To hope under the most extreme circumstances is an act of defiance that permits a person to live his life on his own terms. It is part of the human spirit to endure and give a miracle a chance to happen.

Hope can be imagined as a domino effect, a chain reaction, each increment making the next increase more feasible... There are moments of fear and doubt that can deflate it.

I had learned that every patient has the right to hope, despite long odds, and it was my role to help nurture that hope.

It took more than science to make hope real.

... omniscience about life and death is not within a physician's purview. A doctor should never write off a person a priori.

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 on 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.

True hope has no room for delusion.

The freedom of patient speech is necessary if the doctor is to get clues about the medical enigma before him. If the patient is inhibited, or cut off prematurely, or constrained into one path of discussion, then the doctor may not be told something vital. Observers have noted that, on average, physicians interrupt patients within eighteen seconds of when they begin telling their story.

Certainly the primary imperative of a physician is to be skilled in medical science, but if he or she does not probe a patient's soul, then the doctor's care is given without caring, and part of the sacred mission of healing is missing.