A Collection of Clinical Case Stories as Emotional Landscapes of The General Physician-Comet

Short Communication

A Collection of Clinical Case Stories as Emotional Landscapes of The General Physician-Comet

Jose Luis Turabian ID ^*

Specialist in Family and Community Medicine, Health Center Santa Maria de Benquerencia. Regional Health Service of Castilla la Mancha (SESCAM), Toledo, Spain.

*Corresponding Author: Jose Luis Turabian, Specialist in Family and Community Medicine, Health Center Santa Maria de Benquerencia. Regional Health Service of Castilla la Mancha (SESCAM), Toledo, Spain.

Citation: Turabian JL. (2026). A Collection of Clinical Case Stories as Emotional Landscapes of The General Physician-Comet, International Clinical and Medical Case Reports, BioRes Scientia Publishers. 5(3):1-2. DOI: 10.59657/2837-5998.brs.26.067

Copyright: © 2026 Jose Luis Turabian, this is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Received: July 02, 2026 | Accepted: August 03, 2026 | Published: August 10, 2026

Abstract

This International Clinical and Medical Case Reports section is a collection of descriptive clinical vignettes, "like the plates in a geography atlas" that will present the emotional situations (empathy, frustration, sadness, joy, exhaustion, etc.) metaphorically described as emotional landscapes (which can have emotional, cultural and spiritual significance for people, evoking feelings of peace, beauty, nostalgia or belonging): mountains, volcanoes, rivers, valleys, islands, waterfalls, glaciers, fjords, estuaries, etc, and who are experienced by general practitioners (GP), when they dealing with different clinical cases and patients, with the aim of achieving a greater understanding of what we are and what we do as doctors in relation to patients. This story presents a case of glioblastoma multiforme, the diagnosis of which impacts the GP, causing sadness. It progresses with progressive deterioration and death, leaving a lasting memory for the patient's physician and family. This landscape emotionally suggests a comet to the GP, a celestial body revolving around the sun in an eccentric orbit, which made a solitary and long journey through space… and as it approached the sun, it developed a luminous tail of gas and dust that glows.

Keywords: glioblastoma multiforme; emotions; sadness; metaphor; general practitioner; cultural landscape

Clinical Vignette/Emotional Landscape: Comet

Peter, 57, married with no children, and a clerk, with a history of ex-smoking, high blood pressure, altered fasting blood glucose and dyslipidemia, and microhematuria of possible glomerular origin with urological studies without pathology.

Peter sees relatively little, and in relation to his chronic problems; he seeks checkups or prescriptions for your medications.

Now, he comes to the office early in the morning with his wife:

Peter has had dysarthria or a lack of fluency in language for a few weeks, with difficulty speaking, and forgetfulness or absent-mindedness, which seems to be progressing. He smiles... He apologizes for the dysarthria. His wife is next to him, tense, worried...

"I have problems at work... using the computer... I have trouble thinking, understanding things, and performing tasks that were previously simple and routine..."

The doctor, who had known the patient for years... is impressed by the clinical picture... which suggests a significant problem. The GP is suddenly overcome with a strong feeling of sadness… for the loss…, for the discouragement and helplessness of his medical work, and the distress of Pedro and his wife…, as well as his own mortality…, while imagining the pain and grief that awaits them in the coming months…

Peter is seen by the neurologist, and the GP's suspicion is confirmed…: Diagnosed with non-mutated IDH glioblastoma multiforme [1,2].

A biopsy was performed, and treatment was started with radiotherapy and Temozolamide and Tumor Treating Fields. Later, an MRI showed tumor progression, so second-line treatment with Bevacizumab/Irinotecan was started 6 months after the initial consultation. He was subsequently treated with IV Avastin every 15 days.

The GP saw him when he was brought to the clinic in a wheelchair due to right hemiplegia that prevented him from walking, standing, or making transfers.

The neurologist continued the same treatment until toxicity or progression.

One year after the diagnosis, a day his wife called because Peter had removed the subcutaneous IV infusion line, which had been started that morning in palliative care. His wife mentioned that he was a little nervous and disoriented. IV infusion line was again inserted by nurse and left in place.

Thirteen days later, Peter died at home. It was an expected death…

Peter's wife cared for him during the year he made his journey to the sun… She had requested sick leave, and her employer supported her. After Peter's death, she returned to work. Six months later, she was in the GP's office:

"Although time has passed… and I made a trip to relax, and I'm working… I don't think I'll be able to forget what I experienced, at least for a long time…" Peter's wife confesses to the GP.

Peter was a comet, a celestial body revolving around the sun in an eccentric orbit, made of ice, rocks, and dust, which made a solitary and long journey through space… and now that it has approached the sun, it develops a luminous tail of gas and dust that shines… [3].

and that will be seen for a long time...

Every doctor carries at least one patient in their head: the memory of a difficult case, perhaps, or a tragic outcome. And sometimes a patient simply touches the heart. Often, sadness in a doctor after a serious diagnosis or the death of a patient evolves from a lasting feeling to something fleeting, perhaps due to the instinct to distance themselves from the suffering of others [4,5].

“We move across great distances forcing brilliant trails of light, like comets”, thinks the doctor.

References

Kanderi, T., Munakomi, S., Gupta, V. (2025). Glioblastoma Multiforme. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. 32644380.
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Hou, L. C., Veeravagu, A., Hsu, A. R., Tse, V. C. (2006). Recurrent Glioblastoma Multiforme: A Review of Natural History and Management Options. Neurosurgical Focus, 20(4):E3.
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Moore WG. (1954). A Dictionary of Geography. London: Penguin Reference Books.
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Berry, P.A. (2007). The Absence of Sadness: Darker Reflections on The Doctor-Patient Relationship. Journal of Medical Ethics, 33(5):266-268.
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Da Silva, J. V., Carvalho, I. (2016). Physicians Experiencing Intense Emotions While Seeing Their Patients: What Happens? Permanente Journal, 20(3):15-229.
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