Monday, May 19, 2008

In praise of difficult hope

Hope may have feathers, it may float like Ivory soap, but its key characteristic for me is this: You have to put some weight behind it. That rock isn't going to push itself up the hill by itself. Hope is an idea put into action, a melding of thought and deed that results in something powerful -- the idea gains conviction from the action, and the action gathers reach and scope from the idea.

This is part of why Barack Obama's voice is so powerful. He taps into our sense that we need hope -- and action. I don't expect Obama to magically transform Washington (much less the United States, or our beautiful, miserable world) through the beauty of his face, story and words. But I do expect him to get some crucial work done because when he talks about hope in one breath, he usually talks about action in the next. He'll conjure up images of mutual respect, increased civility, finding common ground -- and then he puts some weight on it, by talking about how he'll build a working legislative majority.

I digress. What I really want to do here, because I haven't sorted out what I think about hope, is defer to Dr. Jerry Groopman, whose book The Anatomy of Hope: How People Pervail in the Face of Illness, has a lot to offer to people working to stay hopeful in the face of calamitous illness:

Hope is one of our central emotions, but we are often at a loss when asked to define it. Many of us confuse hope with optimism, a prevailing attitude that "things turn out for the best." But hope differs from optimism. Hope does not arise from being told to "think positively," or from hearing an overly rosy forecast. Hope, unlike optimism, is rooted in unalloyed reality. Although there is no uniform definition of hope, I found one that seemed to capture what my patients had taught me. Hope is the elevating feeling we experience when we see -- in the mind's eye -- a path to a better future. Hope acknowledges the significant obstacles and deep pitfalls along that path. True hope has no room for delusion.
Here's some of Groopman's sense of how action feeds hope:
Hope can arrive only when you recognize that there are real options and that you have genuine choices. Hope can flourish only when you believe that what you do can make a difference, that your actions can bring a future different from the present. To have hope, then, is to acquire a belief in your ability to have some control over your circumstances.
A little more on the use of hope:
Each disease is uncertain in its outcome, and within that uncertainty, we find real hope, because a tumor has not always [SG note: Uh, Mr. Harvard, ever?] read the textbook, and a treatment can have an unexpectedly dramatic impact. This is the great paradox of true hope: Because nothing is absolutely determined, there is not only reason to fear but also reason to hope.  And so we must find ways to bridle fear and give greater rein to hope.

Will this hope charge up the immune system? Mute pain signals? Power some of us through to survival? I'm not so sure, and Groopman's chapter on the biology of hope isn't terribly convincing. But I know that it makes life richer -- and maybe, just maybe, lays the foundation for the kind of miracle that some of us need (and a few of us get).

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