Customer Reviews

The Anatomy of Hope: How People Prevail in the Face of Illness

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If I had to sum up THE ANATOMY OF HOPE in one sentence, this would be it: this amazing book will make you sing. I would have finished it the day it arrived in the mail had I not had a house guest I had to tend to. After finishing the book the next night, I was so hyped up that I couldn't go to sleep for hours. I wanted to give it to everyone I care about, including my doctor.

Dr. Groopman discusses hope and its impact on the ability of patients to fight serious, sometimes life-threatening illnesses. He gives the examples of several patients of his over the years and the effect that hope had on their recovery from illness. He also traces his own growth in helping patients. Dr. Groopman learns how to relate to patients through trial and error. "I was still feeling my way on how to communicate a poor prognosis to patients and their families. Not once during my schooling, internship, or residency had I been instructed in the skill." The first patient he discusses, Esther, he saw while he was still a medical student. She believed she deserved to have breast cancer because she had had an extra-marital affair. He later learned that she sought treatment too late and died at the age of thirty-four. Dr. Groopman assists another doctor with the treatment of the second patient. She interprets "remission" as a cure for a serious malignancy. The other physician had given her part of the truth but not the whole truth. When she ultimately learns she is dying, she and her family are angry at the doctor. "I guess he [the doctor] doesn't think people like us are smart enough, or strong enough, to handle the truth."

Along Dr. Groopman's journey, he encounters a physician patient who insists on a difficult and painful treatment that Dr. Groopman didn't recommend. This patient was alive many years after his cure. "It took George Griffin [the doctor patient] to teach me that omniscience about life and death is not within a physician's purview. A doctor should never write off a person a priori." There is a Vietnam veteran seriously ill with a cancer that calls for immediate treatment or he will surely die. The patient is obstinate about not having therapy, that it will not work. Dr. Groopman is able to bargain with him. The patient has the right to stop treatment at any time and must understand that he is in the "driver's seat" all the way.

The most poignant patient for me was Barbara, a 67 year-old woman whose breast cancer has metastasized. We meet her in the chapter called "Undying Hope." The good doctor probably would say that he learns far more from her than she gets from him although he of course gives the patient his best. After many months of harrowing treatment, she does not want to stop, however. "'There are many moments during the day that still give me pleasure,'she said. 'Let's keep going.'" The moment comes when the doctor must tell Barbara that there is nothing else he can offer to help her. After "heavy silence," she responds that he can still give her the "medicine of friendship." The patient ultimately dies. "Although I had expected this outcome for quite some time, I felt a gnawing pain of loss. I accepted that medicine had its limits. It was just that I cared for her so much; it was impossible not to. But I also felt deep gratitude. Barbara had opened herself to me in a way no patient had before. A patient's revelation of her deepest feelings and thoughts is one of the most previous gifts a doctor can receive. It has happened with me when I have reached the level of relationship I did with Barbara, of friendship beyond the professional." And finally, "there are some patients whom a doctor grows to love. . . Barbara had sparked that love in me."

The author is not talking here about false hope, denial or the information that the Louise Hays of the world dispense when they blame the victim, that patients who don't get better have a need not to and are weak individuals. I still remember someone saying about a friend with AIDS in the 80's who had come down with pneumonia: "I refuse to go to see him because he had a need to get pneumonia." (This kind of thinking is maddening.) The author gives us hard data and looks at the changes in the brain when we have hope: "It turns out that we have our own natural forms of morphine--within our brains are chemicals akin to opiates. These chemicals are called 'endorphins' and 'enkephalins.' Belief and expectation, cardinal components of hope, can block pain by releasing the brain's endorphins and enkephalins, thereby mimicking the effects of morphine."

Dr. Groopman is obviously a brilliant and competent practitioner, but he is also wise beyond measure. "I try hard to let patients read in my eyes that there is true hope for them. . . Doctors are fallible, not only in how they wield a scalpel or prescribe a drug but in the language they use." So much wisdom here, much about faith and how it differs from hope. At one point the doctor says that hope has wings. I wonder if he knew that the poet Emily Dickinson said that "hope is the thing with feathers."

I repeat: this amazing book will make you sing.

In an easy to read style, this book offers wise insight into the powerful connections between mind and body. It is hopeful and inspiring without ever being simplistic or sappy. The writer, a physician, displays unusual insight and humility. Human stories are well balanced with science, and there is respect for the spirit. This is not a simplistic self-help book. I have been asked a lot about who should read this book. Someone who is suffering with a life-threatening illness, and is feeling hopeless, may feel misunderstood and negated if you give this book as a gift. Better will be for you to read it and see if you can gather some ideas on how to be most helpful. People who have chronic pain may find this book a very welcome read.I cannot imagine many readers who wouldn't find this book thought provoking and hope affirming.

This book has two types of chapters: narratives (not quite case studies) of specific patients who dealt with serious illness with varying degrees of hope, and Groopman's search for scientific understanding of the emotion we call hope.

Groopman describes two patients who refused treatment, one an Orthodox Jewish housewife he met as a medical student, the other a Vietnam veteran who ultimately responded. Two patients maintained hope, despite a depressing prognosis, and one recovered. He remembers one patient who felt betrayed by her physician's unrealistic optimism.

Describing these patients, Groopman shares his frustration: there's a good chance they can be cured, yet at least some of them resist. One physician (not Groopman's patient) insists on aggressive treatment, living fourteen years after initial diagnosis. "Don't give up!" seems to be the message.

Like most physician-writers, Groopman presents cases from a privileged world. All these patients had access to teaching hospitals, presumably without financial worries. All but one had families and careers waiting for them. One reluctant patient had a loyal wife at his bedside. Only the first patient, the housewife in a hostile marriage, had nothing waiting for her.

It would be interesting to contrast these patients with others for whom illness represents a financial as well as physical burden. And, given research on social support, I would have expected to see some discussion on the role of the family in maintaining hope. Few people can survive a regimen of chemo and radiation without meaningful support, which is just not available to everyone.

I particularly enjoyed the chapters on the science of hope, which can be related to the placebo effect. Groopman warns that optimism will not cure serious illness, but will motivate people to initiate and continue painful, debilitating treatment. However, he reports evidence that resilient people respond more positively to flu shots, and that some people respond more strongly to placebos than others.

Seeking relief from his own back pain, Groopman encountered a specialist who roared, "Don't be ruled by your pain!" And, as I read, I wondered if care-avoiders -- people who avoid visiting doctors -- may create their own placebo effects and refuse to be ruled by pain.

Readers of Groopman's New Yorker pieces may find this book written in somewhat looser style, with more of a first person account than a journalistic report. Groopman carefully avoids any hint of woo-woo, while appreciating the widening boundaries of scientific discourse. Overall, he does a masterful job of offering the lay reader access to technical subjects, without sacrificing rigorous thinking.

I could NOT put this book down, as it is so well written and informative on the brain and how it interacts with the body and hoe HOPE gives one the impetus to persevere and fight. I have numerous illnesses, have fought 2 bouts of breast cancer, had a spinal fusion, FMS, etc., but I have always had HOPE in spite of the negativism of some of my doctors. It was a delight to read how a doctor learned from patients and his own struggle with back pain and how he overcame it. This is a very positive book with delightful, upbeat, information in spite of some adversities. It is a MUST read for everyone!

This book is a realistic exploration into the role of hope in life-threatening situations. This book is not about being a wishful thinker nor about denying the truth. I believe it has profound value for those who face debilitating illnesses and their caretakers. I strongly recommend it, and I strongly recommend Optimal Thinking: How To Be Your Best Self, a realistic book which explains the advantages and disadvantages of positive and negative thinking and the thinking that works best in specific situations.

This wonderful book arrived as an early Christmas present. After nine years of illness, I had come to despair. Once I started reading Dr. Groopman's book, I couldn't put it down. I saw through his eyes the way in which one's faith in the future influences one's physical and emotional responses to disease. This is an inspiring book that is backed up with scientific citations. I have ordered several copies to give as New Year's presents for friends who will benefit from Dr. Groopman's wisdom.

Dr. Groopman has written a compelling account of the nature of "Hope" and it's relation to illness. He relates a series of well told stories about patients facing life threatening illnesses. He openly discusses his own revelations as a doctor in dealing with these patients. The stories are both moving and informative. He also journeys into his own patienthood and his battle with chronic pain. This a very enjoyable read. HIGHLY RECOMMENDED.

Jerome Groopman has written a facinating book on the interplay between hope and recovery. He avoids the pitfalls of so many "mind over body" idealists and tries to get a grasp of what hope really is. Groopman is no quack pop psychologist. He's a Harvard educated physician. In this book, Groopman explores why hope isn't just blind faith or optimism, instead he explains how hope is rooted in a square-jawed look at the facts and facing reality with a positive view toward a goal of recovery.

The book starts out as a narrative as Dr. Groopman relates his experiences with various patients and what he learned from them and his sometimes difficult experiences in dealing with various doctor/patient situations. The first part of he book sometimes gets bogged down in ponderous detail but his goal is for the reader to truly understand where he is coming from. He further explains his own struggles with back pain and how his experience as a patient effected his views on pain and the recovery process.

As Dr. Groopman learns though his experience as a physician and fellow sufferer, hope (or lack thereof)always plays an integral role in the ability of a patient to recover. Realizing that he was never taught how to nurture hope in his patients, he sets off in a scientific quest to learn what hope is and how it can be understood and used to assist the healing process.

Toward the end of the book, Groopman begins to lay out his discoveries. I don't want to give the whole thing away but what he discovers about hope is that we are just beginning to understand the vast intricacies between the mind and body. This book will facinate you and bring you a glimpse into the soul of both doctor and patient. This is a book that every health care provider in America should read.

This is a wonderfully well-written book. AMAZING is the one adjective that I would use to describe it. Dr. Groopman can keenly empathize with his reader because he too has suffered from severe back pain. There aren't many physicians, let alone writers, who can truly express what it is to suffer and through this suffering a speck of light shines called HOPE. God bless Dr. Groopman for his excellent work!

Dr. Michael L. Johnson

OK, so hope sounds too pollyanna for "serious medical students and stiff doctors". I'll tell you about hope. It's deeper and more complex than all the so called "only we know what is good for you, you peon." attitudes put together. All I could think about while reading this book was thank God a doctor with deep compassion had the courage to write it. Here we have a doctor who is not afraid to step outside the box to spend years thinking about the single most important part of any illness, in particluar cancer: hope. I've learned a lot about hope. Granted at 20 years old it was probably the last thing I was thinking and probably thought I had all the knowledge I needed. Now at age 62, I have lived longer than expected, and am a living example of hope. I've lived over three years with lung cancer (the last two as stage IV). I found a doctor with great skill whom I admire for his medical knowledge as a great doctor who does in fact treat people everyday with traditional medicine, but every time I am in his presence I feel an energy of profound hope. You can call it whatever "pop" name you want, it just shows you are not really in the trenches. I survived because of my good doctor and because of hope. Near the end of my life, I learned the greatest, most important and enduring things in life are the most simple, yet somehow complex, with hope being at the very top of the list. I can tell by reading Dr Groopman's book that he is a compassionate human being and knows the true meaning of life, and of hope, and was drawn to it by the title: The Anatomy Of Hope. I wish there were more doctors like my doctor, and like Dr Groopman.