ls -la /tmp/workspace/ 2>/dev/null || mkdir -p /tmp/workspace && echo "workspace ready"

mkdir -p /tmp/workspace/als-case && python3 << 'PYEOF' from docx import Document from docx.shared import Pt, Inches, RGBColor from docx.enum.text import WD_ALIGN_PARAGRAPH from docx.oxml.ns import qn from docx.oxml import OxmlElement doc = Document() # ---------- Page margins ---------- section = doc.sections[0] section.top_margin = Inches(1) section.bottom_margin = Inches(1) section.left_margin = Inches(1.2) section.right_margin = Inches(1.2) # ---------- Default style ---------- normal_style = doc.styles["Normal"] normal_style.font.name = "Arial" normal_style.font.size = Pt(11) # ---------- Helper: shaded paragraph for speaker lines ---------- def add_speaker_block(doc, speaker, color_hex, text): """Add a coloured-background paragraph for a speaker turn.""" p = doc.add_paragraph() p.paragraph_format.space_before = Pt(6) p.paragraph_format.space_after = Pt(2) p.paragraph_format.left_indent = Inches(0) # Shade the paragraph pPr = p._p.get_or_add_pPr() shd = OxmlElement("w:shd") shd.set(qn("w:val"), "clear") shd.set(qn("w:color"), "auto") shd.set(qn("w:fill"), color_hex) pPr.append(shd) # Speaker label (bold) run_label = p.add_run(f"{speaker}: ") run_label.bold = True run_label.font.size = Pt(11) # Dialogue text run_text = p.add_run(text) run_text.bold = False run_text.font.size = Pt(11) def add_note(doc, text): """Small italic stage-direction note.""" p = doc.add_paragraph() run = p.add_run(f"[{text}]") run.italic = True run.font.color.rgb = RGBColor(0x55, 0x55, 0x55) run.font.size = Pt(10) p.paragraph_format.space_before = Pt(3) p.paragraph_format.space_after = Pt(3) def add_section_heading(doc, title): p = doc.add_paragraph() p.paragraph_format.space_before = Pt(12) p.paragraph_format.space_after = Pt(4) run = p.add_run(title) run.bold = True run.font.size = Pt(12) run.font.color.rgb = RGBColor(0x1F, 0x49, 0x7D) # ==================== TITLE BLOCK ==================== title = doc.add_heading("Breaking Bad News – ALS Consultation", level=1) title.alignment = WD_ALIGN_PARAGRAPH.CENTER title.runs[0].font.color.rgb = RGBColor(0x1F, 0x49, 0x7D) sub = doc.add_paragraph() sub.alignment = WD_ALIGN_PARAGRAPH.CENTER sub.add_run("Doctor–Patient Role-Play Script").bold = True sub.runs[0].font.size = Pt(12) doc.add_paragraph() # spacer # ---- Patient Info box ---- info_lines = [ ("Patient Name", "Mr. David Martinez"), ("Age", "55 years"), ("Setting", "Neurology Outpatient Clinic – Private Consultation Room"), ("Present", "Dr. [Your Name] (Neurologist) | Mr. David Martinez (Patient)"), ] tbl = doc.add_table(rows=len(info_lines), cols=2) tbl.style = "Table Grid" for i, (label, value) in enumerate(info_lines): tbl.rows[i].cells[0].text = label tbl.rows[i].cells[1].text = value for cell in tbl.rows[i].cells: for para in cell.paragraphs: para.runs[0].font.size = Pt(10) if para.runs else None tbl.rows[i].cells[0].paragraphs[0].runs[0].bold = True doc.add_paragraph() # ==================== SCENE 1 ==================== add_section_heading(doc, "SCENE 1 – Welcome and Making the Patient Feel Comfortable") add_note(doc, "Doctor enters the room, smiles, and gently shakes Mr. Martinez's hand.") add_speaker_block(doc, "Doctor", "E8F4FD", "Hello, Mr. Martinez. Please come in and have a seat. I am glad you could come today. " "How are you feeling right now?") add_speaker_block(doc, "Mr. Martinez", "FFF9E6", "Honestly, Doctor, I am a bit nervous. I have been waiting a long time for these results " "and I keep thinking about what they might mean for my family.") add_speaker_block(doc, "Doctor", "E8F4FD", "I completely understand. It is natural to feel that way. Before we talk about your results, " "I want you to know that I am here to answer all your questions, and we will go through " "everything step by step. There is no rush. Is there anyone you would like to have with you " "today – your wife, perhaps?") add_speaker_block(doc, "Mr. Martinez", "FFF9E6", "She is at work. I thought I would come alone first and then tell her what you say.") add_speaker_block(doc, "Doctor", "E8F4FD", "That is absolutely fine. We can also arrange for her to join us later if you wish. " "I just want to make sure you have support around you.") # ==================== SCENE 2 ==================== add_section_heading(doc, "SCENE 2 – Finding Out What the Patient Already Knows") add_speaker_block(doc, "Doctor", "E8F4FD", "Mr. Martinez, before I share the results, can you tell me in your own words what you " "understand so far about why we did all these tests?") add_speaker_block(doc, "Mr. Martinez", "FFF9E6", "Well, the doctors said my muscles are getting weaker. I have been dropping things, " "and my legs feel heavy. They wanted to check my nerves and muscles with that electrical test.") add_speaker_block(doc, "Doctor", "E8F4FD", "Yes, exactly. We did a test called an EMG – it records the electrical signals inside your " "muscles. We also did a full neurological check-up. Did anyone mention what they were " "looking for?") add_speaker_block(doc, "Mr. Martinez", "FFF9E6", "Not exactly. One doctor said it could be a nerve problem. I looked it up a little online " "but I did not want to scare myself.") add_speaker_block(doc, "Doctor", "E8F4FD", "I appreciate your honesty. What I am going to share with you is serious news, " "and I want to be honest and kind at the same time. Is that okay with you?") add_speaker_block(doc, "Mr. Martinez", "FFF9E6", "Yes, please. I want to know the truth.") # ==================== SCENE 3 ==================== add_section_heading(doc, "SCENE 3 – Giving the Diagnosis (Slowly and Clearly)") add_note(doc, "Doctor pauses, leans forward slightly, and speaks in a calm, clear voice.") add_speaker_block(doc, "Doctor", "E8F4FD", "Mr. Martinez, based on all your tests and examinations, you have been diagnosed with a " "condition called Amyotrophic Lateral Sclerosis – most people call it ALS.") add_note(doc, "Doctor pauses and gives Mr. Martinez a moment to process.") add_speaker_block(doc, "Mr. Martinez", "FFF9E6", "ALS… I have heard that name before. Is that the Ice Bucket Challenge disease? " "Is that very serious?") add_speaker_block(doc, "Doctor", "E8F4FD", "Yes, that is the same condition. And I want to be honest with you – it is a serious " "illness. ALS affects the nerve cells in your brain and spinal cord that control your " "muscles. Over time, those muscles become weaker. This is why you have been feeling " "weakness in your arms and legs.") add_speaker_block(doc, "Mr. Martinez", "FFF9E6", "Does that mean I will… will I be able to walk? Work? Take care of my kids?") add_speaker_block(doc, "Doctor", "E8F4FD", "I understand this is very hard to hear. Right now, you can walk and do many things. " "The condition does progress – meaning it gets worse over time – but the pace is " "different for everyone. Many people continue to live meaningful, active lives for " "years after their diagnosis. We will work together closely to help you do as much " "as possible for as long as possible.") # ==================== SCENE 4 ==================== add_section_heading(doc, "SCENE 4 – Responding to Emotions") add_note(doc, "Mr. Martinez becomes emotional. He puts his head down and is quiet for a moment.") add_speaker_block(doc, "Mr. Martinez", "FFF9E6", "I have three kids, Doctor. My youngest is only eight. My wife already works so hard. " "What is going to happen to them?") add_note(doc, "Doctor places a hand gently on the patient's arm.") add_speaker_block(doc, "Doctor", "E8F4FD", "I can hear how much you love your family. That concern you feel – that is the love of " "a good father. Please take a moment. There is no hurry here.") add_note(doc, "A brief pause. Tissues are offered.") add_speaker_block(doc, "Doctor", "E8F4FD", "I want you to know – you are not going to face this alone. There is a whole team of " "people who will support you and your family through this. We will talk about all of " "that today, and we will keep talking at every visit.") # ==================== SCENE 5 ==================== add_section_heading(doc, "SCENE 5 – Explaining the Treatment and Support Plan") add_speaker_block(doc, "Mr. Martinez", "FFF9E6", "Is there any treatment? Can it be cured?") add_speaker_block(doc, "Doctor", "E8F4FD", "I want to be honest with you. Right now, there is no cure for ALS. But – and this is " "important – there are treatments that can slow the progression and help manage your " "symptoms. There is a medicine called Riluzole that many ALS patients take. It may help " "slow the disease. We will discuss whether it is right for you.") add_speaker_block(doc, "Mr. Martinez", "FFF9E6", "What else can be done?") add_speaker_block(doc, "Doctor", "E8F4FD", "Quite a lot, actually. We will refer you to a full ALS care team. This includes: " "A physiotherapist to help keep your muscles as strong as possible for as long as possible. " "An occupational therapist to help you adapt your daily activities and your home. " "A speech therapist to help if speaking or swallowing becomes difficult. " "A respiratory specialist to monitor your breathing. " "And a social worker and counsellor to support you and your family with practical and " "emotional needs.") add_speaker_block(doc, "Mr. Martinez", "FFF9E6", "That is a lot of people. I do not know how we will afford all of this. " "I am already on medical leave.") add_speaker_block(doc, "Doctor", "E8F4FD", "That is a very real concern and we take it seriously. Our social worker is experienced " "in helping patients access financial support, disability benefits, and community programs. " "We will connect you with them as soon as possible. You should not have to carry this " "financial stress alone.") # ==================== SCENE 6 ==================== add_section_heading(doc, "SCENE 6 – Discussing the Family and Next Steps") add_speaker_block(doc, "Mr. Martinez", "FFF9E6", "How do I tell my wife? And my children? My kids are so young – they will not understand.") add_speaker_block(doc, "Doctor", "E8F4FD", "That is one of the hardest parts. We have a counsellor on our team who specialises in " "helping families have these conversations in a way that is honest but also gentle and " "age-appropriate for children. I strongly recommend that your wife joins us for our " "next appointment. Would that be okay?") add_speaker_block(doc, "Mr. Martinez", "FFF9E6", "Yes. I think she needs to hear this from you, not just from me. I would not even know " "where to start.") add_speaker_block(doc, "Doctor", "E8F4FD", "We will arrange that. I will also write a clear letter for you to take home today " "that explains the diagnosis and the plan in simple language. You can read it again " "later or share it with your wife before the next visit.") # ==================== SCENE 7 ==================== add_section_heading(doc, "SCENE 7 – Checking Understanding and Inviting Questions") add_speaker_block(doc, "Doctor", "E8F4FD", "Mr. Martinez, we have talked about a lot today. Can you tell me in your own words " "what you are taking away from our conversation?") add_speaker_block(doc, "Mr. Martinez", "FFF9E6", "I have ALS. It will get worse over time, but there are people who can help me. " "There is a medicine that might slow it down. And I need to come back with my wife.") add_speaker_block(doc, "Doctor", "E8F4FD", "That is exactly right. You understood everything very well. Do you have any questions " "right now – about anything I said, or anything else on your mind?") add_speaker_block(doc, "Mr. Martinez", "FFF9E6", "How long… how long do I have?") add_note(doc, "Doctor pauses, answers carefully and compassionately.") add_speaker_block(doc, "Doctor", "E8F4FD", "That is the question many patients ask, and I respect you for asking it directly. " "The honest answer is – I do not know, and no doctor can tell you with certainty. " "ALS progresses differently in every person. Some people live for many years. What I " "can promise you is that our goal is to keep you as healthy, comfortable, and active " "as possible for as long as possible. We will be with you every step of the way.") add_speaker_block(doc, "Mr. Martinez", "FFF9E6", "Thank you for being honest with me, Doctor. I was scared you would not tell me everything.") add_speaker_block(doc, "Doctor", "E8F4FD", "You deserve the truth, and you deserve respect. That is what I am here to give you. " "I also want to give you this number – it is a direct line to our ALS nurse coordinator. " "Any time you have a question or a worry, day or night, you can call them.") # ==================== SCENE 8 - CLOSING ==================== add_section_heading(doc, "SCENE 8 – Closing the Consultation") add_note(doc, "Doctor stands, extends a hand.") add_speaker_block(doc, "Doctor", "E8F4FD", "Before you go, let me give you a printed copy of today's plan. Our next appointment " "is in two weeks, and I have asked our social worker to call you within the next 48 hours. " "Please do not hesitate to reach out before then if you need anything at all.") add_speaker_block(doc, "Mr. Martinez", "FFF9E6", "Thank you, Doctor. I feel a little better knowing there is a plan. I was so afraid " "I would just be sent home with nothing.") add_speaker_block(doc, "Doctor", "E8F4FD", "You will never be sent home with nothing. Take care of yourself, Mr. Martinez. " "And please give our best to your family. We will see you soon.") add_note(doc, "Doctor shakes hands warmly. Mr. Martinez leaves with printed materials and the nurse coordinator's contact card.") # ==================== KEY COMMUNICATION NOTES ==================== doc.add_page_break() add_section_heading(doc, "KEY COMMUNICATION SKILLS USED IN THIS SCRIPT") skills = [ ("SPIKES Protocol Applied", "Setting (private room), Perception (asked what patient knows), Invitation (asked permission), " "Knowledge (gave news clearly), Empathy (responded to emotions), Strategy & Summary (explained plan and checked understanding)."), ("Simple Language", "Medical terms (ALS, EMG, Riluzole) were explained immediately in plain everyday English. " "No jargon was left unexplained."), ("Emotional Acknowledgement", "The doctor paused after delivering news, offered tissues, and used physical reassurance " "(placing a hand on arm) to show genuine care."), ("Honest but Hopeful", "The doctor was truthful about the lack of a cure and the progressive nature of ALS, while " "also focusing on what CAN be done and emphasising team support."), ("Family-Centred Care", "The wife was invited to the next appointment. A counsellor for children was mentioned. " "Financial concerns were addressed with the social worker referral."), ("Safety Net", "Patient was given a written plan, a nurse coordinator number, and a follow-up appointment " "before leaving the room."), ("Teach-Back Method", "The doctor asked Mr. Martinez to repeat back what he understood, confirming the information " "was received correctly."), ] tbl2 = doc.add_table(rows=len(skills), cols=2) tbl2.style = "Table Grid" for i, (skill, detail) in enumerate(skills): tbl2.rows[i].cells[0].text = skill tbl2.rows[i].cells[1].text = detail tbl2.rows[i].cells[0].paragraphs[0].runs[0].bold = True for j in range(2): for para in tbl2.rows[i].cells[j].paragraphs: for run in para.runs: run.font.size = Pt(10) # ---------- Save ---------- out_path = "/tmp/workspace/als-case/ALS_Breaking_Bad_News_Script.docx" doc.save(out_path) print(f"Saved: {out_path}") PYEOF