[at-l] Bio

[thornel@attglobal.net (W F Thorneloe)]

I write in a different way.

Patient: Bill Thorneloe

Identifying data: This is one of several presentations of this 50 yo WMM 
Smyrna, GA physician with a chief complaint of "I want to get out of this 
place and walk!"

History of Present Illness: The patient reports persistent preoccupations 
with a desire to leave his suburban successful psychiatric practice in 
order to wander about the landscape while abandoning the benefits of his 
immediate supports and resources. He has developed a pathological trait of 
referring to himself in the third person with an alias: "OrangeBug", 
possible relating to his traumatic experiences as a Clemson football fan as 
well as feeble attempts to preserve the life of his 1974 VW sedan purchased 
by his father and wrecked by virtually every family member who has touched 
it. This obsession has led him into unwise purchases of at least 3 
backpacks, 2 fleece sleeping bags, and innumerable titanium objects. While 
never experiencing movement disorders or neuromuscular degenerative 
diseases, he is often seen in supportive foot apparel and with dual 
expandable ambulation support devices. When dressed in much of this overly 
valued "gear", he appears euphoric and frequently embarrasses those few 
supportive friends and family who still speak to him.

He has been known to have initial insomnia, accompanied by binges of 
reading "trail guides", maps, "How to Keep Your VW Alive for the Complete 
Idiot" (owns 6 different editions), and most recently the Biography of John 
Adams. His children suspect he was a contemporary to the former second 
president of the US. They have privately wished that Dr. Benjamin Rush 
would return to either bleed their father bad to health or demonstrate the 
use of restraints on him. The patient has expressed grandiose delusions of 
walking a ridge path along the eastern seaboard (referred as the "AT" in 
nearly reverent tones), initially in sections an then as a final binge upon 
his unlikely retirement.

His illness is fairly long term, with evidence of etiology in childhood 
associated with Boy Scouting activities, short walks and long drives in the 
mountains of North Carolina and Virginia, wading in the Linville River, and 
obsessions with playing "fort" in his backyard and never coming to dinner 
on time. In college similar behaviors persisted with frequent drives to the 
hills of NC and upper SC, arranging classes in the early morning to allow 
daylight tours and walks - predominantly along streams and small rivers. He 
had wandered occasionally in the "Smokies" and reports fantasies of taking 
long hikes. His family of origin objected strenuously regarding tuition 
expenses and reminded him of medical school aspirations as well as the risk 
of the draft. While he attended ROTC, he has otherwise no military service.

His illness relapsed about May, 1997 when a psychiatrist friend invited him 
for a "little walk" with friends for a weekend. The patient brought gear 
hoarded secretly for decades and stole his daughter's backpack, carrying at 
least 60 pounds and injuring his knees for several weeks. In spite of such 
consequences, his experiences of walking from Hightower Gap to Springer Mt 
appears to have addicted him as surely as a tub of cocaine up a nostril. 
Subsequent walks have usually been associated with highs of elation in 
planning and "views" with lows of tribulations from exertion and 
ill-planning for conditions. He has "walked" most of Georgia (missing a 
single 17 mile "section"), half of NC to Hot Springs, and a central 
Virginia "section."

Habits: While he smoked as an adolescent and rarely has chewed on cigars, 
he is abstinent of tobacco and other herbal substances. Alcohol use is 
endorsed, recreationally without episodes of blackouts or other adverse 
events. Beer (Moosehead and Sammy Adams) and "single malts" spirits are 
preferred. He expresses the peculiar Carolinian preference for Cheerwine, a 
cherry flavored cola brewed near Statesville, NC. He is known to cook 
"bar-b-cue", although this is illness related to his search for sources of 
hickory tree branches for "smoking."

He has few useful hobbies and advocations, including watching woodworking 
tools rust, gardens go to weeds, and swimming pools grow algae crops. 
Disturbingly, he has participated in gang related activities, the Rotarians 
and occasionally "flashes" their insignia.

His wife, Liz, has been know to scream whenever referred to as "Mrs. Bug," 
with his daughters Kate and Martha hopeful that he will not terminally 
embarrass them, and that they have been spared any genetic risks of walking 
sickness. To this point, they have each moved to large urban settings and 
abandoned their gifts of "gear" their father used in attempts to infect them.

Diagnosis: Obsessional Disorder, NOS versus Fetish disorder, foot.
Prognosis: Poor, with family support services recommended along with other 
means of reduction of adverse consequences.