Abstract
For several months I have been trying to tag a greyness that has shaded my doctoring. I was not burned out but uncovered the desert experience of mind and soul known as acedia, which is called the noonday demon because it vexes those in the mid-stages of life. Grappling with the noonday demon has upended all of my assumptions about the workings of hope in the practice of medicine. For me, hope is no longer the anticipation of a positive outcome, or the warm feeling associated with the validation of a correct diagnosis, or the conclusion of successful treatment. I am beginning to realize that hope is the pulse of caregiving beating in me-and in the heart of every physician-which first stirs when I am with a patient, and then propels me forward in all of my doctoring.