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Hope for the Best, Plan for the Rest: A commentary

Updated: Aug 15, 2023

I was immediately drawn to the cover of Dr. Sammy Winemaker and Dr. Hsien Seow’s new book Hope for the Best, Plan for the Rest: 7 key to navigating a life-changing diagnosis because of the birds.

Colourful flying birds grace the cover, contrasting the stark “life-changing diagnosis” words in the title. Not many people want a life-changing diagnosis, do they? The birds soften the premise of a book that talks about the experience of having a serious illness and yes, the inevitability of dying too.

Dr. Seow sent me an advance copy of Hope for the Best, which will be released on September 19, 2023. You can pre-order the book here.

I am not a health professional or a book reviewer, so this is my layperson commentary on the book. Despite my lack of academic credentials, I am someone who received a phone call one snowy February afternoon seven years ago from my family physician, who tearfully told me that I had cancer.

Hope for the Best, Plan for the Rest is a book for patients and caregivers that is co-authored by a physician and researcher who specialize in palliative care. The writing is warm and accessible. It is a book meant to alleviate the unnecessary extra suffering that patients have to endure in health care. Believe me, there is enough built-in suffering when people become patients – infinite waiting, mental anguish, the terror at looking at our own mortality, the emotional and administrative burden and a constant struggle with an often-cold and slow-moving health care system when we are sick and immersed in the most vulnerable times in our lives. (Phew, that sounds like a lot because it is a lot).

My first book Bird’s Eye View outlined all these troubles. Drs. Winemaker and Seow offer practical suggestions, if you forgive my cliché, to those who have been given the rottenest lemons to help make the best lemonade possible, no matter the circumstances.

The authors skillfully weave patient stories into the book, which include sad reflections like “No one had ever sat with him to review the course his disease would take from beginning to middle to end.” Who doesn’t want to leave this earth in a gentle decline instead of in the midst of chaos and crisis? Two palliative professionals are the ones guide us on how it can be done.

The authors describe 7 keys – Walk Two Roads, Zoom Out, Know your Style, Customize your Order, Anticipate Ripple Effects, Connect the Dots and Invite Yourself. I’m not going to spoil the book by detailing each key, for the book explains them best. While I shudder at the notion that it is solely a patient’s responsibility to ensure smooth travels in health care, I do know that being clear-eyed and having information helps mitigate our own patient suffering. Hope for the Best is about what is in our control. And the 7 keys are not just for patients. They are for caregivers and professionals too. What if we could reimagine health care by using these practices together? Then we'd have the more compassionate health care system that I'm desperate to see.

Along with the patient stories, here are the my highlights from Hope for the Best, Plan for the Rest:

  • Gentle conversation starters for patients to broach difficult discussions with clinicians.

  • Assumptions (like “the doctor knows best) contrasted with realities (‘you are the expert of you”).

  • Reflective exercises for patients.

  • The acknowledgement of caregivers’ pain through sections called “Family Shout-Outs.”

  • A discussion about the harm of toxic positivity and the battle/fighting metaphors.

  • Outlining (complete with graphs and timelines) the different trajectories of illnesses.

  • A big take-away is that it is crucial for people to understand their own values (what matters to you?) – even better to have clarity about personal values before one gets sick. That’s work each of us can begin today.

  • The vivid and easy-to-understand phrases that accompany the text, like this description of caregivers navigating the health system, “They started every day feeling as if they were drowning.”

  • On a personal note, I was thrilled to see interviews with health care advocate superstars Claire Snyman, Julie Drury and Donna Thomson included in the book.

I appreciated the authors’ honesty about their frustration at the pace of change, as health care in Canada has not fully embraced the palliative care approach. I feel frustration at the snail’s pace of change too.

After reading Hope for the Best, Plan for the Rest, I can assure Drs. Winemaker and Seow: this book will make a difference. It is necessary reading for anybody who is human, for sickness will eventually catch up to us all.

I encourage the co-authors, through their book, to keep shouting from the rooftops that there is a better way in health care. Hope for the Best, Plan for the Rest is a road map that shines a clear light on that better way, with patients - for once - firmly in the driver's seat.

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