Health Care and Hope: Part 1

This weekly series of posts is from Dominican Friars Health Care Ministry of New York, a ministry of the Province of St. Joseph centered at St. Catherine of Siena Priory in New York, NY. Reflections on Ethics, Faith, and Health Care Health Care and Hope: Part 1 by Fr. Jonah Pollock, O.P., Associate Director, Dominican Friars Health Care Ministry of New York According to J.R.R. Tolkien, author of The Hobbit and The Lord of the Rings, there are two kinds of hope. These two kinds of hope are expressed by two different words in an Elvish language Tolkien invented. The words are amdir and estel. Both words can be translated by the English word ‘hope’ but they have different meanings. Tolkien defines amdir as “an expectation of good, which, though uncertain, has some foundation in what is known.” Amdir is akin to optimism, expecting good things based on evidence or experience. When, in a time of drought, a man calls the appearance of dark clouds “a hopeful sign,” he is expressing amdir, an expectation of good based on what he has observed. Estel is more like trust. As one of Tolkien’s characters expresses it, estel “is not defeated by the ways of the world, for it does not come from experience, but from our nature and first being … [as] the Children of the One.”  Estel is hope in God. For some of Tolkien’s characters, it is an explicit hope in the divine creator. For others, it is an implicit trust that good will ultimately prevail. Unlike amdir, estel is not based on experience of the world. It is based on who God is and who we are as God’s children. Thus, even when amdir is lost, when all worldly experience points toward evil, estel need not be defeated. For it is based on something deeper that worldly experience: our identity as God’s children. Tolkien’s distinction between amdir and estel can help us understand what it means for us to have hope, especially when we or our loved ones suffer illness or injury. One of our goals as health care providers and ministers to the sick and dying is to bring hope. We want to encourage our patients and lift the spirits of those who suffer. Tolkien’s distinction between amdir and estel can help us to recognize the different ways in which we can do that. One way we can inspire hope in the sick and suffering is by showing them the good things that are possible. Doctors do this when they emphasize the positive outcomes that can result from treatments or procedures. They also inspire hope by their own competency. Having a reputation for excellence and high rates of success gives patients confidence. Other caretakers inspire hope by encouraging the sick person to focus on the positive or providing examples of successful outcomes. I count myself blessed to be able to encourage people in this way. I am a survivor of brain cancer and have sometimes, in the course of my ministry, found it opportune to share my story with patients I have visited. Very often, they find in my story a new reason to hope. Seeing that I have made a successful recovery, they are encouraged in the belief that they can too. The sick can also find hope in the many works of healing that have been performed by the power of God in ways that defy human understanding. The Lord Jesus accomplished countless miracles of healing. In this way, He inspired great hope and more and more people came to him seeking to be cleansed from their ailments and afflictions. Many more healing miracles have been performed by the power of His Spirit that is constantly at work in His Church. The sick rightly see these works of healing as a reason to hope. Through their prayers and the prayers of their loved ones, through the intercession of the Blessed Virgin Mary and the saints, God can and often does accomplish mighty works of healing. This kind of hope is what Tolkien’s elves would call amdir. It is the expectation of good results based on worldly experience. This kind of hope is very important for the effective care of the sick. It is important for the emotional well-being of patients and their loved ones that they are able to stay positive by hoping for good outcomes. It is also important for bringing about those good outcomes. When a patient has hope, the patient will be more likely to positively cooperate in his or her own health care. Amdir hope is good and important and we do well to cultivate this hope in ourselves and seek to inspire it in others. But hope, in this sense, can be false. A person has false hope when he or she is deceived or uninformed about the possibility of recovery or healing. A person can also be in denial about the information with which he or she has been presented. Another example of false hope would be the presumptuous expectation of miraculous healing. Amdir hope can be false. What is more, it can be lost. Such is the case when a sick person’s death becomes immanent or when treatment options are exhausted and it is no longer sensible to hope for recovery. So then, amdir hope is good and to be encouraged, but it can be false and it can be taken away. Estel hope, trust in God, which cannot be false or taken away, will be the subject of Part II of this reflection.

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Image: Edward Burne-Jones, Hope