There is a Reason and Science for Hope

I am not a terribly optimistic person, but I am a hopeful person.  I bring this lens with me into my spiritual direction/companion practice.  Let me explain by talking about my work as a palliative care chaplain, which I did for over a decade and only recently took some time off. I have permission from these patients and families to share their stories.

Palliative Care is an interdisciplinary medical specialty that focuses on improving the quality of life of patients and their families as they face life-limiting illnesses. In essence, we try to prevent and/or relieve suffering, and we understand that suffering comes in various forms, whether physical, mental, emotional, psychological, or spiritual.  We also believe that healing comes in many forms. Part of my role as the chaplain on this team is to deal with matters of spirit and emotions. To learn about this person, who they were before they became ill, how this illness impacts them and their family, and where they find hope. One of the questions I often ask my patients is, “How are your spirits holding up today?”  And then I leave space for them to speak, cry, rage, and sometimes, even laugh.  Their responses help me learn about their spirituality.  About the ways, they seek and express meaning and purpose. And about their connectedness to the moment, to themselves, others, nature, and to what they name significant or sacred.

When I ask my patients and families, “How are your spirits holding up today?” I’m aiming to hear about what sustains them during these challenging times. They might communicate using a particular religious language and imagery, which is perfectly okay as long as it brings them closer to the wholeness they desire.  If it turns out that their religious beliefs are causing them to suffer more, then that is an area we can work on healing together. My goal is to address serious illness’s spiritual and emotional pain so that we might find some hope together.

You may have noticed that I used the word “wholeness”—what a beautiful word and experience. I firmly believe that we can find healing and wholeness even when we cannot cure an illness. Even when parts of our bodies must be removed to stop a disease process from spreading further, our bodies and minds might have dis-ease, but we can still be whole.  

When people speak of wholeness, they often mention “body, mind, and spirit.” Many of us know how to take care of our bodies, and we emphasize health, nutrition, and preventive care.  Many of us also understand the importance of mental health. However, we’ve largely avoided conversations about “spirit,” even though many acknowledge that spirituality is essential to wholeness.

It is a spiritual odyssey to live with serious and chronic illness. The question presents itself: “Is there hope for achieving emotional and spiritual wellness even while our bodies remain sick?” Certainty and predictability are in short supply. Some days a person can’t even get out of bed. Can’t keep the plans they made. They miss their loved ones’ milestones due to their illness.

Is there any hope? I think it depends on how you define it.  

Here’s what hope is NOT:

It is NOT:

If I think positively, this will go away.

If I pray enough or have enough faith, this illness will go away.

If I eat leafy greens at every meal and meditate three times a day, this will go away.

Many people do all of this and still have an illness.

So what is hope??? Hope is both powerful and fragile.  

The poet Emily Dickinson said, “Hope is the thing with feathers that perches in the soul and sings the tune without the words and never stops at all.”  Emily lived with various chronic illnesses, such as kidney and heart disease, for over 30 years.

The Rev. Dr. Martin Luther King, Jr. said, “We must accept finite disappointment but never lose infinite hope.” In his struggles against system racism and oppression, which continue even today, he reached deep within himself. He wrestled with setbacks while striving never to lose sight of the bigger picture of hope and justice.  

The author Anne Lamott said, “Hope begins in the dark, the stubborn hope that if you just show up and try to do the right thing, the dawn will come. You wait and watch and work: You don’t give up.” I encourage you to read her books if you have not already because, in those books, you meet an authentic, irreverent, beautiful, spiritual person who has survived various addictions in her own life and her family system by tending her spirit and through the use of humor, too.

What do you think of when you hear the word hope?

I want to highlight what I think are some differences between the three words that often get used synonymously: hope, cure, and optimism.

I’ve heard it said that hope is “harboring optimism in pursuit of a cure.” But what happens if there isn’t a cure?  Does that mean there’s no hope? 

Let me tell you about Max.  Max served in the US Army and retired as a master sergeant.  He spent his career as a journalist, and among his assignments, he covered the war in Grenada.  Max was also a volunteer firefighter. It was the year 2000, and I had recently started seminary and begun a ministerial internship at the Metropolitan Community Church of San Francisco, a congregation that, in its history, lost over 500 people to HIV and AIDS. I was on call my first weekend when the phone rang in the church office.  It was the VA hospital requesting a pastoral visit for one of the patients who was gay.  That’s all I knew, except I also knew that our faith community had a history of seeing people at hospitals when no one else would.  

I met Max in his hospital room.  No one told me that he was dying from AIDS.  I had never seen someone actively dying. I walked to his bedside and said hello. His nurse brought me a chair. I noticed that Max worked hard to breathe despite wearing an oxygen mask.  I sat with him quietly for a little while, and then he removed his oxygen mask and, in a raspy voice, whispered the word “communion.”  

Metropolitan Community Churches all over the world celebrate communion every Sunday. That tradition was started in the 1970s partly because it was something our churches of origin denied us because we were gay.  In our tradition, people come forward, and we take a piece of bread, dip it in juice, then place it in the person’s mouth, and say a prayer together.  Communion became one of our focal points during our worship services because it was a time of memory.  It was a time of powerful connection.  It was a tangible time of touch, especially when people around the globe would not touch us.

Max asked for communion.  I didn’t think to ask his nurse if he was allowed to have juice or bread.  I was innocent enough at that time to do it.  I helped Max take off his oxygen mask and placed a tiny piece of bread in his mouth.  I then took the cup of juice and held it to his lips.  As the juice dribbled out of his mouth, I said a healing prayer for him and reminded him of the unconditional love of God surrounding him.  I will always believe that the communion meal served as a powerful reminder to Max that he was connected to his beloved community even though he was in the hospital.  That he was worthy of touch.  That he was loved.  In that mystical moment, the veil was lifted, and he understood that love is stronger than death.  He would always be with us, still connected, just in a different way.  

I used to think the only definition of hope was “cure.” But there wasn’t a cure for AIDS then, and there still isn’t. Max taught me that even without a cure, there is still hope.  For Max, hope came in the form of communion. A little while later, Max died, but his spirit still lives on as I share this story.

Optimism says, “Everything is going to work out just fine.” Optimism expects a particular result to occur, but it doesn’t always work out.  Sometimes things go very badly.

The word cure means “to eliminate all evidence of disease.” 

There are differences between hope, cure, and optimism.  So how do we define hope?  I like the definition that Bruce T. Marshall gives when he says, “Hope is an attitude that looks for possibility in whatever life deals us.” 

Because I believe in science and spirituality, I want you to know there is scientific evidence that hope protects the brain! In a 2002 University of Kansas study, researchers examined the role hope plays for students.  Hope theory integrates the conceptualization of goals, strategies to achieve those goals, and the motivation to pursue those goals. This study looked at pathways and agency and found that students with higher levels of hope based on the Trait Hope Scale had less anxiety. 

In a 2011 study from Malaysia and Hong Kong, scientists showed the link between having greater hope and reduced anxiety and depression in patients with cancer.

In a more recent study in 2017, Chinese psychologists discovered that hope protects the brain against anxiety and expanded our understanding of how that may be happening. Because hope is considered a stable personality trait, they reasoned, they might be able to figure out where in the brain they can find hope functioning! They were able to pinpoint where hope might potentially reside within the brain and realized how hope might be shielding the brain from the effects of anxiety and pain.

Scientists believe hope lives in the brain’s bilateral medial orbitofrontal cortex area. That is the region involved in the reward-related procession, the production of motivation, solving problems, and goal-oriented behavior. The orbitofrontal cortex is located just above the orbits of the eyes and goes back several centimeters into the frontal base of the brain. So, it’s in the front of the brain, right behind our eyes. Isn’t that a beautiful image? That hope is front and center.  

Other studies out there, some older, some newer, that study hope.

Sometimes we need to redefine hope and learn tangible ways of offering hope to ourselves and each other even when life turns out quite differently than we’d imagined.

This makes me think of a beautiful couple I knew in Bellingham. Toby was this larger-than-life fellow. In his work, he was called an “Explosive Ordinance Disposal Technician.” That means he went all over the world working in fields, finding mines and grenades and diffusing them before they exploded and caused damage.  You could say Toby liked living on the edge. One day Toby met a woman named Phosy, who was completely the opposite of him and they fell in love. He liked being free to roam, and then, of course, with his job, he wasn’t sure he could expect another person to live with that kind of anxiety. I learned right away not to underestimate Phosy. 

Toby and I met when he came to St. Joe’s hospital and was diagnosed with end-stage metastatic cancer. His prognosis was grim; we weren’t sure he would survive this hospital admission.

But Toby was determined he would. Toby believed himself to be invincible so that no cancer would stop him. And he was right, for longer than we expected. Toby started cancer treatments and various medications. The medications took an already larger-than-life guy and put him on a scale of intensity that I’ve never seen before! I’d walk toward the unit he was on and hear him way before I saw him. He couldn’t help it; somehow, it added to his charm.

Toby started taking care of business. He reached out to his brother, whom he hadn’t spoken to for many years because of their falling out. Then, one day, Toby told me he wanted to marry Phosy and asked me to officiate the wedding.

This unit was abuzz. The nurses and nurse’s assistants decorated his room. They brought in flowers and cake, and sparkling cider. And because Toby was born and raised in Hawai’i, he had chocolate-covered macadamia nuts shipped in for the special occasion. Phosy found a beautiful dress, and one morning the nurses, doctors, and I gathered around Toby’s bed for his wedding. His brother, with whom he had reconciled, flew in from Hawai’i and stood there as his best man. We celebrated Toby and Phosy’s love and listened as they recited their vows, and the line “in sickness and in health ‘til death do you part” took on a new meaning.

Toby was flying high on a combination of his love, medication, and treatment that was helping extend his life. He infused that entire hospital unit with hope. He let our communications staff interview him and take wedding pictures so their story could be captured and shared with everyone!

Toby did indeed leave that hospital just like he said he would. He and Phosy lived their married life together for another six months or so before Toby passed away. And in those six months, he lived on his terms, the best he could, and he died peacefully with hospice care.

Bruce T. Marshall says, “Hope advises us to look squarely at the realities that confront us while remaining aware of the possibilities.”  

Toby looked squarely at the realities that confronted him but remained aware of possibilities because there is always hope, even when we have to change what he hopes for.

Hope matters to our spirits.  

Hope may not help us live as long as we’d like, but it can help us live better. 

We can nurture hope in ourselves and each other because even when life is difficult, there is a reason (and science) for hope. 

I am not a terribly optimistic person, but I am a hopeful person. I bring this lens with me into my spiritual direction/companion practice, and I look forward to hearing your stories of hope.