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Hallowsgate Hospital,
1507 Slaughters Creek,
Cabin Creek, WV



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Ambrose Delaine-Smith

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Ambrose Delaine-Smith Empty Ambrose Delaine-Smith

Post  Ambrose Delaine-Smith on Thu Sep 16, 2010 10:13 pm

Ambrose Delaine-Smith 2ymj6ok

-Delaine-Smith, Ambrose Bartholomew-

Ambrose Delaine-Smith Vwpyec

    Date of Birth: 02/23/1992
    Age: 18
    Gender: Male
    Address: 510 Cathedral Street, Baltimore, MD 21201
    Physical Appearance:
    Height (Approx): 5'9
    Weight (Approx): 125
    Ethnicity: Caucasian
    Hair Colour: Dark Brown
    Eye Colour: Brown/Amber
    Distinguishing Marks: Numerous recent scars and injuries consistent with assault to later be explained.

-Medical History-

Do you suffer from any ongoing medical conditions such as heart conditions, diabetes, asthma or other long-term physical disabilities, diseases or afflictions?


Do you have any allergies to foods, inhalants or medications? Please list allergies and age of onset below.

Latex: Age of onset pre-teen.
Codeine: Age of onset Adolescence.

Does your family have a history of any ongoing medical conditions such as heart conditions, diabetes, asthma or other long-term physical disabilities, diseases or afflictions?


-Psychological History-

Do you, or have you ever suffered from a mental affliction, or do you feel that you have problems with your state of mind? Examples could be anxiety, depression, seeing or hearing things that are not there, suffering from uncontrollable impulses, or entertaining damaging thoughts such as wanting to harm/kill oneself or do something damaging to another person. Have you ever abused controlled substances, alcohol, or prescription medications?

I am the attending psychiatrist for Union Memorial Hospital, in Baltimore Maryland. Mr. Delaine-Smith was brought in to our Emergency Room just over a week ago, suffering from dehydration, exhaustion, malnutrition, and a number of injuries consistent with a prolonged assault. Though Mr. Delaine-Smith refuses to divulge the name of his assailant, it is safe to say that the wounds and injuries are consistent with a fairly skilled medical theme. Injuries include multiple incisions and contusions, severe bruising, two broken fingers of the left hand, and a broken fibula in the right leg.
Upon admission, when full consciousness was regained, the patient showed severe agitation and fear of his surroundings and the nurses and doctors assigned to him. Following an irrational reaction and attempt at escape, the patient was sedated for his personal safety, and I was brought in for a psychiatric evaluation. My diagnosis, though I am not aware of all of the details due to withheld information, is of Post Traumatic Stress Disorder and a resulting phobic reaction to medical apparatus, procedures and paraphernalia. What has become apparent is that the patient has a lifestyle consistent with the receipt of physical abuse, in that he has admitted he belongs to cultural sub-genre he refers to, reluctantly, as a "BDSM" culture.
Mr. Delaine-Smith is currently residing on our short-term psychiatric evaluation ward, pending transfer. He is required to use crutches at this time.

Have you ever seen someone for these problems or addictions? Or have you been hospitalised or housed in an institution or home for people who suffer from mental afflictions, or admitted to a drug rehabilitation centre? If so, for how long, and what was your diagnosis?

Mr. Delaine-Smith has records with our hospital dating back two years, which indicate two other Emergency Room visits stated as accidents, but with seem in retrospect to be linked. He has no psychiatric records, and tested negative for controlled substances. I have diagnosed him, upon evaluation, with PTSD and resulting Phobia, and Sexual Masochism.

-Personal History-

Where were you born, and where did you grow up? Were there any complications during your birth? What was your infancy like?

Mr. Delaine-Smith is from Baltimore, Maryland, where he claims to have been born and raised. He did not authorise contact with his parents or any next of kin. No relatives are on file with our hospital. Mr. Delaine-Smith still refuses to talk about his family.

Did you ever have any long-term separation from your parents?


Do you have any siblings? If so, did you get along well with them?


Did you attend public or private school, and if so, what were your grades like and how did you feel about it?

Mr. Delaine-Smith claims to have attended school but not graduated, and would not tell use the name of the school.

Do you have an interest in the opposite or same sex, and if so, when did you become aware of this interest?

Mr. Delaine-Smith will not divulge the identity of his abuser, assumed to be a sexual partner, but has referred to this partner as male. Other than this, little is known. Mr. Delaine-Smith is proving to be adverse to therapy or sharing details about himself.

Were you ever admitted to a psychiatric or correctional facility for juveniles, and if so why were you admitted, and how did you feel about it?

No records have been found to indicate either way.

-Criminal History-

Have you ever been convicted of a crime? If so, what was the conviction, and was was the sentence served, or fine paid?

He matches no known profiles or fingerprints in legal records.

Have you ever taken or abused controlled substances? Have you ever had an addiction to prescription medications, or have you abused alcohol?

His tox-screen was clean, though he has admitted to taking substances recreationally now and then.

-Personal Interview-

What are your goals in life?

It is my hope that Mr. Delaine-Smith will prove more forthcoming in future therapy sessions with your doctors, as many of the details of his life are currently being withheld. He proves to be quite sullen and quiet at most times, and prefers not to leave his room on the ward. He can react hysterically to the presence of nursing staff and doctors, particularly in combination with any medical procedures such as blood testing and the like.

How do you hope that our facilities might help you in achieving those goals?

It is my hope that Mr. Delaine-Smith, with time, may open up and thus allow himself to heal. It is also my hope that he will allow his family to be contacted and seek support from them, and will heal from his ordeal, both mentally and physically.

Finally, tell us a bit about yourself.

Very little is known about this patient, as he is not forthcoming with details and has often made it quite apparent that he does not want to be here, nor does he want help from our staff. He is difficult to talk to much of the time, and painfully afraid of many of our hospital staff.

-Legal Documentation-

    By agreeing to admission to our facilities, you hereby agree to abide by all rules and terms of service outlined in patient or resident handbooks, rules and codes of conduct. You hereby agree to waive your right to voluntary dismissal from our facilities until such a time as facility heads of staff sign paperwork for your release. You hereby agree to comply with facility staff recommendations, demands, or outlines for treatment. You hereby waive your right to informed medical consent before medication changes or medical procedures. You hereby agree to waive your right to hold Crane Pharmaceuticals and its Subsidiaries responsible for any personal harm or distress incurred during treatment. Crane Pharmaceuticals and its Subsidiaries reserve the right to add or amend these terms of service at any time.

Please sign and date below.

    Dr. Jonathan L. Whitaker 06/17/2010

Crane Pharmaceuticals ®2009, 2010
Ambrose Delaine-Smith
Ambrose Delaine-Smith

Posts : 1
Points : 1
Join date : 2010-09-16

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Ambrose Delaine-Smith Empty Re: Ambrose Delaine-Smith

Post  Admin Zephyr on Sat Sep 18, 2010 9:57 pm

Ambrose Delaine-Smith 2ymj6ok

. Your Admission Form Has Been Approved .


    Crane Pharmaceuticals has approved your request for admission to our state of the art facility. Please read the information below for details, and don't forget to read your facility code of conduct and prohibited items guide.

    You have been referred to Ward J.
    Your assigned room number is 113.
    Your primary therapist is Dr. Inna Svidrigailov.
    Your primary issues group and subgroups are listed below:

    • Psychiatric Issues Group
        o Sexual Deviancy Subgroup

    All patients must attend group and individual therapy with their primary therapist. All patients are required to take medications at scheduled times unless otherwise specified by their primary therapist. All patients are provided with a WELCOME PACKAGE. The included scrubs are to be used as night wear, and may be used during the day if the patient so wishes.

    Don't forget to go to the USERGROUP section to sign up for your PRIMARY ISSUES GROUP -O N L Y-! If you don't, you won't get a username colour, and the account will be subject to deletion during the next activity check. Do not sign up for your subgroups. And don't forget to claim your play-by on the face claim and add your character to the who-plays-who.

    Thank you for choosing a Crane Pharmaceuticals facility to help you rehabilitate and grow. We hope that your stay will be a pleasant one, and wish you every luck in your treatment and rehabilitation.

Patient Prescribed CX-05 Once Daily.

Crane Pharmaceuticals ®2009, 2010
Admin Zephyr
Admin Zephyr

Posts : 13
Points : 12
Join date : 2010-08-26
Age : 32
Location : Binghamton, NY

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