Help, then, is the ballast that keeps us steady, that recognizes where along the path are the dangers and pitfalls that can throw us off; hope tempers fear so we can recognize dangers and then bypass or endure 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.

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.

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

Help, then, is the ballast that keeps us steady, that recognizes where along the path are the dangers and pitfalls that can throw us off; hope tempers fear so we can recognize dangers and then bypass or endure them.

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.

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.