My dad died several months ago. He was my buddy, and I fiercely miss him every day. But I’m thankful for the many years I had with him, the memories we made together, and even spending the hard days with him when he was sick.

About a month after he died, I had the opportunity to say “thank you” to his doctor, the one who had cared for him the last several years. His determination opened some possibilities for a few more good days (and years!) with my dad, and I’m grateful. Yet when I said, “thank you” to him, it felt awkward. After all, my dad was no longer with us at the doctor’s office. I guess some would say we lost him, and what could there possibly be to thank the doctors (and so many other caregivers) for under the circumstance?

A lot.

As is often the case, there are many reasons for gratitude even in the middle of pain, grief, and suffering. Thankfulness and sorrow can coexist.

We don’t have to choose between the two. Life doesn’t have to be completely not okay or completely okay. Most times, both are true.

As I told the doctor “thank you,” I realized how many times I do the same to God: express my gratitude even when I’m still in pain. Thank Him despite the chaos around me. I can accept the peace and healing He gives me in the middle of the storm. I can not like what’s going on around me yet find a deep contentment that spurs me to long for more of the right things…of Him.

Thanking God in the middle of my circumstances doesn’t require ignoring those circumstances or putting a mask on and faking happiness. Thanking Him requires authenticity and trust, transparency and humility. It’s not easy. It doesn’t always feel good. It’s as if I scribble a note on a scrap of paper, because it’s all I can do at the time, and I offer it to God with open hands, thanking Him for continuing to work in my life, and handing over everything to Him.