8/22/13: Patient presented in an even worse state of agitation than previously. I may have to consider an SRI like Paxil to deal long term with depression and panic attacks. Patient inquired nervously about the case of Bradley Manning, the Army private who leaked vast numbers of secret documents, who now wants to change sex and be called 'Chelsea'. Manning was said in court to exhibit narcissistic traits. Patient asked that, since I had previously diagnosed him with Narcissistic Personality Disorder, he should immediately begin gender reaassignment. If so, Patient says that he would like to be known as 'Barbie' Obama from now onwards. He would then become both the first black President and first female president in history. This Patient --to use psychiatric jargon --is batshit crazy. --Dictated by Dr. S.H. Rink