300 MILLIGRAMS FOR SHAGGY
by Grady Smith
Case Record: H-B002213
Male, Age 23
Study Record:
Patient brought his dog to first session and insisted
it remain with him. Typically, anxiety disorder analysis will reveal
that this type of attachment is formed as a response to abandonment
fears and may suggest mild prenatal trauma. After offering
his dog a seat, patient sat down on couch and eyed the room suspiciously
and hinted that the bookshelf might lead to a secret passageway.
Note that the patient appeared unkempt: dirty green t-shirt, well-worn
brown pants, unshaven, bags under eyes; however, no visible skin
pigmentation, but subsequent paranoiac ideation suggest methamphetamine
addiction. Like most pseudoneurotic schizophrenics, patient automatically
created a delusionary conspiracy scenario, proclaiming that he was
investigating the theft of a lost Incan treasure, and patient insisted
that the counselor confess to the robbery or face the alternative.
When counselor recommended a mild sedative, patient
became hysterical, the stress of which triggered a possible Tourette’s
relapse, during the course of which patient yelled the enigmatic
expletive “Zoinks” interminably. Asked if he had ever tried
drugs, the patient answered that he “didn’t know what drugs were,”
and when they were explained to him, patient announced that “they
(drugs) didn’t exist in Hanna Barbara productions.” Sophisticated,
crafted social delusions suggest a history of advanced and continued
psychotic episodes. Patient also remarked that he had parked a van
outside which contained his three other co-horts awaiting a signal
if no confession would be made. Delusions were so well-crafted that
patient could provide names of the imagined individuals.
When counselor called for nurse assistance, patient
experienced complete psychotic dissociation. Patient addressed the
dog and tried to coerce it into attacking the counselor using a
primitive bribing mechanism: one treat, then two, then finally three
“Scooby snacks.” Dog leapt at counselor, but counselor ducked. Dog
fell out the window, causing patient great distress.
Patient was then jacketed, sedated with Thorazine,
and admitted to Gilpin’s Medical Center.
Recommendation:
300 mg of Zyprexa, followed by tri-weekly
sessions for first three months. Group therapy integration in 6
months.
