A wonderful patient of mine gave me this framed beautiful needle point that she made for me (pictured on the left). It is hanging directly in front of the blood draw chair in my downtown office. Hope is a big thing to me. I spend much of my time at home, church and work trying to give hope to others and to myself. Because of this I have spent many, many hours thinking about what hope is and how to get it: the mechanics of hope.

Hope is a particularly precious commodity for my patients. Every single patient that walks into my office is struggling at some level with stress and a crisis of hope. They have done studies on the emotion of grief in infertility patients. Using grief scores they have found that every time a patient that is infertile and trying to conceive is unsuccessful and starts her period, she experiences the same amount of grief as someone who has a first-degree relative die. Most of us will experience that kind of loss a few times in life, but not every single month for years. No wonder my patients are stressed and struggling with hope!

How do you bring hope to this situation? Here are some steps that I have found helpful. Years ago, my daughter got to play Annie in the musical by the same name. I got to watch her sing one of my favorite songs, “Tomorrow.” The key to that song is not only that the sun will come out tomorrow, but the following verse, “So you gotta hang on ‘till tomorrow.” The first step in hope is to hang on. Sometimes that’s all you can do. You just have to hang on.

A couple of years ago my second daughter was in the musical “The Secret Garden.” I was watching it for the umpteenth time on an evening when I was experiencing my own crisis of hope. My daughter was playing the role of Mary Lennox. Mary is a 10-year-old girl whose parent’s die from a cholera outbreak and she is sent far away to live with an uncle who she does not know and who shows her no attention or love. In one scene, she is in despair and her care giver, “Martha,” is singing a song to try to give her encouragement. In the song, one verse struck me very strongly:

“Hold on
Hold on, the night will soon be by
Hold on
Until there’s nothing left to try”

What I heard that night was something a little different:

Hold on and think of something else to try.

To me this was revelatory.

The key to having hope was to hang on and think of something else to try!

You must look forward. I am not talking about engaging in false hope. When you are literally hanging on the ledge of a 20-story building it does no good to imagine that the building is only one story. An honest and accurate assessment of your situation can literally be lifesaving.

My role as the infertility specialist is to use the “3 Es:”  Experience, Excellence and Empathy to honestly but sensitively help my patient climb back on to the ledge. We climb back onto the ledge by gaining information about appropriate options and then finding a way to pursue the right option for that patient’s unique situation. I have been doing this for a very long time (23 years). This is not my first rodeo. If there is something that can be done, I probably have done it many times.

Nevertheless, we are always striving to improve. We are always striving for perfection. The reason is because it matters. I care because I have been on the other side of the Doctor’s table. There was I time when I did not know if I would be able to have children, let alone watch them sing on stage. My family is the greatest blessing of my life and that is the hope that I have for every one of my patients.