WHEN I WAS in medical school, I decided early on that although I wanted to specialize in cardiology, I did not want to become a researcher. I also knew I did not want to be a surgeon. What interested me most was building relationships with my patients and taking care of their heart health more holistically. I truly want to know what makes my patients tick. The heart is a wondrous organ, but I don’t just look at their hearts. Understanding them as a whole is key to my work and to their medical outcomes.
I’ve had patients come to me who had so little heart function that it was a miracle they were able to walk into my office at all. But these patients were often the ones to make the most profound changes. Why was this so? I’ve also worked with patients who, with just a minor lifestyle adjustment, could have gotten their blood pressure under control, yet sometimes just weren’t able to make what seems like a slight change. Again, why was this so? Why is it that some of my patients are able to rise to their health challenges in such an amazing way? And why are some, despite the presence of serious cardiac health issues, able to live a great life? These are the patients who fascinate me the most. I decided to explore what separates these patients and allows them to thrive in the face of adversity.
So I began to gather and examine my patients’ stories, searching for some kind of common denominator that put them on a path of healing, even when overcoming an illness or managing a disease was no longer an option. What separates these patients is something that moves beyond the realm of physical health and moves into the territory of mental health.
This is when I realized that these patients were exhibiting a psychological strength that was influencing how they responded to a diagnosis or a treatment plan or even the end of life. I was beginning to understand that, just as the human heart is designed to be resilient and to withstand a fair amount of stress, so, too, is the human mind and spirit.
I STARTED TO take note of the ways in which my patients responded to a diagnosis or treatment plan. I also started to ask patients what they needed and desired in the face of a medical challenge. What they needed, it became clear, was a plan for building and strengthening resilience. In my office, my patients often wondered, “When will I feel like myself again?” And that helped me see how building and strengthening resilience might help them navigate the uncertainty of a diagnosis or treatment plan. What I began to observe intrigued me so much that I became a passionate student of resilience and the psychology of resilience. I wanted to understand how resilience might influence medical outcomes for my patients.
First, a bit about what resilience is not. Resilience is not the capacity to return to the same place you began after trauma or tragedy. Neither our minds nor our bodies are built like rubber bands: We do not “bounce back.” We are influenced and affected; we recover; we grow; we change. This, I believe, is what the core of resilience is: the ability to embrace change. You can build it with ingredients I call the Resilience Response.
It involves numerous factors, but it begins with acceptance. That might sound like an easy task—but ask anyone who has faced a trauma, a challenge, or a failure and has had to accept a new reality after, and they will tell you it is anything but easy. These moments can undo us, but they can also transform us.
I often see patients diagnosed with atherosclerosis [a chronic disease where plaque builds up inside the arteries, causing them to narrow] grapple with acceptance. Many of these patients are shocked, as outwardly they seem to be living generally healthy lives: They are in shape, getting exercise, are a normal weight, and can’t believe they could have heart disease. It is also hard for them to understand that this is not curable. Atherosclerosis can be managed, but it cannot be removed or fully reversed. They will be living with it for the rest of their life and will always be monitored or treated. Managing atherosclerosis is crucial to preventing a heart attack or stroke.
Plaque in arteries is caused by many things that we have a degree of control over (and sometimes things we don’t, such as genetics or age), and that’s why it is so important that I support my patients—without judgment—while they learn about the reality of their condition, including that they may have made lifestyle choices in the past (smoking, eating an excess of processed foods, being sedentary) that contributed to the development of the disease. Once they accept the fact of the disease, then we can move forward and make a meaningful plan to slow its progression and hopefully prevent an event such as a heart attack or stroke.
THE GOOD NEWS is that much of the cardiovascular disease I describe above can, especially if it is detected early, be managed in ways that allow us to continue to live full, active, and rich lives—but it all begins with acceptance. And acceptance means not only accepting the things we cannot change, but having the willingness to change the things we can.
Studies of elderly adults with arthritis, hypertension, and hearing and other impairments, patients with HIV/AIDS, patients with kidney disease who are on dialysis, and other people suffering from chronic conditions have all shown that patients have more positive clinical health outcomes when they have some kind of acceptance intervention as part of their treatment. The goal is to acknowledge the illness, the limitations it may bring, and the emotional distress it may cause, without judgment or resistance.
These interventions often use acceptance and commitment therapy (ACT), which can help us recognize thoughts about our illness—such as “Why me?” or “I can’t do anything anymore”—and acknowledge these thoughts as just thoughts, not facts. This can reduce the power of these thoughts to cause distress. Mindfulness practices, such as meditation or deep breathing, are also powerful tools in this intervention—which is promising news for how we can practice a Resilience Response, even in the face of great challenges.
One of the studies that gave evidence of how crucial ACT can be focused on chronically ill adolescents and their relationship with their diseases. From their conclusions, the researchers developed a four-pronged pathway toward acceptance: understanding of illness, overcoming limitations, normalization, and, finally, readiness for responsibility. They learned that patients who followed the four steps of acceptance were able to effect positive outcomes, such as improved self-esteem, increased quality of life, stronger identity, and better disease control. Patients who did not, on the other hand, experienced psychological distress.
So it’s not just that acceptance can be psychologically beneficial—but it can help the patient literally get better, too. That’s why I believe it’s so important. I’ve seen it in my practice, and beyond.
IN ADDITION TO acceptance, I’ve found that building resilience requires developing certain skills: a flexible mindset that can allow for change—especially important given that change is inevitable; a commitment to pursuing physical health through lifestyle choices; an ability to face fears; a commitment to connecting with those who surround you in daily or more lasting ways; embracing a love of self and others; an optimistic or hopeful outlook on the future; and a feeling or pursuit of purpose. With these ingredients, anyone can build resilience.
Through my work as both a physician and a medical journalist, I’ve seen that resilience is not only essential to meeting the traumas, tragedies, challenges, and failures we all must face, but it’s essential to retaining one’s sense of wonder, joy, and excitement about life. It’s a critical tool. And it is my hope that one day, in the not-too-distant future, we physicians will truly understand how essential resilience is to healing for us living, breathing human beings.
Resilience training should and can become part of the standard of care for patients and what we teach in medical school. In the meantime, you can cultivate resilience in your life in order to strengthen your heart, improve your health, and live the fullest life possible.
Excerpted from The Healing Power of Resilience: A New Perspective for Health and Well-Being. Copyright © 2026, Tara Narula. Reproduced by permission of Simon Element, an imprint of Simon & Schuster. All rights reserved.
