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AROLA. ARSON. D. 1J3 TLST S3Ta STRELT NEH YORK2Z. NEW YORE

February 9, 1954

For your information and files I an enclosing a case report which might be of intcrest.

Yours sincercly,

Harold A. Abraso, . D.

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CASE REPORT ON PATIENT JOHIN Q. SUITH

I was called in coasultation to see Mr, Jobn Q. Smith bout ten days after lir. Saith had. received 70 micrograns by outh in a bighly protected situation. r. Snith, although gitated and conccrned over his relationships in work situations, elated very well to his'iriends, to ue, and to coaunity probless n general. It appeared that Lr. Smith had proiound guilt feelngs because he hid been retired as an oiiicer during the last ar and was drawing a pension. His intense feelings of guilt esulted irom rcceiving govcrnmcnt mopey to which he felt that he as not eztitled. These icelings were not clininated by his ealistic undcrstardisg that ho had appeared before a retirenent oard. à stronz fecliag of inade,uacy dominatcd his present work. c felt that he was not doing as Cood a job as he thought ho hould even thounh he was thought well oi by his colleagues and ronotions had coze rcadily. In sevcral hours of intcrvicwing or a period of two days his agitation could not bo directly inked with a psychotic state until he said that his.sleeplcssess' had becn caused by the FBI who had surrcptitiously becn lacing amphetaainc or caffcine in his lood at night to keop in awake. These ieclings of having drugs being placed in his ood had been present ior at lcast five ronths before he had eceived his thorapcutic dose of 70 micrograss. lle also disloscd that he had shown bizarre behavior for aine nonths berore o that his wife thought hc ncedcd cedical attcntion. This lcd. o an outpouring of an intense ccsire on his part to be punished y thc authoritios for his past conduct of taking money fraudlently froa the governzent followipg his retircment by an Army oard.

Subscyucnt discussion with the patient and an accomanying friend led to his agrccing to entering a nental instiution. Difierent hospitals werc discussed. He chose one near is hoze and appaared to be relioved that soze decisiou had cen made to take care of his problems. Accompanied by his riend who shared the same roon vith hin he went to a hotel for he night beciuse the hospital chosen was distant and he could ot be accepted at once.In the aiddlo of the night without ny warning he plunged head-first throuch a beavy glass window hattering it ani fell to his death on the pavcment below.

Information subsequently received revealed that he ad discussed suicide fre,uently during,the previous year and o tho best of my iniorzation had been talked out of suicide wice. In my opinion lr. Smith had been suiiering for sore ine with a paranoid type of depressive psyczosis which, ltbough reluctantly rccognized by his fanils and iriends, had ot rcccivéd adeuate mecical carc. It is ry opinion, also, a vicw of ny expericnce with various anbulatory types or 25iccts. thit this dosaro could hadl n naa