The Anatomy of Hope

Vividly illustrates the events

Worth reading

My orthopedist recommended this publication as a means of helping me and others I work with address life's medical adversities, whether they be large or small. Using case studies from real-world experiences, the author navigates the reader through his own learning on the non-medical aspects of hope. Written for the benefit of aspiring doctors and support medical staff, he examines the different aspects of hope and how various support roles involving self-awareness, friendships, family, religion and the medical community can change a patient's medical outcome and outlook. This easy-to-read and understand treatise is a useful reference to anybody facing such challenges or helping others do so.

Interesting read

Should you find yourself in the situation of a medical catastrophe, such as I have, this wonderful text is just what you need to determine if "hope" is right for you.Well done Jerome Groopman and thank you very much

ダニエル・ゴットリーブというアメリカの心理学者の"Letters to Sam"というエッセイ集（邦訳『人生という名の手紙』）で紹介されていた本です。ハーバード大学の血液内科・腫瘍学（結局、さまざまなタイプの癌の治療が中心）の大家が、その臨床経験を通じて、患者の治癒に「希望」という「非科学的なもの？」が果たす役割に気づき、自分の体験も含めて医学的な目から記した著書です。医療関係者の方々にも、是非読んでいただきたいですが、一歩間違えば絶望が待っている、現代社会で生きるすべての人に、本物の「希望」とは何かを考えるために読んでほしい本です。医学用語も出てきますから、辞書は手放せませんが、英語の文体自体は、さすがお医者様。明快で読みやすいです。

If I had to sum up THE ANATOMY OF HOPE in one sentence, this would be it: this amazing book will make you sing. I would have finished it the day it arrived in the mail had I not had a house guest I had to tend to. After finishing the book the next night, I was so hyped up that I couldn't go to sleep for hours. I wanted to give it to everyone I care about, including my doctor.Dr. Groopman discusses hope and its impact on the ability of patients to fight serious, sometimes life-threatening illnesses. He gives the examples of several patients of his over the years and the effect that hope had on their recovery from illness. He also traces his own growth in helping patients. Dr. Groopman learns how to relate to patients through trial and error. "I was still feeling my way on how to communicate a poor prognosis to patients and their families. Not once during my schooling, internship, or residency had I been instructed in the skill." The first patient he discusses, Esther, he saw while he was still a medical student. She believed she deserved to have breast cancer because she had had an extra-marital affair. He later learned that she sought treatment too late and died at the age of thirty-four. Dr. Groopman assists another doctor with the treatment of the second patient. She interprets "remission" as a cure for a serious malignancy. The other physician had given her part of the truth but not the whole truth. When she ultimately learns she is dying, she and her family are angry at the doctor. "I guess he [the doctor] doesn't think people like us are smart enough, or strong enough, to handle the truth."Along Dr. Groopman's journey, he encounters a physician patient who insists on a difficult and painful treatment that Dr. Groopman didn't recommend. This patient was alive many years after his cure. "It took George Griffin [the doctor patient] to teach me that omniscience about life and death is not within a physician's purview. A doctor should never write off a person a priori." There is a Vietnam veteran seriously ill with a cancer that calls for immediate treatment or he will surely die. The patient is obstinate about not having therapy, that it will not work. Dr. Groopman is able to bargain with him. The patient has the right to stop treatment at any time and must understand that he is in the "driver's seat" all the way.The most poignant patient for me was Barbara, a 67 year-old woman whose breast cancer has metastasized. We meet her in the chapter called "Undying Hope." The good doctor probably would say that he learns far more from her than she gets from him although he of course gives the patient his best. After many months of harrowing treatment, she does not want to stop, however. "'There are many moments during the day that still give me pleasure,'she said. 'Let's keep going.'" The moment comes when the doctor must tell Barbara that there is nothing else he can offer to help her. After "heavy silence," she responds that he can still give her the "medicine of friendship." The patient ultimately dies. "Although I had expected this outcome for quite some time, I felt a gnawing pain of loss. I accepted that medicine had its limits. It was just that I cared for her so much; it was impossible not to. But I also felt deep gratitude. Barbara had opened herself to me in a way no patient had before. A patient's revelation of her deepest feelings and thoughts is one of the most previous gifts a doctor can receive. It has happened with me when I have reached the level of relationship I did with Barbara, of friendship beyond the professional." And finally, "there are some patients whom a doctor grows to love. . . Barbara had sparked that love in me."The author is not talking here about false hope, denial or the information that the Louise Hays of the world dispense when they blame the victim, that patients who don't get better have a need not to and are weak individuals. I still remember someone saying about a friend with AIDS in the 80's who had come down with pneumonia: "I refuse to go to see him because he had a need to get pneumonia." (This kind of thinking is maddening.) The author gives us hard data and looks at the changes in the brain when we have hope: "It turns out that we have our own natural forms of morphine--within our brains are chemicals akin to opiates. These chemicals are called 'endorphins' and 'enkephalins.' Belief and expectation, cardinal components of hope, can block pain by releasing the brain's endorphins and enkephalins, thereby mimicking the effects of morphine."Dr. Groopman is obviously a brilliant and competent practitioner, but he is also wise beyond measure. "I try hard to let patients read in my eyes that there is true hope for them. . . Doctors are fallible, not only in how they wield a scalpel or prescribe a drug but in the language they use." So much wisdom here, much about faith and how it differs from hope. At one point the doctor says that hope has wings. I wonder if he knew that the poet Emily Dickinson said that "hope is the thing with feathers."I repeat: this amazing book will make you sing.