The Anatomy of Hope

Happy new year. I have been off the blog since December, first in Phoenix on a (fab) family reunion vacation trip, and since then catching up.

During my vacation I got to read The Anatomy of Hope by Jerome Groopman. This is a great book, and well worth the read. You know by now my interest in health care, and Dr Groopman is a great leader and writer in the field. He works at BIDMC (of which blogger Paul Levy is CEO) and practices in Oncology and Virology. This book explores how hope plays a role in fighting disease and finding healing. It explores the link between hope and the underlying causes of the placebo effect (including quoting from the work of the wonderful Dr Ted Kaptchuk).

Many think that the placebo effect is the "null effect" (or random noise) in the face of a "null treatment" like a sugar pill. The truth is much more complicated, and as is discussed in this book, includes the brain's own ability to trigger the production of healing and palliative (pain relieving) chemicals and hormones in the face of certain non-medical stimuli (including sugar pills or "sham" operations). The placebo effect produces real bodily changes (and palliation or healing) even though the medicinal intervention is only the appearance of using a procedure, drug or device. The attention and care from the health care professionals that comes with this appearance seems able to trigger these benefits in some or many (but not all) patients. Such reactions seem to be triggered by the hope that comes with a medicinal intervention, and Dr Groopman tries hard to find and explain how this works.

I surely hope never to have to face the need to find such hope as Groopman finds in cancer and HIV/AIDS patients he describes, although I know more than a few people who have had to do so. But, it is comforting to understand the role that hope can play.

I wonder, with the massive changes humans seem to be causing the planet, if hope can play a vital role in persuading humankind to make the appropriate changes to our collective behavior. Certainly it is a better response than the despair that lurks behind every story about the acidification of the ocean or the rapid melting of land-based ice caps.

Even if this book is just about the role of hope in healing, and the relationship between doctor, patient and hope, it is a worthwhile read, and an enjoyable one.