Gratitude isn’t an attitude; it’s a lifestyle. It’s easy to feel grateful at work when all is well. When you get the extension you needed, when you get the promotion you worked so hard for, and when your patient beats all the odds and gets better. There is no striving towards feeling grateful in those instances because it’s almost an automatic response that produces smiles, dancing and everything in between. The challenge is feeling grateful when things aren’t well. When you miss your deadline, when you don’t get that big promotion, and when a patient dies. I work at a community health center in Boston where the previous examples occur daily and gratefulness is not always the easy option. Although I have not been here long, I have seen staff see gratefulness as a choice and not a feeling. When hard things happen, I have witnessed staff take an active and bold stance that recognizes the gravity of pain and loss, while championing gratitude and joy. This is why I am convinced that gratitude is never an attitude dependent on outer circumstances, but is a lifestyle made up of a series of courageous choices.