With her grey hair pulled back and wearing her Sunday best, Ms. W. gracefully rose from the chair and approached the hospital bed where her ailing husband rested. She stroked his forehead while he lay silent. I stood as respectfully as I could in the corner of the room, witness to their love.
“We have had tough times, moving here without a penny from Mississippi, the murder of our son, and your stroke,” she said to him. “God will show us the way as he has before; isn’t that right, Henry?” She gave him a gentle kiss. He briefly opened his eyes and smiled.
I feel a flush of goosebumps, then fighting off tears, I placed a hand on her shoulder. “Well, we will give him the best care we can, and of course a good dose of TLC from the nurse, too,” I said to her. Then to him: “Yes, Henry, there is a good chance you will get back on your feet.”
As hospital-based doctor, I have a front-row seat to dramas that reveal the beauty of the human condition: love, determination, hope, meaning making, and the sort of grace I witnessed in Ms. W. The conversation with the W. family left me feeling fully alive, emotionally open, my body calmed and my mind ready to give my next patient the same kind attention. It was the beauty of my patients’ lives that got me to this state.
The sense of wonder it evokes is something I have started to actively cultivate to be the best I can be at work. When talking about these experiences with colleagues, I do use the words beauty and wonder—but these types of encounters inspire another word we rarely use in health care: awe.
Why this emotion arises, how the experience can foster resilience, and what we can do to cultivate this emotion should be part of health care education. Awe is a “hack” that can boost well-being in what has become an increasingly challenging profession—or, indeed, any profession that requires daily boosts in resilience. So, let’s investigate what awe is and how it works its magic on us.
What happens to our minds and bodies when we feel awe?
Awe is the feeling we get in the presence of something vast that challenges our understanding of the world.
For most of us, what typifies that “something vast” is physical in nature, like the Grand Canyon. Yet it doesn’t have to be literally large; it can, instead, be emotionally deep. Awe can be induced by great art and music, religious experiences, people moving in unison, big ideas, moral elevation (the grace of Ms. W. was an example of this), or being in the presence of birth and death.
Why do people experience this emotion? Scientists believe all emotions must have some evolutionary purpose. This brings us to the second part of awe: accommodation. When we have this feeling of “wow,” time slows a bit. That marks the event and gives us a moment to “accommodate” the experience—to slightly refine our understanding of the world in light of it. Awe is a tool evolution created for us to learn and grow as human beings.
On fMRI studies, awe quiets the default mode network in the brain, which results in the quieting of our internal and self-referential inner voice, hence a smaller sense of self and greater sense of connection. My experience with the W. family illustrates this well. The most notable physiological response was the goosebumps that I had that day. If I were measuring, I would have seen my heart rate and blood pressure decrease, as a result of the activation of the vagus nerve; this explains the calm I felt. A blood test might show an increase in interleukin 6, which is a sign of a healthy immune response. All this puts human beings in a position to do these things:
- Awe leads to the perception that time is slowing down so that we can fully take in the event;
- Awe leads to humility, so we more readily accept the input of others as we appraise the situation;
- Awe makes us more cooperative;
- Awe sharpens our critical thinking compared to other emotional states;
- Awe leads to more ethical decision making;
- Awe makes us less concerned about ourselves and feel connected to others—and even at times to the universe in general.
These cognitive states are universally useful. For health care providers, they are essential. These are the qualities I need to bring to bedside and which can in turn bring out my best self. Importantly—unlike in the case of a burst of joy or other fleeting emotions—experiences of awe lead people to report more well-being for more than a week.
It’s worth noting that awe, like other emotions, comes in different degrees. If you are not having goosebumps and feeling like your mind has been blown, that doesn’t mean you’re not feeling awe. Natural phenomenon do indeed provoke stronger reactions, and when humans inspire awe, we may not get this sense of vastness. We might instead feel touched. That means we are being moved toward a new understanding of the human condition, a subtle recalibration of the way we think about our world.
How can we cultivate awe?
How do we find more awe? To some extent, stage of life makes a difference: Older people experience more awe than younger folks. But there’s more to awe than demographics; it’s an experience that anyone can cultivate. For example, those with religious and mindfulness practices are more likely to experience awe; the thinking is that greater moment-to-moment awareness helps us to spot and take in important events. Gratitude also correlates with awe; whether a gratitude practice leads to more awe has not been established, but the association is certainly significant. With repeated exposure to the same stimuli, we tend to have less awe, but we can use tools like thankfulness to see the same-old stuff as new again.
At the organizational level, there are things we can do to foster awe. At the start of a huddle or a meeting, we can ask coworkers to talk about a time they were moved or worked with an awesome family; this type of secondhand experience can lead to a sense of awe for the entire team. We can also incorporate awe practices into computer-based educational programs. There’s a well-studied program developed at Stanford called WISER, a curriculum that has staff do a series of online activities to promote well-being by invoking various prosocial emotions, including awe. Studies of the program demonstrated a durable increase in well-being—and possibly increased quality of care.
Intellectually, I believe the research that claims to sort out the intricacy of all our emotions. Yet the family-medicine doc in me also realizes that the world, people’s lives, and our brains are so darn complicated. How can we really claim to quantify and put a name to all the good we experience with all our emotions?
As a human being, I believe, you just need to feel what you feel and allow yourself to be moved. Awe, joy, love, wonder, compassion, and gratitude are concepts we should understand, but in the end, whatever words you want to use, they are all connected, as we as people should be. Our job is to face the world with open-hearted humility, taking in the wonders of our fellow human beings. Yes, I talk about awe, but in my view, that starts with asking folks to look for beauty in the people around us.