While waiting for test results, patients often wrestle with distressing mind games. As a 31-year cancer survivor, I've come to depend on my hope for accurate news to help me manage the uncertainty-a healing hope you can share with patients. To illustrate, here's my personal story.
My latest health venture began after routine bloodwork showed cytopenia that progressed. When my oncologist expressed concern and recommended a bone marrow biopsy, my reaction was probably atypical. I attribute that to having written a textbook chapter in 1998 on late effects (Principles and Practice of Supportive Oncology; Lippincott) and having befriended a few co-survivors who developed marrow diseases-most of whom died.
Knowing my risks in graphic detail made each day without major late effects feel like a gift. While driving home from the biopsy, as the lidocaine wore off, I murmured a prayer of thanks. If my diagnosis was ominous, how wonderful that it hadn't happened before now. Nobody could take away my good fortune: I'd raised my young children to adulthood, enjoyed a fulfilling writing career, and met my five grandchildren.
As expected, gratitude alone didn't dissipate the fog of grief and fear. The ability to keep functioning depended on a different emotion: hope. Not just vague hopefulness, but specific hopes that could decrease the anticipatory grief and build my confidence. To that end, I should hope for...what?
Naturally, I've been hoping for good news. Maybe the low blood counts are a fluke due to a virus or a transient Covid-booster effect. As each piece of information comes in, that hope swings like a screen door in a summer storm, slamming shut and then flying wide open, only to swing back again with a shudder.
Early in my survivorship, "hope for good news" occupied center stage whenever waiting for test results. Now I know better. The trick is to let that hope drift into the background while nurturing hope for something else: accurate news (i.e., evidence revealing the truth of what's wrong). To understand how that hope helps, let's first look at the distress I feel while hoping for good news.
Obviously, I want good news. That desire is echoed by family and friends asserting, "I'm hoping for good news for you!" They repeatedly encourage me to do the same-as if strong hope improves the outcome. Meanwhile, my primal desire for control pushes a little button in my brain. Now my mind is spinning all available information-from preliminary test results to dreams filled with symbolism-to predict the biopsy results, an impossible task. Between the exhausting mental chatter and the social pressure to hope for good news, my anxiety escalates (see Real Good News; 09/25/2011; tinyurl.com/OTrealgood).
In contrast, hope for accurate news comforts and inspires me, its power derived from a dispassionate fact: The news that can help me most is accurate news. Think about it: A false negative will make me happy while possibly delaying effective treatment. My "Aha" moment was realizing that more than I want good news I want accurate news. This desire for an outcome determined by technology and interpretive expertise renders my thoughts and feelings irrelevant. As when hoping for warm weather or light traffic, I accept the hoped-for biopsy results as out of my hands.
Soon they'll post the final biopsy report on my patient portal. My hope for accurate news is in full swing, helping me prepare emotionally for any news. I've surrendered to the uncertainty, which frees my energies to work on making today the best it can be. Each time the mental chatter starts up (and it does), reminding myself to hope for accurate news hits the Off button. It's quite amazing. Until I'd experienced the power of this hope, I had no idea how healing a hope could be.
Patients look to you not only for what's happening and what to do but also for guidance on healthy responses, including what to hope for. During evaluations, consider introducing the notion of hope for accurate news:
* Share your desire. I want good news for you.
* Mention hope. Naturally, we all hope for good news.
* State your primary hope: What I'm hoping for most is accurate news...results that tell us what's going on, so we can know how to make things better.
That approach sends multiple healing messages. For starters, voicing your heartfelt desires and hopes affirms your emotional investment in their well-being. Whatever happens, they won't forget your compassion.
Also, you are acknowledging a natural hope most people want to feel, one promoted by a pervasive belief of the power of positive thinking. Without criticizing hope for good news, you are encouraging patients to foster a variety of hopes and specifying one that works well for you. What's key is that you are not telling them what to hope for. You are modeling an option they can now consider for themselves.
For patients who've never thought about "accurate news," you are introducing a hope that's different from the usual ones because fulfilling it depends on science and technology. Patients who focus on it may benefit from an uplifting feeling linked to letting go of responsibility and accepting the uncertainty.
As for faith and other hopes, my experience has been that hope for accurate news co-exists nicely with my faith in a loving God by my side and my many other hopes, such as to make the most of today.
Healing words that take seconds to say may echo in a patient's mind between visits. Help patients through the distress of waiting for test results by reminding them, "The best news is accurate news." That's the news that enables you to help them and that helps them move forward in healing ways (Healing Hope; page 13; Curant House, 2018).
WENDY S. HARPHAM, MD, FACP, is an internist, cancer survivor, and author. Her books include Healing Hope-Through and Beyond Cancer, as well as Diagnosis Cancer, After Cancer, When a Parent Has Cancer, and Only 10 Seconds to Care: Help and Hope for Busy Clinicians. She lectures on "Healthy Survivorship" and "Healing Hope." As she notes on her website (http://wendyharpham.com) and her blog (http://wendyharpham.com/blog/), her mission is to help others through the synergy of science and caring.