“Hope and Healing: Why Hope Matters When We’re Sick”

By Reverend James Kubal-Komoto

Saltwater Unitarian Universalist Church

Des Moines, Washington

February 12, 2006

            I want to talk with you about hope this morning, about what it is, about how it works in our lives, about why it is important, and about each of us can learn to live with more hope.

            At first glance, hope is not something that easy to wrap one’s head around. We’ve all felt what it’s like to be hopeful. Some of us have felt what’s it like to be hopeless. But when it comes down to saying exactly what hope is, that’s a more difficult task. That’s the reason I think that Emily Dickinson had to use such metaphorical language - - “Hope is the thing with feathers” - - to describe hope, as often is required to talk about matters of spirit.

            While Dickinson said that “Hope is the thing with feathers,” somebody else once said that in our hearts we suspect that hope is everything, but in our minds we fear that it is nothing, nothing but a mirage.

            Which is it? Everything? Nothing? Something with feathers? Does having hope make a difference in our lives? If so, how does it work?

            Somebody who has helped me clarify my own understanding of hope is the author and medical doctor Jerome Groopman.

            Groopman is a professor at Harvard Medical School. His specialty is blood diseases, cancer, and AIDS, and he has spent most of his career trying to figure out the inner workings of these diseases.

             In the years that he spent treating patients with life-threatening illnesses, however, Groopman also became fascinated with something else that seemed to play as an important role in the lives of his patients as the medical care he provided for them, and that something else was hope.

            A man who valued rationality and the rigors of the scientific method, Groopman was interested in discovering an understanding of hope that both satisfied his respect for science and made sense of his observations of the role hope played in his patients’ lives.

            He tells the stories of many these individuals and the role that hope played in their lives and the story of his own quest to better understand hope in his recent book The Anatomy of Hope: How People Prevail in the Face of Illness.

            I’d like to share one of the stories from that book with you this morning, and this is a story about a man named George Griffin. Griffin was not one of Groopman’s patients, but was a colleague, another professor at Harvard University Medical School.           Griffin was the chairman of the Department of Pathology and had been diagnosed with an aggressive form of stomach cancer. Ironically, stomach cancer was the disease that Griffin had spent his career studying. He had traveled the world learning about the disease and perhaps no one else in the world knew more about it than him.

            So when Griffin discovered what type of stomach cancer he had, he knew that less than one percent of patients survived more than a year with that type of cancer. Everyone expected that Griffin would resign himself to the fact that he was dying. After all, nobody knew more about the reality of death than a pathologist.

            What surprised Griffin’s colleagues, including Groopman, was that Griffin chose an extremely aggressive form of treatment for himself: multiple courses of chemotherapy and radiation as well as surgery. He chose this treatment despite the fact that there was no evidence it would make any difference and despite the truly horrendous, sickening side effects.

            Other colleagues suspected Griffin had gone mad and was trying to torture himself to death before his cancer could kill him. Groopman wondered if he was in denial, saying his colleague’s choice of treatment seemed like a “desperate, wrong-headed, ultimately useless effort to resist the inevitable,” that would also rob him of any opportunity to spend his last days in tranquility with family and friends.

            Thirteen years after Griffin’s initial diagnosis, Groopman sat down with his cured colleague and ask him about why he had chosen such aggressive treatment in spite of the odds it wouldn’t work.

            Griffin told Groopman that he had not been mad, nor had he been in denial. He had fully understood his situation. But he had allowed himself to hope, not a lot, but a little. “Even if I didn’t prevail - - and I didn’t expect to - - it was my only chance,” Griffin told Groopman. “I deeply wanted to live,” Griffin said, “so I had to fight. Then I could tell myself that I had tried, that I had done everything possible. There would be no regrets.”

            In his book, Groopman does not tell Griffin’s story in his book to suggest that all patients with a life-threatening illness should always seek the most aggressive form of therapy. That is not his belief, and neither is it mine, and I wouldn’t share the story with you if I thought it was his point.

            Groopman does tell the story to make the point that hope makes a difference. With Griffin and with many of his own patients, Groopman found that hope seemed to make a difference. Those who had little or no hope often did not do well. Those who had hope sometimes got better, and even if they didn’t get better, even if they died, they seemed to do better than those without hope. What Groopman knew anecdotally was also confirmed by numerous studies that showed that patients who are hopeful have higher rates of survival and quicker recoveries.

            It was cases such as Griffin’s that motivated Groopman to learn more about how hope works in people’s lives and if he was to do so, as a scientist, Groopman knew the first thing he needed to do was to come up with a good working definition of hope, something more concrete than hope being a thing with feathers.

            According to the definition that that Groopman came up with, there are two parts to hope - - a cognitive part and an affective part, or in other words, a thinking part and a feeling part.

            The thinking part of hope is a belief that it is at least possible for something good to happen in the future. The feeling part of hope is that comforting, energizing, elevating feeling that we experience when we anticipate a positive future. In other words, hope is made up of belief and expectation.

            But how does hope work? Is it possible that the connection between our minds and our bodies is so strong that if someone is hopeful enough, if someone believes strongly enough that they will get better or wants to get better badly enough, that can actually affect one’s body?

            In a quest to the answer this question, Groopman poured through the writings of self-styled scientific gurus who claimed that with desire and determination and positive thinking, the mind could overcome any disease of the body - - that you could laugh away lupus or cure cancer through meditation and visualization.

            Much of this writing, he says, was “long on claims and short on rigorous scientific data.” Even worse, those who pontificated on a strong mind-body relationship had a built-in explanation if their techniques didn’t work - - a person wasn’t trying hard enough or was holding onto angry or depressive thoughts or negative energy.

            “In essence, invoking a mind-body connection in this way,” Groopman says, “blames the victim for his own malady and ultimately for his demise.”

            What Groopman did find was numerous sophisticated studies that showed quite scientifically that hope has the possibility of tempering both pain and fear. When we are hopeful about something, when we believe that something good is possible and when we anticipate it happening, it alters our neurochemistry. In other words, having hope changes our brains, releasing chemicals into our brains that are akin to opiates, our body’s own form of morphine.

            In other words, if somebody says he or she is “high on hope,” it may not be just a turn of phrase.

            Groopman came to the conclusion that hope cannot cure any life-threatening disease, but that because hope tempers fear and pain and lifts our mood, patients who are hopeful risk treatments they might not otherwise risk and endure more easily the pain caused both by their diseases and the treatment they receive for their diseases.

            More simply put, hope inspires us to take risks and endure difficulties that we might not otherwise take or endure.

            “For those who have hope, it may help some to live longer, and it will help all to live better,” Groopman writes.

            From my own perspective, I think this is especially true if one understands hope as Bruce Marshall, the author of our reading this morning, does - - not as anticipation of the best possible outcome, but as the belief and anticipation that we can discover something good in whatever life deals us, that even if we cannot be cured of an illness, we can still experience love, happiness, integrity, and meaning in our lives.

            As I said when I began, Groopman has helped me clarify my own understanding of hope, and in reflecting on Groopman’s ideas myself, I believe that his understanding of hope and the role it plays in our lives is not only applicable to those suffering from a chronic or life-threatening disease.

            What do I mean?

            Well, it’s not only those who are facing life-threatening diseases that need hope. We all need hope.

            Why?

            The simple fact of the matter is life is difficult. This is the first sentence in M. Scott Peck’s classic book, The Road Less Taken: “Life is difficult.” Of course, life is not always difficult. On some occasions, life is easier than we expect, and this is a pleasant surprise. But in general, I think Peck is on the mark. Life is often difficult, and when life is difficult, we need hope - - to help us take risks and to help us endure.

            Life is especially difficult when we try to do big meaningful things.

            For example, I think of the athletes now gathered in Torino for the Winter Olympic Games. For many of the athletes now gathered in Torino, their participation in the Olympics is the culmination of a lifetime of effort, the pinnacle of their athletic careers, and while I don’t know the personal story of every athlete there, I doubt there is any athlete there who had an easy time getting there. I doubt there is any athlete there who didn’t have to overcome some obstacle or injury or setback to get there. Without some sense of hope, I doubt any of the athletes now gathered in Torino would be there.

            I also think of people like Ed Murray, a state representative in the Washington legislature. As many of us know, Murray was the person most responsible for helping the the recent “gay civil rights” bill become a law.

            Murray was appointed to the legislature in 1995 and elected in 1996, and he introduced the legislation year after year after year, and he watched it fail, year after year after year. I imagine so many times, it would have been easy for Murray to give up, to throw in the towel, to say, “Our state is just not ready for this.” But he didn’t give up. Without some sense of hope, however, I doubt he would have succeeded.

            I suspect that like the athletes in Torino, there are things that each of us in this room would like to do with our lives, or like Ed Murray, there are things that each of us in this room would like to do in the world, but without a sense of hope, we will never be able to make these things a reality.

            One question that Groopman alludes to but does not address directly is, “What if we want to be more hopeful, but just don’t know how to.” Or in other words, “How do we cultivate and nurture hope in our lives, especially if we aren’t feeling overly hopeful to begin with?”

            Here’s my answer.

            What helps us to be hopeful?

            I think Groopman is right about hope being about both belief and expectation, in believing that something is at least possible and living in anticipation of it happening. For me, and I suspect for many of us, the hard part is not the anticipating, the hard part is the believing.

            Why?

            I think too many of us, and I include myself here, live with an overly deterministic view of life, and this makes it hard if not impossible to be hopeful. I think it’s impossible for us to be hopeful unless we affirm the uncertainty and unpredictability of life.

            Or I suppose another, more positive way to say this is that, being hopeful requires us to believe in the creative potential of life, “to be ready at every moment,” as Erich Fromm was quoted in our reading this morning, “for that which is not yet born.”

            Or I suppose another way to say this is that being hopeful is about recognizing that neither we nor anybody else is so smart as to have figured out exactly what’s going to happen next in any part of our lives. As Groopman says regarding treating people with cancer, “A tumor has not always read the textbook.” By this, I think he means that as absolutely amazing as modern medicine is, what’s even more amazing is the incredibly unpredictable ways that our bodies sometimes act and react.

            Or I suppose one more way to say this is that being hopeful requires us to continually re-affirm life’s ability to surprise us.

            I don’t know why I have such a hard time believing in life’s ability to surprise me, in its uncertainty and unpredictability, because it certainly does on an almost predictable schedule.

            Let me give you three quick examples. As many of you know, over summer and fall last year, I and many other religious leaders lobbied the King County Council to put a measure on the ballot that would increase funding for human services by $13 million. All the polling over the summer showed that the ballot initiative would certainly fail, and I pessimistically expected it to do so. It didn’t. It passed. I was wrong. Life surprised me.

            This past fall, one of my dogs was diagnosed with degenerative disc disease in her spine. Our local vet said she would most likely need surgery, which would be painful for her and expensive for me and Hiromi. Hiromi, on the other hand, thought the dog would get better without the surgery. “You can’t argue with an X-ray,” I said. But the vet was wrong, my wife was right, and the dog got better. Life surprised me.

            Whether we’re talking about sports, politics, war and peace, our relationships with family and friends, our jobs, our own health, or any other part of our lives, I believe one of the only things we can say with certainty is that life will continue to surprise us.

            Is this cause for fear? To a degree, yes. But it is also cause for hope, and it’s up to us whether we choose hope or fear.

            Martin Luther King, Jr. once said, “If you lose hope, somehow you lose the vitality that keeps life moving, you lose that courage to be, that quality that helps you go on in spite of it all.”

            With these words in mind, may each of us always choose hope.

            So may it be.

            Amen.