Hope is a creative process

•Hope in the context of serious illness is not limited to cure or life extension.•Hope is a creation of an imagined future.•Scientifically unsupported hope can be of great comfort to the patient and family. Clinicians often limit hope to life extension. Hope, rather, is a much broader, creative process. This reflective piece underscores this through personal experience I had with my wife and her mom and dad, all of who have passed away.