Appearance: Caucasian male, medium height and build, looks of stated age, short brown hair unbrushed, unshaven. Dressed in semi formal office clothes, clothes clean though rumpled.
Behaviour: calm demeanour, good eye contact though prone to reverie, no abnormal movements, gait symmetrical. Cooperative with interview.
Conversation: normal rate, tone, volume, rhythm of speech. Brief answers verbally, more expansive in writing. Some tangentiality and loosening of associations. Occasional inappropriate humour. Themes of anger, being misunderstood, narcissism.
Affect: reactive, engaged. Claims subjective inner turmoil.
Perception: apparently normal. No attendance to internal stimuli.
Cognition: not formally assessed. Grossly intact.
Intelligence: above average though possibly not as high as he asserts.
Insight: good though limited in the context of accepting and integrating criticism.
Judgment: impaired by innate laziness.
Rapport: superficially established.
Impression: ?tormented artist
?selfish prick
?dysthymia
?intern burnout.
Plan: 1. Ship him off to another hospital and let them sort him out.
2. Put him in the scuppers with a hosepipe on him.
3. Encourage writing: entertaining at times.
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2 comments:
I vote for #3 - but perhaps in scuppers as a sort of composite hybrid of #2 and #3?
Oh, a vote? It was more of a multi-disciplinary integrated management plan rather than an experiment in medical democracy, but let's run with your bold idea.
Any other votes?
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