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February 1997

Reason, Hope, and Brain Injury

Author Affiliations

Department of Neurology West Virginia University Health Sciences Center Morgantown, WV 26506-9180

Arch Neurol. 1997;54(2):119. doi:10.1001/archneur.1997.00550140007002

The chances for a meaningful recovery are nil." How often do we, as neurologists, find ourselves uttering this or a similar phrase to family members of a patient who has sustained a serious brain injury? Our training, our experience, our reason allows us to say little else. However, how often do we consider the hope-crushing impact of our statements?

"Hope springs eternal." The power of hope is reflected in our cultural sayings. Some physicians have long recognized the importance of not extinguishing the last glimmer of hope. Charles Darwin,1 in his autobiography, relates an insightful incident concerning his country physician father, Robert Darwin. Dr Darwin and another physician were consulted on the same case. The other physician correctly predicted the fatal outcome of the patient's illness. Dr Darwin assumed that he would never again be consulted by the patient's family. Much to his amazement, however, it was the other

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