Center to Advance Palliative Care

As our modern medical tools, including pharmaceuticals, biologicals and techniques, get more sophisticated and powerful, it seems that our faith in people’s inner healing abilities gets weaker. Examples are common in cancer care. People are told, often early in their care, that, “We cannot cure this cancer; we can only buy you some time - perhaps months.” This kind of pronouncement can rob those who might be able to bring some personal healing abilities to bear on their disease, even on cancer. Many of us in the support group world see people with terrible cancers, even some stage IV cancers, get better and live quality lives for long periods of time.

A more useful pronouncement might be, “We are going to do all we can for you, and we want to support your own efforts to travel on this journey with cancer. We will do the best that we can, and we will be here for you and with you. What we have to offer is…. Some people have found that nutrition, attitude, support groups, love, exercise, yoga, faith, and other personal efforts have been useful. We encourage you to explore all possibilities that can support your own healing abilities, and we will explore all the tools of modern medicine that can be of help. Statistics may suggest that your outlook is serious, but there are cases that do well in spite of the statistics. Together, we will travel this cancer journey in the best way that we can.”

Why not start by encouraging people to work at self-healing in addition to conventional therapies? Why pronounce their imminent demise in a way that can hasten that end and possibly deprive some people of their own self-healing abilities?

Everyone with a cancer diagnosis, or with other serious diagnoses needs to be practical, getting affairs in order and creating advance directives in case things do not go well. That is different than killing all hope at the start.

Good physicians understand that diagnosis and treatment are part of a journey. If the journey does not go well, then they will have to be there to help: relieving suffering, assisting with pain, and doing the human things needed as things deteriorate. That is different than predicting failure at the beginning of the journey, so as not to cause disappointment or distress in patients who do not do well. Promising cure is one thing. Creating hope is another, and part of the work of being a physician. Dealing with hard endings on the journey of a person with a disease is part of the work of being an excellent physician. That work must not be avoided by depriving people of all hope at journey’s beginning.

Hope is an enormous asset. It may evolve from hope of getting over a disease to hope of relief of suffering, and to the best possible experience at end of life. Let us use hope as a valuable tool and an essential part of modern healthcare.