This is a powerful piece of writing, and it touches on so much.  I'm in good health (so far) and CAN work, but what strikes me is something a friend of mine once said.  "There is no reason to get up in the morning, there is no purpose in life."  It sounds cynical and depressive on the surface, but what I noticed is the incredible amount of freedom embodied in that sentiment.  There are no reasons to get up in the mornings, there is no meaning to life...this doesn't mean that it's not worth it to get up and live, it just means that the universe/world is kind and gentle enough to let us all come up with our own reasons!  We have no obligations, no real ones anyway...and so to get up and to live is actually a choice, and each time we do it for our own reasons, we give meaning to those things that are inherently meaningless.  Humans are pretty darn good at that.  THIS is why I like your poem so much; it reminds me of that, and it lets me see that as long as I (or anyone else) continues to strive, I'm (or we are) giving meaning to so many different things.

Great work here!