The potency of hope

The holiday season brings many reminders of the power of belief, faith and hope. Unfortunately, we in the medical profession often focus so much on science that we forget how important these other factors can be in our patients’ healing. On a recent plane trip I sat next to a Brad, a 50 year old engineer who painfully recounted the experience of listening as his mother was told that she had pancreatic cancer and only months to live. Brad realized that the physician was attempting to be compassionate by quickly jumping from announcing the diagnosis to explaining medicine’s ability to make Brad’s mother comfortable as the cancer progressed. Clearly, the physician had forgotten that a whole lot of living could occur between those two points – life events that would give meaning to the rest of her time; provide strength for her to face treatment, uncertainty, and discomfort; and create memories to live on after she was gone.

Fortunately, the family understood this.

As the months passed and her illness progressed, her family helped her live fully by focusing on a granddaughter’s graduation, then a friend’s daughter’s wedding, next a family trip and, finally, Thanksgiving. Each event was something to look forward to – something to hope she would live to see. Her presence made each event even more special to everyone there. A similar interaction was described by Rachel Remen, MD, the founder of the Institute for the Study of Health and Illness and author of Kitchen Table Wisdom. Rachel was told at 15 that she had Crohn’s disease, that she would have a difficult life and probably wouldn’t live past the age of 40. She often wonders how differently she would have approached her life if she had instead been told that she would have a difficult life, but that it could still be a good life.

None of us knows how long our patients will live, what challenges they will face, and what their future will hold. Medicine is not an exact science and we each have experienced the mystery of patients becoming ill or recovering unexpectedly. By admitting our uncertainty and allowing our patients to have hope – of fully recovering or living to the next event or of being engaged with their loved ones and life itself until the time comes to let go – we give them a very powerful tool that will help them meet whatever life does bring. We demonstrate that we believe in the importance of living their life to the fullest – for as long as they possibly can. That is the essence of partnership and it can offer our patients an important and compelling source of healing.

With warm wishes that your holiday season will be filled with the promise of hope.

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About Helane Fronek

Over the past 28 years I have had a fascinating and fulfilling career in medicine, initially practicing as a general internist and then as a procedural specialist, caring for patients with vein disorders. As Assistant Clinical Professor of Medicine at UC- San Diego School of Medicine, I’m thrilled to be teaching medical students crucial communication skills along with many other aspects involved in the practice of medicine.
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