![]() In other words, optimists simply believe things will work out for the better. The influential psychologists Charles Carver and Michael Scheier, who have built careers studying optimism, describe it as the tendency to believe that outcomes in life will generally be positive, favourable or desirable. The Cambridge Dictionary defines optimism as ‘the feeling that in the future good things are more likely to happen than bad things’. But that doesn’t mean it’s the same as hope. Research shows that optimism is associated with many beneficial outcomes. There’s nothing wrong with being optimistic, of course. ![]() Hope is not wishful thinking, optimism, or ‘the power of positive thinking’. And because unpleasant realities permeate our lives beyond the realm of illness, this new understanding may also pay dividends no matter what difficulties we’re facing. If we buy into this equation, it means accepting that hope simply isn’t accessible for patients for whom cure isn’t possible, unless, of course, they deny the medical truth.īut these treacherous waters are navigable for physicians willing to follow a new body of research in psychology and accept a broader understanding of hope, one that allows the inclusion of difficult truths. This dilemma results from an overly narrow view – one commonly held in the medical world – that equates ‘hope’ with ‘cure’. Ignoring people’s need for hope won’t make it go away. But this isn’t a tenable conclusion either. But they also worry about the opposite strategy: that not accurately providing all relevant medical information or putting too rosy a spin on that information could lead patients down a path of false hope, denying them the time and space to emotionally prepare themselves and their families for whatever awaits.Ĭaught in this bind, physicians are tempted to throw up their hands and conclude that addressing hope isn’t their job. On the one hand, they worry that sharing the whole truth about a medical situation might destroy their patients’ hopes, leading to despair. Oncologists and other physicians who care for seriously ill patients such as Melanie often find themselves entangled by such a predicament. That felt more honest, but wouldn’t Melanie’s hope be crushed?ĭr Tamika’s thoughts capture what we call ‘the double-bind of hope’. But, under these circumstances, wouldn’t it be less than totally truthful to talk about hope? Perhaps, Dr Tamika pondered, she should instead speak with Melanie about her goals for the time she had left, preparing her for the likely scenario that it would be only a matter of months. She had undoubtedly already uncovered the fact that long-term survival was achievable only in a relatively small percentage of cases. Surely someone as bright as Melanie had Googled pancreatic cancer and seen the adjectives (deadly, devastating) and the clichés (‘the tumour that gives oncology its reputation’) that go along with this particular malignancy. After 20 years in practice, it seemed like having these conversations had gotten only harder. Inside her office, Dr Tamika was reviewing the PET scans and mulling over what to say to Melanie. The agony catapulted her to seek medical attention and, within a week, the work-up was complete. She could deal with the unexplained weight loss and the yellow tint that had altered the colour of her eyes. Indeed, her personal and professional lives were textbook descriptions of how to use ingenuity and grit to overcome grim obstacles. Her drive had been easily identified by her supervisors, and she was continually rewarded with broader responsibilities. But she was a fighter and would not be deterred. Sitting there, her thoughts drifted back to her advisor in college, who cautioned her that it would not be easy to succeed in a male-dominated field. ![]() ![]() Melanie, a 47-year-old partner at a top civil engineering firm in Boston, could not accept the fact that she was staring at tacky art in a physician’s waiting room.
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