As we move through the Coronavirus pandemic, there is so much uncertainty, so much change, and so much difficulty for many. Especially in healthcare, the level of hardship is unprecedented. As I coach physicians across North America, I’m struck both by the impact of the pandemic and also by the impact of the difficulty we can have in accepting all the uncertainty and change.
I’ve found myself thinking about something called the three marks of existence. Never heard of these? Well, here goes:
I had the very good fortune to study in a two-year intensive mindfulness meditation teacher training with world renowned leaders Tara Brach and Jack Kornfield. Amongst the myriad things I learned, I heard for the first time about the Buddhist three marks of existence. The three marks tell us that suffering and difficulty occur for all of us, that change is a part of life, and that human beings tend to bring a great deal of ego to everything they experience. I feel foolish that I didn’t understand these previously but I’m very grateful that I do so now. They have provided a very firm foundation for me, as a physician, as a physician coach, as a mother, and as a human being. In this blog, I’d like to unpack these three marks and think about how they can help you build resilience to healthcare and physician burnout, and to the stress of this time.
1. Build Resilience by Understanding that Pain and Suffering are a Part of Life

The first mark tells us that pain and suffering are part of the lot of all human beings, and probably all living beings. This probably does not come as a surprise. When you consider your life thus far, have you experienced suffering and difficulty? I suspect that you have. With the pandemic, certainly, there is, suffering aplenty. So, you know that difficulty and challenge are a fact of life. But do you still find yourself railing against the difficulties that life presents you?
Or thinking something like “This really isn’t fair“ or “Why do I have to struggle in this way when others don’t?” or “Why do all these bad things keep happening to me?” Perhaps, with all the comparisons that Facebook and other forms of social media so readily offer us, “Why is their life or marriage or family so perfect when mine is a shambles?”
When we lose sight of fact that everyone struggles, we can feel singled out by the difficulties we face, with a sense that our problems are greater than other people’s. When we think about the first mark of existence, though, it helps remind us that everyone struggles in one way or another. We just don’t get through this journey of life without hardship.
Illness, accidents, loss, a toxic boss, difficulties in our kids, or public health crises. Whatever form it comes in, everyone encounters difficulty. When we keep the first mark in mind, we can develop a more flexible perspective about the difficulties that we encounter, and greet them with greater ease.
It’s not that the first mark means that difficulties become easy, but perhaps our experience of them can become somewhat less burdensome.
2. Build Resilience by Understanding that Change is the Only Constant

The second mark of existence is that everything changes and nothing is permanent. Our bodies, our relationships, and our environment all change. Leaves fall off the trees, our skin ages, seasons pass, time never stands still. Look at how different the neighborhood you grew up in looks today.
Examples of change abound. But do we accept change gracefully and with ease? Most definitely not! And we’re a bit fussy about it to boot. We want the things we like to stay exactly as they are, and the things we don’t like to transform into something else as soon as possible. But we suffer unnecessarily when we hang on tightly to the ephemeral good things, and uselessly rail against bad ones that are bound to pass.
I know that I certainly struggle with change. Because of the Coronavirus, my 23-year-old son has been home unexpectedly for this time. It’s been an unbelievable blessing and silver lining to this difficult period. But now that he’s planning to leave for his final semester of college, I find myself distressed, fretting that the time will soon come when he leaves, and wishing that somehow he could stay home longer.
I can get so caught up in this train of thought that I am more tense in the time I do have with him, almost bracing myself against his inevitable departure. But when I can remind myself that it’s the natural progression of life for a grown child to leave the nest, and that change is the norm and not the exception, I can relax a bit and resist less. And I can lean more into gratitude for the time I do have with him. All of which help me build resilience.
And with the growing societal awareness of police brutality against Black Americans, we see that change and impermanence can be highly positive, and, in fact, essential.
The second mark can help us gain more comfort with change, large and small.
3. Build Resilience by Seeing that the Mind Revolves Around the Self

The third mark of existence is a lot to take in so please be sure you’re sitting as you read this next sentence!
In strict Buddhist terms, it’s that there is no self. That’s right: no self. Now, I’m not going to try to tackle that complex existential concept, but what I want to draw attention to is the idea that we all live with a lot more emphasis on the self than may actually be in our interest. In truth: the universe doesn’t revolve around us, and the narratives we craft about ourselves aren’t always true.
Mindfulness can help us build resilience by becoming more aware of what’s going on inside and around us, in the present moment and with compassion. When we pay close attention, we can get to know our minds and the stories our minds tell us. We can begin to see just how many of our thoughts revolve around “I, me, mine…”:
“I’m not as smart as my peers.”
“Why did that person say that to me?”
“My child is a star athlete.”
“I’m not a good enough parent, spouse, friend …”
We begin to recognize that our mind perceives our reality with us at the center. This makes sense, as our minds need a reference point for understanding our world. What’s important, though, is realizing that this lens is not necessarily the most accurate one. When we become too attached to the lens of I, me, mine, we can lose our ability to focus on the wider lens of difficulties others may be experiencing.
And haven’t you found, when you’re off in your own preoccupations, that you are less present with others? Perhaps more irritable and short tempered? And we can become preoccupied with small details about our existence. Details that are not truly all that important. For myself, I’m aware of how much better it feels when I step out of my small, preoccupied, self-focused state. On days when I do so, I feel a sense of pride in myself and my actions.
The third mark reminds us, as the saying goes: Don’t sweat the small stuff.
What’s happening to others may be of more consequence than the small matters we often preoccupy ourselves with.
How do we do so? With practice, we can work to question our beliefs about ourselves, and think more fluidly about who we are. We can learn to approach conflicts from other perspectives. We can move out of a self-focused reality into a wider lens. Most importantly, we can remind ourselves not to take ourselves and our problems quite so seriously!
Resilience Training Equals Flexibility Squared
Paying attention to the three marks can reduce the strife we experience, yet it requires a great deal of flexibility to develop this resilience. And training in the form of practice. Flexibility to loosen the reigns on what we want and expect to happen. Flexibility to roll with the punches life throws us. Flexibility to embrace the lens that others bring to the disagreements we have with them. And with greater flexibility we become more resilient.
Build Resilience Everyday
Did you enjoy today’s blog?
I’ve been fascinated by these themes for some time and have a book coming out on the topic this summer! It’s been a long time in the making and now it’s going to be birthed into the world. It’s a short book and an easy read where I guide people to understand what resilience is, know that we all have it inside of us, and provide many tips and practices to build and foster it in your life. One of the major themes I cover in the book is flexibility.
With a countdown of just 9 weeks, I look forward to sharing “Everyday Resilience” with you very soon.
Related posts
If you’ve missed any previous posts in our popular Mindfulness In Medicine Series, here’s a list of them for your convenience.
- Mass Medical Society features Dr. Gazelle’s meditations and short talks for resilience in the time of COVID
- 4 Keys To Emotional Intelligence and Resilience During the Coronavirus Outbreak
- Leadership during Covid-19 – White Paper
- Fear and Worry During Covid-19: 3 Practical Anecdotes
- Physician Leadership in the Time of Covid-19: 3 Things You Need to Know