I was a level 1 fieldwork student in a hospital. My patient was in his 70s, post-stroke. He had a favorite occupation- playing Mah Jong! As a treatment idea, I asked the patient to stand and stack Ma Jong tiles while I facilitated using NDT techniques. After the treatment, I asked my CI how I did and she said “okay” but my patient asked why he had to stack the tiles. I realized that I just used the activity to facilitate and completely overlooked what it meant to the patient. It was then devoid of meaning, and not an occupation.