The voyage of discovery lies not in seeking new vistas but in having new eyes.
— Proust
Most of us live far more meaningful lives than we know. Meaning is a function of the heart, an organ of vision that allows us to see below the surface of things. Our training does not encourage us to bring our hearts into our examining rooms or to explore the deep river of meaning that is the undercurrent of our work as physicians. Our habitual way of seeing things and even our expertise can blind us to the meaning of even the simplest of our daily interactions and relationships. Meaning is the antecedent of enduring satisfaction and fulfillment in our work. This simple little journal may be all that it takes to give us fresh eyes.

Keeping a Heart Journal
 draws on the wise work of Angeles Arrien, author of The Fourfold Way. This exercise requires a notebook to write in and 10-15 minutes of time every day. It is best to do this exercise at the same time and place — every evening if possible — and find a quiet place to reflect and write where you will not be interrupted.

Begin by sitting in silence for a few minutes and paying attention to your own breathing. At the end of each out breath there is very brief moment of rest and peace before your next in-breath begins. See if you can notice this tiny natural space of stillness. Pay attention to it. Each time you arrive there, let yourself be there and surrender into the stillness as fully as you can.

When you feel ready, begin the exercise by slowly reviewing your day BACKWARDS, going from the present moment back to the time that you awoke in the morning, recalling the events and conversations you experienced and the people you met as you moved through your day. Review your day backwards THREE times, each time asking yourself a different question.

The first time you review your day backwards ask yourself the question:

What surprised me today? 
As soon as you find ANYTHING that is an answer to this question, stop your review and write it down in your journal. It is not necessary to write a great deal or to find the MOST surprising thing that happened all day – the important thing is to re-examine your day from this new perspective and not how much you write about it.

Now begin a review of your day once again, going from the present moment back to the time that you awoke in the morning, recalling the events and conversations you experienced, and the people you met.

The second time you review your daybackwards ask yourself the question:

What moved me or touched my heart today? 
As soon as you find ANYTHING that is an answer to this question stop your review and write it down in your journal.

Now begin a review your day backwards a third time, going from the present moment back to the time that you awoke in the morning, recalling the events and conversations you experienced, and the people you met.

The third time you review your day backwards ask yourself the question:

What inspired me today? 
As soon as you find ANYTHING that is an answer to this question stop your review and write it down in your journal.

This finishes the task for the day.
Put your journal away until tomorrow. As time goes by re-read your journal to yourself.

Often when people first start this journal they find the same answer to all three questions “Nothing. Nothing. And Nothing”. Do not be discouraged if this happens to you. Meaning is an innate capacity but also an acquired skill. If you do this exercise daily, before long answers to all three questions will come to you.

Sometimes you may notice that you were not surprised, touched or inspired as you lived through your day, but that you are only surprised, touched and inspired as you reflect and do this exercise. Do not be discouraged! Most people experience this time lag at first. After a while you will begin to grow in your capacity to find that more and more things surprise, touch and inspire you at the time they actually occur during the day. When this happens, notice any change in your attitude towards your work and those around you.

One Person’s Story
To read about one doctor’s personal experience with keeping a Heart Journal, click here.

Applications: 

This exercise has many creative applications. This is a useful exercise for residents to do together as a group. This could be done by keeping individual journals and then meeting once or twice a month to share some of what has been written. Or you may want to set up this exercise process with the people you work with daily in a clinic setting or an office practice. Sharing parts of your journals at a fixed time will give everyone a far deeper appreciation of each other and of the rich nature of your shared work. Children as young as eight are able to do this exercise and many enjoy it immensely. Doing this exercise with your family and sharing what as been written once a week can have surprising results – revealing the inner life of the family and the many ways we matter to one another without knowing.