Chapter Text
The nurse enters the office.
The patient, Park Jimin, 18 year old male, is seated on the opposite side of the table, his back i to the wall and facing forward. His right leg is in a cast that disappears beneath his green hospital pajama pants. He’s seated in a wheelchair and a pair of crutches is propped against the wall behind him.
- Appearance
- He looks young for his age. His face is youthful but tired. His facial structure suggests he once had chubby cheeks, but now appears gaunt and hollow. His hair is a natural black and he has soft, expressive dark brown eyes.
- Asian - Korean.
- Dressed in hospital pajamas. His pants are too large because of his cast but the shirt hangs off his frame as well. He wears one black converse low top on his right foot. Age appropriate, weather appropriate, occasion N/A.
- He wears thick framed black glasses, small hoop earrings, one in each ear. Style is casual; glasses look clean and in good shape, no obvious scratches. Earrings are simple but do not appear either cheap or expensive.
- No body odor, alcohol, stool/urine, ketosis or perfume present.
- Patient appears a bit sweaty but no odor suggests a single event. Does not appear dirty. He is clean shaven and his hair while not styled appears relatively neat and clean. His nails appear bitten short and the cuticles on right hand look damaged; impression is bitten. Otherwise nails and hands are clean.
- Patient is wearing baggy clothing that hangs off his frame. His shoulders present as bony through his shirt and his wrists look small. Patient appears very thin and malnourished based on his stature, face and frame of his shoulders.
- Speech
- Normal amount; responsive to questions but sounds nervous.
- Somewhat rapid to begin with - appears anxious.
- Clear speech.
- Soft volume.
- Not lively or animated, sounds exhausted.
- Stammering, sounds nervous.
- No swearing or slang picked up; sounds relatively professional and intelligent.
- Appears pressured.
- Motor Behaviour
- Using crutches - has mastered the technique but his body seems to be struggling due to lack of strength. Moves slowly.
- A bit restless but otherwise calm, not agitated, appears tired.
- Posture is good though head is dropped. Although he appears tired, his shoulders are back and his back is straight. His hands are folded in his lap. Appears almost elegant.
- Grimaces slightly, picks at his fingernails and pads of his fingers anxiously.
- Presenting behaviour and interaction during interview
- Maintains eye contact until asked questions that make him uncomfortable, such as questions about body image and eating. Eyes drop to the floor. Appears focused but sullen. No notes of suspicion.
- Body language appears anxious but no strange movements.
- Remains in his own space.
- Facial expression appears sad, tired, engaged but depressed. Gets tearful when talking about his injury or his best friend.
- Cooperative, appears that he wants to please but is still hesitant to reveal certain things. Offers information that would make him appear healthy, but struggles with questions about body image/food. Seems ashamed. Not evasive but a bit guarded.
Interview:
Hi Jimin, welcome to the unit for mental health. My name is Jill and I’ll be your nurse today.
Hi Jill .
I’m just going to start by asking you some questions to get to know you and get an idea of where your mental status is currently at, then I’ll show you your room and introduce you to the unit. Sound good?
Sure.
Jimin, can you tell me what brought you into the hospital today?
I broke my leg.
I see that. How did this happen?
I was dancing.
You broke your leg while dancing. Did you fall?
Yes.
Do you know what caused you to fall?
No. I guess I just lost my balance maybe.
Has this happened before?
Falling? Yes. I dance a lot.
Have you hurt yourself dancing before?
Yes.
What happened?
I’ve fallen before. I broke my ankle once and my arm another time.
How long ago was this?
Arm four years ago, ankle about a year and a half.
Did you sustain any other injuries when you fell today?
No.
What happened after you fell?
I- I don’t really remember. It’s kind of a blur now.
How did you get to the hospital?
My best friend brought me.
What’s your friend’s name?
Hoseok. Jung Hoseok.
You sound nervous, Jimin. Is something about me making you nervous?
No. I’m just… anxious, I guess.
I see you’re picking at your fingertips. Is this something you do often?
*nods* when I’m anxious, yeah.
What is making you anxious right now?
Being here? I’ve never been to a psych ward before.
Mental health, Jimin. It’s a mental health unit. We’re here to help you get better.
I didn’t agree to stay.
I know. But the doctor thinks you’ll be safer here with us for a little while. Do your parents know you’re here?
No.
Why not?
My mom died when I was a kid and my dad works out of the country.
I see, so you live by yourself?
Yes.
Do you have a job or go to school?
I work as a dance instructor.
Does that cover your living expenses?
My dad pays the bills. I just pay for food and other things I need on a daily basis.
Do you spend a lot of time alone?
Sometimes? I spend a lot of time with my best friend. We dance together and teach together.
I see. He must be worried about you.
He is...
Would you say he’s your strongest social support?
Yes. Though he shouldn’t have to be. I stress him out a lot. He should just leave me alone.
What makes you say that?
Life would be easier for him without me.
What kind of self care regimens do you have in place?
What do you mean?
How do you take care of yourself physically? Your appearance?
I shower every day? Is that what you mean?
Yes, what else?
I do my hair? I use skin care products, makeup sometimes.
You look tired but your posture is still very strong, would you say this is normal for you?
I’m a dancer. We’re taught to always be aware of our posture.
Do you feel tired?
It’s been a long day…
Can you tell me more about your admission? You came to the hospital for your leg injury, but what brought you to this unit.
They told me I had to stay.
Did they tell you why?
Because I have an eating disorder… and apparently I’m depressed.
Tell me about your eating disorder.
What’s to tell? I don’t eat very often.
Why don’t you eat?
Because I’m overweight.
Did someone tell you that?
No.
What makes you think that you’re fat?
I can see it when I look in the mirror. No matter how little I eat I’m still fat.
So you’ve been starving yourself?
Yes.
For how long?
Few years? On and off…
Do you ever make yourself throw up?
Sometimes, if I have to eat.
In what situation would you have to eat?
When I’m with friends.
Do they tell you to eat?
Sort of. But I don’t want them to worry.
Do your friends know about your problem with food?
Hoseok, my best friend knows.
Did you tell him?
He told me I lost weight and asked if I’d been eating. I told him I was on a diet.
What did he say to that?
That I shouldn’t diet because I’m already thin. He’s just being nice though.
Does your weight fluctuate a lot?
Yes.
What was the most you weighed recently?
I went up to 150 pounds a couple of months ago.
Were you eating well then?
I guess?
And then what happened?
I committed to a new diet.
And how much weight did you lose?
About 45 pounds.
Did you feel better after losing that much weight?
Yes, but it was never enough. It doesn’t matter how much weight I lose, I still feel large.
Does that make you feel hopeless?
Yes.
Would you say you’re depressed?
Maybe? I feel frustrated and sad a lot.
Are you suicidal?
I don’t know.
So you’ve had thoughts about killing yourself?
Yes.
How recently have you had these feelings?
I thought about it while I was lying in the emergency room.
What about being there made you have those feelings?
My injury. It means I can’t dance.
You love dancing, hey?
I do. It’s my one passion - the thing that makes me happiest in life. But it’s more than that. If I can’t exercise I’m going to get fatter .
So you’re worried that because you can’t dance, you’re going to gain weight?
Yes. I know I will.
Had you had suicidal feelings before today?
Yes.
How often?
Um, it’s becoming more and more often. Maybe once a week?
Have you thought about how you might do it if you decided to kill yourself?
Not really. Maybe pills would be the easiest. But I think a lot of people fail that way.
Have you thought of when you might do it?
No.
So you don’t have a plan in place?
No. I always thought if I did it, it would be spontaneous.
Does that scare you?
Not really. I don’t feel like I have a lot to live for.
Are you currently feeling suicidal?
*shrugs* not particularly strong feelings either way.
Have you ever intentionally harmed yourself?
Yes.
Can you tell me about it?
I used to cut when I was younger. I haven’t done it a lot recently because I always have short sleeves on. If anything I’ll punch walls when I get upset.
Would you say you feel like you’re losing control?
Yes.
And does hurting yourself make you feel like you’ve regained some of that control?
Yes.
Do you ever let anyone see your injuries when you hurt yourself?
No.
Do you ever have feelings of injuring others?
No.
Do you ever see or hear things others can’t?
No.
What’s your best friend’s name?
You already asked me that.
I’m assessing your memory.
Jung Hoseok.
What’s my name?
Jill.
Good. Is there anything else that concerns you that I haven’t touched on?
I don’t think so?
Ok. I’ll show you to the unit and we’ll get you settled into your bed.