Dr. J on the science of hope
Contributor: “Dr. J”Dr. J offers his irreverent, slightly irrelevant, but possibly useful opinions on health and fitness. A Florida surgeon and fitness freak with a black belt in karate, he runs 50 miles a week and flies a Cherokee Arrow 200.
My hospital is rated as one of the best hospitals in the country! It’s current advertising motto is “The Science of Hope.” When I first heard that motto my impression was that sounds good, what does that mean? The longer I reflected on this, the less I liked their choice of words!
Hope is all too often not reality!
Hope is all too often a belief that is unfounded and irrational. In the long run it will prove more detrimental than beneficial because it will prevent actual change and true progress. That, unfortunately, is the true nature of hope. In the end hope will never improve our actual existence, and we need all the help we can get!
Medicine as Art and Science
When I first forayed into medicine, there was constant mention of the Art and Science of the field. Originally mostly art, medicine has worked hard to become mostly science. Vast amounts of credible research have been done by dedicated doctors to advance the boundaries of medical knowledge. In the field of surgery, I have personally seen tremendous improvements in treatment and technique.
There is a problem, however, that arises in medicine, involving the areas of what are we curing, or even treating reasonably successfully, and what are we unable to treat with much success. As “Madison Avenue” and image has become more important than reality in many areas of life, medicine has not escaped those effects.
I’m sorry to say that the same dishonesty that permeates product commercials and claims that is so ubiquitous in advertising has more than infiltrated medicine. Just as products are advertised with unrealistic promises, so is medicine.
Medicine is not a cure-all
The reason for this is no one wants to face the truth!
As successful as medicine has become, we are not that successful with many major medical conditions. Several diseases are pandemic and getting worse! Diabetes is out of control. Heart disease, stroke, and hypertension are rampant, and worst of all, cancer is probably not being treated any more successfully now than it was 50 years ago, in spite of what you may have been led to believe, and it is a lot more prevalent!
Rather than face up to these more than sobering realities, we as a society live in serious denial and distort statistics and reality to conform to our need for comfort rather than make the hard choices that could give us real hope.
So rather than advertise treatment, hospitals advertise hope. That would be fine, but medicine cannot deliver enough of the results people hope for.
What we need to do
The first thing we need to do is to be honest about what we can and cannot medically treat. This is not to say abandon those with existing medical conditions, but a vast effort must be directed toward prevention of disease rather than treatment. The reason is obvious — treatment doesn’t work nearly as well as we want to believe!
Prevention does work! Prevention will require serious paradigm changes in our lifestyle choices, and they will be, for the individual and for society, very painful. The environmental and behavioral factors that are breaking down our health will either be addressed or they will not be. We must be honest with ourselves, in spite of our fears to see the truth.
Perhaps if we can accept that, we will move on from The Science of Hope to The Science of Results.
(Send your questions for Dr. J to calorielab@gmail.com or leave a comment. If your question is used by Dr. J, CalorieLab will send you a $25 Dining Dough restaurant certificate — limited to U.S. residents. More Dr. J posts can be read in our archives.)
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December 1st, 2008 at 7:06 am
Oh Dr. J! “Hope is all too often a belief that is unfounded and irrational.”?? Usually I agree with you 100% but this time I’m not with you. What is the human condition without hope that things can get better? Perhaps you mean that wishful thinking without intent to act that leads to ennui. But hope is not baseless dreaming. Hope is the belief that things can be better than what they are. Hope is that one can change. Hope is motivating and illuminating! Oh no, hope is a gift and one I cultivate in myself and my children:) Just ask Eli Weisel.
That said, I certainly agree with you about medicine not being a cure all.
December 1st, 2008 at 7:20 am
Yay for the motto The Science of Prevention! I mean, I’m all for treatment, obvs (my friend is in the hospital right now with a suddently-birst appendix that no one could have predicted) - prevention would not have helped her, but the surgery sure saved her! But for most things (my niggling neck injury, many types of cnacers, obesity-related illnesses, even the common cold!) prevention is KEY. I feel like my generation is one of the first to truly embrace that concept.
Happy belated T-day!
December 1st, 2008 at 8:04 am
Dr. J,
I agree with Charlotte on this one. Taken from wiki: To hope is to wish for something with the expectation of the wish being fulfilled. So The Science of Hope to me is applying the trade of medicine to get to expectations beyond what we can do for ourselves. Now obesity and all the complications that come with it can be prevented, but when the problems arise, you’ll need that hope to find out if life can be extended or not.
I do agree with you on almost all other things you discuss. I’m just taking a differnt view on this one.
December 1st, 2008 at 8:28 am
While “hope” is always good, “stupid actions justified by wishful thinking” is not. I see a lot of folks ignoring prevention and common sense and figuring doctors will just fix whatever ends up wrong.
Good point about the limits of modern medicine!
December 1st, 2008 at 8:32 am
Being the eternal spectator, I can see this issue both ways.
For instance, without hope, I would probably be dead by now. Maybe that wouldn’t make a difference to the world, but it would matter to the few people I actually let into my heart. I have been locked in a push-pull battle with clinical depression for over a decade, and very nearly threw in the towel four years ago and several times before and since. Without irrational hope, I would almost definitely not be writing this today. Perhaps I’m just prolonging my suffering. But I hope, I hope, I hope that I can bring some joy to this world yet and still experience some for myself.
That being said: This particular case (depression) is probably quite a bit different from lots of other medical syndromes in that I don’t think my initial onset of depression could have been prevented. Also, I must face up to the fact that the definition of insanity is doing the same thing again and again and expecting different results. I have been on various medications for my depression for almost ten years. During this time, I have sporadically attended therapy as well. This has not worked for me, I am willing to admit. And yet I have not tried other remedies (or rather, “coping mechanisms,” because I believe the depression can go into “remission,” so to speak, but must always be watched for).
What I have not given my full attention to: regular intense exercise; modifying my diet; and actually sticking with one therapist for longer than a few months. I will allow myself to hope that changing my tactics may actually work. And this will keep me going. . . .
While hope can keep you mired in denial (as I have been the past few years), it can also sustain you until you open yourself to a new way of living, a new kind of treatment. It’s a mixed bag. As always, I appreciate the way you make me consider these issues, Dr. J.
December 1st, 2008 at 10:53 am
I agree that science of hope makes no sense.
Hope is a powerful emotion. Doctors should give realistic hope to patients, but hospitals?
Unrealistic hope leads to unrealistic expectations.
I guess it boils down to defining hope in your own way.
December 1st, 2008 at 11:06 am
I really believe that prevention is the best option. Why wait until you’re ill to start trying to fix it? Might as well just not get ill in the first place.
Unfortunately honesty doesn’t seem to be one of our society’s strong points.
December 1st, 2008 at 11:32 am
First I want to thank everyone who commented!! Hope is one of those qualities that cuts different ways. As with many other behaviors, how it is used by the individual can make all the difference!
Charlotte!
“Hope is motivating and illuminating!” I like that!!
NeverSayDiet!
As you say, prevention is key!!
Tom!
I respect your disagreeing!
Crabby!
I wish we could fix everything! Glad you are back home!
Liz!
Thank you for expressing all that you did! You are a wonderful writer with so much depth!
December 1st, 2008 at 11:35 am
Dr. Hubbard!
I see as a doctor you understand what I was trying to say, thank you!
Sagan!
I like that not get ill in the first place attitude!
December 1st, 2008 at 3:43 pm
Great post! Well said Dr Hubbard, I agree!
December 1st, 2008 at 5:30 pm
I’m scared to death of hospitals…I “hope” to stay far far away from them! If by some unfortunate twist of events, I land in one, I want the most science-minded and experienced health care providers that medicine has to offer so I can make it a brief stay. I’ll bring my own hope to the situation and they can bring what they know to be true.
December 1st, 2008 at 6:38 pm
“Set Thine House In Order” (Second Kings, chapter 20, verse 1)
That said, a gram of action is worth a metric ton of hope or prayer. Physicians, heal thy selves, and we are all physicians to ourselves.
December 1st, 2008 at 9:09 pm
In between visits to the oncologist, the lab, and the CT scan earlier today, I *hope* no one finds any more evidence of cancer inside my body. I have to go to scientists to find these answers.
I’m not sure there is *any* science in hoping. For me, there is science and there is hope. I enlist the services of both as needed.
December 1st, 2008 at 9:54 pm
I am with you on prevention - there’s way too much focus on treatment and not enough on preventing so many preventable diseases. It’s like the whole HIV/AIDS thing - once people found out there was a treatment and less of a chance of dying, it seems they stopped being as careful to try to prevent it.
December 2nd, 2008 at 6:42 am
Rupal!
Thank you!! Liked the squat post and your sensible approach.
Kami!
My brother won’t even say the word, “hospital!” Working in them gives me a more comfortable view, sort of.
Emergefit!
Our own physicians or fools by 30 is the saying!
POD!
Good plan! I want the scans to be clear!!
Sahar!
I do not like hearing that people are doing LESS prevention :-(
December 3rd, 2008 at 4:41 am
and HOPE can get us way beyond modern medicine.
Ive seen it in so many friends given terminal diagnosis too.
December 4th, 2008 at 9:40 am
As a final note on this post, I want to express my thanks to all the commenter’s and their various opinions!
I may have not been as clear as I hoped with mine. I do not think for the individual that being hopeful is wrong. I do feel that a hospital should not be using hope to sell their scientific medical product.
I hope this is clearer :-)