About six years ago, I received the startling news that I had breast cancer. The diagnosis arrived shortly after I went to work at Cedars-Sinai as chief of surgery. Happiness, of course, was fleeting during those months as I underwent my own surgery, chemotherapy and radiation.
Ironically, I happened to be writing a speech at the time for fellow surgeons titled, "Finding happiness in life and work." As I wrote, I found myself thinking about that great American philosopher Woody Allen. "Life," he said, "is full of misery, loneliness and suffering, and it's all over much too soon." I also found myself contemplating two questions that apply to anyone who yearns for the elusive feeling of joy: What produces a happy life? And perhaps even more important: Can we meaningfully influence our happiness by our attitudes and behavior?
I discovered answers in hard science -- specifically, the field of "happiness research," which has blossomed over the past decade as it merged with psychology, neuroscience and economics. Much of this scholarship has focused on the relationship between money and fulfillment. And it has produced a complex picture.
Personal happiness does seem to increase as family incomes rise, a phenomenon apparent in both the U.S. and Britain. But once we reach a modest level of income, more money doesn't bring greater satisfaction. On the national level, the percentage of the U.S. population describing themselves as "very happy" has remained constant at about 30 percent from the mid-1940s to 2000 despite a three-fold increase in per-capita income, according to economist Richard Layard.
Social scientists explain this happiness plateau through the "aspiration adjustment hypothesis." As soon as we acquire a moderate amount of wealth, our expectations rise for a higher quality of life. When we don't reach these new levels, our spirits flag, leaving us disillusioned. Doctors, lawyers, teachers, accountants -- they all find themselves on what experts call the "hedonic treadmill," working harder and making more money but still feeling blue.
A second explanation comes from the idea of "relative position": We compare our wealth and place in the social hierarchy to those around us. No matter how high we climb, we almost always encounter someone who is richer or who has more things.
The hectic pace of our lives takes its own toll. According to a recent Pew survey, 27 percent of people who are rushed in their daily lives describe themselves as "very happy," but 42 percent who are never rushed are very happy. Whether we are frantically thumbing our smartphones or staring at a television in an airport terminal, too often we spend our time focused on matters that lack any intrinsic meaning. I call this "urgency without importance," and it's a defining characteristic of our time that will not make us happy over the long haul.
Thankfully, there is a solution. It lies in the concept of "flow" -- when we completely immerse ourselves in an activity inspired by our own talents and interests.
The initial observations of this phenomenon were made among surgeons, athletes and musicians who trained for years to develop skills to perform at the highest levels. In detailed interviews, individuals described a sense of clarity, serenity and even ecstasy when they engaged in activities that paired their innate abilities with meaning and purpose.
Psychologist Mihaly Csikszentmihalyi, a former University of Chicago colleague who coined the term, explains that true happiness is found among those who maximize the time they spend "in flow" in their personal and professional lives.
Experts point to other important factors for creating a joy-filled life, including satisfying personal relationships at home, spirituality or religious observance, and strong doses of optimism. After 40 years in the doctor business, I know that all of these are important. I spend my days in the hospital, talking with all kinds of doctors. Despite their comfortable incomes and positions of authority, many bemoan the pressure they experience along with sleep deprivation and a lack of time to enjoy their lives outside the operating room. Many seem downright unhappy. I also spend my days listening to patients who feel robbed of any hope, the way I felt when I had cancer.
As I listen to all of these people, I can't help but think of Woody Allen. For all his wit and wisdom, he had it wrong. Life can have moments of misery, loneliness and suffering, but there's plenty of joy if we know how to find it.
Bruce L. Gewertz, MD, is surgeon-in-chief and chair of the Department of Surgery at Cedars-Sinai Medical Center in Los Angeles.