Story 9: Proactive behavior

Preview of  Ninth Clinical Simulation

Take-home Message

Graphic representation of emotional flow and turning point

(Fictional narrative by the doctor)

James Fleck: Anticancerweb 12 (12), 2021

 

Lyla was a 27-year-old young lady when she was diagnosed with triple negative breast cancer as a result of a double mutation in the BRCA1 and BRCA2 tumor suppressor genes. Lyla's story is an illustration of proactive behavior. Early on, she expressed self-determination and took control of her life. She used to take full responsibility for her decisions and actions. She developed a strong sense of self-criticism and actively sought to rescue a previous wrong, hasty, and traumatic decision. She resolved old family conflicts, revealing emotional balance and reasoning. After cancer diagnosis, she established strong bonds with the entire medical team, being sensitive and adhering to the recommendations. She took the lead in exercising shared decision-making, focusing on her goals. Despite all the adversities and challenges, Lyla managed to build a favorable outcome.

The exhibition (PLOT 1) took place with an unwanted pregnancy in which Raul criticizes Lyla's hasty and reckless attitude. The conflicted couple decide to live apart. The raising action (PLOT 2) occurred during Lyla's first appointment. Despite being very young, she faced the diagnosis of cancer with a mature and resolute attitude. The conflict (PLOT 3) was focused on decision making about the extent of surgical breast resection. The climax (PLOT 4) brought a double challenge, as in addition to triple negative breast cancer diagnosis, she received a positive result for both BRCA1 and BRCA2 mutations. In the falling action (PLOT 5) Lyla faced a breast cancer reconstructive surgery, involved herself in an assisted reproduction and started a surrogacy. The resolution (PLOT 6) will be presented by the storyteller in a comprehensive biopsychosocial approach.

The graph shown below is a simplified representation of the ninth story’s emotional flow. In each PLOT element, the doctor-patient relationship leads to emotions, occurring at different time intervals (△ t). Actions are responsible for the emotional flow, which is unique to each story. The continuous sinuous blue wave represents the oscillating patient’s emotional status, with the larger inflections representing the “turning points”.


*   Attention: Story 9 will be published sequentially from PLOT 1 to PLOT 6 and you will always see the most recent posting. To read Story 9 from the beginning, just click in the numbered links located at the bottom of the homepage. 

 

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