What's important, says Bidwell, is for the patient's "team members" -- family members, doctors, nurses, social workers, friends and chaplains, among others -- to do things that help create and activate hope pathways for the patient.
Hope is present, ordinary and 'normal'
When asked what he found most compelling or surprising about his findings, Bidwell says his team asked the children to talk about a time when hope became real during their disease treatment.
"More often than not," he recalled, "they told us about ordinary moments with family and friends -- saying grace around the dinner table, times when they were aware of the abundance they had in their lives, even though ... they build their lives around dialysis and medication."
We so often discount these ordinary daily moments, Bidwell says. But those who are more intentional about the practices that bring hope right now are better able to take care of themselves.
The children in Bidwell's study experienced mostly psychosocial suffering, he says. "Things like being different from their peers because they were stuck to a dialysis machine or always on medication." Hope enabled the children to claim power -- to say: "Here's where the disease gets to influence my life and here's where it doesn't get to influence my life."
"I'm normal," Bidwell recalls a young girl telling him. "Hope helps me be more normal."
What hope is -- and isn't
There is a thin line between hope and denial, and that line is an unwavering commitment to truth and reality.
Groopman writes: "False hope does not recognize the risks and dangers that true hope does. False hope can lead to intemperate choices and flawed decision making. True hope takes into account the real threats that exist and seeks to navigate the best path around them."
Both Lopez and Bidwell emphasize that hope is not about positive thinking. Hope is half optimism, Lopez explains. The other half is the belief in the power that you can make it so.
There is a profound difference between hoping and wishing, he continues. Wishing encourages passivity, whereas hope represents an active stance.
"Wishing is the fantasy that everything is going to turn out OK. Hoping is actually showing up for the hard work."