VII/61. Hope
There are times to surpass hope with belief.
Hope resides on a spectrum: on one end is the vague hope that is no more than a dream; in the middle is the optimistic hope that sustains ambition and plans; on the other end is the justified hope that motivates one to work and achieve reality. Each, in turn, is essential and valuable, but only if it is clearly differentiated from the other two and matched with appropriate actions and expectations.
––John Roberts
Hope is itself a species of happiness, and, perhaps, the chief happiness which this world affords.
––James Boswell, Life of Samuel Johnson, 1791
While I breath, I hope.
Motto, South Carolina
Courage is like love, it must have hope for nourishment.
––Napoleon
Every patient has the right to hope, despite long odds, and it was my role to help nurture that hope. As medical science advanced, it became easier for me to help my patients see and sustain hope because I believed in it myself….Hope is constructed not just from rational deliberation, from the conscious weighing of information; it arises as an amalgam of thought and feeling, the feelings created in part by neural input from the organs and tissues. …Hope can be imagined as a domino effect, a chain reaction, each increment making the next increase more feasible.
––Jerome Groopman, M.D., The Anatomy of Hope, 2003
The test of a first-rate intelligence is the ability to hold two opposing ideas in mind at the same time and still retain the ability to function. One should, for example, be able to see that things are hopeless yet be determined to make them otherwise.
––F. Scott Fitzgerald
Refusal to hope is nothing more than a decision to die.
––Bernie S. Siegel, M.D.
Treat your hope with respect and merge it with your optimism, but also temper it with the reality it must have to be meaningful. It is important for the doctor and loves ones of a seriously-ill person to give hope. That obviously improves morale and the fighting spirit, and it is probable that it will improve the outcome or ease the burden of final days. But, judgment is required: some people want direct honesty, without the sugar; others may benefit from the absence of the really bad news, or at least a gentle presentation of reality at the appropriate moment.
Many great accomplishments began as unreachable hopes and dreams. In each case, someone believed in the dream, and did the work of building it into a possibility, then a reality. Success is more than a dream: it is vision, then a financial plan, then a floor plan, then a construction project, then a conversion of a house into a home and, finally, a place to live in happiness with those you love.
Miracles, low-odds cures, or prolonged remissions can happen; the patient, and some loved ones, should have some sense of those possibilities and promote the positive attitudes that create the benefits I have described elsewhere. On the other hand, we must be on guard against the harm and shock that may result from an exaggerated belief in a positive outcome and the resulting dismay when it does not occur.
To achieve a useful level of hope, a level of realistic expectation that a dream can be achieved, is a wonderful feeling and a source of strong motivation. It brings the dream from outer space to within reach and sets off the hard work that still must be done to finish the job. Hope, in other words, is only the necessary beginning. A lot of hard work is involved in moving it from the dream stage to the accomplishment of practical objectives.
Hope can be a small flame, hardly different from an unreachable goal. Such dreams, when realism is demoralizing, can be a source of happiness, perhaps even an escape, even though we know they will never be. But we must guard against investing our time and energy in this way if that diverts us from the practical necessities of life and the more likely probabilities that set our remaining course.
