Background (085-028-01-1) Michael and Aviezer
The patient aspired to be an historian but became a tour guide. Later, he was forced by difficult economic circumstances to work for his brother-in-law as an overseas salesman of irrigation equipment, exclusively to accounts in third world countries.
Although he had one period of bowel dysfunction associated with stress while a university student he had been symptom free in the subsequent 18 years. However, in the last 3 years, since travelling frequently abroad he has started having intermittent pain and diarrhea- usually while abroad.
He hates his job, hates travelling and finds great difficulty in the task of meeting with foreign clients- usually at long, ceremonial and boring meals at restaurants. In his mind it is the level of hygiene in these foreign countries that is causing his bowel disorder. This visit to the doctor is in order to get something to prevent his symptoms medicine or at least something effective to take should the symptoms recur on his up-coming trip.
The action
In this clip the patient presents his “presenting complaint”: the idea that has gastrointestinal problems are related to the food in far-away places. He gives ample expression to what he thinks about his job. The doctor makes an attempt to clarify the facts, but the patient again complains about always being sent to some hole-in-the-ground.
Educational opportunities
This clip can be used to demonstrate the following:
- cues to a variety of CASE elements in a very short segment of the video [ concept, affect, expectations ]
- how the patient’s preoccupation with his CASE interferes with the doctor’s problem-solving.
- the patient’s body language as a cue about how he feels.
The clip could be used as a basis for the following discussion(s):
- How did the doctor respond to the patient’s cues? What might have been lost or gained by his responses? What might he have done differently and with what intended outcome?
Tags applying to this clip
concept, affect, expectation, body language
