Resolution of Second Clinical Simulation

Take-home Message

Learning from a rationality debate

(Fictional narrative by the doctor)

James Fleck, MD, PhD & João A de Andrade, MD

Anticancerweb 20 (03), 2019

Theophilus used to see life as a mathematical equation. His health care had always been based on the results of laboratory tests, reinforcing a distorted view that health was dictated by numbers. Suddenly, a blood test showed a high PSA level, which could be associated with either malignant or benign diseases. He was surprised by what he perceived as an unacceptable inconsistency and became very disappointed with medicine. Fortunately, he opened a line of communication with the doctor, asking objective questions, trying to understand the process of decision-making in Medicine.

A real dispute between two different perceptions of the world ensued. Theophilus proposed a mathematical puzzle that required a recursive algorithm to be solved. In turn, the doctor realized that he needed to make Theophilus understand the process of medical decision making and demanded that he took a tutorial. Both were committed to their tasks and delayed any further discussions for 48 hours. The gap would be essential for mutual understanding and would not delay care.

The double challenge helped to improve their communication.

The physician entered the world of algorithms that is one of the foundations of the exact sciences. Theophilus, on the other hand, came to understand Medicine as a science of probabilities, in which an interdisciplinary team of professionals takes into consideration the best available evidence to develop plans of care.

What started as a dispute of sorts, turned into a playful activity. In due time, both realized that there were significant areas of overlap and that there was mutual commitment to achieving the best possible results. 

Gradually, mutual understanding and appreciation led to a level of equality in their relationship that greatly enhanced trust and communication. 

Patient and physician joined forces and both contributed to a good outcome!

*     Attention: The story 2 has been published sequentially from PLOT 1 to PLOT 6 and you will always see the most recent posting. To read Story 2 from the beginning, just click in the numbered links located at the bottom of the homepage. 

Wait for Story 3: Mixed feelings…

© Copyright 2019 Anticancerweb

 James Fleck, MD, PhD: Full Professor of Clinical Oncology at the Federal University of Rio Grande do Sul, RS, Brazil 2019 (Editor)

Joao A. de Andrade, MD: Professor of Medicine and Chief Medical Officer, Vanderbilt Lung Institute, Vanderbilt University Medical Center, Nashville, TN – USA 2019 (Associate Editor)