“Happiness is the absence of striving for happiness.”
– Chuang Tzu

A hunter once lost his way deep inside the jungle while chasing a deer. He used all his navigation skills, but he did not find any way out of the jungle or food for several days. He started feeling so hungry that he could eat an entire elephant in one go. Disappointed, he lost all hope. And that is exactly when an apple tree caught his sight. He gathered ten apples to feed him for the rest of his journey.

As he ate the first apple, his joy knew no bounds, and he just could not stop feeling grateful and blessed. He thanked life and God. He could not believe his good fortune when he ate the first apple, but he was less grateful when he had the second apple and even less grateful when he had the fifth apple. Somehow, with each additional apple, his hunger increased until the joy of eating apples reduced drastically. He could not enjoy the tenth apple.

Why? He had already taken for granted the gift of having found an apple tree in the middle of a forest after long days of hunger. When he took the tenth apple in his hand, he was still hungry but did not feel like having it anymore. Economics refers to this as the law of diminishing marginal utility. It really is the law of diminishing gratitude or taking things for granted. Let’s call it the 10th Apple Effect.

The tenth apple did not lack taste or the potential to satisfy his hunger; the only thing lacking was his gratitude for finding food in the middle of the jungle.

The tenth apple is really as sweet as the first apple. If the tenth apple fails to give you as much pleasure as the first one, nothing is wrong with the apple, but with the person enjoying the fruit. If you get bored with your medical practice and seeing patients, it is not because the day is dull. It is because your gratitude has become dull.

Remember the excitement when Apple Inc. released its first iPhone? People stood in line all night to grab that glorious piece of technology. Do people have the same excitement buying the iPhone 16 or the 10th Apple Effect? Probably not!

Think about your first few days in practice. Were you grateful for the job and passionate about making a difference? You can remember your first patients and their families. Fast forward 10 or 20 years—are you still grateful for being a doctor? Do you still wake up each morning with full energy and passion to make a difference? Are you still excited to go to the operating room or office? Perhaps you are experiencing the 10th Apple Effect at work.

It may be time to pull back and experience gratefulness with our patients and work.

It is very easy to focus on what is wrong with the health care industry as there is no shortage of problems and complaints contributing to the 10th Apple Effect. However, have we paused to look at what is right? Have we stopped considering the remarkable accomplishments of pharma, biochemists, and genetic engineering that created a vaccine in six months instead of the usual five or more years? Have we forgotten to marvel at the millions of Americans who received a vaccine in just three months in early 2021? Have we forgotten to acknowledge the concept of gene editing and that perhaps many genetic diseases, like cystic fibrosis and sickle cell anemia, are going to be cured by removing defective genes and replacing them with normal genes? We have forgotten that we can use robots to assist surgeons in many operations, reducing blood loss, operating time, and the patient’s hospital stay. Now AI can perform many administrative tasks in medical offices, allowing physicians to focus on patients and not computer screens.

Isn’t it time to condition ourselves to look at the brighter side of patients, staff, colleagues, and events? There is so much negativity swirling around the surgical lounges and physician lunchrooms where so many doctors say they would not choose a medical career or are retiring early because navigating the EMR is too cumbersome. You might take notice of the ways that your self-talk and internal dialogues are contributing to your state of unhappiness.

If you keep focusing on what is not working, you may feel frustrated and consider leaving your medical practice. Our thoughts and choices create our own feelings and thoughts.

It may be time to start counting your blessings in your practice. Let me provide a few suggestions.

Thank everyone around you, even for small things. Do not wait until someone does something monumental for you to say thanks. Just saying “thank you,” acknowledging kindness, or engaging in a helpful act are all ways of expressing gratitude.

Take this to your gratitude bank: 80 percent of employees would be willing to work harder for an appreciative doctor, and 70 percent said they would feel better about themselves and their efforts if their doctor thanked them more often.

Maybe you might create an “appreciation board” in the employee lounge where doctors and staff post thank-you notes for their fellow staff members and doctors. Trust me, it feels nice to give and receive thank-you notes.

An old proverb states, “Show me your friends, and I’ll tell you who you are.” You cannot hang out with negative people and expect to live a positive life. Our thoughts are influenced by the people around us. Step away from people who focus on negativity at work. Negative people will drain your energy. If you are in the doctor’s lounge and hear negative comments about medicine and health care, politely excuse yourself and move to another table where positive thoughts hold the day.

Before you can follow your passion, you must find it. If you have a clear purpose and are passionate about what you do, then each day will be a grateful day in your practice. If you cannot find passion, I suggest the mantra, “Do what you love or love what you do.”

Deep six the “If-then” excuse. For example, you might convince yourself that “If I do more procedures and earn more money, then I will be happy.” Honestly, there is nothing that you must do to be happy. Happiness is a choice. Gratitude is also a choice; you can look at the glass half full and be thankful.

Enjoy the journey. Avoid those “if/then” thoughts. Next time you find yourself envious of someone else or in another practice, reconsider, reassess, and perhaps even be careful of what you wish for because you will probably get it.

Bottom line: Don’t let the 10th Apple Effect affect your happiness. Find ways to be grateful. You will enjoy all the other apples.

Neil Baum is a urologist.