Preview of the Sixth Clinical Simulation

Take-home Message

Graphic representation of emotional flow and turning point

(Fictional narrative by the doctor)

James Fleck, MD, PhD: Anticancerweb 09 (05), 2020

Alex was still very young when he was diagnosed with non-Hodgkin's lymphoma. Since his first consultation, he expressed himself as a communicative and cooperative patient. He was married to Sue, a Philippine lady. They used to have a close relationship, sharing everything in life. Alex was an athlete and projected the internalized figure of a coach in the relationship with the doctor, which expanded my professional responsibility. A coach not only communicates technical information, but follows the learning process, promoting behavioral modulation.

The exposition (PLOT 1) took place at doctor’s office. Alex and Sue were surprised and very concerned with the diagnosis of cancer in a very young patient. During raising action (PLOT 2) Alex identified the doctor's image with that of a coach and requested for a tutorial. The conflict (PLOT 3) was characterized by Alex and Sue running the tutorial and becoming familiar with the medical language. The climax (PLOT 4) was reached when the couple master the tutorial and began to exercise shared decision making. The falling action (PLOT 5) was entirely dedicated to the assessment of the risk-benefit ratio of the treatment. The resolution (PLOT 6) was presented by the storyteller in a comprehensive biopsychosocial approach.

The graph presented below is a simplified depiction of the story 6 emotional flow. At each PLOT element the patient-physician relationship leads to emotions that occur along distinct time intervals (△t). The actions are responsible for the emotional flow, which is unique to each story. The continuous sinuous wave represents the oscillating patient’s emotional status. The larger inflections represent the "turning points".  

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

To be continued on PLOT 1 (exposition): Cancer in the young adult

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James Fleck, MD, PhD: Full Professor of Clinical Oncology at the Federal University of Rio Grande do Sul, RS, Brazil 2020