The Anatomy of Hope: How People Prevail in the Face of Illness
Jerome Groopman, MD
Random House

Can hope contribute to recovery by changing physical wellbeing?

Alternative therapists have been asking this question for eons. But now, in The Anatomy of Hope, one of the leading blood, cancer and AIDS specialists in the United States has written an absorbing and well-researched book about it.

Much popular literature written about the subject before, Groopman writes, was little more than vague wishful thinking in which hope was seen as a "magic wand" curing cancer or expunging HIV from the blood.

His book is different. Readers come face-to-face with Groopman's patients and their struggles with pain and disease. The book also explains the scientific research being done into how hope might alter physiology and therefore the trajectory of illness.

Research-wise it's early days, but Groopman, for one, is convinced of hope's therapeutic value: "For all my patients true hope has proved as important as any medication I might prescribe, any procedure I might perform."

In 1979, when training for the Boston Marathon, Groopman ruptured a disc. Failed surgery and 19 years of excruciating back pain followed. A doctor at the New England Baptist Hospital finally prescribed exercises that initially caused more pain, but eventually "re-educated" his memory so Groopman could work through it.

Now he's pain free and says hope exerted potent and palpable effects on both his psychology and his physiology - aiding his healing.

The first case study in the book deals with Esther who believes her breast cancer is a punishment from God for transgression. This leads her to "mortgage her future to hopelessness" and refuse treatment until it is too late.

Barbara's case is the opposite. She faces her diagnosis of metastasised breast cancer with a clear idea of the possible cures and their chances of success or failure. She also faces her illness with Christian hope. When medical interventions fail, she seems ready for death, having handled the disease on her own terms.

George is a leading stomach cancer specialist who is afflicted with the very form of cancer he knows most about. Treatment rarely works and he is criticised by colleagues for pursuing it.

George lives.

After his cure he visited cancer patients who were losing hope. He wanted to show them that the tumours "hadn't always read the textbook". He wanted to inspire them to reach back into their heritage and their faith to locate needs, desires and beliefs that would help them make their own choices regarding treatment.

Groopman learns from George that "it is part of the human spirit to endure and give a miracle a chance to happen". He also discovers that George was deeply comforted by the vast network of people from all faiths who prayed for him while he was ill.

"Hope," Groopman writes, "is the elevating feeling we experience when we see - in the mind's eye - a path to a better future. Hope acknowledges the significant obstacles and deep pitfalls along that path. True hope has no room for delusion."

Hope, too, he discovers, inspires the courage to overcome fear and encourages resilience during arduous treatment. The words used by doctors, nurses, social workers, friends and family are also powerful tools that can inspire or dash a patient's hopes.

Physiologically, he discovers that the cardinal components of hope - belief and expectation - can block pain by causing the brain to release endorphins and encephalins which have similar effects to morphine.

An observant Jew, Groopman believes hope is at the heart of healing: "For those who have hope, it may help some to live longer and will help all to live better."

My one wariness about this fascinating book is that it could unwittingly make sick people feel that hope is one more thing (like faith) they must have enough of in order to heal. This seems a cruelty. Cruel too if healthy Christians use it to endorse simplistic theology that says it is a lack of hope that makes people unwell or unable to heal.

Marjorie Lewis-Jones