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BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f3111 (Published 16 May 2013) Cite this as: BMJ 2013;346:f3111
  1. Max Kamath, foundation year 1 doctor, Central Middlesex Hospital, London NW10 7NS, UK
  1. maxkamath{at}gmail.com

Early in my medical career, I was caring for a middle aged man with a disabling chronic disease that had left him bedbound. While he could barely open his mouth to eat, he could open it enough to drink, as evidenced by his multiple admissions with acute alcohol withdrawal. On this occasion, he had been admitted with an exacerbation of his underlying illness, accompanied by alcohol withdrawal and aspiration pneumonia. This time he did not seem his usual self. He had lost a lot of weight and had the …

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