Get happy - get hopeless

Researchers have found when patients with a serious illness abandon hope they cheer up - a tactic Copperfield thinks may work for GPs too

There's that bit in Invasion of the Body Snatchers where our hero (a doctor, naturally) is surrounded by alien beings who have taken on the physical form of his family and friends. 'Stop fighting. Join with us,' they say. And why shouldn't he give up the struggle? He's one man against an army of hyperintelligent shape-shifters.

And there was that John Cleese movie, Clockwise - a thin comedy where the plot revolved around a headmaster trying to get to a conference in time to deliver a lecture. He battled one obstacle after another until it was inevitable he would miss his chance to speak. Only then did a feeling of quiet resignation take hold, with a consequent fall in his systolic blood pressure.

Pope wrote that 'hope springs eternal'. What I'm saying is, that isn't always a good thing. We are always warned about the dangers of giving up hope. As brave yet tragic Tracey boards the plane to Indonesia for life-saving hocus-pocus treatment for her inoperable medulloblastoma, we have to wish her Godspeed instead of suggesting she might prefer to spend her last weekend at Disneyland.

But as dear old Uncle George would have said, 'If at first you don't succeed, try, try, try again. If after the fourth go you're still stymied, sod it.'

Now the proof is here in black and white. Psychologists from the University of Michigan have determined that hope has a 'dark side'. When patients with a serious illness - in this case a permanent colostomy after hemicolectomy - were told that there was not now, nor ever would be, any chance of restoring oro-anal continuity, they cheered up.

The idea that one day they might be able to pop to the john and take a regular dump like their fellow men and women had been weighing them down.

Once they realised they'd have to play the hand they'd been dealt and get on with life, their mood changed for the better. The authors came up with the wonderful term 'happily hopeless' to describe the situation.

Enough of this 'where there's life there's hope' crap. Take your Little Book of Calm and stick it where only a trained gastroenterologist could find it. Fall seven times, stand up eight? No thanks, I know when I'm beat.

So how can we apply this new knowledge to our everyday lives? We can stop hoping that our patients will one day become empowered and/or educated enough to stop being such pains in the arse. We can toss the hope we cling to that PCTs might evolve into insightful resources, that actually help us do our job, down the rubbish chute into the skip of despair.

We can stop hoping that nurses will take professional responsibility for their actions and inactions instead of passing the buck to the first MBBS they see on the horizon. We can just accept that the Department of Health's plans for walk-in surgeries and dual registration will eviscerate NHS primary care by removing the last vestiges of continuity.

And then we can find our happy place, take a deep breath and smile as we succumb to the irresistible attraction of the warm whirlpools that will drown us.

Come on in, the water's lovely.

Dr Tony Copperfield is a GP in Essex