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

Hope differs from optimism. Hope does not arise from being told to "think positively," or from hearing an overly rosy forecast. Hope, unlike optimism, is rooted in unalloyed reality.

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

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.

To hope under the most extreme circumstances is an act of defiance that permits a person to live his life on his own terms. It is part of the human spirit to endure and give a miracle a chance to happen.

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 gives us the courage to confront our circumstances and the capacity to surmount them.