Barbara: At age nineteen, Barbara had required dialysis for three years. We heard from Barbara how two previous attempts at transplant had failed. Her doctors now recommended a third try. But her lack of optimism concerned them. They had known Barbara as excited and optimistic before her previous transplants. Her mood was now very blue. But they hadn't known how demoralized she had been after the second failed attempt. Barbara had decided then that her lot in life was to remain on dialysis indefinitely. The failed transplants had taken their toll on Barbara's confidence in herself and toward her future.

The team worried that Barbara was far more pessimistic than necessary. They believed that in her case, a successful transplant should still be possible. It worried them that due to her diminished confidence; she might decline an opportunity for what she most wished.

Although skeptical that she would change her mind, Barbara agreed to join a group that met and talked about dealing with illness. She quickly learned that many others faced circumstances similar to or worse than she did. From their own experience, they recognized Barbara's fear of getting her hopes up again. The potential for disappointment was painful.

Nobody tried to change Barbara's mind about another transplant. But the discussions did give her lots to think about. She knew that several others in the group would jump at her chance for better health. Eventually, Barbara accepted the team's suggestion of a third transplant. But she still did not show much enthusiasm about the surgery. Given her previous experience, there was no way that she could ignore the possibility that things could go wrong. The transplant team understood that for Barbara, this was a way of trying to protect herself from any future disappointments.

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