Some say having patience is a good thing. Ambrose Bierce defined patience as “a minor form of despair disguised as a virtue”. I take the middle ground, believing patience can be either—virtue or despair.

Patience allows one to withstand the vicissitudes of life. It allows one to look the future in the eye and know that one can survive a great deal of stress, ambivalence, abuse, and sorrow.

Patience entails hope, which is in some ways antithetical to despair. For this reason, although one sometimes experiences despair while being patient, I don’t believe patience is a minor form of despair, although it may be strongly associated with despair.

Patience, I believe, is a virtue and not a disguised virtue. It allows for a hopeful resolution to a problem. It allows one to “wait” and maintain hope despite uncertainty. It allows one to make decisions calmly and resolutely despite knowing that the outcome may be months or even years away.

Patience is an important virtue. It provides time to think and plan and implement if necessary. It delays precipitous decisions and makes decisions more robust and realistic. Patience provides the necessary extension of faith for someone else who needs time to plan and bring about change.

Patience entails faith, hope, and love. Faith in the future, hope in a positive outcome, and love that transcends time. Patience is the basis for faith, hope and charity (love).

What is patience and why is it important in life and health care? Without patience many abrupt decisions would be made without thought or time to consider consequences. Without patience many disastrous decisions and their consequences would taint the final outcomes for many people and patients.

In life and healthcare, patience allows the time necessary to reach an optimal solution to a problem. It allows one to “stand back” and assess a situation. It allows one to try various solutions. It allows one to feel some sense of security while one waits for the final outcome.

Patience may also be a reaction to despair. Not a minor form of despair but a reaction to despair. It may be the adult, mature reaction to despair. While one is looking for a solution one waits patiently for the final arbiter—the final conclusion, the answer to the question, or the optimal choice.

Patience allows for faith, hope, and charity but also for moral courage. It allows one to maintain an attitude of questioning. What will happen if I do this? Or this? Or this? How long may I wait?

One aspect of patience is knowing when to resolve patience. That is, when to speak up, stand up, or make that difficult decision. Patience entails knowing when it has reached its limit and when it is necessary to make a choice or answer the question.

I think of patience in the context of chronic illness or acute irritating maladies. In some cases patience has a limit and there is a resolution. In other cases patience must be infinite.

Patience must not deter one from trying to find a solution. It must not push one to accept the unacceptable. It must not make one lazy or easily accepting of solutions that may be possible to optimize, or, solutions that are premature or which have simply been maintained for too long.

As a child I tried to cultivate my own patience. I have found that patience is a true virtue sometimes accompanied by despair but that in most cases having patience is a positive aspect of life. Patience has allowed me to surmount great odds over many, many years. It has allowed me to develop skills and abilities that I never thought possible. It has made my relationships happier and more loving. It has supported my faith, given me hope and allowed me to be charitable in situations where others would have lost patience.

Limiting patience ought to be a conscious decision. When one finds that patience is inimical to one’s health, life or safety then maybe one should curtail it. But, if at all possible, patience is the first virtue, and the most important one. Not a minor form of despair but the antidote to despair.

This antidote to despair, however, is not easily won. One must have a certain moral courage to maintain patience, since despair is always lurking. Patience requires strength, courage, and optimism—strength because patience is not a frail virtue, courage because one may wish to give in to despair, and optimism because optimism is the basis for the hope that patience allows.

Can one provoke someone who is patient? Or is patience a transcendent virtue that defies provocation? Can one control one’s patience to the point of not being able to be provoked? This is where moral courage begins and maybe ends. One must have the courage to maintain patience despite provocation but if provoked one must not allow this provocation to end patience. Just because one has “lost patience” does not mean it cannot be regained or reinforced or renewed.

Renewal of patience is a great challenge and requires even more strength, courage and optimism. One must admit one’s loss of patience to oneself and maybe others. One must admit that one may have been weak in the face of provocation. But one must also allow one to lose patience and not to feel “lesser”. One must be tolerant of one’s loss of patience and be determined to regain patience.

Chronically ill patients must feel this provocation when an illness continues to raise hurdles that prompt despair. The provocation to give up on patience, to see oneself as “lesser” because one has lost patience is always a challenge.

One must pick oneself up and try again. One must continue to believe that patience has meaning and importance in life and health. One must not give up or in to the despair that follows a loss of patience or feeling lesser in many ways – less faithful, hopeful, optimistic, courageous and, yes, in control.

Patience is a necessary virtue. Without patience many disastrous consequences would occur in life and health. Patience is hope, faith, optimism, and courage. It is the antidote to despair.

Mary Ellen Wurzbach is John McNaughton Rosebush Professor Emerita, University of Wisconsin – Oshkosh in Oshkosh Wisconsin.