Pulse Check with Dean Nelson - November 2025
Sharing thoughts, laughs, and a little wisdom!
Choosing Gratitude
In the emergency department, you learn to make decisions fast. A patient arrives with chest pain, and your brain immediately runs through possibilities: unstable angina, pulmonary embolism, anxiety attack, muscle strain. Most of the time, you rule out the dangerous causes and send the patient home reassured. But here's what I noticed over decades: we remember the one complex case we struggled with far more vividly than the ninety-nine straightforward ones we handled well.
There's actually Nobel Prize-winning research that explains this tendency. Daniel Kahneman and Amos Tversky's Prospect Theory discovered that humans experience losses about twice as intensely as equivalent gains. This isn't just academic theory - JAMA has explored how prospect theory shapes medical decision-making, from patient choices about treatment to how physicians present options. The pattern shows up everywhere: losing $100 hurts more than gaining $100 feels good. The grant that doesn't get funded stings more sharply than the three that do feel gratifying. It's not pessimism - it's just how our brains are wired.
Gratitude it's not just a nice sentiment for Thanksgiving. It's actually one of the most powerful tools we have for better decision-making. When we consciously practice gratitude, we create balance in how we evaluate our reality. We still see challenges clearly - maybe more clearly - but we also see our resources, capabilities, and opportunities with equal weight.
Think about what we have at the Schmidt College of Medicine: faculty innovating in the classroom, researchers pursuing ambitious questions, staff who embrace positive change, and students choosing this profession during healthcare's greatest transformation. These aren't just warm feelings – they are strategic assets that should inform every decision we make.
This month, I'm challenging all of us to use gratitude as an active decision-making tool. When facing a difficult choice, before diving into risk assessment, list what you are grateful for in the situation. What resources do you have? What support? What opportunities? Don't skip the critical analysis - just don't let it be the only analysis.
When we lead with gratitude rather than fear of loss, remarkable things happen. We make bolder curriculum decisions. We pursue aspirational research. We build meaningful partnerships. We create environments where talented people do their best work.
As we head into Thanksgiving, let's practice gratitude not just at the dinner table, but also in how we think, make decisions, and lead together.
If you think your Thanksgiving travel plans are stressful, meet Neal and Del from "Planes, Trains and Automobiles." Their three-hour flight from New York to Chicago turns into a three-day odyssey involving every mode of transportation except, apparently, ones that actually work.
Steve Martin plays Neal, the uptight executive, while John Candy is Del, the well-meaning shower curtain ring salesman who becomes Neal's unwitting companion. What follows is spectacular: burned-out rental cars, wrong-way highway driving, and a motel scene with one bed that I'll let you discover for yourself.
The brilliance is watching Neal obsess over everything he's losing - his first-class ticket, his dignity, his peaceful family Thanksgiving - while completely missing what's right in front of him: a genuinely kind person trying to help, who happens to have nowhere to go for the holiday.
The turning point? Neal stops dwelling on his losses and recognizes what he's gained. Del is not the problem - he's the gift.
It's the perfect parable for gratitude as a choice. You can catalog what went wrong, or you can celebrate who helped make it right. Both are real. Only one leads somewhere good.
Happy Thanksgiving, MedOwls.