Mentally ill friend, no one to tell.

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Bulldog5454

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I need advice about something:

I was "friends" (more like tolerated) with this guy in undergrad who had a lot of "little problems" -- a girl had accused him of rape, some other girl complained he stalked her, he was going after underage girls as a senior, little situations where they were definitely red flags but because the facts were always so fuzzy,nothing beyond rumors ever amounted. After college he was fired from a job because of similar reasons, but again, because the situations were fuzzy, the company's way of dealing with it was to just get rid of him.

He ended up getting into a low ranked med school in the US and became completely unstable (drugs), doing poorly in his classes first year. For whatever reason, the school ended up letting him retake first year and he saw a doctor who diagnosed him with depression. He took anti-depressants for a while, but then stopped and stopped seeing the doctor.

I guess the reason why I'm writing is, we're both about to start third year (we go to different schools) and every time I talk to this guy, I get this really uncomfortable feeling, like he's someone who in no shape or form should be anywhere near patients in a clinical setting but at the same time, there's really no one for to me to tell. He did okay enough to get to third year, the school doesn't have a problem, his parents are in denial there's anything wrong with him, so I'm the only one who thinks maybe this guy doesn't belong in medical school.

Has anyone ever been in a situation like this before? Do you just hope nothing bad happens to anyone? Should I just ignore it and let it go considering I can't do anything? I mean there's no doubt this guy is mentally ill, but how much does it matter if no one else thinks it's a problem.

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I need advice about something:

I was "friends" (more like tolerated) with this guy in undergrad who had a lot of "little problems" -- a girl had accused him of rape, some other girl complained he stalked her, he was going after underage girls as a senior, little situations where they were definitely red flags but because the facts were always so fuzzy,nothing beyond rumors ever amounted. After college he was fired from a job because of similar reasons, but again, because the situations were fuzzy, the company's way of dealing with it was to just get rid of him.

He ended up getting into a low ranked med school in the US and became completely unstable (drugs), doing poorly in his classes first year. For whatever reason, the school ended up letting him retake first year and he saw a doctor who diagnosed him with depression. He took anti-depressants for a while, but then stopped and stopped seeing the doctor.

I guess the reason why I'm writing is, we're both about to start third year (we go to different schools) and every time I talk to this guy, I get this really uncomfortable feeling, like he's someone who in no shape or form should be anywhere near patients in a clinical setting but at the same time, there's really no one for to me to tell. He did okay enough to get to third year, the school doesn't have a problem, his parents are in denial there's anything wrong with him, so I'm the only one who thinks maybe this guy doesn't belong in medical school.

Has anyone ever been in a situation like this before? Do you just hope nothing bad happens to anyone? Should I just ignore it and let it go considering I can't do anything? I mean there's no doubt this guy is mentally ill, but how much does it matter if no one else thinks it's a problem.

Gotta love the med student "police." This guy is not your responsibility and I have no idea why you think he would be. Never gotten in a car after having a drink or two? Never done anything irresponsible? Worry about yourself, for all you know this guy has grown up and cleaned up his act. You may have good intentions, but this attitude reeks of self-importance considering your current position in the medical hierarchy.
 
Gotta love the med student "police." This guy is not your responsibility and I have no idea why you think he would be. Never gotten in a car after having a drink or two? Never done anything irresponsible? Worry about yourself, for all you know this guy has grown up and cleaned up his act. You may have good intentions, but this attitude reeks of self-importance considering your current position in the medical hierarchy.

Yeah I guess you're right. I wasn't really thinking it was my responsibility or anything like that (like I said, no one to really tell), but it was something that had been bothering me since I saw him last week. He's just a really unstable guy.
 
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Gotta love the med student "police." This guy is not your responsibility and I have no idea why you think he would be. Never gotten in a car after having a drink or two? Never done anything irresponsible? Worry about yourself, for all you know this guy has grown up and cleaned up his act. You may have good intentions, but this attitude reeks of self-importance considering your current position in the medical hierarchy.

What an irresponsible thing to say. How will the OP feel if this guy does something inappropriate to a patient? Being accused of rape and sexual harassment multiple times (yes all alleged so who's to say) is not something to just brush off. He will be dealing with many female patients and children and if you get a creepy vibe from this guy you can't just ignore that. It's your responsibility not just as a future doctor, but just a decent human being to at least CARE. What you actually do, yeah that is up for debate. Who do you tell if you tell anyone?

Maybe you can send an anonymous note to his school, director, IDK but to someone. They can't outright accuse him or kick him out of course, that would not be fair. But once you plant that seed in their head, they will hopefully keep an eye out for any inappropriate behavior. If someone is at least looking, maybe he can be nipped in the bud before he does something bad.
 
What an irresponsible thing to say. How will the OP feel if this guy does something inappropriate to a patient? Being accused of rape and sexual harassment multiple times (yes all alleged so who's to say) is not something to just brush off. He will be dealing with many female patients and children and if you get a creepy vibe from this guy you can't just ignore that. It's your responsibility not just as a future doctor, but just a decent human being to at least CARE. What you actually do, yeah that is up for debate. Who do you tell if you tell anyone?

Maybe you can send an anonymous note to his school, director, IDK but to someone. They can't outright accuse him or kick him out of course, that would not be fair. But once you plant that seed in their head, they will hopefully keep an eye out for any inappropriate behavior. If someone is at least looking, maybe he can be nipped in the bud before he does something bad.

There was a girl at my school during M1 who tried to get 2 people kicked out for smoking MJ (during a period with no patient contact). There were people who cheated in undergrad. Where do you draw the line?

If the person in question has sexually assaulted someone, yes that is a huge problem and they should not be a doctor. The problem here is that without evidence, you can't really do anything. Someone could simply drum up a story. The school cannot take unfounded accusations seriously or there would be all kinds of problems (pissed off exes, etc).

If this person puts out a creepy vibe, it won't go unnoticed. Attendings and residents aren't stupid and their opinion matters more than some random guy calling in who could very well be pissed off about something else entirely.
 
He's going to be in contact with lots and lots of health care professionals and patients in the upcoming year. If he's truly unfit to be a doctor I'm sure someone out there will notice and do something about it. Quite honestly, if he made it through the first 2 years and is able to get to graduation under all these watchful eyes--and YOU are the only one who feels this way about him--you may want to consider that your perception of him may be skewed. People do change between undergrad and med school (and TECHNICALLY you don't really know if he ever did anything wrong before med school... they were all rumors, right?)
 
He's going to be in contact with lots and lots of health care professionals and patients in the upcoming year. If he's truly unfit to be a doctor I'm sure someone out there will notice and do something about it. Quite honestly, if he made it through the first 2 years and is able to get to graduation under all these watchful eyes--and YOU are the only one who feels this way about him--you may want to consider that your perception of him may be skewed. People do change between undergrad and med school (and TECHNICALLY you don't really know if he ever did anything wrong before med school... they were all rumors, right?)

I'm going to strongly disagree with this from personal experience, and then I'm going to send the OP a private message with more info. But what I will say publicly is that if you have legitimate concerns about a student, it is absolutely worthwhile to share them. You'd be surprised by how a person can get through med school in spite of serious problems that prevent him from functioning as a resident--and it's much better to get kicked out of or decide to leave med school than it is to get kicked out of residency.
 
I need advice about something:

I was "friends" (more like tolerated) with this guy in undergrad who had a lot of "little problems" -- a girl had accused him of rape, some other girl complained he stalked her, he was going after underage girls as a senior, little situations where they were definitely red flags but because the facts were always so fuzzy,nothing beyond rumors ever amounted. After college he was fired from a job because of similar reasons, but again, because the situations were fuzzy, the company's way of dealing with it was to just get rid of him.

He ended up getting into a low ranked med school in the US and became completely unstable (drugs), doing poorly in his classes first year. For whatever reason, the school ended up letting him retake first year and he saw a doctor who diagnosed him with depression. He took anti-depressants for a while, but then stopped and stopped seeing the doctor.

I guess the reason why I'm writing is, we're both about to start third year (we go to different schools) and every time I talk to this guy, I get this really uncomfortable feeling, like he's someone who in no shape or form should be anywhere near patients in a clinical setting but at the same time, there's really no one for to me to tell. He did okay enough to get to third year, the school doesn't have a problem, his parents are in denial there's anything wrong with him, so I'm the only one who thinks maybe this guy doesn't belong in medical school.

Has anyone ever been in a situation like this before? Do you just hope nothing bad happens to anyone? Should I just ignore it and let it go considering I can't do anything? I mean there's no doubt this guy is mentally ill, but how much does it matter if no one else thinks it's a problem.

These are some pretty heavy conclusions to draw.

Also, be careful when drawing conclusions based on rumors and speculation. You are not trained to medically diagnose someone yet (mental illness accusations can have some pretty heavy consequences for someone). Honestly, the accusations could be false and unfounded.

This is not to say that your conclusions are unfounded and your viewpoint unsubstantiated.

If you really feel the need to report him, do so. But really make sure you have specific evidence to back up what you are saying (evidence is not just saying "he gives me a creepy vibe." Evidence would be something like showing up drunk for clinicals, purchasing a gun and speaking of killing people or himself, illegal sexual/romantic activity, clear criminal activity) and how he is in danger of causing harm to patients, coworkers, students, family members, or himself. Think about if this is something about which you would call law enforcement and not just the school.

As a third year medical student, he will be supervised pretty extensively. If problems are noted, he will be refered for further evaluation, and the medical school will take action. The medical school is fully aware of his previous class performance (or I should hope so), and is really going to be the judge of his fit for duty and career (or at least giving him his diploma).

Also, not to be harsh, but why did you feel the need to include your opinion on the ranking of your friend's medical school? He can get an MD or DO degree and become qualified to practice medicine regardless of school rank. Does it really matter what school he attends?
 
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There was a girl at my school during M1 who tried to get 2 people kicked out for smoking MJ (during a period with no patient contact). There were people who cheated in undergrad. Where do you draw the line?

If the person in question has sexually assaulted someone, yes that is a huge problem and they should not be a doctor. The problem here is that without evidence, you can't really do anything. Someone could simply drum up a story. The school cannot take unfounded accusations seriously or there would be all kinds of problems (pissed off exes, etc).

If this person puts out a creepy vibe, it won't go unnoticed. Attendings and residents aren't stupid and their opinion matters more than some random guy calling in who could very well be pissed off about something else entirely.

I agree.
 
These are some pretty heavy conclusions to draw.

Also, be careful when drawing conclusions based on rumors and speculation. Also, you are not trained to medically diagnose someone yet (mental illness accusations can have some pretty heavy consequences for someone). Honestly, the accusations could be false and unfounded.

If you really feel the need to report him, do so. But really make sure you have evidence to back up what you are saying.

As a third year medical student, he will be supervised pretty extensively. If problems are noted, he will be refered for further evaluation, and the medical school will take action. The medical school is fully aware of his previous class performance (or I should hope so), and is really going to be the judge of his fit for duty and career.

Also, not to be harsh, but why did you feel the need to include your opinion on the ranking of your friend's medical school? He can get an MD or DO degree and become qualified to practice medicine regardless of school rank. Does it really matter what school he attends?


It's hard for me to respond to some of this because if I give more detail, it would be obvious if he ever found this thread that I was talking about him but the rumors weren't all rumors. There was a pattern of behavior.

He was diagnosed by a physician as having a mental illness.

I was not planning on reporting him or anything like that, I mean what could I report really. I was just feeling very uncomfortable since I saw him last week and wondered if anyone else had been in a similar situation.

As for mentioning the rank of his school, I wondered if the motives of his school for letting him continue had more to do with money than not. I guess that might not be unique to his school and I honestly wasn't trying to bring up rankings to be snide (and I apologize if it came across that way).
 
It's hard for me to respond to some of this because if I give more detail, it would be obvious if he ever found this thread that I was talking about him but the rumors weren't all rumors. There was a pattern of behavior.

He was diagnosed by a physician as having a mental illness.

I was not planning on reporting him or anything like that, I mean what could I report really. I was just feeling very uncomfortable since I saw him last week and wondered if anyone else had been in a similar situation.

As for mentioning the rank of his school, I wondered if the motives of his school for letting him continue had more to do with money than not. I guess that might not be unique to his school and I honestly wasn't trying to bring up rankings to be snide (and I apologize if it came across that way).

I understand. Still, be careful and objective when evaluating your feelings of this person (which is tough to do). Assess why you feel the way you do.

Also, his health information is legally protected by HIPPA. There are instances where it can be released without patient consent. However, it is up to the provider to do so.

Just because you don't necessarily like someone doesn't mean they are not qualifed for the profession.

Like I said above, if you have evidence of how he is causing harm to someone or himself, engaging in harmful illegal activity, or something along those lines, by all means report him. If you just feel this way because you don't like him, forget about it and move on.

As for the school allowing him to repeat for money, let me put some things into perspective. The costs of him harming a patient, coworker, fellow student, and so on are far higher (think millions in liability) than $40K in tuition money. Not to mention the bad press and other possible reprecussions (remember Philip Markoff).

Also, rank has nothing to do with the money grubbing attidude of a medical school. Higher rank medical schools are equally likely to be this way as a lower ranked school.
 
Wow mind your own business please. I totally agree with medstudent1968 about being a pretentious medical student holier-than-thou wannabe cop.

[YOUTUBE]http://www.youtube.com/watch?v=CtwJvgPJ9xw[/YOUTUBE]
 
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With all due respect, sending an anonymous note to this guy's medical school about how he is "unfit" seems incredibly "toolish." Most of your argument against him is based upon rumors. You yourself said that facts were fuzzy. I cannot count the number of times someone has told me something awful about another person that turned out to be untrue. He took drugs, did poorly his first year, was diagnosed with depression, and is now off of medication. Maybe he has turned his life around? He's a third year now. It is not your job to judge him as unfit to practice because you get a "feeling" when you talk to him. Plenty of med students were creeps. Some made great doctors. Some didn't. It's best not to police and attempt to remove these students on your own.

If you really don't like this guy (it sounds like you don't) and think he's mentally ill, just leave him be. Let the natural selection process work its magic.
 
What's your problem?

It seems like you're the one with the issues, OP.

Why don't you mind your own business? It sounds like you talk to this guy regularly--you seem to know quite a bit about him, and apparently know this person well enough to know his parents. And yet here you are, ostensibly gathering information on this person so you can make a thread about it on SDN and consider "reporting" him over what you yourself admit are rumors?
 
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Depending on your state, an intermediate option is to report the person anonymously to an impaired physicians organisation. They'll evaluate him independently and determine if he needs monitors for a drug problem if medication for unstable depression/bipolar. Technically these organizations really only have legal authority over a licensed physician, but they can often intimidate someone into being monitored as a medical student.

That being said, these organizations can haunt someone. They can tie your ability to be licensed to your agreement to take psychiatric medications. Its not something to refer to lightly. Bad rumors and a creepy vibe are not sufficient reason to refer. You need to really KNOW that this person is a danger to themselves or others.

Contacting his school to get him removed from, clinical duties is nit only inappropriate, it nay leave you legally vulnerable. There are laws around impaired physician organizations that protects anyone who reports to them. On the other hand if you simply call someones boss and talk about how they're unfit it can be slander.
 
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What's your problem?

It seems like you're the one with the issues, OP.

Why don't you mind your own business? It sounds like you talk to this guy regularly--you seem to know quite a bit about him, and apparently know this person well enough to know his parents. And yet here you are, ostensibly gathering information on this person so you can make a thread about it on SDN and consider "reporting" him over what you yourself admit are rumors?

As I had clarified to another poster, I wasn't considering reporting him and was more wondering if anyone else had come across a similar type of person in medical school. As for collecting information and knowing a bit about him, he readily volunteered this information to me and was just noticing a pattern of behavior.

Unfortunately, the stuff wasn't all rumors which I had clarified in another comment. I can't go into too much detail because it would reveal identifying details.
 
What's your problem?

It seems like you're the one with the issues, OP.

Why don't you mind your own business? It sounds like you talk to this guy regularly--you seem to know quite a bit about him, and apparently know this person well enough to know his parents. And yet here you are, ostensibly gathering information on this person so you can make a thread about it on SDN and consider "reporting" him over what you yourself admit are rumors?

As for having a problem or issues --

I honestly would have never posted if this guy had sobered up and gotten his life together and I don't know why people would think I would. I don't dislike or like this guy or am out to ruin his life and I thought I had made that clear by the "no one to tell" part of my first post. When I saw him last week, he was still acting erratic and I left feeling uncomfortable with the situation, mostly because I wondered if he was going to a different medical school, if he would have gotten this far. But people are right, there's nothing I can do and someone else has to make judgement calls about him being fit as a physician so I need to just forget about it.
 
This. Don't assume that just because someone gets into or through medical school that they must not have serious issues. Impaired physicians organizations exist for a reason. Take a look at state medical board sites that list board disciplinary actions for physicians and you'll be surprised by some of the things supposedly educated and high functioning individuals do, as well as how long some of them are able to do it, before they get stopped. It's really quite disturbing.

At the same time, I don't really have any idea what someone would do in this situation as there are too few details the OP is able to give. Also, perhaps someone already is keeping an eye on this guy and you just don't know about it.



I'm going to strongly disagree with this from personal experience, and then I'm going to send the OP a private message with more info. But what I will say publicly is that if you have legitimate concerns about a student, it is absolutely worthwhile to share them. You'd be surprised by how a person can get through med school in spite of serious problems that prevent him from functioning as a resident--and it's much better to get kicked out of or decide to leave med school than it is to get kicked out of residency.
 
This. Don't assume that just because someone gets into or through medical school that they must not have serious issues. Impaired physicians organizations exist for a reason. Take a look at state medical board sites that list board disciplinary actions for physicians and you'll be surprised by some of the things supposedly educated and high functioning individuals do, as well as how long some of them are able to do it, before they get stopped. It's really quite disturbing.

At the same time, I don't really have any idea what someone would do in this situation as there are too few details the OP is able to give. Also, perhaps someone already is keeping an eye on this guy and you just don't know about it.

I don't think anyone here is saying that his concerns may not have merit, and we agree that there is a need to remove physicians whose behavior, actions, and health may prevent them from functioning as a physician and compromise patient safety.

If he knew something about his friend that could cause him or another person harm, yes, the person should be reported (most appropriatly to law enforcement or the student's Dean of Student Affairs or something like that). But as far as judging suitability for the profession, the OP is not in that position yet. The chances are quite good that the school is aware of this student's issues (academic and personal) and will act if necessary.
 
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He's going to be in contact with lots and lots of health care professionals and patients in the upcoming year. If he's truly unfit to be a doctor I'm sure someone out there will notice and do something about it. Quite honestly, if he made it through the first 2 years and is able to get to graduation under all these watchful eyes--and YOU are the only one who feels this way about him--you may want to consider that your perception of him may be skewed. People do change between undergrad and med school (and TECHNICALLY you don't really know if he ever did anything wrong before med school... they were all rumors, right?)

I have to strongly disagree with this as well. There are very high rates of drug addiction among physicians and numerous stories of things going on and on as people let single events slide. In fact, the whole idea concept of a residency program was started at Hopkins because Halsted as chief of surgery was so addicted to opiates and cocaine, that he couldn't reliably take care of patients on his own.

In clerkships, the student will rotate through several different services, and all may pass him noting only minor issues seeing only a tiny slice of his behavior, although, admittedly there will be much more contact with clinical staff than in the preclinical years. I know a couple med students at my medical school who went through the preclinical years with relatively little contact with the teaching staff or other students.

You may have good intentions, but this attitude reeks of self-importance considering your current position in the medical hierarchy.

The hierarchy and conservatism is often what prevents people from acting when someone in the medical profession is doing something that puts his or her patients at risk.

Also, perhaps someone already is keeping an eye on this guy and you just don't know about it.

One of the first things that they teach in community first aid is that the most dangerous place to have a medical emergency is often in a crowd. Everyone assumes it is someone else's problem. The Kitty Genovese story is the most classic example.

If you watch the news at all, the Jerry Sandusky is an excellent example of how institutions can tolerate and essentially ignore egregious behavior.

In terms of what actions you might take, why not talk to one of the attendings at your school? The person who taught your medical ethics material? Someone in pscyh who knows about substance abuse? I don't know about your school, but we definitely have people around who are sympathetic listeners and know about things like the impaired physicians organization in the state, have known or seen drug addicted medical students and physicians in the past, etc. As long as you approach is as an honest interest in trying to help your peer and make sure no one gets hurt, it is likely to be received well.

Depending on your state, an intermediate option is to report the person anonymously to an impaired physicians organisation. They'll evaluate him independently and determine if he needs monitors for a drug problem if medication for unstable depression/bipolar. Technically these organizations really only have legal authority over a licensed physician, but they can often intimidate someone into being monitored as a medical student.

Residents are my hospital/school definitely get drug tested, and if they are suspected of drug abuse can get drug tested all the time. Which sucks for them, but is not really a big deal. If they are not using drugs, then it is just incovenient. I don't know about medical students, but drug testing would at least clear up ambiguity on that account. Maybe start with the concern about erratic behavior, history of instability and suspected drug use. The sexual misconduct is more hear say, but the erratic behavior and suspected drug use are something that you are observing directly. If he is not using drugs, but is mentally unstable to a level that would be dangerous to patients, it puts him on "the radar".

Anyway, it's just an opinion, but I feel like you are doing the right thing by trying to figure out how to bring attention to what you perceive is a problem.
 
What's with all the attitude toward the OP? He doesn't seem like he's being a douce, he just seems legitimately concerned. There is a big difference between someone smoking weed when they get home or even cheating on a test (not cool but i mean i'm not gonna get involved in int that) and raping someone! Jesus. It's a big concerning how quick everyone here is to brush this off as "mind your own business." As the poster above me said, I suppose that's what all of Penn State did with Sandusky right? I'm not being holier than though, I'm just saying give the guy a break for caring.
 
What's with all the attitude toward the OP? He doesn't seem like he's being a douce, he just seems legitimately concerned. There is a big difference between someone smoking weed when they get home or even cheating on a test (not cool but i mean i'm not gonna get involved in int that) and raping someone! Jesus. It's a big concerning how quick everyone here is to brush this off as "mind your own business." As the poster above me said, I suppose that's what all of Penn State did with Sandusky right? I'm not being holier than though, I'm just saying give the guy a break for caring.

Different situations. The OP's role is much different.

No one is telling him to hide illegal activity or help his friend cover up a crime. If the OP was Mike McQuery and the friend were Jerry Sandusky, I think everyone on here would encourage the OP to go to the police.

The consensus appears to be that the OP needs to have some more evidence of physician imapirment other than rumors at this point.
 
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I admire your courage, but to echo what others have said -- you need more evidence than simply hearsay (even if your friend in question has admitted to these events). It's doubtful that he has depression, probably just a misdiagnosed antisocial personality disorder.

If you feel that he is still doing drugs, then send an anonymous e-mail to the school informing them of such and requesting that he be tested. At my school, we are required to do periodic tox screens but I guess this is not universal as evidenced by some of the replies in this thread.

Believe me, I understand your frustration. I have a fellow student that I'm convinced is a pedophile, and he is in the process of applying to Pediatrics. I have no concrete proof so I keep my mouth shut and pray that that PDs ae able to pick up on the "creepy" factor (despite his extremely high Step 1, class rank, etc.). :scared:

Medical school and hospitals are a virtual stew of psychiatric conditions, unfortunately.
 
I admire your courage, but to echo what others have said -- you need more evidence than simply hearsay (even if your friend in question has admitted to these events). It's doubtful that he has depression, probably just a misdiagnosed antisocial personality disorder.

If you feel that he is still doing drugs, then send an anonymous e-mail to the school informing them of such and requesting that he be tested. At my school, we are required to do periodic tox screens but I guess this is not universal as evidenced by some of the replies in this thread.

Believe me, I understand your frustration. I have a fellow student that I'm convinced is a pedophile, and he is in the process of applying to Pediatrics. I have no concrete proof so I keep my mouth shut and pray that that PDs ae able to pick up on the "creepy" factor (despite his extremely high Step 1, class rank, etc.). :scared:

Medical school and hospitals are a virtual stew of psychiatric conditions, unfortunately.

I don't think my friend has "true" depression either. His doctor at one time threw out some terms like "impulse control problems" and "difficulties with boundaries", but then because he had some element of depression/lack of motivation, everyone focused on that because it was an easy fix. I think he has borderline personality disorder, which I think is what plays out in his very messed up male-female interactions (re stalking, obsession, idealizing high school girls, etc).

The thing is, I know everyone is right in that I can't do anything and I really wasn't planning on it. I don't even go to school with the guy but it's just this very uncomfortable feeling with the entire situation knowing how long he's been acting this way.
 
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