Hope in the medical setting is often reduced to whether a seriously ill person will live or die, or cured of an illness that’s not life-threatening. When cure is not possible, patients want their suffering treated and soothed. Suffering can be complex, caused by many different things. Researchers have discussed that we need to do a better job in training clinicians to identify the many ways a patient suffers. Once identified, care will improve, strengthening hope.

As my late wife went through her journey with lung cancer, we constantly identified and addressed as many sources of suffering as we could, sustaining her hope, improving her quality of life and creating purpose as a loving couple.

Kinds of suffering

What kinds of suffering can a patient experience? Suffering can be medical, psychological, interpersonal/social, economic and spiritual. If you’re a patient or family member reading this, I hope the following list will help you identify an experience you may not have thought about as a form of suffering, so you can ask for help. If your primary clinician doesn’t have the expertise or time to address your needs, perhaps he or she can refer you to another clinician such as a social worker, medical specialist, case manager, physical or occupational therapist, nutritionist, chaplain, psychologist or psychiatrist. I also hope this list will help clinicians identify forms of suffering they’d like to sharpen their skills around.

Medical: Physical pain in all it’s forms, thirst, difficulty sleeping, memory loss, confusion, joint stiffness, fatigue, side effects of treatments (medication, surgery, radiation treatments), muscular weakness, inability to walk, incontinence, paralysis, difficulty seeing/speaking/hearing/tasting/numbness, constipation, diarrhea, lack of appetite, nausea, vomiting, weight loss, difficulty keeping track of complex medication regimens.

Psychological: Depression, worry, self-doubt, self-hate, self-disgust, anticipating your death or the death of a loved one, panic, hopelessness, meaninglessness, loneliness, isolation, boredom, despair, apathy, guilt.

Interpersonal/social: Perceived and actual burden on loved ones; changed role within a family or social group; loss of standing within a community; increased dependency on others; dividing time between medical appointments, work and home responsibilities; lack of a solid support system in your network of family, friends or community.

Economic: Lack of access to care due to insurance issues; large co-payments that limit your ability to buy certain medications; depletion of economic resources due to out-of-pocket expenses or difficulty sustaining work hours; loss of job.

Spiritual: Loss of meaning in life; belief that you are the cause of your suffering (guilt); feeling abandoned or punished by your religion, God or spiritual practice; feeling disconnected from the world; purposeless.

If you’ve identified suffering that you haven’t addressed yet, please discuss this with your clinician or support system.

The next post will discuss hope as a creative process.