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Dr. Chip
Dr. Chip, Board Certified Physician
Category: Medical
Satisfied Customers: 35564
Experience:  20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
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I am the grandfather of a boy/young man (his 20th birthday

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I am the grandfather of a boy/young man (his 20th birthday is XXXXX up soon) who is showing some very worrisome and dangerous behavior.
I'll get into his behavior, shortly, but I want to describe the family situation, first, which will show you why we can't depend on any local resources or help.
I live in Alabama, but my grandson, his parents, and his sister reside in the British Virgin Islands, where I am visiting them. For minor medical problems, we have a few competent MDs. Anything more serious requires (depending on it's nature) requires a trip to St Thomas in the US Virgin Islands - an hour by ferry. Somewhat more serious can require a fight to Puerto Rico (45 mins).
But VERY serious problems, or most problems that require a strong specialist, mean flying to the States - most conveniently, Miami.
I won't go into any family details, at this point, but My boy Carl has had a somewhat difficult life. He has been a bit odd in some ways for a long time, but nothing particularly serious in his behavior.
Recently, though, he has seemed unusually troubled in some aspects of his behavior, but especially in his behavior toward his mother. He has become more argumentative, more disagreeable, and, beginning on Friday, more aggressive toward her.
On Friday, some minutes since he had had any communication with not only his Mother, but with any of the family, he was on the patio, while the rest of the family was in the living room (off the patio), we heard a loud noise like something made of metal had been hit, hard! Immediately it was repeated, and then, again.
By this time we had gotten out on the patio, only to see him turning and walking (not quite stomping, toward the stairs to his room. What we found was the rather ordinary, and typical box fan, lying on the patio tiles, seriously bent, scraped and chipped. He had been smashing it on the ground, obviously in a rage!
His father followed him up the stairs, but I have no real way of knowing what was said, beyond his Dad's too brief description. But none of us had any hint of "why" he had done it, or what he intended. He didn't come out of his room, and the next morning went to work. (He works in his fathers paint shop, learning the business so that eventually he can take over the business. BTW, his Dad is in his mid-60's. His Mom is 53.
Saturday was uneventful, as he came home from his 1/2 day work, although he did not (would not?) speak to his mother.
Today, he seemed almost typical in his behavior all day, although he barely spoke to his mother. Then, a couple of hours ago, he suddenly started yelling (screaming?) at his mother, in a physically very agitated manner, threatened to beat her, and acted as if to throw a very heavy crystal platter at her, and he continued to threaten her, verbally, as his Dad took him out of the room.
His father had stepped in, and stilled the boy (he is one of the top ten-ranked judo dons In the Japanese judo world. He is, actually British, but he learned his judo in Japan, and they rank him higher than any non-Japanese, ever), as soon as he could.
The boy is, I'm convinced, seriously disturbed, and needs help. If he doesn't get it, I fear his anger will manifest itself in the worst way.
I would like, from you, two things: first, an opinion (not a diagnosis) as to whether we are right in believing he needs treatment, NOW, and, second, where we might take him.
Again, Miami would be easiest and cheapest (in terms of getting there and - if necessary- in being able to keep someone (probably me) near him.
(The family have many responsibilities and really MUST be here, MOST of the time. I, on the other hand, am a retired Episcopal Priest who has had SOME experience in dealing with seriously disturbed people, young and older. Assuming he will need to be admitted somewhere -again, he CAN'T be treated here- I can be there as long as may be needed.).

I realize this May NOT be the kind of inquiry you are used to, but I've had no luck finding any other source of help/wisdom/information/suggestion.
Please respond a without TOO much delay - though if time is needed (to consult?), we can wait a day or so (But NO MORE).
Thank you, XXXXX XXXXX bless you.
Fr Robert C Granfeldt
Hi Robert. I fully understand the situation and all your concerns. A couple of questions here--who would be with him if he went to Miami, and is he covered by any medical insurance here in the states. Also--do you think he would voluntarily agree to therapy?
Customer: replied 4 years ago.
Sorry to be so long in getting back to you.
When I asked about insurance, my daughter said, "yes and no." We cannot just pack up and take him to the US and activate the coverage. (I don't understand the details, so I can't explain the "rules".) But as we talked, she remembered a psychologist in St Thomas that she saw a number of times some years ago, when suffering from serious depression (maybe post-partem, which would make it about 20 years ago).
She got on the phone and located her - still there and still in practice.
She just talked to her, explaining the situation. And made an appointment on Thursday. I will go with him on the ferry.
If she, and/or one of the psychiatrists she works with thinks it advisable to take him to the States, she/they can write the order, and with prior approval, the insurance will cover the treatment prescribed.
So we'll try. She and I (or just I, depending on how he's feeling about her on that days) will go. If it turns into more than one day for testing and whatever, we'll get a room and stay as long as need be.
If, in the end, he needs treatment of some kind in the States, then their insurance will cover!
Meanwhile, thank you for your time and assistance. I HOPE I will not have to get in touch with you, again - but if I do, my computer will be at hand.
Fr. Bob Granfeldt
Bob, I was going to say that he definitely needs evaluation and therapy as well as possible medications like Prozac or Paxil. This could escalate into a situation where he does physical harm to himself or others but it can be avoided with proper treatment. Hopefully he'll recognize that he has a problem and will work in therapy. If you need a doctor in Florida still, let me know and I'll find one for you
Dr. Chip and 3 other Medical Specialists are ready to help you
Customer: replied 4 years ago.
We're waiting for a callback from St Thomas, now. We've already spoken to the Dr, and we're waiting for the appointment time.

Thank you, XXXXX XXXXX hope and pray we can get the help we need from the Dr in St Thomas, but if not, you'll be hearing from me. Meanwhile, you have my thanks.

My pleasure entirely Bob but please consider rating my service to you for now