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

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.

There is an authentic biology of hope. Belief and expectation - the key elements of hope - can block pain by releasing the brain's endorphins and enkephalins, mimicking the effects of morphine.

Hope, true hope, has proved as important as any medication I might prescribe or any procedure I might perform.

I feel that I have to do everything better just to be judged as okay. It is something I wish I could let go of. It's something that I wish just wasn't there.

Many years before when I had serious back pain from a sports injury, the surgeons said they would explore my spine and "figure it out." Out of frustration I had impulsively opted for the procedure. They ended up fusing the vertebrae. It left me debilitated. In hindsight, I blamed myself more than the surgeons. I had pressed them for a solution when in fact none was apparent because the cause of the pain was obscure.

Hope is the elevating feeling we experience when we see - in the mind's eye - a path to a better future.