Post by Deleted on Sept 3, 2015 18:28:19 GMT
 |
| full name: lachlan miller kennedy nickname(s): lach, lockie age & dob: 22 (10/09/1993) hometown: newport, rhode island current city: new york, ny education: college drop out occupation: bartender, death + company _________________________________ I L O V E M Y J O B  _________________________________ PSYCH REPORT 08/22/2015 DESCRIPTION: Patient suffering from PTSD and depression, following extreme motor collision. IDENTIFYING DATA: The patient is a 22-year-old Caucasian male. CHIEF COMPLAINT: The patient’s mother submitted him for treatment following the loss of his brother in a traffic collision approx. one year ago. Patient was arguing with brother at the time. Mother believes he is depressed – he has dropped out of college, temporary lost the use of his legs, and shows early signs of alcoholism. HISTORY OF PRESENT ILLNESS: During the patient’s three month rehabilitation following the accident, hospital workers reported that he was despondent in manner, with severe insomnia, recurrent nightmares when finally asleep and low responsiveness to questioning. The patient refused and still refuses to discuss the event, and initially showed great reluctance to enter a vehicle. Since then his parents have described his emotional state as increasingly erratic, with moods shifting from extreme optimism to extreme pessimism seemingly without cause. The patient has lost considerable weight and has not slept consistently since the accident. The patient claims to have had no thoughts of self-harm and says he “feels fine, all things considered”. PSYCHIATRIC HISTORY: The patient has never been hospitalized for psychiatric purposes. He was previously taking Flurazepam to aid his insomnia, but stopped six months ago after developing a tolerance. He was proscribed Effexor but did not begin the course. SUBSTANCE ABUSE HISTORY: Caffeine: Three to four cups of coffee per day. Tobacco: Claims to be an “occasional, social” smoker. Alcohol: CAGE questionnaire indicates significant alcohol problems. Patient claims to drink no more than “one or two beers every other night”, but his mother claims the actual figure is three or four times this. Illicit drugs: Patient admitted to occasional use of marijuana and to having tried cocaine. We discussed some of the major risks of these substances. MEDICAL HISTORY AND REVIEW OF SYMPTOMS: Constitutional: See History of Present Illness. Neurological: No history of seizures, occasional (no more than one a year) migraine headaches. Cardiovascular: Denied. Pulmonary: Denied. Gastrointestinal: Denied. He has no history of liver disease or peptic ulcer disease. Endocrine and Hematological: Denied. Dermatological: Denied. Musculoskeletal: Chronic back pain from the herniated disc. The patient suffered a severe back injury in the collision, preventing him from pursuing athletic ambitions. Movement has returned to normalcy, but cannot sustain prolonged intensive physical activity. Genitourinary: Denied. Other: Denied. SURGERIES: Lumbar spinal fusion to correct herniated disc. ALLERGIES: No known drug allergies. CURRENT MEDICATIONS: Prescription: Denied. Over-the-counter: Denied. Herbal: Denied. BIRTH AND DEVELOPMENTAL HISTORY: The patient’s mother confirms he was born fullterm, after a normal pregnancy, weighing about 6-1/2 pounds. Shee believes he reached the developmental milestones at the usual ages. ABUSE HISTORY/TRAUMA/UNUSUAL CHILDHOOD EVENTS: The patient claims to have had a normal, "though almost abnormally happy" childhood. FAMILY PSYCHIATRIC HISTORY: There is some depression on the mother’s side of the family, and she admits she personally suffered from post natal depression following his birth. There are apparently a number of family members with alcohol issues. FAMILY MEDICAL HISTORY: The patient's paternal grandmother had breast cancer and died in her mid-fifties. His father suffers from hypertension. SOCIAL HISTORY: The patient was born in Massachusetts but spent the majority of his life in Rhode Island. He has lived in New York for the past year, after dropping out of the University of Florida, where he held a sports scholarship that he could no longer fulfil. The patient is single. SPIRITUAL BELIEFS: He denies any spiritual beliefs. EDUCATION: High school diploma. EMPLOYMENT: He is employed at Death + Company NYC, as a bartender. LEGAL: He denies any legal problems. MENTAL STATUS EXAMINATION: The patient arrived ten minutes late, accompanied by his mother. He is alert, but reluctant to be here and uncooperative with questioning. He is well groomed and maintains good eye contact. Intelligence is above average. Insight and judgment are good. He is oriented to time, place, and person. Speech is goal-directed, coherent, and of normal rate and tone. Patient claims his mood is “bored”, but affect is hostile. The patient becomes more hostile with some of the questioning during the mental status examination, particularly CAGE evaluation. He denies auditory or visual hallucinations. He denies suicidal or homicidal ideation. FORMULATION: The patient is a 22-year-old Caucasian male with a recent history of depression and borderline behaviors, most likely resulting from PTSD. DIAGNOSES: AXIS I 296.32 Major depression, recurrent, moderate. AXIS II V71.09 No diagnosis. AXIS III History of chronic back pain following automobile accident. AXIS IV Occupational problems, other psychosocial and environmental problems. AXIS V Current GAF: 58. Highest in the past year: 51. STRENGTHS: Above average intelligence, stable employment, strong self-awareness. PROGNOSIS: Good, if the patient follows through with appropriate treatment. Without proper treatment, the patient will likely have further substantial deterioration of psychosocial functioning. _________________________________  THEY FUCK YOU UP, YOUR MUM AND DAD. THEY MAY NOT MEAN TO, BUT THEY DO. Having parents who've been madly in love with each other from early childhood sounds like a nice thing, but you know what? It fucking sucks. Yeah, I can hear all you kids of divorce groaning at my bullshit, but hear me out. My parents have only ever seen each other, they got married at the tender age of eighteen and never looked back. I genuinely believe them when they say that they've never doubted the decision. I mean, that's fucked up, right? Borderline psychopathic? Talk about setting an unrealistic example. No wonder I'm still trying to make things work with a girl I happened to live down the road from as a kid-- with the example my parents set, settling down with anyone else could only mean failure. _________________________________ A LETTER FROM AVA KENNEDY TO ROBBIE KENNEDY 09/07/2000  Lachlan broke his arm yesterday. Cormac says he was showing off in front of the Bartlett girls (surprise, surprise) when he decided to climb that beautiful tree in their backyard – (you know the one, with all those blossoms in spring. How I used to dream of marrying you under that tree!) - only to misstep and fall straight onto his right arm. The poor thing was so stoic, at least in front of the girls—the moment I shooed them away the tears came flooding! I think he was finding it more difficult to keep up his bravado than to manage the pain. Our little soldier. He’s so like you, Robert. Cormac says he wrote you a letter, did you get it? Lachlan had planned to write one too, but alas, his writing hand is now out of service. Not that his handwriting could be much worse, mind you. They talk about you all the time, always ticking off the days until you’re due home. I know you can’t help it and you’re at the mercy of this glorious country’s needs, but I do hope you aren’t delayed. They’re getting so big. Rosie and Cormac staged their own little wedding last week, with Lachlan and Louisa acting as best man and maid of honour. They’re a perfect pair, and all who attended agreed that this must be a trial run for what will one day be the real thing. You can’t imagine a cuter display! Lachlan seemed vaguely disgusted by the whole affair, but then he is only seven. I suspect we’ll be wishing he still felt that way when he’s fifteen and obsessively clearing his internet history. I’m so happy we moved here, Robbie. You were right, moving out of the city really has given our boys a proper childhood. Remember how much they used to fight, back when we were in that cramped apartment? They’re best friends here, completely inseparable! I can’t wait for you to come home so we can be a family, but until then your letters are enough. Please write as soon as you can (I know you always do). With all my love,  _________________________________  "You should be nicer to her, y'know. One day you'll wake up and she'll be gone, and all you'll have is all those snide remarks you made ringing in your ears." Ironic, that it was my now dead brother who said that to me. The brother I was calling an asshole, swearing and shouting at in my near-drunken rage. It's too much to expect yourself to always be able to say the right thing at the right time, but Christ, I couldn't have done much worse than I did. What would I have said if I'd known? I don't know. I've thought about it a lot and nothing comes close. "Swerve" might have been a good start, then he might not have plowed into that truck... that makes it sound like his fault, and it's anyone but his. I want to say that I'd say what I'd said at his funeral but to him rather than about him - that he was my best friend, my hero, a father figure when ours was overseas. That I can't do up a tie without thinking about him, can't go grocery shopping without thinking about his likes and dislikes, can't look in the mirror without seeing that strong family resemblance I was blind to before. But the truth is, even if I had known, I was still too angry. No matter what Louisa says, something was going down, and I can't believe they'd do that to me. That he'd do that to me. It makes all the times he intervened before seem hollow and self-serving, and it's making me second guess every bit of advice he ever gave me. That's not fair, I know it's not. But he's not here to set the record straight and Louisa is being too much of a cunt to do it on his behalf. |
lex, gregg, visitor (coding @ rae) |