In this week’s presentations, there was some mention that a healthcare provider needs to see him/herself as the patient’s hope. What is the role of hope in medicine and healthcare? Does hope not make us more vulnerable?
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Hope is the precursor of resilience and grit. Hope can also show us a glimmer of happiness when we need it. However, hope is born from both happiness and sadness.
Happiness comes about when we’re in a balance and can deal with the various stressors, ideas and life circumstances that each of us has to interact and engage with. As I believe that medicine and public health can do (as demonstrated by the approach made by the Transcultural Psychiatry article), people have built-in resiliency as mentioned before – medicine can give ideas and tools for the physiological, psychological and emotional health of a person in an open-minded way, even if the doctor sees that patient only once. Their entirety of their being can also be reaffirmed and not dismissed. In addition as mentioned in previous weeks, there is an idea of post-traumatic growth in positive psychology that we need to have the ability to adapt to life adversity, but we can be positively transformed by our lows in life. This does not mean or advocate that people should go through straining life circumstances, but it highlights the importance of how people are strong in however they cope and happiness is an on-going, lifelong process that is facilitated by hope. However, as I stated last week, as we carry pain and sorrow with us, we are enlightened and challenged by it too – we become more emphatic with the world around us by understanding how it feels to hurt and feel that without meaning, our life may not be what it is meant to be or how it should be. We are “enlightened to perceive new periods of pain” by experiencing sorrow in its forms for us. This can give us hope too to find a better life or to keep living.
It’s also challenging to hold on to hope or to even want it at times, because the desire to hope can be hard with the circumstances placed in front of us. Being able to hope has to involve vulnerability though, which is hard. It’s hard to tear down our walls placed to protect us from the world, especially when we don’t want the world to know, but being vulnerable as the power to connect us to the world even more. A quote that I heard at the National Active Minds Conference last year was “Secrets are the currency to relationships” – being vulnerable allows us to build ourselves and each other up.
Being vulnerable allows us to make the conscious choice to challenge the realities in front of us, to make the choice to be happy, and to step in someone’s shoes to try to understand them better when we need to be, as the Health Humanities Reader illustrated this week in Chapter 24. As Paul Farmer stated in the chapter, “To accompany someone….is to go somewhere with him or her….it requires cooperation, openness, and teamwork.” In order to elicit hope in someone, we must be able to empathize and understand their pain to some degree, which may be sorrow, pain or suffering. We also have to believe in ourselves enough to hope. Hope speaks to a strength of will.
However, I wouldn’t necessarily agree that a doctor needs to be seen as hope for the patient. I moreso think that the job of a healthcare provider, through practicing medicine and public health, is to elicit a patient to empower and create hope in the patient. I think if healthcare providers do that, then narrative humility can remain a key component in helping ourselves, patients and the broader world around us.
Hope is what I see in patients every week when I volunteer at the Winship Cancer Institute on campus. In the infusion center, there is a bell that patients ring when they are free of their cancer. When it rings, everybody claps because someone has overcome a disease that is often seen as insurmountable. The bell is a symbol of hope for patients, families, and healthcare staff alike. The patients are people who come from all different walks of life, and both their disease and their treatments drain them. However, I have seen more solidarity and positivity in these patients and their family members than I sometimes see in healthy people. Although hope makes people vulnerable to sorrow, such as when a community of providers and their patients know they are dealing with terminal illnesses like cancer, and that they will experience loss, hope enables people to cope.
Like Courtni, I also find this idea that a healthcare provider needs to see himself or herself as the patient’s hope too paternalistic. In fact, I would even say that this viewpoint of the provider as the source of a patient’s hope may lead to the compassion fatigue Ms. Graham mentioned, and even hubris. While patients might see their provider as one source of hope, I would say that ideally, a provider helps patients find hope within themselves in order to keep going during the healing process. Hope in medicine does make people vulnerable to sorrow, pain, and loss as we discussed last week, but it also has the capacity to make people – patient and provider – more resilient in the face of adversity. We have seen how this resilience manifests itself through the generations that carry hope forward in Mr. Mackey’s talk on art. Only by knowing sorrow can we find hope and joy meaningful.
In my mind, the role of an empathetic healthcare provider is to help his or her patients find and sustain hope in their own capacity to get better, or in the knowledge that they are living their lives to the fullest extent. Science and medicine do not have all the answers, but hope does not have a limit if one does not give it one.
Hope is extremely important in regards to holistic medical practice. Hope bolsters the patients mental status, which in studies has been shown to be important in improving their physical state as well. As Courtni stated this feeling of hope provides resilience and strength, without these the patient will likely find themselves depressed that is not conducive to healing.
As we discussed last week, those that are experiencing sorrow or are depressed cannot imagine a future free from those feelings. Hope allows us to break this cycle seeing a happy future. As discussed earlier in this post hopefulness allows the patient to strengthen themselves spiritually and mentally in order to prepare to fight their illness. The doctor as the power holder is responsible for providing this spark and must lead the powerless patient along their journey back to health. Though hope is extremely important, it is important to make the distinction between useful and false hope. In regards to end of life care, hope will be more detrimental to both the patient and their family/friends. This can put the physician in a precarious position and can have legal implications if the family feels that the physician overstepped their responsibilities. And then there is the other aspect of this in regards to terminal or prolonged care, false hope will cause the physician to lose credibility in future interactions; this will be detrimental to the patients health and the quality of treatment. While hope is important as well as other holistic treatments, it is important for the physician to weigh the cost and benefits of this tactic as they do with all medical treatments.
Vulnerability is an interesting subject in regards to health, as yes hope makes us more emotionally vulnerable; however, as we have frequently discussed the healthcare dynamic fosters these feelings of vulnerability.We have discussed the power dynamic where the physician is this godlike figure and the patient has already experienced loss of autonomy and liberty due to their illness. This opens up for many instances where vulnerability can come into the picture. In regards to hope this opens the patient up to emotional downfall. It is once again important to weigh the risks and benefits of providing this hope as the risk of emotional pain can be very high. Hope certainly makes the patient and humans in general more prone to feelings of vulnerability, much like the hope for the best plan for the worst motif. This must be done in a calculated manner because hope can both help our mental status and deal a death blow if used improperly.
Hope gives the patient a reason to keep fighting. It bestows upon the ill the faith that one day they may once again lead a normal life free from the limits of disability and disease. In terms of medical assistance the ultimate source of hope for a patient is the attending physician. The doctor is often viewed as the gatekeeper to better health; he alone is in possession of the tools and knowledge necessary to cure the patient and allow him to fully rejoin society. Doctors simultaneously represent both hope and limits. They see people when they are at their most vulnerable on a daily basis. They offer a glimmer of hope in the sense that they provide advanced medical treatment. Yet by their job description they are obligated to be transparent with their patients and give them accurate analysis on their prognosis. However while the doctor provides the greatest amount of hope in a biomedical sense the patient often gains his sense of strength and will to fight through sources that are not medically rooted in nature. A sense of belonging in either a family or a subgroup of a particular culture can give the patient the will to keep fighting. It is important to see patient as something other than a diagnosis or a case number; the inability to do so is an inherent flaw of the American medical system. Therefore it is crucial that the patient have membership to a type of group. The members will continue to see the patient as a person through out the course of treatment and provide the sufferer with a lasting tie to humanity.
In our discussion on photography, health and ethics we mentioned how there are ways to manipulate a photo. Everyone brings their own opinions to the forefront, which affects their analysis of the situation. The same concept can be extended to the role of hope in health care. The expression of hope is important across cultures if the patient hopes to maintain his sense of humanity during treatment. While this expression can vary across different circumstances the benefits it brings are the same. Therefore what is important is not what gives a patient a sense of hope but rather that he has something from which hope can be derived. Another interesting assertion made by was the idea of active construction in photography. When we look at a photo what we get is not reality but it is nonetheless accurate. Similarly when we are given a momentary glimpse into the life of a patient the suffering we see is not the entirety of the patient’s story but it a reality all the same. A person experiencing the maladies from illness and disability is understandably suffering but this suffering is not the patient’s entire story. It is important to remember that even in times of tragedy a patient is still a human being.
Hope does make us vulnerable but it is this vulnerability that ultimately makes us human. Hope allows us to put out faith in something that is beyond our control.
Dealing with disease often causes a person to shut himself off emotionally from society and develop a cold, distant exterior. Hope allows us to feel in a society where this emotional distance is often the norm. This concept of hope and vulnerability parallels the importance of religion in health care. Religion provides a sense of connection to the sacred In order to provide effective care it is absolutely essential that practitioners be attentive to the variables present in different religions. As we discussed in class, in times of poor health and emergency the idea of a God who is always present is often forgotten. There is not only the God who alleviates suffering but also the God who chooses to suffer with the patient. In this sense the sufferer is never truly alone sense of solidarity offers a sense of hope to the patient and gives him the will to continue to fight.
Hope is absolutely important in medicine and healthcare. As I shared with Dr. Mackey in lecture, hope resides within the patient, and hence, physicians assume a humble responsibility to rekindle hope in all patients. In connection to last week’s lecture with Judy, a disease can oftentimes create a sense of despair that take over a patient’s life and leave the patient feeling trapped in a “liminal” space. Physician must therefore remind the patient that his or her narrative story transcends beyond the disease and this one finite moment of time.
Vulnerability is the essence of being human. When a patient enters a liminal state, the future and state of health are shrouded with uncertainty. Instinctively, people latch on to hope. One comment I enjoy that was shared in class was how hope also stems from a sense of community. This greatly speaks to the profession of medicine in the sense that part of the rekindling of hope for patients comes from the physician’s commitment to the patient. Hope is felt greatest when a person has a physician who is willing to fight for that patient to the very end. When a physician accepts this responsibility of caring for a patient, the doctor enters the patient’s vulnerable space and builds a relationship with the patient. A disease then becomes a hurdle that no one should face alone.
Hope also relates to Cory’s lecture about the importance of religion in medicine and can encompass the recognition of limits in medicine. Some patients seek comfort in religious faith and hence, perceive life in two stages: the finite and infinite. This infinite realm becomes the anchoring hope. Overall, hope is important in medicine because it propels patients to gaze forward beyond the limited present in order for healing to be possible.
Hope plays a central role within medicine and healthcare. Without the hope to get better, hope for a cure, or hope for improving one’s health, there is little motivation for providing healthcare and medicine. More often than not, doctors and medical professionals are looked upon to provide hope to the patient as well as to the patient’s family and friends. Medicine can sometimes be thought of as the one sure cure and the light working to break through the darkness of disease. However, as Akanksha mentioned, a doctor or medical professional should not be the sole source or provider of hope for a patient. Just as the “hope and limits” theme of the Healthcare Ethics Consortium suggests, there are limits to the hope a healthcare provider can give. A healthcare provider can certainly provide hope to patients, but they should also focus on showing their patients how to cultivate hope on their own.
Both Dr. Mackey and Ms. Graham discussed and illustrated in their presentations that art, specifically photography, is a very effective method for instilling hope within patients. The beauty of photography is that it is open to interpretation. What one person sees as suffering foreign woman another person may see as a suffering yet strong woman who that person can sympathize and connect with. As Dr. Mackey explained, “Art is both a window and a mirror”. Art allows people to view the world in different lights while simultaneously enabling them to reflect on themselves differently. Photography has a way of momentarily removing us from our place to explore new places, ideas, and emotions while we remain in the same physical location. By utilizing photography in medicine and healthcare delivery, healthcare providers enable patients to find their own sources of hope to battle whatever diseases or illnesses they may be facing. Thus, by using inspiring, visually stimulating images in conjunction with medicine, healthcare providers extend the limits of medicine and strengthen patients as they discover their unique sources of hope within photographs.
Hope can manifest itself in many ways within medicine and healthcare. However, I believe the role of hope in medicine is to use optimism to cope and to overcome harsh times. Such optimism for a better future of some sort can be found in many realms. While it could be the hope for a cure, as mentioned in class, it may also be expressed as the hope for a fulfilling life or even the hope for a desired afterlife.
Where I believe hope can get a bit tricky, especially within the health field, is when one is in a situation where hope for a certain outcome seems unrealistic. For example, if a patient is hoping to be healed in a situation with what seems to be a definite negative prognosis, where does the hope lie? Hope, in my opinion, not only suggests optimism, truly believing something can be attained. So how can hope survive in what seems to be an unbeatable limit in the medical field? This was an issue brought up in the Carlton Mackey lecture. While there may be many answers to this, I do believe many of the topics brought up in this class, such as the arts and religion, could be where this hope can survive. This could be in the belief of an afterlife or simply an escape. Our last ScholarBlog mentioned the nurse that described the arts to almost be an escape; where she was free to connect with others on a more personal level. This suggests how important the humanities are to the health field because they are able to provide an escape to more possibilities in an area where everything seems so definite.
With all of this being said, I agree with my peers in that I do not believe claiming healthcare providers are the hope of patients is the right way to put it. There is a difference between being the hope and sparking the hope. By being the hope, I believe it almost suggests that all desires for a positive outcome lies in the healthcare providers. Healthcare providers can do everything they possibly can to reach a positive outcome, and still fall short due to things that are simply out of their control. As Carlton Mackey and Aubrey Graham suggested, and do every day, the physicians and other members of the hospital environment can help the patients and families remain hopeful. This can be in many different realms, such as the art and photography of our guest speakers. These are inspiring actions which results in the hope not lying in another individual, but within the patient.
Hope serves in many roles within the healthcare setting. Hope gives patients a drive to overcome and not succumb to illness. Hope works in families and gives them the strength to be a positive supporter for an ill loved one. Hope gives healthcare providers the ability to speak with and comfort patients in the midst of bad news. Hope for healing gives everyone involved the will to not give up. Hope for an afterlife provides comfort and peace in death and loss. Hope for a cure affords a hope that the future will be the reality of a dream that all of the pain and suffering endured by patients and all of the seemingly futile research will yield a world with a cure. Hope is the beacon that makes every action in the healthcare setting worthwhile. Without hope, no treatment has meaning. Without hope, both patients and doctors alike would give in to sorrow and failure. Hope is the lifeblood of healthcare. Yes, hope makes us vulnerable. It has the potential to come crashing down, but the alternative to vulnerability and hope is despair and callousness. Our ability to feel emotion makes us human.
I disagree with the healthcare provider seeing him/herself as the patients hope. Not only is that too much pressure to place on a vulnerable and imperfect human being, but it also encourages a paternalistic dynamic to the relationship. I do feel, however, that the healthcare provider should see him/herself as a provider of hope. Every interaction a healthcare provider has is an opportunity to offer hope, comfort, and understanding. This responsibility should not be taken lightly, but requires an humble understanding that hope can only reach so far and human hands and technology can only do so much. This provision of hope must be accompanied with a realistic understanding of health outcomes and an ability to empathize.
As we talked about last week, hope plays a big part in medicine and healthcare. Usually hope is given to the patient by the healthcare provider and the hope can come in a form of type of therapy, medicine, or procedure. I feel that if a health care provider see themselves as the patient’s hope, then they are more prone to try hard and give their best efforts to cure the person. Let’s look at a scenario, a patient has a strange pain in their body so they go get a check-up at a clinic. Once there they are told that they have a serious illness and only have a certain amount of time to live. In that moment their life flashes before their eyes. Any menial task they had to do later (like pay the bills) now seems insignificant. How to tell their loved ones, and how can they be going so soon? In that moment they are filled with sorrow and eventually acceptance to their fate. Then they begin to look everywhere for a treatment, cure, medicine even if its a maybe it doesn’t matter, anything will do. Ten doctors later they feel shattered and despaired, but then stumble upon a healthcare provider that tells them there could be a chance of redemption. Those words are like music to the patient’s ears and the health provider becomes the hope the patient was so desperately looking for. But by seeing themselves as hope, the healthcare providers must also be cautious with what they tell the patient. They must remember that the patient may not be in the best state of mind and therefore make sure to not give the patient false hope.
Hope is the driving force of medicine and health. Without hope, medicine would not be as advanced or prestigious as it is today. It is because people have hope in the medicine that they are willing to undergo treatment or take certain medicine. The positive results that occur with the people before us has become hope for those struggling with the illness now. Hope definitely makes us more vulnerable. This is because we are exposing ourselves to the unknown, and hoping everything goes good. We allow other to drive our choices and are overtaken by an emotion that tells us “this will work”. Therefore if things don’t go as planned then we are left with our shattered dreams and the idea that it was all for nothing.
Society constructs symbols. In an article titled “Medicine’s Symbolic Reality”, Arthur Kleinmann discusses how the socially constructed symbols play out in the medical field. For example, a physician’s white coat symbolizes knowledge and an expertise in science and medicine. As a result, patients look to the “white coat” as a symbol of hope, hope in the science that will cure their disease or treat their illness. Thus, by default, physicians become a source of hope for patients.
As illustrated by the name of the ethics consortium conference, “Hope and limits: Cradle to Grave Ethical Care”, hope has limits. When hope exists as a cure, its limit stems from the nature of the disease. For instance, if a patient has zero medicine-based or science-based chance of recovering, then the physician should not make additional efforts to instill hope of surviving into the patient because of ethical issues. Thus, end-of-life care, and death itself as Dr. Raggi-Moore articulated with the generational photograph of Mrs. Brim, limits the appropriate context or situation for hope.
Moreover, however, because of the symbolism of the white coat and of a physician, patients may gather hope from the physician’s mere presence. As a result, physicians may experience a great deal of pressure, for they serve as the inspiration or motivation that enables the patients to continue fighting for their lives. This sense of pressure can foster vulnerability. When one becomes vulnerable, he or she becomes open, often to possible emotional injury. As a result of the potential injury or vulnerability, two dynamics often occur in the patient-physician relationship. To begin with, when a patient views a physician as the source of hope, then he or she may deem the physician as a “God-like” figure. As a result, the vulnerability would create distance between the patient and the physician. On the other hand, if the physician recognizes his or her association to hope, then the physician may become more vulnerable in the relationship and consequently increase communication and treat the patient as a fellow human being rather than just a disease.
Therefore, a physician does not “need” to see himself or herself as a patient’s hope. Society has constructed the symbol of the physician as the source of hope, so a physician needs to navigate the experience of holding that responsibility. In certain situations, a physician should know when to refrain from giving additional hope to the patient, but other dynamics may encourage vulnerability and hope.
I think there’s an integrated role hope plays in medicine and healthcare. There’s hope on the patients and their families side that the illness they have is treatable and that they can overcome it. This is beneficial for them because it makes the m more willing to try treatments and medicines that may help them. Without hope for survival, they lose the internal drive to carry on. It can lead to the happiness and recovery they wish for. There’s also hope on the doctors side that they have mastered their craft well enough to aid in the healing of their patients.
As sure as we wish doctors should know everything about the human body and illnesses, we need to remember that they are human too and can make mistakes. So they need hope and confidence everyday to be the strong and logical person their patients see them as. This also makes the patient put hope in their doctor that they can lead them to overcoming their illnesses. This is all wonderful and optimistic, but this can sometimes lead to present struggle during the process to lead to the destination of happiness.
When Carlton was showing his photography during his discussion of the slaves of Bunton Island and the modern descendants in parallel, I saw a hope and dream fulfilled. You could see the struggle and pain in their eyes, but also the hope of a better life for their future, even if they didn’t get the better lives themselves. That tinge in their eyes was luckily caught in art, frozen in time, so we can see it. The nurses in his films bringing objects that represent why they do what they do show their hope and drive in others, or what others had in hope for them. This parallels with what patients bring whenever they come to doctors: the hope they have in a cure, the hope and drive to live and carry on, as well as the hope they have in the healthcare providers they encounter to succeed.
Though I believe this hope opens up our vulnerability, on all levels, I feel its necessary to get the results we strive for. To want to do a big of a task to heal others, or allow yourself to be “seen”, one cannot hide their true desires for fear that it may not work. Only hope can do that.
Through my Sociology of Happiness class, I’ve learned that vulnerability is vital to having meaning and purpose in life and relationships. This applies to medicine and healthcare as well. To have hope comes from placing your beliefs and trust in a result that is not guaranteed, or one that you may or may not see. To a patient, the physician serves as a motivator for hope – hope for living a normal life or one with less suffering and pain. To a physician, a patient also represents hope. When the physician acknowledges hope in a patient, he or she would need to find balance between false and realistic hope. When the Grady nurse expressed her coping methods through the arts, we witnessed her vulnerability. She was a healthcare provider that understood a patient’s dreams, and also her own limitations. In these vulnerable and liminal experiences, patients and physicians seek to reconcile realities, hopes, and limitations. Lucky made a fantastic connection between this topic and Cory’s previous lecture on the limitations of a physician in terms of ethics. I am not sure if it is ever possible to have hope without feeling vulnerable. In the same way that it is impossible to have meaning in life without vulnerability.
Hope definitely makes us more vulnerable in the health care setting. However, I believe that vulnerability has gotten a bad reputation. To be vulnerable does not mean you are weak or lesser as a human being. I think about marriage and how being able to be vulnerable with your partner is an important process of trust and the overall strength of the relationship. If you are unable to trust and be vulnerable in front of your partner, the relationship is not healthy. Relating this back to the health care setting, if the provider is the source of hope for a patient, the patient is in a vulnerable position. They could get better, or they could not. They put trust into the health care provider to do everything they can (within reason, of course) to make sure the patient is getting the best care possible. They are vulnerable because their health is not totally in their own hands – it is in the hands of the provider. This vulnerability shows the trust that has (hopefully) formed between the patient and the provider. It also shows the importance of contact and interaction between the patient and provider in order to develop this trust.
As far as the role of hope in medicine, I believe that hope is meant to let the little voice inside you (the patient) keep fighting for something. In the health care setting, this could be the fight to survive. Both the patient and the provider are holders of hope and givers of hope. In some cases, the patient may have some terminal illness that the doctor does not believe the patient will beat. However, the patient could call upon family, or their faith, and still have hope in beating the illness. Seeing this, the doctor could gain a sense of hope. It may not help, and the patient may still die, but the sense of hope also seems to make the whole process of illness easier for those who have hope.
On the other hand, the patient could be the one in search of hope. The doctor may be the source of the hope, and the patient might have the will or voice inside to not give up. It can be so easy to give up, to not have hope. When a patient gives up hope, I believe a little part of them inside stops trying to get better. The “fight” inside them goes away. This is completely just my opinion, but I do believe that there is a certain power in hope and giving up… That there is something inside us that either helps or hurts our cause based on if we are hopeful or optimistic or if we have given up.
Hope is the driving force behind medicine. Hope is what makes us vulnerable, and that’s what makes us human. To know someone’s hopes and dreams is to know the human experience. We all hope to be healthy and happy, and we want this more when we are ill. As Farida pointed out from the Sociology of Happiness class I am also in, hope for others also allows us to be vulnerable. We saw with the Grady nurse how the arts opened her mind to the experience of her patients. She saw hope in their vulnerability. When doctors do not prey upon patients’ vulnerability, there exists a well functioning medical system. As Amelia stated, doctors are a source of hope for people just by nature and they must recognize this privilege they have. They must not view it as power, but as an opportunity to connect and heal.
Carlton Mackey displayed what hope looks like to some. This may not be what hope looks like to everybody, but that is what make its human. To share what your hope is (even though others may not share it) is one of the most vulnerable things you can do, therefore making it one of the most human things you can do.
According to the prayer of St. Francis, hope is the opposite of despair. Hope is a sign of healing and of peace. Therefore, hope is important in the healthcare setting because the patient and the patient’s healthcare provider ultimately work towards healing. I believe hope is something within all of us naturally and revealing vulnerability is powerful because it presents genuineness that transfers into compassionate communication. Hope is a sign that better things are yet to come – the expectation of happiness, if you will. I see several hints of that in the above comments. I am currently reading a book called “The Open Heart” by cardiologist Lester Sauvage. Dr. Sauvage argues that three questions have revolutionized the way he interacts with his patients and reports that most patients who answer these questions find a greater sense of hope, even though they face life-threatening surgery:
1. What will I do with the added years that surgery will bring?
2. How will I find increased happiness in these “extra years”?
3. What is happiness to me?
One of the things I really found important during Carlton Mackey’s lecture is the idea that hope grows with community. This is apparent with the following his art and photography projects (Typical American Families, 50 Shades of Black/Beautiful in Every Shade, Black Men Smile) have – he builds community around these themes and explores their history, while circling back around to remind people of the importance of their ancestors, of how their choices regarding engaging race have changed or affirmed their families. To me, it’s natural to assume that a doctor or any healthcare professional is an asset of any community. Their role confers status and power, but also an understanding of human dignity and healing. Therefore, to me it is only natural that he or she needs to see themselves as their patients’ hope. And for that matter, we should learn to see ourselves as someone else’s hope. The simple truth is that we all need one another.