We humans wish in an assortment of ways. There is the first star of the evening. If that doesn’t work, there is the wishing well. Drop in a coin and you buy a wish. There also is the dried wishbone from last year’s Thanksgiving.

We humans wish in an assortment of ways. There is the first star of the evening.

Star light, Star bright,

First star I see tonight,

I wish I may, I wish I might,

Have the wish I wish tonight.

If that doesn’t work, there is the wishing well. Drop in a coin and you buy a wish. There is the dried wishbone from last year’s Thanksgiving. You grab one end and we will both make a wish in our minds and then pull. The one of us who ends up with the larger piece of the furcula gets the wish. Don’t you wish it were that easy?

If there is no well, the holidays are over and the first star is obscured by clouds, we may have to wait awhile until our birthday. Then, depending on the number of candles and the resulting conflagration, if we blow them all out in one mighty wolf-like huff and puff, our wish will come true. Of course, you can’t tell anyone, or it won’t happen. That silence clause makes a double-blinded, cross-over scientific study impossible to perform.

We will just have to rely upon faith that wishing works regardless of the modality. If it didn’t, why do we all do it? There must be some evolutionary advantage. For what reason does wishing exist if it doesn’t enhance the odds of the survival of our species?

It is impossible to know if wishing is a quality of only humans. Because wishes are silent, we don’t know if a wounded zebra wishes with all its might a lion won’t eat it. On about the same intellectual level, we humans put money down an empty well when we forgo the math of lotteries.

Perhaps we don’t count the odds or question the public health danger of spreading our spittle across the top of a cake. It is because someone does win the Powerball in spite of the odds. Maybe we keep wishing each year in spite of the growing number of burning candles and the corresponding drop in our lung capacity because eventually we will get our wish.

It is easy to see why we wish for good. We know we won’t be chosen as the homecoming king or queen, but it doesn’t hurt to wish. We wish our team would finally beat its longtime rival, but it doesn’t look so good this year, just like last. We wish because we know someone will be crowned the royalty. We know someone will win the big game.

It is tougher when an outcome is not known. It stretches every wishing muscle and bone to think there is the possibility of being the first to do the impossible.

It is different when you know that someone has experienced a bad outcome that makes wishing for the absence of misfortune more painful but perhaps more necessary.

Recently at the children’s hospital, our medical team of residents and nurses took care of a child with an extremely rare, fatal disorder. The scientific literature reported that there were only 23 known cases in the whole world. That meant the baby in the crib was 1 out of 328,571,428. Paraphrasing a statistical truism, it may be a 1 out of 300 million chance, but for that child, it was 100 percent.

That is why, when we wish for bad to pass us by, we know that bad doesn’t always consider our wishes. There is that one child in front of us who is going to die. What happened to the parents' wishes? Didn’t they wish hard enough?

It is not that I don’t believe in faith and the resulting potential for miracles. It is just that on top of that, I still want to wish. Just maybe this time I will get to be homecoming king, or maybe no other child will have the 1-in-300,000,000 syndrome ever again.

Joseph Cramer, M.D., is a board-certified pediatrician, fellow of the American Academy of Pediatrics, practicing physician for 30 years and a hospitalist at Primary Children's Hospital and the University of Utah. Email: