Hopeful people are better copers. That’s what the research says. They heal more quickly, deal with problems more creatively, demonstrate more tolerance for uncertainty and pain. Regardless of the circumstances, hope is most certainly influenced by the things we hear from others. That’s what the research says. It says we are susceptible to hope.
Gramma is susceptible to hope. I think of this when I visit her. Though she speaks with conviction and clarity, she is not always an easy woman to understand.
As I understand it, there are two things Gramma would like. She would like to die suddenly and conclusively of a heart attack. Any time would do. Now would be fine with her. She would also like to resume her active and happy life after recovering quickly and fully from the hip fracture that sent her to surgery. Though apparently in conflict, these two wishes dwell side by side in Gramma’s conscious awareness. The slightest shift will turn her attention from one to the other. “Gramma is susceptible to hope,” I tell myself when I am with her. “Make sure you help her to see it.”
A test of hope arrives while I am visiting. In comes the physio team. This is the team that gets Gramma moving. Though she wants more than anything else to get moving, she has been anticipating their arrival with a sense of impending doom.
Gramma’s mind is on the pain. Come to think of it, it’s even more than that. Her mind’s on the hope-sucking implications of the pain. She has been saying, “I shouldn’t be in this much pain. They tried to cut back the medication. It’s been six days. I shouldn’t be in this much pain!”
Gramma does everything she can to help the physio team get her moving. The pain is unspeakable. She tries to make them hear it. They are kind, and I know they hear what she is saying. To her they say, “You’re doing better.”
This convinces her that they haven’t heard her. She says, “It’s not better!” They don’t argue. They know she’s talking about the pain.
The physio team is about to leave. They are going to leave now, taking Gramma’s hope out with them. When they are gone there will be only the memory of Gramma saying, “It’s not better!” I picture the remains of the day. When her son comes she will say, “It is not better!” To her granddaughter she will say, “It’s not better!” Soon the whole family will be saying, “Gramma’s not better!” It will be the truth.
But it won’t be the whole truth, only the truth without the hope. I was sure I had heard them say something that should have brought hope, something that would have brought hope if only they’d said more about it. “Wait,” I cry to the retreating physio team. “Gramma says she isn’t better because of the pain, which I know you have heard and I know you are dealing with in terms of medication. But I heard you say that she is better. What did you mean by that? Could you tell us why you said that?”
Back comes the team. They tell us that Gramma is stronger today then she was yesterday. They show us what they mean. She has lifted her foot higher, stretched it farther. Then they go back a few days and remind us of what Gramma cold do a few days ago—much less.
“She is stronger you say?” I repeat. Then I ask if it is normal to have this pain.
They explain that pain is extremely variable, that it is affected by bone density, that some medications work better for some patients, that we just have to experiment with medications. They get the doctor and we all have a chat about the pain. Gramma is in control now. I tell them what Gramma has told me about the medications, she enthusiastically backs up what I say she said. A new pain plan is made.
When they are gone Gramma is ready to take a tour of the hospital in her wheelchair. The nurse asks about the pain and she says it is a little better now. As we wait for the elevator she says, “It’s so much better if somebody is here to ask questions when they come.”
Now she is chatting in the elevator. Things are factually no different then they were ten minutes earlier, but Gramma is visibly different. The part of her that wants a heart attack has receded into the background. She is different because the physio team came back and put the hope in the room instead of taking it away with them.
It is one of those times when I know beyond all doubt that it matters to be a hope specialist. There is still so much to teach so many about the need to pay careful attention to hope when you talk to vulnerable people. There is so much to teach about the need to make sure hope is visible before you leave the room. It is my day off, but it seems that I have been at work anyway. How could I not be?
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