Name: Harold Brown Gender: male Age:60 years old T- 98.8 P- 74

Name: Harold Brown

Gender: male

Age:60 years old

T- 98.8 P- 74 R 18 134/70 Ht 5’10 Wt 170lbs

Background:

Has bachelor’s degree in engineering. He dates casually, never married, no children. Has one

younger brother. Sleeps 7 hours, appetite good. Denied legal issues; MOCA 28/30 difficulty with

attention and delayed recall; ASRS-5 21/24; denied hx of drug use; enjoys one scotch drink on

the weekends with a cigar. Allergies Dilaudid; history HTN blood pressure controlled with

Cozaar 100mg daily, angina prescribed ASA 81mg po daily, valsartan 80mg daily.

Hypertriglyceridemia prescribed fenofibrate 160mg daily, has BPH prescribed tamsulosin 0.4mg

po bedtime.

VIDEO TRANSCRIPT of the case study

00:00:00

[sil.]

00:00:15

OFF CAMERA So, you told your supervisor you were having difficulty with concentration, and then it was your supervisor who set up this appointment, right, is it?

00:00:25

HAROLD Yeah, I, I work at this large architectural engineering firm and it’s all great. Except, they’ve accelerated the deadlines now and it just puts a lot of pressure on. And I, I just can’t concentrate. I mean, everyone else is, doesn’t have a problem with it. But, but I just, I just can’t seem to be able to do the same job they’re doing.

00:00:50

OFF CAMERA Okay, tell me about your problem with concentration.

00:00:55

HAROLD Well, um, you know it’s just… Perfect example is, is they wanted me to design um, air ducts.

00:01:05

OFF CAMERA Right.

00:01:05

HAROLD Air ducts, simple. But I designed them through solid wall, a fire wall, and a supporting wall and I didn’t even realize what I was doing.

00:01:15

OFF CAMERA Uh-huh.

00:01:15

HAROLD You know, I mean, um, I’m making silly mistakes like that because, another time we had these windows, we already bought them, design, beautiful, they’re going to be in this entire building.

00:01:30

OFF CAMERA Right.

00:01:30

HAROLD Every floor. Well, I drew the window opening way too small. Now, I mean, if that would have gone ahead, it would have cost millions. I just, it’s, it’s just silly things like that.

00:01:45

OFF CAMERA Uh-huh, is this a new kind of problem for you?

00:01:45

HAROLD Well, I mean, I didn’t seem to have a problem when everything was relaxed, and the deadlines were normal.

00:01:50

OFF CAMERA Right.

00:01:55

HAROLD I could do the job. Everything was fine. But now we’re on these, these ridiculously tight deadlines and, and I just, can’t seem to do it. Everyone else can. It’s, there’s not a problem for them. And I end up like I’m not pulling my weight.

00:02:10

OFF CAMERA Uh-huh.

00:02:10

HAROLD And they think that and it’s true, I’m not.

00:02:10

OFF CAMERA Now did you have these, uh, similar kind of problems back in school?

00:02:15

HAROLD Well, yeah, I mean, in school everyone would go to the library to cram for big exams, so, I mean.

00:02:20

OFF CAMERA Right.

00:02:20

HAROLD That was a normal thing. And, yeah, I’d go but I’d end up looking out the window. Look it’s snowing, oh, it’s spring time. I’ll go for a walk. And, and if someone is whispering in a library well, I have to go to the other side. All my friends could study anywhere.

00:02:35

OFF CAMERA Uh-huh, but, what other kind of difficulties do you seem to have?

00:02:40

HAROLD Well, at the job we have, these uh, lectures, you know.

00:02:45

OFF CAMERA Right.

00:02:45

HAROLD We’d get together, it’s groups. This is the lectures by the chief of the department gets together with all the architects and engineers and he talks about the mission of the day. What we’re trying to work for, our goals.

00:02:55

OFF CAMERA Right.

00:03:00

HAROLD Do I listen? I’m thinking, maybe, my dog needs a bath. Or what am I going to have for lunch? Or, you know, anything other than what he’s saying.

00:03:05

OFF CAMERA Mm-hmm.

00:03:10

HAROLD And because of that, you know, it’s not a good idea.

00:03:15

OFF CAMERA So, so, is it difficult to sit and listen?

00:03:20

HAROLD Yeah, I mean, okay, we were suppose to be designing this other, on top of this penthouse, this, kind of, a patio, party area.

00:03:30

OFF CAMERA Right.

00:03:30

HAROLD And the gutters around it just to make sure everything was very comfortable for everyone. Well, I got up there and I’m designing and the gutters are here, and no, wait a minute, there’s Italian, tile floor. Doesn’t look like it’s tilted the correct way. So I started studying that and there were already two people assigned to study that. To fix that problem, not me.

00:03:50

OFF CAMERA Mm-hmm.

00:03:55

HAROLD I got in a lot of trouble for that one.

00:03:55

OFF CAMERA Do you have any problems organizing?

00:04:00

HAROLD At home or the office?

00:04:00

OFF CAMERA Uh, either.

00:04:05

HAROLD I’m a bit of a mess. I mean, and I’m messy. I will forget my shoes, my socks, my phone, my jacket, I, I can’t find them. I’m not that organized. And I have a calendar. One of my coworkers, actually bought me a calendar to motivate me.

00:04:20

OFF CAMERA Yeah.

00:04:25

HAROLD To get more organized. So, I started writing down all the important dates and events, but then do I ever look at that calendar? No, I don’t. So, it’s a complete waste of time.

00:04:35

OFF CAMERA What about problems paying bills?

00:04:40

HAROLD Bills, I mean, yeah they get paid. After two or three times of the threatening calls or letters. And then I have to pay the penalties.

00:04:50

OFF CAMERA Hmm, what about hyperactivity?

00:04:50

HAROLD You know, I mean, I’m, sometimes I’m a little more uncomfortable in a chair or you know. But I don’t think that’s that big a deal. I mean, I used to be a lot worse. I mean, uh, there was a time when I was in school, I would get marked down for citizenship because I never raised my hand and I talked out of class and, and I just, couldn’t seem to stay focused. But I’m a lot better now.

00:05:20

OFF CAMERA Mm-hmm, were you ever um, treated with medications or behavioral therapies for ADHD?

00:05:25

HAROLD No, no. My mother threatened that one time, but I was never evaluated. Never went, uh, I’m kind of amazed she never just dragged me into a doctor’s office, but she never did.

00:05:40

OFF CAMERA Do you drink any caffeinated drinks?

00:05:45

HAROLD Coffee, soda, you know, once in a while. But when I was a kid, my mother said no caffeine, no sugar, cause you’ll climb the walls. I was already doing it anyway and so she, I uh, once and a while I’ll have a little caffeine now and it kind of helps me focus a little but, sugar, I stay away from that. It’s just not a good idea.

00:06:05

END TRANSCRIPT