http://exhibits.library.stonybrook.edu/mfp/files/original/ebcea7e45e86772f150deb23bfcac163.pdf 3203cda05854588db73e6e12447d1163 PDF Text Text June 16, 1978 Dr. Julian Lieb Yale University School of Medicine New Haven, Uonnecticut Dear Dr. Lieb, Mr. Guillermo Paz was seen at my office was in no distress, presenting his story well. and appeared his stated age of 30. on June 15. He He was neatly dressed principal complaints are emotional instability, depression, tension, working up to 18 hours a day, lack cf concentration, poor memory and inability to enjoy life. The symptoms have been present since early adolescence. At one time, he was classified as suffereing from hypothyroidism and took Cytomel for more than four years until a re-analysis found that he was no longer suffering from hypothyroidism His ' and no longer required the medication. Dr. Paz describes himself as a hard driving and exuberant is in his success rates in reducing death in cardiac resuscitation units, in maintining life for terminal patients and his stated work time of 33,500 hours during the three years of his training. (On calculation, this averages 214 hours a week or worker. His pride 30 hours a day).» His marriage to a pathologist and schoolmate ended recently in divorce, without children. He asserts that his wife failed to understand his drive or to encourage his need for success. has been under medication for a number of years for the of anxiety and tension. The range of compounds is extensive and he asserts that he has taken the medications at the recommended dosages. For the MAOI and diphenylhydantoin, the drugs that might be logically used in his condition, his dosages were adequate for He symptoms trials. principal quation is the suitability of BCT for his condition. In reviewing his symptoms, there is no insomnia, anorexia, weight loss, or dry mouth. Libido has been diminished byt his work activity has been maintained at a high level—- averaging 16-18 hours a day. He is of above average intelligence, critical in his perceptions, and exhibits a low score on the California F Scale (2n). The �"hp—www.— w. I have not received the history and other medical records at this time, the basis for the following recommendations is the history as presented by the patient without verifying documentation. As It is clear that he does not exhibit the principal symptoms of an endogenous depression; rather the syndrome seems more like a personality disorder of the obsessive—compulsive type. For a number of reasons-- the absence of endogenous features, the continued performance at work, the critical thought processes and the low California F Scale; the presence of anxiety and the investment that he has in memory functions, this patient is a poor candidate for HOT. The principal result would be an exaggeration of the memory complaints and no relief of symptoms. Indeed, it is quite likely that he will have more complaints. it While is clear that ECT is not indicated, it is not what clear measures would be more helpful. In talking to him, and reviewing the symptoms, I enquired as to the type of psychotherapy which hashes experienced. Is it possible that he may do better with an approach that follows the rea-ity npfiels used by Sullivanian therapists ? I am struck by his drive and wonder whether his interests could not be harnessed for his welfare by discussions of the immediate problems in living and the realtion these problems have to his attitudes to his family and the expectations that they seem to have for him. » Thank you for the opportunity to see Dr. Paz. If the review of the records alters the recommendation, I will write again. Otherwise, please accept this opinion as definitive. Sincerely yours, ,Max Fink, M.D. Professor of Psychiatry �/"‘%. W 49>” /_ ”W W �fifz/(l WW a WM W' AWE” { W? 7%: W M" WM V :6 ; WMW‘ - 133??" W“ WWW or“? ewcwm ””173". WW Wye/*7 42’» 9 . W” - MW WWW W.M5 if“ Q‘Mx �Appendix Social Attitude Questionnaire (F Scale)* are a number of statements. For each statement we want you to give us your personal opinion of whether you agree or disagree. Answer each statement according to one of the following: Below A / I AGREE A b I AGREE PRETTY MUCH I AGREE VERY MUCH 1 /&/VV-9 LITTLE 1. No I DISAGREE 5? I DISAGREE PRETTY / I I "“ 5 A LITTLE DISAGREE VERY MUCH MUCH . . of hurting a close sane, normal, decent person could ever think 125 friend or relation. 2. Science has its place, but there are many important must always be beyond human understanding. If people 3. off. would talk less and work more, everybody would be better a person has a problem or worry, it is best for him not think about but to keep busy with more cheerful things. 4. 5. tion, When What it, the youth needs most is and the will to work and strict discipline, fight for family 8. The best be done and how teacher or boss is the to go about it. to 21 A {3/ rugged determina- and country. 6. Nowadays when so many different kinds of people mix much, a person has to protect himself especially carefully an infection or disease from them. 7. Sex crimes, such as rape and attack on mere imprisonment; such criminals ought to be / things that é; together so against catching children, deserve more than publicly whipped, or worse. tells one who us exactly what is to 23’ 1/ / 9. Young people sometimes get rebellious ideas, but as they grow up theyé; [ought to get over them and settle down. 10. strong. M0 . . . People can be diVided ten into . . classes: the distinct . * From weak and the ’9 ’////////////, /‘. /1fi}4 Gallagher, Levinson and Erlich (l957). Agreement is scored as +7 (agree very much), +6 (agree pretty much), and +5 (agree a little); +4 for no response or uncertain; +3 (diagreee a little), +2 (disagree pretty much), and +1 (disagree very much). The ten items are summed for a single F—Scale Score Scoring: � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Correspondence Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. 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Title A name given to the resource Correspondence to: Lieb, Julian Type The nature or genre of the resource Text Identifier An unambiguous reference to the resource within a given context mfp-05-00-029-2-069 Date A point or period of time associated with an event in the lifecycle of the resource 1978 Creator An entity primarily responsible for making the resource <a title="Fink, Max, 1923-" href="http://id.loc.gov/authorities/names/n79039548" target="_blank">Fink, Max, 1923-</a> Subject The topic of the resource Correspondence -- Correspondence Relation A related resource The Max Fink Collection Description An account of the resource Rights Information about rights held in and over the resource <a title="IN COPYRIGHT - EDUCATIONAL USE PERMITTED" href="http://rightsstatements.org/vocab/InC-EDU/1.0/" target="_blank">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a> Source A related resource from which the described resource is derived Special Collections and University Archives, University Libraries. 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