The patient is a 27-year-old man in the US military with no pertinent past medical history. He first sought medical care due to sharp periumbilical pain, profound loss of appetite, and nausea. His laboratory tests were unremarkable and he was initially treated for gastroenteritis. Repeated similar episodes while still under medical care prompted a computed tomography scan that demonstrated ileocecal intussusception with scattered enlarged intra-abdominal lymph nodes. A subsequent surgery and biopsy confirmed a stage

3 carcinoid tumor of the appendix. Despite initial efforts, there was persistent ileocolic intussusception with associated small bowel obstruction. The patient’s recovery was complicated by an abdominal abscess, ultimately leading to sepsis and warranting a right hemicolectomy.

The patient spent the next 4 months recovering from these procedures; however, the cancer diagnosis, repeated hospitalizations, multiple surgeries, and complicated recovery significantly affected his psychological well-being. He subsequently presented to psychiatry for evaluation. Upon presentation, his evaluation revealed noteworthy changes in his personality since his cancer diagnosis. His medical condition had transformed him from an adventurous person into someone who avoided sports and challenging activities. His alteration in demeanor and physical limitations resulted in him feeling ineffectual at work and ambivalent about both his military career and future in general.