I recently met up with an old friend of mine for lunch.

After exchanging the usual pleasantries, he began to relate to me his current dilemma.  Due to changes in the business environment, it seems that the model that his business was based upon was quickly becoming economically non-viable.

He wasn’t complaining or pounding his fists on the table about the unfairness of the world.  He simply related to me how he had been out networking and exploring all of his options, including revamping his business model, merging or closing down, and going to work for someone else.

He said, “Hope is not a strategy.  I can’t just sit around hoping that things will get better.  I need to be working on a strategy for how I am going to move forward.”

I was struck by this comment.

Hope is not a strategy.

As I left lunch, the phrase reverberated in my head and I began to think about it in terms of my own situation, multiple myeloma patients, and cancer patients in general.

Hope is of course essential for me and for any cancer patient.  It is an integral part of human nature.

I am certain that without hope, my disease would have sunk me a long time ago.

But is hope alone enough?  Do we need a strategy as well?

I have to admit that I am a bit of a control person.  I try not to leave things to chance if I can help it.

I am not naïve or egotistical enough, though, to think that I can actually control the outcome of my disease.  I know that nature and the biology of the disease will ultimately win out.

I did, however, begin to evaluate what I would consider strategies that I have employed since my diagnosis that I feel may have impacted my chances or changed the course of my disease.  I know that most of these are not groundbreaking and have been touched on by many other writers and posts.  I also know that coming from my background as a physician that some of these things may come more naturally for me than for others.

1)  Knowledge is power.  I have tried to read and learn anything I can about multiple myeloma as a disease and its treatment.  I try to understand the rationale behind what I am doing. One of the simplest things to do is to register online for Google Alerts for multiple myeloma or subscribe to the Beacon’s email list ^[1].  Just by doing that, I receive daily updates on what’s going on in the myeloma world.

2)  Seek as many opinions as possible.   I have always been a huge believer in second and even third opinions.  I am acutely aware of the gaps in knowledge, biases, and cognitive traps that physicians fall into when forming an opinion.  I am also often amazed at how differently one physician may view a situation from another and how many different answers there may be to the same question.  There is no question in my mind had I not gotten a second opinion that pushed for a donor (allogeneic) stem cell transplant I would not be alive today.  Having said this, I understand that many times multiple opinions can be confusing, frustrating, and disconcerting.  But it’s the best we have.

3)  Be proactive and take control of your own health care as much as possible.  Rather than going with the flow, I try to be an active participant in the decision-making process.  What’s right for one person may not be right for another.  No one knows your body better than you do.  Physicians are well-meaning and caring, but they are also busy and have lots of other patients.  While they usually watch over things, I never assume that is the case.  I ask what labs are being drawn before I get stuck, and I make a point to keep track of my own lab results.  Don’t be afraid to request myeloma labs more frequently than ordered if you are concerned about the status of your disease.

4)  Try to think one or two steps ahead.  If something isn’t working, I have always found it both helpful and comforting to already have a Plan B in mind.  Of course, all these plans can be subject to change on a moment’s notice.

5)  Don’t necessarily accept the conventional wisdom.  One size does not fit all.  Conventional wisdom had me dead by now.  If something doesn’t seem to make sense, question it.  Be willing to try things that may be outside the box.

So, at least for me personally, while hope is essential, I also feel that having a strategy plays an important role.  If nothing else, I have peace of mind that I have done everything I can that is within my control.

I am curious what others think about hope.