What My Patients Taught Me About Gratitude 

Recently, two of my patients — I’ll call them Patty and Kevin — told me bad news during their appointments. Patty’s cardiologist told her she’d had a heart attack, and Kevin’s oncologist told him his colon cancer had returned. You'd expect despair. Instead, both surprised me with gratitude.

Patty focused on everything that hadn't gone wrong — the heart attack could have been more severe, she told me. Kevin listed the people who showed up for him: friends driving him to appointments, neighbors dropping off groceries, visitors making the days less lonely. Both mentioned their pets with particular tenderness. Both had spent time unhoused over the year, but both now have stable housing.  Each confessed how envy and cynicism had once blocked them from feeling this way.

Their response reveals something profound about gratitude. It's not just thankfulness for good fortune — it's recognizing goodness even when life feels hard, and acknowledging that much of what sustains us comes from beyond ourselves.

I’ve seen how gratitude is a skill we can cultivate. And the science backs up what Patty and Kevin discovered intuitively. Studies show that regularly practicing gratitude reduces stress and blood pressure, strengthens immune function, increases happiness, and deepens relationships.

Social scientists have found that gratitude creates a powerful cycle. When someone thanks us genuinely, we're more likely to help again — and even to extend kindness to others. This feedback loop strengthened our ancestors' chances of survival. Gratitude became a social glue, building trust and cooperation that helped communities become cohesive.

Brain scans reveal the mechanics: expressing gratitude releases dopamine and activates the prefrontal cortex, the region involved in decision-making and social connection. It's a physiological event that, over time, creates new neural pathways in our brain.  

Gratitude also shifts our psychology. When we focus on what we appreciate, we're less likely to get trapped in negative spiraling thoughts or let interpersonal tensions fester. It doesn't erase problems; it creates space around them.

Some steps we can take include keeping gratitude journals, regularly noting what went well and who contributed. We can write thank-you notes — I write actual physical cards. At the end of each day, we can pause to name the goodness in our lives and acknowledge the people behind it. These small practices strengthen relationships, build trust, and encourage the kind of behavior that makes communities more livable.

So let me begin. Thank you for listening. Thanks to KCRW management for sticking with me for 34 years. Thanks to my editor, Ted Robbins, who is insightful and patient with me, to Nick Lampone, my engineer, who produces this segment each week with such care, and to Joey Ponticello for putting together an attractive newsletter each week. And thanks to the scientists whose curiosity and rigor give us insights worth sharing.

I wish you, your loved ones, and your community a meaningful holiday season and a new year filled with recognition of all that sustains us. And, of course, good health!

— Dr. Michael Wilkes with a Second Opinion