We all need hope. It is powerful and its absence is devastating. Hope allows us to move forward and to dream. Over decades of practice, I have found it to be the most powerful medication I can give a patient.
When we dispense hope, we must be as honest as we are with any treatment. False hope must be vigorously avoided. It is lying. In giving false hope, we might deprive our patients of the opportunity to make critical decisions such as planning for their death. False hope can steal precious moments from loved ones who want to be with the patient one more time. It can sway a patient to elect a treatment plan that is as likely to add days of suffering as add calendar days. These decisions are theirs to make. Our role is to give them the tools they need to decide.
Hope must always be put in perspective. Hope of surviving may seem paramount to us, but that is the decision of the patient and not ours to make. Studies have shown that those in the dying process are most afraid of the loss of independence and dignity. They fear pain, but it is not their greatest fear, and we now have so many effective tools to help them relieve pain. Suffering is always to be defined by the patient and respected by those caring for them. Hope is assuring them we will relieve their pain. Hope is letting them know we will be there for them. Hope is providing a care environment that attacks loneliness.
The value of hope is magnified for those at the end of their life. It is part of our daily care of every patient as well. We must give the new diabetic hope that in working with us to control their disease they will live long and be healthy. We must give the new hypertensive the real hope that in controlling their blood pressure we are preventing a stroke and heart attack. With each COVID vaccination, we must also inject the real hope that they and their loved ones are now being protected. I love meeting with my patient to discuss their test results. It is an encounter filled with opportunities that will open doors for their future.
Hope must drive us as much as it should our patients. We need hope to see us through COVID. Hope will allow us to get up the next morning and start all over again, but armed with another day of that invaluable tool of experience. By reflecting on what went well at the end of our day, we realistically fuel our hope for tomorrow. Those who care for patients must embrace the power of hope. We must respect it and dispense it honestly. We must all find that light in the darkness and let it guide our patients, those we love, and ourselves.
John F. McGeehan is an internal medicine physician.
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