NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation Template

Title 21

OFF CAMERA Y 00:00:15OFF CAMERA Nice to meet you Sergeant. I’m Dr. Schwartz.

00:00:20SERGEANT Nice to meet you, sir.

00:00:25OFF CAMERA Can you tell me why you came here today.

00:00:30SERGEANT My fiance suggested, well demanded that I make an appointment.

00:00:40OFF CAMERA Why was she concerned?

00:00:45[Sighs]

00:00:45SERGEANT Three nights ago, we went with her sister and husband to a county fair. Carnival rides, cotton candy, toss balls at bottles, and win big panda bears, all that silly, old-fashioned stuff, but we were having a good enough time.

00:01:15OFF CAMERA So all was going well.

00:01:20SERGEANT Then these fire works go off. No warning. Just big, full sky explosions.

00:01:30OFF CAMERA Like county fairs do.

00:01:35SERGEANT I didn’t know they did that.

00:01:40OFF CAMERA Then what happened?

00:01:45SERGEANT I took off running. Fast as I could. Tried to find cover.

00:01:55OFF CAMERA Frightened?

00:02:00SERGEANT [Sighs] Yeah, scared the… you know, out of me.

00:02:10OFF CAMERA You didn’t expect the fire works.

00:02:10SERGEANT These two cops saw me running, I guess they thought I pickpocketed someone, maybe tried to rob a poor country person and I was running away. They took me down, tried to cuff me.

00:02:30OFF CAMERA Wow.

00:02:35SERGEANT So I yelled “I’m a combat veteran sir.” Immediately they backed off. They were veterans, understood.

00:02:50OFF CAMERA They understood that the fireworks sounded like combat fire?

00:02:55SERGEANT Yeah, exactly sir. God. [Sighs, quivering]. They helped me to my feet, gave me some cold water. I was shaking pretty bad.

00:03:10OFF CAMERA So they were helpful?

00:03:15SERGEANT Yeah, absolutely.

00:03:20OFF CAMERA The explosive sounds took you back in time.

00:03:25SERGEANT I was… I was right back in the middle of enemy fire, sir.

00:03:35OFF CAMERA What about other loud noises?

00:03:40SERGEANT The same. Last week, a car backfired, I jumped behind a magazine rack. Even a sudden circular saw cutting into wood and I’m… right back there.

00:04:05OFF CAMERA Are there any smells that set you off?

00:04:10SERGEANT Yeah, it’s funny you should ask. Yes sir. Diesel fuel. I hate smelling diesel fuel. Chopper smells. And last week, Charlie, my neighbor, was grilling for Jenna’s birthday and he singed some hair on his arm. No injury but… the smell… I had to leave the party pretty fast.

00:04:55OFF CAMERA What came to mind?

00:05:00[He pauses, struggling to hold back tears].

00:05:10SERGEANT Two of my buddies, they got burned when their Humvee was blown and I smelled their… I’d rather not talk about that, sir.

00:05:40OFF CAMERA Memories are too strong?

00:05:45SERGEANT Yeah, way too strong.

00:05:50[sil.]

00:05:55OFF CAMERA Do you ever dream about these events?

00:06:00SERGEANT Every night, sir. Yeah, makes me not want to crawl in bed, not close my eyes.

00:06:10OFF CAMERA So you have nightmares. You startle easily. Are there any other problems that you’ve noticed?

00:06:20SERGEANT Like what, sir?

00:06:25OFF CAMERA Other cues that cause flashbacks or make you anxious?

00:06:35SERGEANT Traffic. I hate real busy, downtown traffic. Stopping at a traffic light, with people in front of you and behind you, on both sides of you. I can’t stand that. I start breaking out in a sweat, I start shaking, and I can’t catch my breath.

00:07:05OFF CAMERA What about traffic is so bad?

00:07:10SERGEANT Someone could roll an IED under your car. You’re trapped. You can’t get out.

00:07:25OFF CAMERA That happened overseas?

00:07:25SERGEANT Yeah. Yeah, to four of my buddies. Blew’em to hell. And I saw it happen to two other vehicles. I didn’t know the guys but… God several times we’d be stuck in traffic, and people were staring at us. And I knew we were going down. Men, women, children. I mean, any of ’em could’a rolled an IED under us.

00:08:10[He breathes heavily]

00:08:15OFF CAMERA You look like you’re breathing heavily right now just talking about it.

00:08:20[Holding back]

00:08:20SERGEANT Yeah, sorry, sir. I can’t help it.

00:08:30OFF CAMERA Any other difficulties?

00:08:40SERGEANT Sometimes my fiance argues with her mother. It used to not matter. Now I can’t handle it. It seems like any negative situation and I just want to crawl into a hole and hide. I’m a wimp, a freaking coward. I don’t, I don’t want to go anywhere. I don’t want to go out to restaurants, or shopping or even to baseball parks. I just stay in my room all day. Afraid to sleep. It’s bad.

00:09:40OFF CAMERA Have you talked to anyone else about this?

00:09:45SERGEANT Just you. Just now. I don’t want to remember.

00:09:55OFF CAMERA You’re very brave for sharing your story with me. I know that must be horribly difficult for you.

00:10:05SERGEANT Sometimes my stomach muscles get tight. I start getting nauseated.

00:10:15OFF CAMERA Your body is reacting normally to bad events that you’ve experienced.

00:10:20SERGEANT I don’t want to be a whiner.

00:10:25OFF CAMERA You know, talking can actually help your brain to heal. Talking takes it out of the feeling mode and puts it into the thinking mode so that you don’t hear those same stories over and over again. So in a way you feel like you’re in control. We could work on this together.

00:10:55SERGEANT I would like that, sir. Very much.

00:11:00OFF CAMERA Good. Let’s get you scheduled for an appointment then.

00:11:05SERGEANT Thank you, sir. Sometimes I feel like it’s never going to end. You know I thought I was going to crazy. Sometimes my mind just sinks back into itself, like I can’t see or hear or move. It’s like I’m numb all over. Lose track of time.

00:11:40SymptomMedia Visual Learning for Behavioral Health www.symptommedia.com

00:11:40END TRANSCRIPT

eah. So what do you fear could happen if you talk wit them?

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