Advertisement

Suffering, Hope, and Healing

  • Jack CoulehanEmail author
Chapter

Abstract

The words “pain” and “suffering” are so often used together in clinical practice they often seem to merge into a single concept, “pain and suffering.” Writing in the early 1980s, Eric Cassell bemoaned the fact that the medical literature contained few studies that specifically addressed suffering, while many hundreds of reports focused on all aspects of physical and psychological pain (Cassell 1982). Since then, the study of human suffering has advanced considerably, in large part due to the development of palliative medicine as a clinical specialty Wall (1999). Nowadays, clinicians have learned to focus their attention on existential factors not directly dependent on the experience of physical or psychological pain (Kellehear 2009).

References

  1. Akhmatova, A. (2004). The word that causes death’s defeat. Poems of memory (trans: Anderson, N. K.). New Haven: Yale University Press.Google Scholar
  2. Beck, A. L., Arnold, R. M., & Quill, T. E. (2003). Hope for the best, and prepare for the worst. Annals of Internal Medicine, 138(3), 439–443.CrossRefGoogle Scholar
  3. Becker, H. S., Geer, B., Hughes, E., & Strauss, A. (1961). Boys in white: Student culture in medical school. Chicago: University of Chicago Press.Google Scholar
  4. Bennett, M. J. (2001). The empathic healer: An endangered species? New York: Academic.Google Scholar
  5. Benzein, E., & Saveman, B. I. (1998). Nurses’ perception of hope in patients with cancer: A palliative care perspective. Canver Nursing, 21(1), 10–16.Google Scholar
  6. Benzein, E., Norberg, A., & Saveman, B. (2001). The meaning of the lived experience of hope in patients with cancer in palliative home care. Palliative Medicine, 15, 117–126.PubMedPubMedCentralCrossRefGoogle Scholar
  7. Berglund, M., Westin, L., Svanstro, R., & Sundler, A. J. (2012). Suffering caused by care: Patients’ experiences from hospital settings. International Journal of Qualitative Studies Health and Well-being, 7, 18688.  https://doi.org/10.3402/qhw.v7i0.18688.CrossRefGoogle Scholar
  8. Blum, L. (1980). Compassion. In A. O. Rorty (Ed.), Explaining emotions (pp. 507–517). Berkeley: University of California Press.Google Scholar
  9. Blumgart, H. L. (1964). Caring for the patient. The New England Journal of Medicine, 270, 449–456.PubMedCrossRefGoogle Scholar
  10. Bolton, G. (1999). Stories at work: Reflective writing for practitioners. The Lancet, 354, 243–245.CrossRefGoogle Scholar
  11. Broadhurst, K., & Harrington, A. (2016). A mixed method thematic review: The importance of hope to the dying patient. Journal of Advanced Nursing., 72(1), 18–32.PubMedCrossRefGoogle Scholar
  12. Cassell, E. J. (1982). The nature of suffering and the goals of medicine. New England Journal of Medicine, 306(11), 639–645.CrossRefGoogle Scholar
  13. Cassell, E. J. (1995). Pain and suffering. In W. T. Reich (Ed.), Encyclopedia of bioethics (2nd ed., pp. 1897–1904). New York: Simon & Schuster.Google Scholar
  14. Cassell, E. J. (2004). The nature of suffering and the goals of medicine. New York: Oxford University Press.CrossRefGoogle Scholar
  15. Charon, R. (2001a). Narrative medicine. A model for empathy, reflection, profession, and trust. Journal of the American Medical Association, 286, 1897–1902.PubMedCrossRefGoogle Scholar
  16. Charon, R. (2001b). Narrative medicine: Form, function, and ethics. Annals of Internal Medicine, 134, 83–87.PubMedCrossRefGoogle Scholar
  17. Charon, R. (2004). Narrative and medicine. The New England Journal of Medicine, 350(9), 862–864.PubMedCrossRefGoogle Scholar
  18. Cherny, N. I. (2004). The challenge of palliative medicine: The problem of suffering. In D. Doyle, G. Hanks, N. Cherny, & K. Calman (Eds.), Oxford textbook of palliative medicine (pp. 7–14). Oxford: Oxford University Press.Google Scholar
  19. Chochinov, H. M. (2007). Dignity and the essence of medicine the A, B, C, and D of dignity conserving care. British Medical Journal, 335, 184–187.PubMedCrossRefGoogle Scholar
  20. Chochinov, H. M., Hack, T., Hassard, T., Kristjanson, L. J., McClement, S., & Harlos, M. (2002a). Dignity in the terminally ill: A cross-sectional, cohort study. The Lancet, 360, 2026–2030.CrossRefGoogle Scholar
  21. Chochinov, H. M., Hack, T., McClement, S., Kristjanson, L. J., & Harlos, M. (2002b). Dignity in the terminally ill: A developing empirical model. Social Science & Medicine, 54, 433–443.CrossRefGoogle Scholar
  22. Chochinov, H. M., Hack, T., Hassard, T., Kristjanson, L. J., McClement, S., & Harlos, M. (2005). Dignity therapy: A novel psychotherapeutic intervention for patients near the end-of-life. Journal of Clinical Oncology, 23, 5520–5524.PubMedCrossRefGoogle Scholar
  23. Chochinov, H. M., Johnston, W., McClement, S. E., Hack, T. F., Dufault, B., Enns, M., Thompson, G., Harlos, M., Damant, R. W., Ramsey, S. D., Davison, S., Zacharias, J., Milke, D., Strang, D., Campbell-Enns, H. J., & Kredentser, M. S. (2016). Dignity and distress towards the end of life across four non-cancer populations. PLoS One, 11(1), e0147607.  https://doi.org/10.1371/journal.pone.0147607.CrossRefPubMedPubMedCentralGoogle Scholar
  24. Coles, R. (1989). The call of stories: Teaching and the moral imagination (p. 179). Boston: Houghton Mifflin.Google Scholar
  25. Colliver, J. A., Conlee, M. J., Verhulst, S. J., & Dorsey, J. K. (2010). Reports of the decline of empathy during medical education are greatly exaggerated: A reexamination of the research. Academic Medicine, 85, 588–593.PubMedCrossRefGoogle Scholar
  26. Cook, D., & Rocker, G. (2014). Dying with dignity in the intensive care unit. The New England Journal of Medicine, 370, 2506–2514.PubMedCrossRefGoogle Scholar
  27. Coulehan, J. (2005). Today’s professionalism: Engaging the mind, but not the heart. Academic Medicine, 80, 892–898.PubMedCrossRefGoogle Scholar
  28. Coulehan, J. (2012). To suffer with: The poetry of compassion. In J. Malpais & N. Lickiss (Eds.), Perspectives on human suffering (pp. 227–245). Dordrecht: Springer.Google Scholar
  29. Coulehan, J., & Block, M. R. (2006). The medical interview: Mastering skills for clinical practice (5th ed., pp. 29–44). Philadelphia: Davis company.Google Scholar
  30. Coulehan, J., & Clary, P. (2005). Healing the healer: Poetry in palliative care. Journal of Palliative Care, 8(2), 382–389.Google Scholar
  31. Coulehan, J., & Williams, P. C. (2003). Conflicting professional values in medical education. Cambridge Quarterly of Healthcare Ethics, 12, 7–20.PubMedCrossRefGoogle Scholar
  32. Coulehan, J., Platt, F. W., Frankl, R., Salazar, W., Lown, B., & Fox, L. (2001). Let me see if I have this right: Words that build empathy. Annals of Internal Medicine, 135, 221–227.PubMedCrossRefGoogle Scholar
  33. DasGupta, S., & Charon, R. (2004). Personal illness narratives: Using reflective writing to teach empathy. Academic Medicine, 79(4), 351–356.PubMedCrossRefGoogle Scholar
  34. Daudet, A. (2002). In J. Barnes (Ed.), In the land of pain. New York: Alfred A. Knopf.Google Scholar
  35. Del Canale, S., Louis, D. Z., Maio, V., Wang, X., Rossi, G., Hojat, M., & Gonnella, J. S. (2012). The relationship between physician empathy and disease complications: An empirical study of primary care physicians and their diabetic patients in Parma, Italy. Academic Medicine, 87, 1243–1249.PubMedCrossRefGoogle Scholar
  36. Derksen, F., Bensing, J., & Lagro-Janssen, A. (2013). Effectiveness of empathy in general practice: A systematic review. British Journal of General Practice, 63(606), 76–84.CrossRefGoogle Scholar
  37. Dickinson, E. (1960). In T. H. Johnson (Ed.), The complete poems of Emily Dickinson (p. 116). Boston: Little, Brown and Company.Google Scholar
  38. Donato, S. C. T., Matuoka, J. Y., Yamashita, C. C., & Salvetti, M. G. (2016). Effects of dignity therapy on terminally ill patients: A systematic review. Revista da Escola de Enfermagem da U.S.P., 50(6), 1011–1021.Google Scholar
  39. DuFault, K., & Martoocchio, B. (1985). Hope: Its spheres and dimensions. Nursing Clinics of North America, 20, 379–391.PubMedGoogle Scholar
  40. Frank, A. (2001). Can we research suffering? Qualitative Health Research, 11, 353–362.PubMedCrossRefGoogle Scholar
  41. Frankel, R. M., Quill, T. E., & McDaniel, S. H. (Eds.). (2003). The biopsychosocial approach: Past, present, future. Rochester: University of Rochester Press.Google Scholar
  42. Frankl, V. (2006). Man’s search for meaning. Boston: Beacon Press.Google Scholar
  43. Galanti, G. A. (1997). Caring for patients from different cultures. Case studies from American hospitals. Philadelphia: University of Pennsylvania Press.Google Scholar
  44. George, R. (2009). Suffering and healing—Our core business. Palliative Medicine, 23, 385–387.PubMedCrossRefGoogle Scholar
  45. Groopman, J. (2004). The anatomy of hope. How people prevail in the face of illness. New York: Random House.Google Scholar
  46. Gunderman, R. B. (2002). Is suffering the enemy? Hastings Center Report, 32(2), 40–44.PubMedCrossRefGoogle Scholar
  47. Halpern, J. (1992). Empathy: Using resonance emotions in the service of curiosity. In H. Spiro et al. (Eds.), Empathy and the practice of medicine (pp. 160–173). New Haven: Yale University Press.Google Scholar
  48. Halpern, J. (2003). What is clinical empathy? Journal of General Internal Medicine, 18, 670–674.PubMedPubMedCentralCrossRefGoogle Scholar
  49. Halpern, J. (2007). Empathy and patient-physician conflicts. Journal of General Internal Medicine, 22, 696–700.PubMedPubMedCentralCrossRefGoogle Scholar
  50. Hauerwas, S. (1990). God, medicine, and suffering (p. 69). Grand Rapids: William B. Eerdmans.Google Scholar
  51. Helwick, C. (2010, March 24). Fostering hope in hopeless situations. MD Consult News.Google Scholar
  52. Herth, K. (1990). Fostering hope in terminally ill people. Journal of Advanced Nursing, 15, 1250–1259.PubMedPubMedCentralCrossRefGoogle Scholar
  53. Herth, K. (1993). Hope in older adults in community and institutional settings. Issues Mental Health Nursing, 14, 139–156.CrossRefGoogle Scholar
  54. Herth, K. A., & Cutcliffe, J. R. (2002). The concept of hope in nursing 3: Hope and palliative care nursing. British Journal of Nursing, 11, 977–983.PubMedCrossRefGoogle Scholar
  55. Hertzler, A. E. (1940). The horse and buggy doctor. Garden City: Blue Ribbon Books, 322 pages.Google Scholar
  56. Hojat, M. (2009). Empathy in patient care (pp. 10–15). New York: Springer.Google Scholar
  57. Hojat, M., Gonnella, J. S., Nasca, T. J., Mangione, S., Vergare, M., & Magee, M. (2002). Physician empathy: Definition, components, measurement, and relationship to gender and specialty. The American Journal of Psychiatry, 159, 1563–1569.PubMedCrossRefGoogle Scholar
  58. Hojat, M., Vergare, M. J., Maxwell, K., Brainard, G., Herrine, S. K., Isenberg, G. A., Veloske, J., & Gonnella, J. S. (2009). The devil is in the third year: A longitudinal study of erosion of empathy in medical school. Academic Medicine, 84, 1182–1191.PubMedCrossRefGoogle Scholar
  59. Hojat, M., Louis, D. Z., Markham, F. W., et al. (2011). Physician empathy and clinical outcomes for diabetic patients. Academic Medicine, 86, 359–364.PubMedCrossRefGoogle Scholar
  60. Holstein, M. (1997). Reflections on death and dying. Academic Medicine, 72, 848–855.PubMedGoogle Scholar
  61. Johnston, B., Pringle, J., Gaffney, M., Narayanasamy, M., McGuire, M., & Buchanan, D. (2015). The dignified approach to care: A pilot study using the patient dignity question as an intervention to enhance dignity and person-centered care for people with palliative care needs in the acute hospital setting. BMC Palliative Care, 14, 9.PubMedPubMedCentralCrossRefGoogle Scholar
  62. Kearney, M. (1996). Mortally wounded. Stories of soul pain, death and healing (p. 60). Dublin: Marino Books.Google Scholar
  63. Kearney, M. (2000). A place of healing: Working with suffering in living and dying. Oxford: Oxford University Press.Google Scholar
  64. Kearney, M. K., Weininger, R. B., Vachon, M. L. S., Harrison, R. I., & Mount, B. M. (2009). Self-care of physicians caring for patients at the end of life. “Being connected… A key to my survival”. JAMA, 301, 1155–1164.PubMedCrossRefGoogle Scholar
  65. Kellehear, A. (2009). On dying and human suffering. Palliative Medicine, 23, 388–397.PubMedCrossRefGoogle Scholar
  66. Kodish, E., & Post, S. G. (1995). Oncology and hope. Journal of Clinical Oncology, 13(7), 1817–1822.PubMedCrossRefGoogle Scholar
  67. Lawrence, D. H. (1947). Selected poems (pp. 138–140). Introduction by Kenneth Rexroth. New York: New Directions.Google Scholar
  68. Leget, C., & Olthuis, G. (2007). Compassion as a basis for ethics in medical education. Journal of Medical Ethics, 33, 617–620.PubMedPubMedCentralCrossRefGoogle Scholar
  69. Lief, H. I., & Fox, R. (1963). Training for “detached concern” in medical students. In H. I. Lief & N. R. Lief (Eds.), The psychological basis for medical practice. New York: Harper & Row.Google Scholar
  70. Marcel, G. (1960). Fresh hope in the world. London: Longmans.Google Scholar
  71. McCormick, T. R., & Conley, B. J. (1995). Patient perspectives on dying and on the care of dying patients. The Western Journal of Medicine, 163, 236–243.PubMedPubMedCentralGoogle Scholar
  72. Meier, D. E., Back, A. L., & Morrison, R. S. (2001). The inner life of physicians and care of the seriously ill. JAMA, 286, 3007–3014.PubMedCrossRefGoogle Scholar
  73. Mendiola, M. M. (1996). Overworked, but uncritically tested: Human dignity and the aid-in-dying debate. In E. E. Shelp (Ed.), Secular bioethics in theological perspective (pp. 129–143). New York: Kluwer Academic Publishers.CrossRefGoogle Scholar
  74. Miller, J. (1985). Hope. American Journal of Nursing, 85, 23–25.Google Scholar
  75. Morris, D. B. (2001). Narrative, ethics, and thinking with stories. Narrative, 9, 55–77.Google Scholar
  76. Nouwen, H. J. M., McNeill, D. P., & Morrison, D. A. (1982). Compassion. New York: Image Books.Google Scholar
  77. Novack, D. H., Plumer, R., Smith, R. L., et al. (1979). Changes in physician attitudes toward telling the cancer patient. JAMA, 241, 897–900.PubMedCrossRefGoogle Scholar
  78. Novack, D. H., Suchman, A. L., Clark, W., Epstein, R. M., Najberg, E., & Kaplan, M. D. (1997). Calibrating the physician. Personal awareness and effective patient care. JAMA, 278, 502–509.PubMedCrossRefGoogle Scholar
  79. Ober, K. P. (2003). Mark Twain and medicine. “Any mummery will cure”. Columbia: University of Missouri Press.Google Scholar
  80. Oken, D. (1961). What to tell cancer patients: A study of medical attitudes. JAMA, 175, 1120–1128.PubMedCrossRefGoogle Scholar
  81. Olsman, E., Leget, C., Duggleby, W., & Willems, D. (2015). A singing choir: Understanding the dynamics of hope, hopelessness, and despair in palliative care patients. A longitudinal qualitative study. Palliative and Supportive Care, 13, 1643–1650.PubMedCrossRefGoogle Scholar
  82. Osler, W. (2001). Aequanimitas. In S. Hinohara & H. Niki (Eds.), Osler’s “a way of life” and other addresses with commentary and annotations (pp. 21–29). Durham: Duke University Press.Google Scholar
  83. Ozick, C. (1989). Metaphor and memory. In Metaphor and memory: Essays (pp. 265–283). New York: Knopf.Google Scholar
  84. Pellegrino, E. D., & Thomasma, D. C. (1996). The Christian virtues in medical practice. Washington, DC: Georgetown University Press.Google Scholar
  85. Post-White, J., Ceronsky, C., & Kreitzer, M. (1996). Hope, spirituality, sense of coherence, and quality of life in patients with cancer. Oncology Nursing Forum, 23, 1571–1579.Google Scholar
  86. Reich, W. T. (1989). Speaking of suffering. A moral account of compassion. Soundings, 72(1), 83–108.PubMedGoogle Scholar
  87. Rodríguez-Prat, A., Monforte-Royo, C., Porta-Sales, J., Escribano, X., & Balaguer, A. (2016). Patient perspectives of dignity, autonomy and control at the end of life: Systematic review and meta-ethnography. PLoS One, 11(3), e0151435.  https://doi.org/10.1371/journal.pone.015143.CrossRefPubMedPubMedCentralGoogle Scholar
  88. Saunders, C. (1984). The philosophy of terminal care. In C. Saunders (Ed.), The management of terminal malignant disease. London: Edward Arnold.Google Scholar
  89. Shakespeare, W. (1952). Measure for measure act III, scene 1. In The complete works (p. 1116). New York: Harcourt Brace.Google Scholar
  90. Snyder, C. R., Rand, K. L., King, E. A., Feldman, D. B., & Woodward, J. T. (2002). “False” hope. Journal of Clinical Psychology, 58, 1003–1022.PubMedCrossRefGoogle Scholar
  91. Solano, J. P. C., Gomes da Silva, A., Soares, I. A., Ashmani, H. A., & Veira, J. E. (2016). Resilience and hope during advanced disease: A pilot study with metastatic colorectal cancer patients. BMC Palliative Care, 15, 70.PubMedPubMedCentralCrossRefGoogle Scholar
  92. Spiro, H. (1992). What is empathy and can it be taught? In H. Spiro et al. (Eds.), Empathy and the practice of medicine. New Haven: Yale University Press.Google Scholar
  93. Sulmasy, D. P. (1997). The Healer’s calling. Spirituality for physicians and other health care professionals. New York: Paulist Press.Google Scholar
  94. Vehling, S., Kamphausen, A., Oechsle, K., Hroch, S., Bokemeyer, C., & Mehnert, A. (2015). The preference to discuss expected survival is associated with loss of meaning and purpose in terminally ill Cancer patients. Journal of Palliative Medicine, 18, 970–976.PubMedCrossRefGoogle Scholar
  95. Von Roenn, J. H., & von Gunten, C. F. (2003). Setting goals to maintain hope. Journal of Clinical Oncology, 21(3), 570–574.CrossRefGoogle Scholar
  96. Wall, P. (1999). Pain: The science of suffering. London: Weidenfield and Nicholson.Google Scholar
  97. Warr, T. (1999). The physician’s role in maintaining hope and spirituality. Bioethics Forum, 15(1), 31–37.PubMedGoogle Scholar
  98. Wilkinson, I. (2005). Suffering: A sociological introduction. Cambridge: Polity Press.Google Scholar
  99. Williams, W. C. (1951). The autobiography of William Carlos Williams (p. 35). New York: New Directions.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Center for Medical Humanities, Compassionate Care, and BioethicsStony Brook UniversityStony BrookUSA

Personalised recommendations