Hoping for a Miracle (Part 1)
One of the most common expressions of hope by patients, especially those facing a difficult cancer or similar life-threatening illness, is the hope for a miracle. You might think that this sentiment would be restricted only to those with a strong faith, but the hope for a miracle can be felt even by those with the strongest doubts. This stems from the innate part of our humanity that recognizes that there are things greater and more mysterious than we can understand.
What does it really mean to hope for a miracle? To begin, it is critical to understand specifically what is meant by the word “miracle” in the minds of the patient, their family, and the clinician. From my perspective, there are multiple ways that miracles can be experienced. For some, a miracle equates to the extraordinary outcome of being completely cured of an incurable illness, likely thanks to divine providence. For others, a miracle may be the achievement of a momentous event of great importance, such as being able to make it to a big anniversary celebration. A miracle may even be envisioned by some as finding the right physician with the latest state-of-the art treatment or clinical trial that provides a chance for longer survival. Miracles may even be unseen or may manifest in unexpected ways.
How does the thoughtful clinician approach this discussion? It is important to take the time to understand where a patient is coming from and what expectations are brought to the conversation. A non-judgmental approach that honors the patient’s values is essential to keeping open the possibility of hope. Acknowledging that miracles can come in many different forms can help frame the conversation between patient and clinician more clearly. In contrast, dismissing a patient’s beliefs as irrational or delusional can create an impassable barrier that impedes care and steals away hope.
Research discoveries can provide a type of scientific miracle. Patients hope to benefit from new breakthroughs that could alter the course of their lives, with treatments that may turn aggressive rapidly lethal cancers into manageable chronic diseases. In many cases, this is what motivates patients and their families to seek out second opinions or participate in clinical trials. Additionally, there is the hope each patient holds that they could be one of the lucky ones. Every oncologist has seen tumors that respond much better to a treatment than would have been expected. The same uncertainty about the future that can create so much anxiety and distress for patients can also be a source of hope. We never really know how well a treatment is going to work until we try it.
Similarly, there can be miracles of a sort effected by the patient’s health care team. Hard-working, resourceful, and compassionate clinicians can often “move mountains” in providing care. The hospital care coordinator and palliative care team that are able to get a critically-ill patient home for his last days on earth, rather than languishing in the hospital. The physician and social worker who work hard to obtain an expensive new medication or treatment for a patient with limited resources. The intensive care unit physician and nurse who hold vigil with a patient, doing everything they can to help the patient stay alert enough to say goodbye to family flying in from out-of-town. These are all types of caregiver miracles that happen more than we realize in every clinic and hospital throughout the world.
In the next post, we’ll discuss the supernatural type of miracle and the unseen or unexpected miracle. Until then, keep hope alive!
