The profound impact of hope on both spirit and body
By Chandrea Serebro
“Why do some people find hope despite facing severe illness, while others do not? Can hope actually change the course of a malady, helping patients to prevail?” Sounds like some kind of new spin on the elusive ‘Why do bad things happen to good people?’ question. The answer, seemingly as elusive as the question itself. Is it religion? Is it spirituality? Is it some kind of new age hack or something or other?
It’s funny, though, that these two fundamentally unanswerable (or so we would think) questions are asked by Dr Jerome Groopman, the Recanati Professor of Immunology at Harvard Medical School, Chief of Experimental Medicine at Beth Israel Deconness Medical Centre, and one of the world’s leading researchers in cancer and AIDS – yes, those two dread diseases, the names of which are even unutterable. We say strange that he is the one asking because Dr Groopman has spent his life leading the way in the very two fields that see little in the way of hope, and sadly too many tragic ends. Yet, perhaps because of this, it is these questions that Dr Groopman has spent his life searching for answers to, and it’s these questions that he answers in his book, The Anatomy of Hope.
“Hope, unlike optimism, is rooted in unalloyed reality. True hope has no room for delusion,” says Dr Groopman. “For all my Patients, hope – true hope – has proved as important as any medication I might prescribe or any procedure I might perform. Only well into my career did I come to realise this. Hope, I have come to believe, is as vital to our lives as the very oxygen that we breathe.” Dr Groopman says this after decades of research into hope from both a scientific and psychological viewpoint. Starting his journey of exploration into the meaning of hope and how it factors into the lives of real people, Dr Groopman looked for the answers to these two fundamental questions in the lives of “several extraordinary patients” he cared for spanning thirty years, leading him “on a journey of discovery from a point where hope was absent to a place where it could not be lost”.
Each person, he says, helped him to see “another dimension of the anatomy of hope”. Taking his cue from his patients and using the indisputable medical facts, Dr Groopman looked at all the angles. He arrived at a place where he was able to find a working theory on how hope can play a vital role in the world of medicine, to both patient and doctor alike. “Many books depict hope as a magic wand in a fairy tale that will, by itself, miraculously restore a patient. As a rational scientist, trained to decode the sequence of DNA and decipher the function of proteins, I fled the fairy tale claims of hope. In effect, I slammed the door on hope and closed off my mind to seriously considering it as a catalyst in the crucible of cure.”
But then, as a young man, Dr Groopman suffered a personal back injury which was only made worse by the “promised land” of surgery, an injury that would see Dr Groopman spend the next two decades suffering from pain and debility. He was in his own personal place of hopelessness, and through a series of changed circumstances, he found an exit. “Personal experience opened my mind. I felt I had been given my life back. I recognised that only hope could have made my recovery possible.” He sensed that hope had done more than “push me to take a chance and not give up”. “It seemed to exert potent and palpable effects not only on my psychology, but on my physiology.” As a scientist, he says, he distrusted his own experience, and so he went out to discover whether or not this could be true, and he discovered by way of scientific discovery that “hope changes us profoundly in both spirit and in body”.
Dr Groopman and his wife, Dr Pamela Hartzband, both specialists at the Beth Israel Deaconess Medical Centre and affiliated to Harvard Medical School, were recently in South Africa speaking on the aspect of hope as guests of Reach for a Dream. As one of the biggest agents for hope, for thirty years Reach for a Dream has inspired hope to so many by bringing dreams – up to six dreams a day – to life; the dreams of children who suffer from life-threatening illnesses, and through which they find happiness, strength, and hope. “We believe in the power of dreams; we encourage children to use their dreams to fight life-threatening illnesses, and we try, as far as possible, to make these dreams come true,” says Reach for a Dream’s CEO, Julia Sotirianakos. “When a child is faced with a life-threatening illness, the impact that a dream coming true can have on their wellbeing is overwhelming.”
And the brand of hope that this generates resonates with the ideas expressed by Dr Groopman in his book. “Hope is central to the human experience.” He cites the Talmud, where Rabbi Yochanan says, “As long as there is life, there is hope.” True hope, he says, is not optimism, and neither is it the belief that things can get better despite the odds. We have to remain clear-eyed and realistic, yes, but while doing this, we must still open ourselves to the path to a better future.
Dr Groopman admits there are two dimensions to hope. One always hopes for wellness and a cure. But, when faced with a medical reality that flies in the face of this, one must ask himself: what else am I hoping for? Find the things in my life that uplift me despite my situation. And this is why Reach for a Dream is so important, says Dr Groopman. “In the face of often incredible suffering, it takes courage to hope when the chips are down. And, when we need a powerful shot of motivation to help us find new ways to reach our goal and push us forward toward its achievement, there is no substitute for hope.”
To explain what they call the “biology of hope” – which Dr Groopman says is “authentic” – a real, tangible impact that hope can have on a person during a trial – Drs Groopman and Hazelband refer to the placebo affect. This is the beneficial effect produced by the patient’s belief in the treatment more than by the treatment itself. The flipside of this is the ‘nocebo’ affect – adverse effects from what are actually chemically inert treatments. Dr Hartzband explains that if people believe that there is the chance of a better outcome for them, they will be positive and open to it, which will in turn cause real chemical reactions in the brain and body, that will in turn impact their sense of wellbeing. And, conversely, if people are negative about their chances, they are off to a rocky start, and will inevitably feel worse.
As for the link between the emotions of a patient and their maladies, Dr Groopman looks to the lessons taught to him by his patients over the years and what he calls “the stirrings of serious science”. “We are just beginning to appreciate hope’s reach and have not defined its limits. I see hope as the very heart of healing. For those who have hope – it may help some to live longer, but it will help all to live better.”
For more from Dr Groopman, visit: jeromegroopman.com
For more information on Reach for a Dream, visit: www.reachforadream.org.za