You visit the doctor, and the routine checkup is absolutely fine. The doctor then informs you that something unusual in was flagged up by the tests, and that some further examinations will be necessary to determine what the abnormality is. The doctor is unable from the initial results to tell you what the possibilities are, and books you in for an appointment two days later. You go home wondering what to make of it, and your mind, in its spare moments, is occupied with unanswered questions, hopes and fears.

As always, the question must be: what are we to do in order to maximize our happiness?

Let us first define four terms, with reference to the examinations two days hence.

Success

A favourable outcome.
The tests show there is nothing to worry about.

Failure

A non-favourable outcome.
The tests show a serious condition.

Hope

A pleasant emotion during which we find the possibility of a success agreeable.
We enjoy the fact that the tests may show there is nothing to worry about.

Fear

An unpleasant emotion during which we find the possibility of a failure disagreeable.
We do not enjoy the fact that the tests may show a life-threatening condition.

Now, we clearly cannot do anything to secure a favourable outcome in the examinations themselves. What's done is done, and either the illness is there or it is not. No amount of prayer, meditation, hand-healing, dieting, exercise, belief, love, anger, crying, laughing, hoping or fearing is going to change that in two days. So the question returns: what are we to do?

Many are taught that in such a situation, since the outcome is out of our control, we should do nothing but trust to hope. Hope, many believe, will keep us going in such a situation, and can occupy our minds to the exclusion of fear. One of the usual notions of common sense would tell us here that we should keep busy, in order that our minds do not dwell on the unpleasant question of whether we have a life-threatening illness or not. Western religions teach us that we should put our trust in god, prayer and hope. Nihilism tells us that we shouldn't give two hoots. Alcoholism tells us we should drink the worries away.

Certainly there is some value in the common-sense approach. It will certainly not maximize our happiness to spend the next 48 hours thinking non-stop about our impending doom. We must certainly continue with our usual tasks, such that we do not spend every waking minute dissecting every detail of our memory of the doctor's facial expressions to glean the smallest insight into the probabilities involved. Up to this point the common sense approach is perfectly valid, we must keep busy and function normally.

It is however a very limited approach. Ever tried not thinking about something? We've all done it, with, I would imagine, relatively small amounts of success. Suppose that the probabilities are shifted in favour of the illness, so that it seems we are fairly sure to be diagnosed with this illness. We will certainly spend a very significant portion of the day thinking about the upcoming examination, and any conscious effort to do otherwise will most likely be futile.

So, given that we must spend time thinking about our situation, our two options seem to be hope on the one hand and fear on the other. Not a hard choice to make, we cry. We'll take the pleasure of hope please, rather than the misery of fear. However our thinking in this instance is clouded, since much of the discussion concerning hope and fear portrays these two emotions as separate and opposite. They are not.

Two Sides to the Same Coin

Hope and fear are the same emotion. Let's imagine that we have definite odds from the doctor. To my knowledge I have a 50/50 chance of having this life-threatening illness. We have all gone through the full range of emotion regarding such information. One moment you are filled with hope: of course it will all be fine; the next minute with fear: I might have only weeks to live. We have no conscious control over which of these two appears, because they are shades of the same emotion. In my experience, depending on the odds involved (if we know them) and our propensity to anxiousness, hope and fear will arrive in differing proportions. In this example perhaps around half the time hopeful, half the time fearful. If the odds were 90/10 in favour of the all-clear, I might spend 90% of my time being hopeful that all was going to be fine, and the other 10% in fear of the illness. None of this is a conscious decision. Both hope and fear stem from the same root, namely the state of mind that arises as soon as we are not in conscious control of a situation.

I would argue that as soon as we allow ourselves the comfort blanket of hope, we have already succumbed to fear, as the inevitable flipside of the same coin.

Hope is a good thing, in the same way that winning the lottery is a good thing. It doesn't mean that it's a sensible idea to play.

What Are We To Do?

The doctor has told us the odds at 50/50, we have gone home and are thinking about the upcoming tests. Let us review the facts. We cannot affect the outcome of the tests, since the illness is either present or not. We cannot control whether the emotion that appears is hope or fear, since they both stem from the admission that we are no longer in charge of the difference between success and failure. So what can we control?

Come 48 hours from now, we will then either have this life-threatening illness or be in the clear. We cannot control which. Hope and fear stop us from looking beyond the 48th hour, which is precisely the time that we should be thinking about, as it is the point at which we gain control again. Once the 48th hour has come and gone we'll still be alive and conscious (barring mishaps), and we will be making decisions as to what to do next. We will have absolute control over what actions to take when we have the knowledge about our state of health. Surely, rather than focusing on the tests, we should work out what we will do when presented with the news. If I am ill, then I will be mentally prepared for the trials to come. If I am well, then I will be free to live my life with the joy of health.

Someone who has succumbed to hope will be desolate if told they are ill, or relieved if told they are well.

Someone who has taken the time before the event to accept the reality they face will be resolute if told they are ill, or overjoyed if told they are well.

There is always something you can do to maximize your happiness, even if you can't control the circumstances of your choices.

Giles Hayter
London
February 2009