where to focus

I listened to Brooke’s podcast about transitions – she was discussing empty next and mid life
I am in a transition and not sure where to turn.
I’m 42. My 20s were spent in medical school and training. My 30s were spent with my first job as an attending doctor and having a family and grappling with my oldest son being diagnosed with a terminal rare genetic disorder. My 30s were chaotic, sad, and about survival.
My 40s have felt.. full. With scholars I have been “forced” to pause and think. I have three major areas I focus on: work, my kids, and my non profit designed to cure the rare disease my son has. Life is so full and so busy I have little time for foresight into the future and what I want my 50s to look like. How does one pause long enough to understand future goals? How does one make future goals when the day to day is too busy? How does one determine which aspect of life to focus on when there are so many?