the author and not Everyday Health.

Simran Malhotra, MD
Author
Dr. Malhotra completed her internal medicine residency at Medstar Franklin Square Medical Center, where she also served as chief resident in 2015. She completed her fellowship in hospice and palliative medicine at Johns Hopkins Hospital in 2016. She was named Top Doc in Palliative Medicine in 2019 and 2020 by Baltimore Magazine.
On a personal note, she is a BRCA1 previvor with a strong family history of breast and female reproductive cancers, and underwent a risk-reducing bilateral mastectomy and total hysterectomy in 2020 at 32 years old. After learning about her own genetic risk of cancer, and grounded in her professional experiences in palliative care, she founded Wellness By LifestyleMD, a platform where she works with and educates women at high risk for cancer with or without genetic mutations on the powerful impact that positive lifestyle changes can have on their quality of life and even longevity.
In addition to being a diplomate of the American College of Lifestyle Medicine, she completed the T. Colin Campbell plant-based nutrition certification in 2019, the CHEF culinary coaching certification in 2020, and the WellCoaches health and wellness coaching certification in 2022. She is a member of the ACLM women’s health member interest group and serves as the co-chair of the breast cancer subcommittee.
Malhotra has been featured on several blogs and podcasts, where she has shared her unique perspectives and experiences from palliative care as well as from being a genetic mutation carrier who is passionate about using lifestyle as medicine.
- Brown J et al. How Gratitude Changes You and Your Brain. Greater Good Magazine. June 6, 2017.
- Diniz G et al. The Effects of Gratitude Interventions: A Systematic Review and Meta-Analysis. Einstein (Sao Paolo). July 31, 2023.