An inspiring and profoundly enlightening exploration of one doctor’s discovery of how hope can change the course of illness
Since the time of the ancient Greeks, human beings have believed that hope is essential to life. Now, in this groundbreaking book, Harvard Medical School professor and New Yorker staff writer Jerome Groopman shows us why.
The search for hope is most urgent at the patient’s bedside. The Anatomy of Hope takes us there, bringing us into the lives of people at pivotal moments when they reach for and find hope--or when it eludes their grasp. Through these intimate portraits, we learn how to distinguish true hope from false, why some people feel they are undeserving of it, and whether we should ever abandon our search.
Can hope contribute to recovery by changing physical well-being? To answer this hotly debated question, Groopman embarked on an investigative journey to cutting-edge laboratories where researchers are unraveling an authentic biology of hope. There he finds a scientific basis for understanding the role of this vital emotion in the outcome of illness.
Here is a book that offers a new way of thinking about hope, with a message for all readers, not only patients and their families. "We are just beginning to appreciate hope’s reach," Groopman writes, "and have not defined its limits. I see hope as the very heart of healing."
When Dr. Groopman is not in his laboratory at Boston’s Beth Israel Deaconess Medical Center, where he is chief of experimental medicine, he focuses his expertise as a hematologist and oncologist as well as his compassion on the inner workings of his patients. It is this unusual nexus of medicine, healing and faith in the preciousness of life that characterizes Dr. Groopman’s career and core being. At age 44, Dr. Groopman turned his gentle yet meticulous lens to writing about his patients’ courage, endurance and resilience.
Though he considers himself a scientist and physician first, his eloquent pen captures the pace and pathos of medical mysteries and human dramas. The Measure of Our Days (Penguin) was published to critical acclaim and inspired the ABC television drama Gideon’s Crossing. In 1998, The New Yorker asked Dr. Groopman to become a staff writer in medicine and biology.
From a patient perspective... as someone who interfaces with multiple doctors on a very regular basis, I was pleased to hear, in this book, that Western medicine is heading in a different, better, direction. A direction that incorporates the mind-body connection and the psychology of illness. A more Eastern approach.
I'm a total fan of hope as a tool to "prevail in the face of illness." I'm entirely sold on the concept. What I felt was lacking in this book, however, was how, exactly, to obtain the "real" hope vs. the false hope that Groopman dichotomizes in this manner:
"False hope does not recognize the risks and dangers that true hope does. 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 paths around them."
"Hope tempers fear so we can recognize dangers and then bypass or endure them."
I feel like I have that part down. I know my personal prognosis is a very bad one and I'm navigating around the obstacles of it pretty well. I'm plowing headstrong into the dangers (questionable treatments) while still maintaining hope, but I think one of the best tricks in this whole process is using the imagination, which isn't really discussed in the book. Groopman proffers:
"Hope is the elevated feeling we experience when we see- in the minds eye- a path to a better future."
Well said, but how do we obtain that mind's eye view?
A similar sentiment:
"Kindling and sustaining hope depend not only on images that may be conjured in the mind but also on how those images are brought into focus or blurred by the ongoing input of nerves from organs and tissues to the brain."
I know personally that things such as guided imagery and meditation can get a person to obtain this mind's eye view and to conjure these images of a better future. But the book doesn't go there and I think it ought to.
Despite all of this, I feel it was decent book in that it gave me some fodder to add to my ever-growing collection of information that, I hope, one day will meld into some sort of very significant insight.
Overall, Dr. Groopman hits a point that I want to one day encompass as a provider. While my job of prescribing treatments is what I am going to school for, the idea of sitting at a bedside with nothing left to administer but a friendship morphs into the ultimate medication. At the end of the day, the right to surrender and welcome death belongs to the patient and my opinion as a provider is no longer of value. People more often than not, need acceptance more than advice. It's true that tumors don't always read the textbooks and it remains a comfort that no one is beyond the capacity to hope. I look forward to the day (dare I say- hope) when the miraculous is commonplace and the incurable becomes cured.
Definitely *not* one of those rah rah, mind over matter self help pseudoscience books, The Anatomy of Hope is a serious scientific survey of research into how expectations affect our ability to overcome injury and illness. Peppered throughout with intimate tales of patients' personal journeys – including the author's own struggle with debilitating back pain – it's an eminently readable and quite touching book.
I've read all of Groopman's previous word and ordered this book from Amazon as soon as I heard it was being released. Groopman writes regularly for 'The New Yorker' about medical issues with the focus on his role as a physician and healer. What is remarkable about Dr. Groopman is that he respects every one of his patients and values their uniqueness.
This book explores the role of hope in fighting disease and healing. It discusses the biochemical changes related to hope and the physician's role in fostering real hope when applicable but not encouraging false hope.
Dr. Groopman examines his early experiences as a doctor, mistakes he made and lessons he learned. He also reflects on ways that hope has played a part in his own life. One such way that hope has been important to him is when he suffered chronic pain following two failed back surgeries. Hope enabled his to regain strength after 19 years of chronic pain.
Dr. Groopman treads on difficult ground, intertwining science and spirituality along with the impact of one's emotions on their physical being. He manages to tread well with his beautiful writing, clarity and a respect for the personal choices we all make that change the course of our lives.
His chapter on exiting the cycle of pain was especially thoughtful. He discussed how we might be better off ignoring pain. In fact doing something painful may not be harmful. We must realize that pain is only a message that can be interpreted in many ways. Sometimes we create a cycle of pain by being prisoners to it.
Dr. Groopman discusses the biochemistry of the pain cycle and his own experiences with rehabilitation, including his initial distrust of his physiatrist's recommendations. I appreciated how he related what he leared from his patients. He is not a typical know-it-all doctor.
One chapter that I liked very much is about a patient named Barbara. Barbara has managed to maintain hope and dignity in the face of metastasized breast cancer. She prioritizes and lives her life to the fullest. However, when the time comes she plans to face her death with courage and dignity. She maintains a sense of hope. Her strengths are her living life to the fullest, her faith and her belief in medical interventions as long as they provide a quality of life wherein she can thrive. When she realizes her death is imminent, she accepts this and is able to let go of false hope and die with dignity having lived a life of meaning. In order to live life her way, she does all she can including enduring difficult chemotherapy. However, she will recognize when to stop treatment.
This is an amazing book. Anyone who is interested in the medical establishment and what makes a really good doctor will appreciate this book. It will also raise and answer many questions about quality of life issues and ways to raise real hope without fostering a false sense of hope.
The title sounded so promising. This book was 80% the healthcare/biomedicine of patient cases, 15% hope-adjacent things (e.g., placebo effect, stress responses), and 5% pondering on hope, none of which really helped me figure out how to help patients or myself be hopeful.
I don't know -- I guess it's not an unfamiliar progression in books like this: 1) i overemphasized hope at the expense of a more realistic prognosis and there was a fatal outcome and the family was mad 2) i overemphasized the more realistic [negative] prognosis at the expense of hope and there was a fatal outcome and the family was mad 3) i guess i need to try harder to get to know the patient (which wouldn't be a terrible conclusion if it wasn't clear that he actually tried really hard (and was successful, from my reader's view) to get to know these patients).
In other words, this book did not dissect hope or show "how people prevail in the face of illness" in any meaningful way. There was nothing harmful or foolish in the book (hence not one star), it was just a bit empty of insight.
If you are going to read one nonfiction book this year, let this be it. There is wisdom here, not just for people who are facing illness but for anyone who is dealing with suffering. Calamities happen in our lives. That part of it is not optional. How we choose to respond is what makes us unique and what gives our lives meaning. It is possible to experience joy during tragedy, peace during uncertainty. I have experienced this in my own life, and the stories in this book deep in and enriched my understanding of what hope and personal choice can do when calamity happens. I chose to start reading this book because I am dealing with a serious form of heart disease that is unlikely to reverse. I found encouragement, comfort, and real and very practical ideas on how to deal with the dark days and how to make the most of the time I have left, whether that is a day or a decade.
I suppose I started reading this because I've become interested in the connection between our emotional and mental well-being and our physical well-being. I was hoping for some heavy-hitting insights here. But I felt it was mostly profiles of cancer patients and then some very technical scientific research. There was really no elegant tie-together of the two parts of the book.
As someone who recently underwent her own (comparatively minor) health crisis, I can clearly see how crucial hope is to recovery. I can fully understand how crucial it is to balance the truth with a hopeful outlook--this is what led me to undergo a relatively experimental surgical procedure with hopes for full recovery. I knew going in that there was a chance this wouldn't work, but my doctor was honest about all treatment options and I could see this was the most sensible route to take. I was hopeful that it would help and determined to comply with his orders and care for myself. Doctors, therapists, and friends alike have cheered me on and encouraged me to hope for complete healing and have empathized with me on my bad days, acknowledging that it's a long, slow road. So far, so good--very good. I continue to hope that I will recover 100% and never need another surgery. I believe my positive outlook and proactive stance are crucial to this procedure's success.
So for these reasons I was so curious to read more about the precise role hope plays in our healing. But this book left me feeling dissatisfied. There's no real take-away in terms of how to strengthen your own hope in the face of illness or other hardship. Yes, Groopman examines some of the science and brain workings that seem to indicate how our bodies physiologically react and create hope, but there wasn't a real message of, "Here's how some patients faced their trauma with hope, here's how others didn't, and here's what you can do in tandem with doctors and loved ones." I wish there had been a stronger conclusion to this book, because it's a truly fascinating subject.
I liked this book pretty well - the things I wanted to hear/learn more about (HOW people prevail in the face of illness) were somewhat limited in scope.
Dr. Groopman is a hematologist/oncologist. So he deals mostly with cancer and HIV, that kind of thing. He discusses the differences he saw in outcomes and experiences according to the different degrees of hope each patient had. He also shared how some patients went from having little hope, to having more hope for a positive outcome. I enjoyed the anecdotes of his patients; seeing the situation from the other perspective is always interesting. I guess I was hoping for more information on how to acquire more hope in the face of illness & difficulty.
One quote I enjoyed (and probably made reading this book worthwhile for me), was this,
"The more pain we experience, the less we are able to feel hope. To break that cycle is key. It can be broken by the first spark of hope. Hope sets off a chain reaction. Hope tempers pain, and as we sense less pain, that feeling of hope expands, which further reduces pain."
At this point, I still felt unanswered questions, the most pressing of which was how to find that spark of hope? And what about the cycle of having hope & losing it? I know I'm not the only chronic illness sufferer who suffers with that cycle.
Hopefully something in this review helps -- for others, this might be a great book. And from a clinical perspective, I'm sure it's very interesting.
"While attending physicians... instructed us about manifestations of diseases and showed us the operative techniques to remedy them, the subjects of hope and despair were not part of our curriculum. Conversations like the one between Dr. Foster and Esther occurred behind closed doors. Students and interns and residents were not privy to the words a doctor used to change a patient's mind and heart...I wish I had learned what Dr. Foster told her and how he was able to break through. He could have shown me, beyond scalpels and sutures, the ways a doctor tries to make a person whole again."
Jerome Groopman discusses his experiences with compassion and humility. He's long past his training days, but still writes about his early years from medical school through residency with emotional clarity and honesty. There's no hubris to be found in these pages; Groopman is not pompously talking at you from behind a lectern. He lays his mistakes and missteps bare, inviting you to learn from them as much as you can.
I thoroughly enjoyed this book and would recommend it to just about anyone, especially my friends who are in the midst of their medical training.
Umuda dair bir doktorun gözünden tespitler. Yazar, kitabın ilk bölümlerinde kanser hastalarının ilginç hikayelerini aktarırken, sonunda kendi yaşadığı sıra dışı hastalık tecrübesini paylaşıyor. Akıcı bir kitap. İnsanların hastalıklarına çok farklı yaklaşımlarını güzel bir dille anlatmış. Okuması keyif verici. Kitapta umuda dair fazla felsefi bir yaklaşım yok. Fakat yine de umudu şiirsele benzer bir dille ve akıcı bir üslupla güzel anlatmış. Kitapta bazı hastalıkları öyle detaylı anlatıyor ki, bir ara ayağa kalkıp sağlıklı olduğuma çok şükrettim. Elimizdekilerin kıymetini hatırlatması yönüyle de bu kitap bir mutluluk kaynağı denilebilir.
This is the first Jerome Groopman book I read, and it made me realize that everyone approaches illness differently, and those differences can affect our relationship with doctors and with disease itself. The consideration Jerome Groopman has put into thinking about these relationships is what I think makes him such a compelling advocate for good health care on the individual level. His insight is healpful for anyone, no matter what side of the doctor-patient relationship you are on, but especially for doctors.
Jerome Groopman’s How People Prevail in the Face of Illness: The Anatomy of Hope taught patients, vital lessons about coping in life. This book covered a number of medical case studies. It showed the author as a beginning intern while undergoing his first experiences with patients, and later in his profession as an oncologist. Groopman’s growth became evident by the way he related to patients. At first under a teaching associate, he tried to give a patient a hopeful picture. This was the case, although this woman had cancer that had metastasized. But as this doctor developed in his practice, he provided his patients with the necessary data, and instilled a true hope in their condition. His patients therefore benefited from this new approach. Groopman was able to develop professionally, and made it his duty to talk to experts about patients’ emotions. He was particularly interested in the nature of hope. This information made him aware of sections of the brain that were responsible for positive behavior. Yet, he realized that there could be false hope. This new gift in his medical tool box led him to successfully treat his patients. But he also lost others to illness in the process. One patient who he was fond of died, and devastated him. This setback was hard to take. Some chapters dealt with Groopman himself as a patient. He had suffered a back injury during a marathon. The author was experiencing excruciating pain, visited specialists at different hospitals, but was unable to find relief. It was interesting to note that how being a doctor didn’t help his condition. To find a cure he consulted with different specialists. Fortunately, he was able to find relief, his condition improved, and he could walk many blocks. Groopman had put this belief of hope in action as he underwent physical therapy, and the stress of living with a bad back just like he did with his patients.
The first half of the first chapter is slow, but after that I couldn’t put it down. Every story was touching, gripping, and meaningful. The overall thesis on the nature and capacity of hope in the face of debilitating disease is an incredibly important one for both doctors and patients. Doctors carry enormous responsibility, even before they have attained the wisdom to fulfill it completely, if such a goal is possible. They must learn through experience treating patients late at night, through conversations with patients, and sometimes even as a patient themselves. Without being schmaltzy, the author details his journey into understanding caregiving imbued with hope.
Dr. Groopman is respectful, humorous, and earnest throughout the whole book. He admits his failings and limitations throughout his illustrious career, as well as his reluctance to admit them. I really enjoy this writing style — the vivid narratives come to life, laced with beautiful imagery and wordplay. I’ve highlighted phrases and even whole passages that were a marvel to read. Even his acknowledgments and footnotes are fun in a way I haven’t really seen before.
Compared to other books dealing with how doctors address death, I would rank this book top of the list, though that may be recency bias. If I had to choose between this and When Breathe Becomes Air, I would say the author’s humility, kindness, and reflection shine even brighter in the former than the latter. The latter is no easy standard to attain.
I can only hope to someday be as strong a writer, physician, and researcher as Dr. Groopman.
Dr. Groopman evaluates how hope affects a patient's willingness to take chemotherapy treatment for cancer, as well as how to help patients find hope, by reflecting on various patients and colleagues whom he has known during his career as an oncologist. He discusses the importance of hope, as well as the biology of hope. I found this very interesting. As an ED physician, who treated children and young adults, I usually found that my patients had an abundance of hope. Even when I gave them a frightening diagnosis, since it was early in their illness and treatment, I referred them to the specialists to discuss the details of diagnosis and treatment. It was rare that we saw patients with more chronic debilitating illness or illness with poor prognosis. When I did see death it was usually sudden and unexpected. So what he is talking about is not as applicable to the ED scenario, though the importance of discovering WHY a patient wants specific testing (family history of severe disease or death) or wants to avoid it (fear of being in the hospital, fear of needles, fear of doctors) is similar to the "puzzle", as Groopman calls it, of why a patient does not seem to have hope for recovery or treatment.
I remember I ended up with this book while I was looking for a chemical breakdown of "hope", to understand how the human body generate hope or maybe the other way around; how it responds to it, But what I found was far more appreciable. This book is mainly composed of Dr. Groopman's experiences as a physician, and partly of his quest for the biology of hope from a scientific presepctive. His field, being an oncologist-hematologist, had invited him to tackle perhaps the most essential emotion to survival: Hope And throughout his patients' stories, not only do you sense and begin to grasp what true hope looks like but also you gain much more insight into the importance of the doctor-patient relationship... As I was reading the book and seeing how Dr. Groopman is learning how to deal better with patients and to look for hope in them, I as well was learning more about this pivotal relationship between doctors and their patients, and how "it" can save lives as much as medications and surgery, and again that's because of hope.
Retired Family Physician: I throughly enjoyed the book in the beginning. This is when the author was describing the patients during his early career. The book changed for me and became reductionist and over bearing when he describes his back pain and how he worked to overcome. He seems to not realize that terminal illnesses are different from his chronic pain. His success then triggered a search for what is hope.
This is where the book becomes hopelessly entangled in brain anatomy and biochemistry. The real issue in my mind is that the “hard issue “ of emotion was never addressed. That is how one distinguishes good pain from bad and how does a structure which is primarily water, fat and protein make the complicated and very difficult assessment of these very complex ideas.
Pain is not just patterns of electrical activity and of course no one knows where or even if memory is actually stored in the brain. To think otherwise is simply promissory reductionism.
Hope acknowledges the significant obstacles and deep pitfalls along that path. True hope has no room for delusion.” ― Jerome Groopman
Hope does not have a clear definition, therefore, it's hard to describe. Illness is approached differently by everyone and according to holistic methods of treatment, the underlying emotions of depression or hope, plays a vital part towards the patient's eventual cure.
Though the book contained anecdotes of the Doctor's experience with hope, it did not mention anything new. Placebo effect? yes I get it. Mind over matter? I believe in three planes of health: Physical, Mental and Spiritual which all needs to be healthy and balanced for a good, productive and most importantly, a healthy life.
A short and powerful read but the title is a tad misleading as it gives the illusion of offering more. Also, how does one keep on hoping in the face of terminal illness? How can a physician inspire hope? Some basic guidelines would've been nice.
A little slow, and a bit depressing at first. But then, I think I started to understand how the story was going to go. Dr. Groopman describes several cases that he was involved with, and he describes the patient that those cases were about, and then he sort of just moves onto the next case. There are not a lot of conclusions that are drawn, mostly because I don’t think you CAN draw any conclusions. Every case is different, every patient is different, everyone’s reactions are different, and will be different. It’s definitely worth reading, but I think the main thing I got from this, is that hope helps. Hope makes things easier. But I think most people already know that. Still good!
Oh man, I wish this concept of offering hope (and not false hope) were taught to and understood by more doctors!!
Earlier this year I went to a series of doctors about some bothersome new symptoms and was told repeatedly that it's permanent and there is no cure and no real treatment. It's not life threatening though, so they just shrugged it off and sent me home to continue in that anguish on my own. What a way to break the spirit! I did hold to my own personal faith and kept looking for answers until I found another doctor and then a treatment that offered some hope. The condition is still permanent, but that little glimmer of hope made all the difference in my outlook.
A collection of medical cases the narrator treated during the course of his career. A very personal retelling of physician-patient relationships and the influence hope had on outcome and quality of life. A good recommendation for anyone practicing medicine or training to be in the health field. I found the stories a bit to clinical for the casual reader who has a life threatening illness but I am ignorant in the ways of dying, for no
A great book full of both anecdotal information and summaries of studies on how the mind and body affect each other. I loved the stories of real patients and this doctor’s work with them. The only thing that would’ve made me happier is if they had some practical suggestions for how to have help, and how to help people who don’t seem hopeful to have more hope. I will say this… Every doctor, especially oncologists, should read this.
I found Dr. Groopman's search to define hope and it's power in healing very inspiring and filled with stories of hope. As a physician, I agree with his concluding sentences: "I see hope as the very heart of healing. For those who have hope, it may help some to live longer, and it will help all to live better."
A thought-provoking collection of anecdotes and research summaries on the concept of hope in oncology and other patients. Tips for medical professionals were to find a middle ground between conveying blind optimism and harsh statistics when speaking with patients, be a friend, alleviate fatigue, provide opportunities for patients’ peer-to-peer interaction, and believe in hope yourself.
Read it for a class and enjoyed it! As per usual, did tear up several times.
This is probably a rare opinion for a casual reader, but I wish that the evidence in the neurobiology at the end had been updated with a more recent edition. It's been almost twenty years since this book came out and I'm certain there's more research that could add to the discussion.
Thoughtful and thought-provoking. Much of the book is composed of stories about the author and patients, with a few chapters toward the end exploring scientific theories about hope and healing. An interesting and helpful read for someone who is healing or is friends with a healing person.
I felt so hopeful after reading this. I also considered the power of the mind and what limiting beliefs I'm holding to that are not serving me. Very powerful and I'm glad this book came to me when it did.
Such a brilliant scientific account of the power of the mind-body connection so many philosophies emphasize. For me the part that stood out the most was the emphasis placed on the fact that “we are not prisoners of our DNA”. You have the right to hope and by extension, change your outcome.