In about a week, the president will go to Martha’s Vineyard for his summer vacation. There he’ll have time to stroll the beach, maybe take a nap, almost surely look back on seven of the most exhilarating and difficult months of his life, and of the life of his country. As he reflects on those months, what questions is he likely to ask, and how is he likely to answer them? Here’s a guess:

• Did I translate the hope and optimism of the campaign into the presidency? There is nothing like a presidential campaign to set up a presidency for failure: all those adoring crowds, all those caucus and primary victory statements amid the cheering and the bunting, all that promise and, worse yet, all those promises.

Barack Obama had more than his share of all of those. He campaigned on hope, which even a president and a compliant legislature cannot enact into law. He then faced the difficult chore of translating hope into reality, and, in truth, the record isn’t half bad. The six-month appraisal poll taken for Time magazine shows that 51 percent of the public believes that the country is heading in the right direction.

That’s a good sign. But there are danger signs, too. About three out of five people believe the final health care measure will raise their medical costs, according to the poll. About the same rate believes the new health care scheme will make their medical lives more complicated. And more than half fear it will give them less freedom to choose their doctors and coverage.

One more element, another danger sign: A summer poll taken by National Journal shows that only 31 percent believe that their children will have more opportunity than they had — as opposed to 36 percent who believe they will have fewer opportunities. The disparity is even greater among men, who by a 41-to-21 percent split believe their children will have less opportunity than they had. (Among women, the disparity is about the margin of error.) In the nautical language of island Massachusetts, the breezes seem gentle now, but gales are gathering offshore.

• Does hope really matter all that much anyway? Sure it does, at least in this country. The United States is an optimist’s paradise; we believe in many things here, but most of all we believe in opportunity, progress — and in believing itself. More than half the public believes the president is doing a good job. (Sobering news: He’s at about the same level as Jimmy Carter and Richard Nixon at the same time in their presidencies.)

But hope is more than Obama’s oxygen. It is his peculiar form of political capital. He has a lot of it, and now he is going to have to spend it. The question is whether it can buy the kind of health system overhaul he promised in the campaign, or whether it will be sufficient only to buy the kind that the lobbyists and the lawmakers are telling him he must accept. So far Obama’s political capital is still on the sideline. Capitol Hill is waiting for him to move it into the game.

• How about health care? This is where rhetoric meets reality. Obama hoped for a health care bill before his summer vacation. He will be lucky to get it before his Thanksgiving break. All the forces of opposition that until now have been quiescent suddenly have mobilized. They are ambushing his Democratic allies (and, worse yet, the undecideds and moderates) at town hall meetings during the congressional recess, and though Democrats are complaining about the tumult at these sessions, they have a grudging admiration of the organizational reach of their opponents.

Health care overhaul is still a work in progress, though, to the naked eye, not all that much progress is being made this month. The president and Congress will come back from their summer holiday sobered by the obstacles and stunned by their opponents’ ferocity. The unknown is how that new sobriety will affect their strategies and their choices. You might think of the month ahead as a duel between two statistics: The Time poll shows that 86 percent of Americans are satisfied with their current health care plan. (There is almost no question in American life that gets an 86 percent affirmative answer.) But it also shows that 55 percent believe the current system needs major change.

Therein lies the collision.

Or, to put this problem in bold relief: People are happy with what they have, but they believe the system needs to change. It’s not often Washington gets a no-win choice quite as stark as that — and when you factor in the importance of health care in the social and economic life of the nation, you get an idea of the difficulty of this problem.

• Who is more alienated, my friends or my enemies? Jimmy Carter had the unhappy ability to alienate them both. Bill Clinton alienated his friends first and then they rallied as his enemies gathered steam, force and ferocity.

Obama has been slow to mobilize his opponents, in part because their numbers were smaller and their self-absorption and self-destructiveness larger than those of rivals that past presidents faced. But an anti-Obama caucus that once counted the columnist Charles Krauthammer as the only vocal mainstream voice has grown, slowly but inexorably.

At the same time, a small but growing number of Democrats and liberals are beginning to get restless and restive, wondering why Obama, whose profile in the Senate was unabashedly liberal, is tacking so often toward safer, more tranquil waters.

The situation is reminiscent of the Carter years, when top campaign aide Hamilton Jordan said that if the Georgia governor were elected and Cyrus Vance turned out to be secretary of state and Zbigniew Brzezinski turned out to be the national security adviser, the whole effort would have been a failure. That, of course, is exactly how things turned out. Obama faces increasingly vocal challenges from friends, who are afraid he will cave, and from foes, who are afraid he won’t. No wonder he wants to take a week off.