Patient: Leo (M)
Characteristics: Green eyes, medium blue coat, blue/black mane, alleged five years old
Report: Began visit with a sleeping Leo around 1600. In his slumber, he appeared distressed, and was noted grinding his teeth and having a sweaty coat, sleep talking incoherently, as well as scratching a particular spot on his right cheek. At around 1615, he was briefly woken by the couple who found him, Herbal Essence and Thundertail, because of his distress to be comforted. He was noted telling them, “I wish you were my parents”. He then resumed sleeping much more peacefully until around 1900.
An interview with Herbal Essence and Thundertail revealed that he was found sleeping outside near the center of town around 0600. He was found covered in dirt, and appeared to have been outside for several days. He was found with a fractured fetlock, and bite wounds, and was carried to North Star Hospital, where he was presented to Doctor Moonlit Night. He denied to them knowing his age or parents, and denied knowing how he received bite wounds. He was noted as having a severe itch with no known cause, and was noted as scratching one particular spot on his cheek. He was noted as having a slight temperature, which cleared up shortly afterwards.
Herbal Essence and Thundertail describe him as “emotional” and “resistive”, as well as “unsure at times”. They described him having a severe aversion to medicine said to help hoof pain and itching, despite previous outbursts due to itching, as well as taking antibiotics with no complaint. As well, he was noted to have an aversion to receiving help with food, and chose instead to not eat what he would have to receive help with. He was not noted to have issues with being picked up or touched in general, although Thundertail noted he seemed “uncomfortable” with help with bathing.
During a brief period of alone time, Doctor Night reports him screaming “stop thinking about it”, and being angry and upset during a brief examination of his coat for signs of skin conditions. He was noted being upset at receiving offers for help, in particular itching, and intensely denying attempts to make him comfortable. Doctor Night notes that his itching is “likely psychological” and that he presents a “nervous and anxious demeanor”. He also reports that Leo seems to have a “nearly nonexistent” magical field, likely due to lack of use.
A brief, incomplete examination while Leo slept showed no obvious signs of any other recent physical trauma or any sexual trauma. However, this exam was too brief to be taken as conclusive.
Leo was once again woken at around 1920, and seemed suspicious of my presence and asked to know who I was. When presented with his meal for the evening, which consisted of salad, oatmeal, and hay, he reported that he “doesn’t like hay and can’t use magic”. When offered help with feeding, he opted instead to eat hay, which he seemed upset by and had trouble finishing, and stated he “wasn’t that hungry anyway”. When asked if he needed to use the restroom, he became distressed to the point of self harm, and had to be calmed down. When asked why he was upset, he stated that he “hated his life” and he “hated being a colt”. He also stated he “hated being treated like a five-year-old”, and “hated that he has to care about what happens to him”. He regarded himself as “stupid” and felt like he was going to “screw everything up”.
Several minutes afterward, he was interviewed, and described being outside walking for “two days” but denied knowing where from. When asked about his bite wounds, he denied knowing how he received them, although he appeared conflicted when answering. He denied knowing why he was itchy, although he had a notable reaction to the question. He had no reaction to being asked about physical abuse, seemed uncomfortable when asked about sexual abuse, and flinched when asked about drug abuse. He denied feelings of worthlessness and self harm despite an observed case of the latter, but seemed surprised when asked about suicide. He was observed scratching his cheek throughout the interview.
After the interview, he was hesitant in asking for help in the restroom, and appeared nervous about the idea of having me in the room with him. He was noted saying that he felt like he “wanted to die” about the situation, and was still upset by the situation for several minutes afterward.
During a game where we practiced using magic, he became increasingly agitated by his itching, and continuously refused offers for help with it. When told that it wouldn’t hurt him, he stated that he didn’t believe me. He later stated that “it was only going to get worse”, and upon being denied the ability to scratch, and stated once again that he “hated his life”.
Later on, during a second interview, when asked if he felt like himself, he stated angrily that he “feels like a five-year-old”. He then stated he “hates how little control he has over anything”, and began to state something else he hated, but stopped himself before he said it. He refused to answer how long he felt these things, and stated that he doesn’t have any friends, saying he “guesses he doesn’t want any” when asked. He admitted that he feels like he isn’t treated fairly, but doesn’t know how, and that he feels like he messes things up. When asked what he thought would happen when he messes things up, he stated he’d “hate where he would sleep”, which he immediately tried to backtrack from, saying it “would be his own fault”. He then refused to answer any other questions.
Diagnosis: Leo seems to have quite possibly been sexually abused and potentially drugged and neglected. He seems very conflicted at times, and presents self confidence issues, as well as extreme hostility to help in certain situations. He has a general anxiousness, which is likely to be the root cause of his itching. He displays no general discontent at being touched or being around adults, but does present nervousness in and to certain situations, which can range from uncomfortableness to distress to the point of self harm. He presents himself as “older” than other ponies his age, and dislikes the idea of “being treated like a five-year-old” or "like a colt".
Treatment: Leo will need counseling, as well as a home that can adjust to his needs, where he can feel safe and gain self confidence. Although it doesn’t seem as though Leo will need too much accommodation, it is still early and we don’t know his full story. It should be noted that Leo already seems to have a certain fondness for Herbal Essence and Thundertail, and, when asked, the couple announced they’d be willing to foster him. Regardless, if Leo can find a home that suits him, his prognosis looks excellent.
-Dr. Ivory Spark