Scenario:

Matteo is an 18-year-old bisexual adolescent of Latino decent, who has been on and off diets for the past five years. They are in their sophomore year of an accelerated bachelor’s degree program and have been binge eating takeout meals from fast food restaurants on campus late at night. The binge eating episodes have become so expensive that Matteo’s parents have addressed this overspending, which has led Matteo to begin shoplifting and stealing money to support the bingeing.

Currently, Matteo has been binge eating at least three times a week over several months. This episode followed the breakup of a stormy relationship with their high school boyfriend. They are beginning to gain weight even though they restrict food between bingeing episodes and induce vomiting afterward to control weight. In the past, they have used laxatives and diuretics to rid themselves of calories but did not like the side effects of constipation. Matteo’s eating problems became severe when they started college and was living in a dormitory with a self-serve cafeteria.

As a child, Matteo had difficulty controlling snacks between meals and would get into arguments with their parents, who threatened to put a lock on the refrigerator. Matteo’s weight has fluctuated by 10 to 20 pounds within several months. They is secretive about the binge eating, which is difficult to manage because they live in a quad with other students. They plan the late-night episodes and then often walks downtown through unsafe neighborhoods to consume food and vomit. Recently, they have been approached by older men who are soliciting them. Parents found out from one of Matteo’s friends who was concerned about their judgment.

Matteo fears gaining weight because they are on scholarship with the dance department. Matteo often goes days without eating. They have begun using methamphetamine with a new acquaintance for the euphoric and appetite suppressing effects. Matteo has had problems with insomnia for many years but recently reports decreased need for sleep.

Matteo has been having headaches, muscle cramps, and fatigue for several days and has not been going to dance practice. They are being seen by the nurse practitioner in the health clinic with whom Matteo confides that they “feel horrible and need some help.” Physical exam and labs show serum potassium at 3.2 mEq/L, BUN:creatinine ratio >58, volume depletion, scarring on the dorsum of the right hand, dental caries, and enamel erosion.

 

 

1. What important information is missing from the case study?

2. Discuss normal developmental achievements and potential vulnerabilities.

3. What precipitating factors could be contributing to the current symptoms?

4. What is the differential diagnosis?

5. Describe the etiology of the primary diagnosis.

6. How should physiologic complications be monitored and assessed?

7. What are the usual nonpharmacologic therapies that would help?

8. What medications could help and why?

9. Identify safety risks and how they should be dealt with in the treatment plan.

 

Sample solution

Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell. 

In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.

God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.

Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.

To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.

 

References

Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.

Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies4(8), 487.

Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.

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