Perfect days: Leading with gratitude
When you woke this morning, what did you first think of? Or did you not have time to notice as your phone beckoned to you impatiently from your bedside with its tyrannical demands?
That would be understandable. There are certainly plenty of urgent reasons to see what your phone has to tell you next. 2025 has been a year without respite. A year where the volatility, uncertainty, and challenges to what it means to provide healthcare have been head-spinning. Full 360s.
Yet amidst this buzzing, tumultuous milieu, as we prepare for Thanksgiving, it is the most beautiful quiet gem of a film, Perfect Days, that keeps coming to mind.
Perfect Days, Japan’s 2023 entry for Best International Feature Film, doesn’t tell a story as much as shares the life of its main character, Hirayama, a Tokyo public works employee.
Hirayama lives alone in a small apartment where he wakes each day, tends to his plants, goes to work cleaning public toilets throughout the city, and eats dinner at the same small diner. As we watch him, we are slowly drawn in as we appreciate the unremarkable ever-present reverence with which he holds all that he does.
The film is as much a lovely meditation on the sacredness that can attend ritual and daily routine as it is a reflection of the complex emotional tableau that is life itself.
In many ways, Perfect Days manifests the reframe of “I have to” to “I get to.” From “Woe is me!” to “How lucky am I?”
This reorientation of our attention—how we resolve to experience our days—is a choice to be grateful. It is an appreciation that we have the good fortune to be granted the opportunity to do that which is before us.
As healthcare leaders, we have been granted good fortune
You “get to” be the ones who, in this tumultuous time, guide the future of how this country will deliver care to its communities. While the current challenges may not be the ones you would wish for, you “get to” be the ones who take it on.
To be clear, there is no suggestion that such a reframe is easy or that it alleviates the weight of accountability you feel upon your shoulders. The healthcare challenges you are striving to meet are, in many ways, existential:
- How do we care for our most vulnerable?
- How do we provide greater access, greater care, when resources are ever-more constrained?
- How do we support our caregivers and employees at a time when burnout is prevalent?
- How do we continue supporting world-changing basic, translational, and clinical research?
- How do we effectively harness the promise of technology to address these challenges?
Your answers and actions will be greatly informed by your attention, whether you live in a conviction of defensive scarcity or generous possibility. What do you choose to see?
Healthcare in America is on the precipice of great change, and you “get to” be the change agent—the one in a position of leadership who is privileged with the opportunity to answer the call.
And that is something to be grateful for. To be able to have impact, drive direction, alleviate suffering, elevate the spirit.
To be grateful is to act
For here’s the thing: Gratitude is not merely a feeling of deep appreciation (though it begins there). To be grateful is to act, to be a worthy steward of that very thing for which you are thankful and have been privileged to behold.
To be grateful is to be in debt to appreciation. To be fortuitously accountable to it.
This reframe is not new. To paraphrase stoic and Roman emperor Marcus Aurelius:
“At dawn, when you find yourself challenged to rise, tell yourself: I get to go to work – as a human being… I get to do what I was born for. The things I was brought into this world to do.”
If you’re Hirayama in Perfect Days, at dawn you rise, admire your bonsai tree and, from time to time, you trim it, and prepare for the day, appreciating the sacredness of what lies ahead.
And if you are a U.S. healthcare leader, you have the same opportunity when you rise—before the chaos and tumult of the day take over—to take a moment to breathe and be grateful to be in the position to make a difference to so many.
And as we look out across the healthcare delivery landscape, at the leaders assembled across myriad fronts, we are grateful to you. For all you have done and all you will do. Day in and day out. And in their context, perfect days.
Happy Thanksgiving.
About the authors
Ken Graboys, CEO of Chartis, began his journey not in an office, but in rural Africa, working in communities facing famine and limited access to care. It was there he saw how the foundations of health—food, medicine, compassion—could shape the trajectory of entire communities. In 2001, he co-founded Chartis with the mission to improve the delivery of healthcare in the world. His career path—from fieldwork in Mauritania to healthcare transformation—illustrates a commitment to cultivating healthier communities through thoughtful, sustainable action.
David Jarrard, Chairman of Jarrard, grew up in Oak Ridge, Tennessee—a town shaped by science and innovation. His early career as a journalist covering human stories gave him firsthand insight into how storytelling can influence public perception and drive change, which naturally connects to healthcare, a field where clear communication can impact patient outcomes and organizational success. This foundation led him to build one of the nation’s leading healthcare communications firms.