Should heart patients make a ‘Bucket List’?

by Carolyn Thomas    @HeartSisters

Tomorrow is my cardiac anniversary. It’s been three years since the day I was hospitalized for a heart attack caused by a fully occluded left anterior descending coronary artery. Ongoing cardiac complications mean I’ve often wondered since then if I’d actually live to celebrate this milestone.

Since surviving a heart attack, I’ve been asked on occasion by friends and family (and even people who barely know me) about my “Bucket List” – that Hollywood invention of wonderful things we really must do before we kick the bucket.

Because I have survived what many do not, they wonder if:

  • I now have a greater determination to live every moment to the fullest?
  • I plan to experience all those adventures I may have put off until now?
  • I have created a list of exciting life-affirming things to complete before I head off to that great Coronary Care Unit in the sky?

The answer, dear heart sisters, is an unqualified “No!”

In fact, I sincerely doubt that I’d actually be any happier than I am right this moment if only I could go bungee jumping/skydiving/bull riding/Everest climbing.

My personal belief has long been that I always have enough time, money and energy to do what I really, really want to do.

So if I haven’t done it by now, I’m thinking that – based on results – it simply wasn’t that important to me after all, or the truth is I would have already found some way, somehow, to get it done.

And I also like the lines from the Mary Oliver poem called The Summer Day:

“Tell me, what is it you plan to do
with your one wild and precious life?”

I take these lines as inspiration to plan not just for one limited Bucket List task, but for LIFE. 

It means spending this “one wild and precious life” doing far more of what we love doing right now, and far less of what we don’t.

It means that how we spend our days is in fact how we spend our lives. Today, right this moment – not someday, one day, maybe, down the road, just in time before we kick the bucket.

But perhaps the most important reason I don’t need a Bucket List:

I hate making To Do lists and don’t want to add anything more onto any of them.

Last Wednesday morning, for example, I had only two tasks on that day’s To Do list:

  1. a doctor’s appointment
  2. a stop at the farmer’s market on the way home.

But that latter task actually took me three exhausting days. As a heart patient living with ongoing symptoms, I apparently have enough energy to shop for several canvas bags of produce, clean out the fridge to make room for all this new stuff, prep and pack away all the incoming fruit and veggies – just not all on the same day.

A Bucket List is merely a fancy-schmancy To Do list with major deadline pressure, created by people who aren’t already doing what they love doing in life.

And each item on this list must really deserve to be there. Not just: “I think I’d like to go to the bead shop and make a couple bracelets this weekend.”  .  .   .  Oh, no…

What about everybody’s favourite Bucket List goal:  a fabulous vacation?

I was listening recently to the American author PJ O’Rourke being interviewed on BBC‘s World Book Club, in which he stated:

“I don’t get much pleasure out of traveling for pleasure!”

He says, for example, that when on vacation, he inevitably risks uttering the inane sightseeing response:

“Well! This is beautiful!  This is really beautiful.  Isn’t this beautiful?  Is it time for lunch yet?

Vacation travel is simply not on any of my To Do lists any longer. After too many years spent traveling on business during my corporate PR career, I’ve already expended my lifetime quota of time wasted on waiting for delayed flights and car rentals, fretting over lost luggage, drinking bad coffee, trying in vain to get a good night’s sleep in too many strange beds, standing in endlessly long lines, making inane small talk with strangers I’ll never see again, and recuperating from jet lag.

If I never again see the inside of another airport, that would be just dandy with me. *

Besides, I live in Lotus Land here on the magnificent West Coast of Canada, arguably the most gorgeous spot on earth. People from around the world save up their money all year long just to be able to vacation here. Why would I ever want to leave?

And yet many of us seem to exist for those expensive far-off vacation dreams  and more of PJ O’Rourke’s inane sightseeing responses. At any given moment, for example, there are about 2 million of us Canadians traveling outside of Canada.  Mostly we vacation in the U.S.A.  Next most popular holiday destinations for us include Mexico, the Dominican Republic, and Cuba. Across the ocean in Europe, the U.K. attracts the largest share of Canadian travellers, followed by France, Germany and Italy. Many of us just can’t wait to get away from here.  But remember:

“Wherever you go, there you are.”

And then, of course, there’s always the debilitating post-vacation “Oh No It’s Over!” reality hangover slump that hits just before you realize you need to go back to your real life tomorrow morning, and again after you open the credit card bills.

RuthAnne Terrero, writing in Travel Agent Central, warns:

“Travel agents need to be careful of the “want-to-believe” syndrome by managing their clients’ expectations.

“There will always be those who book a trip and want the experience to be perfect – their hopes can be dashed when the slightest bit of reality enters the scene. They won’t be prepared for the fact that it might be hot in Rome during August, or that it tends to rain in the Caribbean on some afternoons because they are, after all, in the tropics, or that the hallways of their open-air-lobby hotel may not be air-conditioned!”

In a Psychology Today essay, Dr. David Rock, author of Your Brain At Work, offers some tips on managing these expectations. Instead of making a Bucket List, perhaps we could, as Dr. Rock suggests:

  • live a life with a good amount of novelty
  • create opportunities for unexpected rewards
  • believe that things are always going to get slightly better

For example, Dr. Rock recommends:

“Imagine you are trying to get an upgrade for a long international flight. If you keep your expectations low, you will either be okay if you don’t get the reward, or thrilled if you do. Whereas if you allow yourself to get excited about the possible upgrade, you will either have a terrible flight if you don’t get the upgrade, or only be quietly happy – though not thrilled – if you do get it.

“When you step back and look at all the possible outcomes this way, it makes sense to minimize one’s expectations of positive rewards in most situations.”

This is good advice for those of you working through your own Bucket Lists.  Just imagine how horrible you’d feel if you actually did accomplish one of your ultimate Bucket List goals – let’s say, completing a triathlon – and it turned out to be an even uglier experience than a triathlon normally is!

Speaking of keeping our expectations in check, consider the wise counsel of Chicago physician Dr. David Lickerman, who blogs at Happiness In This World: Reflections Of A Buddhist Physician. Here’s his take on four distinct possible outcomes of our expectations:

  1. Low expectations and a poor experience, where our low expectations can mute the disappointment or even the discomfort we feel at actually having a poor experience
  2. Low expectations but a good experience, leading to a pleasant surprise
  3. High expectations and good experience, in which we get to enjoy not only the anticipation of looking forward to something fabulous but an experience that actually lives up to our expectations and therefore feels thoroughly satisfying
  4. High expectations but a poor experience, in which we often emerge bitterly disappointed or even traumatized

Another Buddhist health professional, Pennsylvania’s Michael Formica, is the editor and project coordinator for the non-profit organization, Living Beyond Breast Cancer. He may be on to something when he writes:

“Just as soon as humans cross the boundary from basic survival needs to social needs, we are inevitably doomed to foster a sense of our own perpetual dissatisfaction.  This is a conflict that’s at the core of the human condition.

“Basically, this is a conversation about stuff. Not just material stuff, but all sorts of stuff – intellectual, emotional, social – all of our human stuff.

When we collect some stuff, we, quite naturally, want more stuff. It is this desire for more that traps us in our own dissatisfaction, because we are always grasping for more.”

Bucket Lists by definition represent “more” of what we don’t already have now, but somehow believe that if only we could have it/buy it/do it/eat it/see it/experience it, we would really, finally, truly be happy.

Thus “more” becomes the fantasy cure for whatever dissatisfaction we feel for not having quite enough yet.

To me, it seems that the only actual sure-fire road to happiness might well be accompanied by being happy with small pleasures of day-to-day life, and by keeping your expectations low.

And by not making Bucket Lists.


* Update:   And speaking of airports that I hope to never set foot in ever again: my experience in San Francisco after attending Stanford University’s Medicine X conference at nearby Palo Alto takes the cake.  Not only was the temperature a sizzling 100+ degrees all day, leaving me feeling limp as a wet rag, but the airport and United Airlines staff I encountered at SFO appeared intent on directing me (on more than one occasion) on a Three Stooges tour of not one but two major terminals over two frustrating hours in a fruitless game called “Where’s Gate 38?” – as it appears that knowing basic travel information (such as: “Canada is not an American state and thus does not belong in United’s domestic terminal”) doesn’t seem to be in the job description of the staff I encountered there. Never, ever again!

© 2011 Carolyn Thomas   ♥

♥  I wrote much more about making (or not making!) a Bucket List in Chapter 9 of my book, A Woman’s Guide to Living with Heart Disease (Johns Hopkins University Press, 2017).

Q:  Do you have a Bucket List?

16 thoughts on “Should heart patients make a ‘Bucket List’?

  1. I have a very long Bucket List. But there has always been some good “excuse” for not being able to do all the exciting things on that list “some day”. After my husband showed me this article this morning I took another look at my list. I saw that many of these things (“learning to fly a plane”) have been there for decades. If I REALLY wanted to learn to fly, you are so right —– I would have somehow found the time and money to make that happen years ago, the truth is that other things have been far more important than taking flying lessons, maybe that “goal” wasn’t a goal so much as it was something that sounded important and adventurous enough to impress other people, ouch, ouch, and actually why is that even on my list since I really truthfully do not have any interest in taking flying lessons any longer. WOW! thx for this….

    Liked by 1 person

    1. Like you, Gabbi, I’ve been feeling discouraged because I’ve been procrastinating with my lengthy Bucket List. But now I feel SO MUCH BETTER after reading this. I’m ripping up that stupid list . . . .

      Thanks for this Carolyn. Love this website!


  2. Pingback: Medical Lessons
  3. I found your article on Grand Rounds this morning. It’s so refreshing to read a no-nonsense perspective on what we “should” or “shouldn’t” be doing. Some days, it’s exhausting enough to live with heart disease without feeling an expectation that we also ought to be out there taking exotic trips or riding motorcycles! Love your site, thanks so much.


  4. I am a new nurse and when I was only 12 years old, I was diagnosed with Dilated Cardiomyopathy.

    Some of my friends in my classes always made a big deal about it especially from what they learned about Cardiomyopathy in nursing school. I always tell them not to worry about the future. I enjoy every moment that I have, and if an issue does arise, I will deal with it.

    I want to be content with what I have accomplished, so no bucket list is needed.

    Liked by 1 person

  5. Carolyn —

    Wonderful post.

    I have always been troubled by the idea of a “bucket list”, the idea that doing external things and seeing external things is the point in life… It makes more sense that it is about the daily appreciation of the “wild and precious life” that you mentioned….

    Probably the closest I have ever come to the right attitude were moments in the week after the heart attack, where I was grateful just to be breathing, and had no sense of entitlement to anything, particularly any desires to do a thing on a before-you-kick-the-bucket list…. It was amazing just be to alive…

    Liked by 1 person

  6. Thank you Carolyn! If I hear the expression “bucket list” one more time, I think I will spontaneously combust! I believed long before my heart issues that life should be lived not watched, but if a particular “want” or dream did not happen, my life still went on. The bucket list phenomenon focuses all our attention on some distant point and we miss all those small day to day things that fill our hearts: a hug, a bird song, a sunset, a laugh with a friend, a cup of tea. I love the big adventures, but I don’t live for them.


    1. Thanks Lauren for some great examples of those “small day to day things that fill our hearts” – precious moments we can sometimes take for granted.


    2. I’ve been feeling that there was something lacking because I do not have a Bucket List. Actually, the fact that I do not have a Bucket List means that there is not something lacking at all.


  7. Carolyn,
    May you have an anniversary filled with a satisfied soul. You’ve done some great things in this one wild and precious life ~ and may you continue to do them.


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