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

True hope is cleareyed. It sees all the difficulties that exist and all the potential for failure, but through that carves a realistic path to a better future.

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

Even when there is no longer hope for the body, there is always hope for the soul.

False hope can lead to intemperate choices and flawed decision making. True hope takes into account the real threats that exist and seeks to navigate the best path around them.

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.

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.