Keeping hope alive for the seriously ill

As a physician caring for seriously ill AIDS and cancer patients, Jerome E. Groopman, M.D., has learned that doctors need to temper their prognoses with humility, regardless of how bleak the patient’s outlook may appear. “We should not sit like a judge and hand down a death sentence,” he said during a visit to Yale in November. “Never write someone off a priori.”

Delivering the Iris Fischer Lecture, the bestselling author, Harvard Medical School professor and chief of experimental medicine at Boston’s Beth Israel Deaconess Medical Center recounted some of the stories and themes from his recently published book, The Anatomy of Hope: How People Prevail in the Face of Illness. In the context of illness, he said, hope and science are often in conflict. “There’s a tension in how to be truthful to patients and ourselves and not take away hope,” he said. “We have to be careful about slamming the door on hope.”

His patients’ efforts to derive meaning from their illness, he said, offered a lesson about hope. “Hope arrives,” he said, “when you believe you have real choices to make, when you believe the future can be different than the present.”