Fewer days are more exciting for me than the day I get my cast off. Roughly ten days before The Big Liberating Event is to happen I start a count down and tell all my friends, including all the strangers I meet who ask me "how did you break your ..?" Without even answering their questions I am usually quick to spit out "I get it off in 10 days!"
So when the day arrives, and the doctor flicks the x-ray up onto the screen - I am just chillin' like a villain, lying flat on the examination table: my hands are tucked behind my head, leg is propped up onto a pillow, and my toes are wiggling impatiently. By this time the cast has usually become a lot looser, and I try flexing my ankle  a few millimeters at a time - smiling happily when no sharp pains trail after my impatient movements.

He gets up from the computer where he has been peering over the x-ray for a few minutes.
"So there's still a very small sliver of a crack left." He tells me, and waits a few seconds for the news to sick in. I stop wiggling and prop myself up on my elbows, suddenly all eyes and ears on edge.
"I think in about another two and a half weeks or so.." But his voice escapes me and falls into some noiseless vacuum where all bad news any doctor has ever had to say goes.
But today was supposed to be the day! Nothing hurts! I can wiggle! And.. secretly... behind my parents' backs I had even been doing my own transfers on the leg, without any pain! This is blasphemy! Sham! The disbelief continued ranting and raving inside of my head.
I am no longer 3 or 4 so I know it wouldn't do any good for me to voice my disappointment. It was clear as day on the x-ray, in literal black and white, the facts were there: the bone hadn't healed completely yet.
After some discussion we decide to go with a bi-val cast, something that I still have to wear all the time but would be able to take it off for baths and showers. He looked at me sternly,
"You'll still have to wear this all the time because the bone isn't strong enough without the support yet." I nodded grudgingly.

Having your hopes dashed can be disappointing regardless of the situation. But in the medical world I have learned a few things about the delicate presence that hope can have. Here are a few of my observations --

Hope is the thing with feathers:

• Hold onto it with or without the facts. In the incident above the hope I had that my leg was healed didn't match up with the black and white image. But that doesn't mean we should give-up the hope! Usually it just means we need to be patient, allow the body to heal more or try a different course of medication. Whatever it is, holding onto that hope allows you to have a kind of standard in which to compare real-time results with. If the test results match up to the hope that you held onto then that might be a good thing, if it doesn't match-up then that helps to inform your next decisions. It serves as a kind of benchmark or check-point for progress, and the best part is that you won't ever be wrong.
• There is always a friend in it. Once you've grasped it then you know that its energy and motivations that hope can exert has no depth. This is important because often times things can get scary and precarious in the midst of confusing medical activity, and when there is uncertainty the environment can be intimidating for everyone involved but particularly for patients. However, if you keep hope near there will always be at least one consistently reliable component in the whole scene that you can look to as a familiar face in an otherwise uncertain crowd. 
• It is low-maintenance. Just have it drifting around in the back of your mind, or even write it down on a scrap of paper if you have to - but that's all you need in order to lay claim to your hope. There is no added cost, no health insurance policy to sneak it through, or extra amenities that it requires. Hope is just there at the ready for you.