As Hope Fades, I Press on: Here’s How

Hope can be an effective tool to ease human suffering. In many cases, though, it’s not enough.

After my diagnosis 15 years ago, I set out to become the most informed patient on the planet. Even though there were no FDA-approved treatments for primary progressive multiple sclerosis (and there still aren’t), I knew the answer was out there. I just needed to be smart, brave, and hard-working enough to find it. Oh, and cocky too. Every fighter needs a little swagger.

I tried chemotherapy and immunosuppressants. No luck. I self-administered daily, painful shots. Didn’t help. I participated in a clinical trial where I had to drive two hours each way, two times a month, for two years. It slowed down progression for a while; then it didn’t. I convinced interventional radiologists to thread catheters from my groin into one side of my heart and out the other, so that they could balloon supposed restrictions in my internal jugular veins—twice. In retrospect, I doubt there was anything wrong with those veins. I lobbied doctors to inject powerful medicine into my spinal cord every two months for two years. Again, helped for a while; then it didn’t. I pursued all these treatments in the hope that I might slow down, stop, or even reverse the course of my disease. Instead, I progressed from a limp to a cane to a wheelchair, and my arms and hands are headed in the same direction.

Understandably, I began to lose hope that I would ever find a medical solution. I discussed this with a well-intentioned friend who warned me, “If you don’t have hope, you have nothing, right?”

No. That didn’t describe how I felt. As hope faded, something else took over, and it wasn’t despair. I remained in generally good spirits, even though I knew I might never get better. Something more impassive, almost comforting had intervened.

Acceptance.

Where hope receded, acceptance filled the void.

It’s not that I studied the alternatives and chose acceptance as the best path forward. It lived inside me the whole time, waiting to be called upon. Perhaps I inherited it from my mother or learned it by watching her live as a quadriplegic for 39 years. No matter its origin, I was fortunate to have such a tool at my disposal. I suspect, however, that acceptance can be discovered, learned, or acquired if you don’t possess it already.

Acceptance should not be confused with surrender, although the differences are subtle. Surrender carries a negative connotation. “I give up. Do with me what you will.” Acceptance carries a neutral connotation, “If this is my life, then so be it,” or sometimes a positive connotation, “If this is my life, I will make the best of it.” In its purest form, acceptance has a Zen feel to it. You are exactly where you are supposed to be in life. Don’t fight it. Embrace it.

I don’t lament what might have been, envy what healthy people can do, or ask “why me?” I’m grateful for what I have, and I accept what I’ll never again be.

I haven’t given up all hope. I continue to keep one ear to the MS research world. In a dispassionate manner, I evaluate each potential treatment on its merits. But I don’t rely on this hope to motivate me. I’m not emotionally invested in it. I keep hope around only for practical reasons, so that I don’t miss an opportunity for a treatment that may work. There is a lot of research going on. I just don’t know if it will become available to me in time.

Hope is the much sexier cousin to Acceptance. Hope can produce spectacular results. Books and songs have been written about the power of Hope. Acceptance does its work anonymously. The results, important though they may be, don’t garner much attention, save for this obscure essay. Although it may seem counterintuitive, I find that hope and acceptance work together quite well.

For my healthy and disabled readers: how do you manage hope and acceptance in your lives?