In times like these, it’s important to have a raison d’être

Years ago, when I was doing a medical school clerkship, I decided to visit my fiancée’s grandmother, Belle, who lived near where I was working.

I recognized Belle wanted to meet me, and I also wanted to get to know her. She was in her 80s at the time, so I asked her:

“What do you attribute your longevity to?”

“I always have a reason to get out of bed every morning,” she responded.

While it struck me at the time, I didn’t really gain a full appreciation of her response until several decades later, when I read recent studies that demonstrated that having life purpose — the sense that life has meaning and direction — not only helps psychologically, but also raises life expectancy.

A study published in the Journal of the American Medical Association (May 2019) looked at the association of life purpose and mortality among nearly 7,000 U.S. adults older than 50. The results showed that people with a sense of purpose in life had half the mortality during the study years compared to those who did not. The association remained true regardless of gender, race, education or economic level.

Having goals in life was more important to mortality than the health risks of smoking, drinking excessively and/or not exercising.

In a study published in December 2019 in the Journal of Clinical Psychiatry, researchers from UC San Diego School of Medicine found that people who found greater meaning in life had better physical and emotional health.

Other studies have shown that having reasons for living can lower the risk of stroke and heart attack by 50 percent or more, and can protect against Alzheimer’s disease. In the latter study, people with low life aims had twice the risk of developing Alzheimer’s compared to those who scored with high life aims.

Although I regret that I did not ask Belle what, in particular, drove her to get out of bed in the morning, medical studies have similarly not addressed the question of how participants define their meaning of life.

When I was working as an internist at Kaiser for more than 30 years, I never gave a second thought about how to find meaning in my day.

When I was discussing retirement with one of my patients, he blatantly expressed his fear about retiring. “If I retire, I will die,” he said.

So when I retired, I knew I had to find other ways to give motivation to my day. In addition to volunteering at the Samaritan House free clinic in San Mateo and playing viola and violin in the Peninsula Symphony, I have discovered the joys of teaching, medical writing, reading more books (instead of medical journals) and playing with my granddaughters.

Whatever your fulfillment may be, it’s important to find something that suits you — even if it’s simply having online Zoom gatherings with friends.

The absence of having a reason to get up in the morning should be conceived as a modifiable risk factor for optimal health — just like lack of exercise or poor diet.

How might having a sense of purpose improve one’s health? My speculation is that when one has something to live for, there may be more incentives to care for oneself (such as engaging in daily exercise and eating healthy).

Also, there may be less desire to engage in detrimental behaviors, such as drinking excessive alcohol, overeating or playing mindless computer games.

When one gets sick, having a baseline sense of life being worthwhile could potentially help someone cope better with disease.

In a 2014 study from Rockefeller University, having a purpose in life was linked with greater use of preventive health services such as obtaining a cholesterol test, colonoscopy or mammogram, or getting a prostate check.

When I clerked and studied at the National Institutes of Health, I acquired an enormous amount of medical knowledge. But, in retrospect, perhaps the most important lesson I learned was from Belle.

During the current pandemic, having a reason to get up in the morning may be even more essential in achieving a worthwhile and longer life.

Dr. Jerry Saliman is a contributing wellness writer for the Peninsula Jewish Community Center in Foster City. He retired from Kaiser South San Francisco after a 30-year career and is now a volunteer internist at Samaritan House Medical Clinic in San Mateo.


Dr. Jerry Saliman

Jerry Saliman, MD, retired from Kaiser South San Francisco after a 30-year career and is now a volunteer internist at Samaritan House Medical Clinic in San Mateo.