It has been rather conspicuous that there has been little public commentary on something fairly obvious: that much of the social unrest in the past decade seems to have come from people who appear as generally unfit and unwell. They are in many ways social outcasts, awkward, and misfits. As I began penning this I recalled that the same person seems present in a sense on both extreme left and right wings. Whereas we have the blue-haired girl with a septum piercing screeching that “words are violence” while shouting down professors she dislikes at college lectures, there is the far-right man dressed like a denim-leather halloween costume from an 80’s movie. They are both green behind the gills. They don’t really understand how society operates in normalville.
When I lay my eyes on these folks and think about their general appearance, I remember the purpose of a mental status examination in my role as a clinical psychologist. The MSE is a visual descriptor a clinicians’ notes that is meant to give another doctor who may be reading them at some point a broad sense of the patient’s presenting appearance. This can tell a clinician a fair amount, such as whether the person dresses in a socially appropriate manner, their general level of physical health, speech difficulties, coherence of thought, eye contact, motor problems, etc. Taken as a whole, the basic question an MSE is meant to address is whether the person is normal or fits somewhere into something called abnormal.