Gawande shared the most important realization of his post-college life. After years of wandering before settling on medicine and writing, he came to understand that purpose isn't an abstract concept you think your way into — it's a physical place where your work connects you to others. It could be a classroom, a business, a neighborhood. For him, it was a hospital, where he found satisfaction in learning difficult skills that others depended on and in being the kind of person that environment demanded him to be.