the differentiation between fantasy and reality develops around 3 years of age among children . yet this distinction may be blurred under some circumstances like in the absence of adults , evocation of intense emotions , due to cultural traditions or presence of psychiatric morbidities . drawing from piaget 's examples of circumstances like involuntary imitations , intense desire for or fear of presumed outcomes ; woolley argued that adults also engage in fantasy about certain things and in certain situations . research has shown that high frequency of media exposure reinforces a child 's belief in the true - to - life nature of media . deviation from reality appraisal pre - dispose to risk taking behaviors , which refers to one 's purposive participation in some form of behavior that involves potential negative consequences or losses as well as perceived positive consequences or gains .  risk taking behaviors may manifest as impulsive decision - making , reckless behavior , promiscuous sexual relations , experimenting with substances , antisocial or even criminal activities and extreme sports . deliberations on risk taking among adolescents are pertinent because of the strong link between risk taking and mortality . we present a case of a 15-year - old male , not formally educated , member of muslim nuclear family of lower socio - economic status and resident of a village in north india . he first presented to surgery outpatient department of community health center and was subsequently referred to surgery department of all india institute of medical sciences , new delhi with multiple granulomas over his left forearm along with skin ulcerations [ figures 1 and 2 ] . on interviewed , it was discovered that he recently tried to inject mercury into his forearm , after watching a fictional character logan in the movie  wolverine  of the x men series , undergoing an operation to reinforce his skeleton with adamantium ( a hypothetical silvery shiny metal ) . on detailed assessment , it was found that right from childhood , he emulated in acts shown through electronic media including television and cinema . though , patient could not elaborate the cognitions , but reported the intentions to imitate . he had an interest in watching science fictions and would relate to the actions of the heroes and would wish to get such powers . when he saw the movie , spiderman ( at the age of 13 years ) , he tried to eat cob webs and repeatedly put spiders caught by him on his wrist thinking that he would also become spiderman . some of these acts would be solitary while others would be in the company of peers . his peer group consisted of adolescent and adults of different ages who worked together as laborers . recently , they saw a movie in which the superhero was injected with silvery metal in his body after which he became invincible . patient from that time thought of doing the same , but could not find any such material in his vicinity . later when he saw a sphygmomanometer in his father 's junkyard , he thought of taking the mercury out and injecting in his body . at that time , he reported that he thought he would get the super powers if he does it correctly and subsequently injected the same . though , because of lack of skill in injecting , he ended up injecting mercury in subcutaneous tissue of his left forearm . patient reported that he felt minimal pain similar to the hero in the movie and tried manipulating the resultant swelling from injection to show its effects . when his family members realized there was a swelling over his forearm , he was brought for treatment . he also tried smoking cigarettes after seeing on television , along with peers , despite not liking the effects . his usual cue for smoking would be watching movie heroes smoke on tv . on the suggestion of his friends he also tried alcohol and cannabis , but did not like the taste and effect of it . he would often fantasize having a physique like famous bollywood actors and would purchase clothes similar to the ones worn by them . a thorough psychiatric evaluation was carried out , though the possibility of mania , psychosis , borderline and schizotypal traits were considered eventually were ruled out in the face of lack of evidence from history and present interview and observations . his psychological evaluation was performed during hospitalization with bhatia 's battery of performance test of intelligence to assess his cognitive functioning , multidimensional iowa suggestibility scale ( miss ) , draw a person test ( dapt ) , children 's apperception test - h ( cat - h ) , and rorschach inkblot test to assess the pattern of behaviors and traits . his iq was found to be in the range of 112 - 116 , suggesting above average intellectual functioning . he was found to be suggestible to consumer media messages ( z = 1.83 ) with high psychosomatic control ( z = 1.53 ) . findings on cat - h revealed the need for power , recognition and existence ; content analysis revealed his wish to possess special powers to exhibit to others , he seeks novel adventure that gives him emotional stimulation and his inner state is that of conflict between the need to exhibit self - worth which frequently meets with restraints . image showing multiple granulomas over index patients left forearm along with skin ulcerations x - ray showing subcutaneous penetrated mercury in the forearm of patient the present case report is a rare example of risk taking behavior involving injecting mercury into one 's body as an attempt to become a superhero . such form of risk taking though appears to be bordering with poor reality testing ; however psychiatric and psychodiagnostic evaluation ruled out that possibility . the case , then , brings to light the risk of imitation injury among youth . to the best of our knowledge , this is the first case of injecting mercury as a copycat act in the published literature . another reason for which we found this case interesting is that it advocates the interplay between personal predisposition and effect of media . patient had suggestibility to media messages and the portrayal of risk glorification by media interacted to make him engage in such a life - threatening act . a temporal relationship between committing the act and watching the movie is evident . given his personal pre - disposition for impulsivity , seeking novel experiences and need for power , he may have been especially impressionable to the process of making an ordinary person a super - hero by a simple act of injecting somebody with a  shiny silver liquid . the cognitive processes such as  availability heuristics  in the form of repetitive exposure to the movie could have potentially blurred the fantasy reality differentiation in this case . to conclude , media has an impact on cognitions and behavior of children and it not only has grave consequences like fatalities , injuries or death for population at greatest risk , but also has high economic costs . though a single case is limited in offering generalizations , the present case provides an evidence of media influence on more impressionable individuals .
the impact of media on cognitions and behaviors of adolescents is well - known . 
 high frequency of exposure to media may distort the reality testing among predisposed youth , hence the rise in risk taking behaviors among this population . 
 we present a rare manifestation of risk taking behavior in an adolescent who injected mercury in his body after exposure to a hollywood film . 
 the results of investigations and possible explanation to understand risk taking behavior in the present case are discussed .