Ryan was brought to the hospital after having a panic attack in the parking lot of a movie theater, during which he felt he was going to die.  Ryan was in the car on the way to a movie when his hands began to tingle and went numb, started sweating, and experienced pain as if he were having a heart attack.  Visibly distraught even in the recollection of the events, Ryan is afraid the symptoms will come back if he talks about them.  At several points during the interview, the nurse must ask Ryan to take deep breathes in order to calm his escalating panic.  When questioned about recent stresses, Ryan reveals that his grandmother died a few weeks ago, which exacerbated the symptoms he’s been experiencing and hiding for years.  Ryan describes his past episode of panic, which tends to correlate with his fear of these episodes being seen publicly by others.  Because of his fear of these episodes, Ryan has seen a significant impact in his daily routines, having stopped driving, refusing eat in the cafeteria, and often running to the bathroom at school to hide when he feels the symptoms returning.