Solve the Medical Riddle: She Suspected That Her Husband Was a Closet Drinker, Second Week

By Marie Savard MD

Editor’s note: Welcome to our ThirdAge feature that gives you a chance to play medical sleuth as we share the details of what happened when a patient presented with a problem that stumped the physician at first.

Last week, the patient reported his symptoms. The doctor proceeded with the examination using the components of the classic S-O-A-P notes, which are as follows:

S=Symptoms or Chief Complaint

O=Objective Findings

A=Assessment or Analysis

P=Treatment Plan or Recommendations

The doctor referred the patient to a gastroenterologist, a specialist in digestive disorders. This week the GI specialist will continue the quest for a diagnosis of Sam’s condition. The third week, we’ll let you know what some people have suggested as possible diagnoses. The fourth week, the specialist will reveal the actual diagnosis. Then we’ll begin a new riddle for the following month!

The gastroenterologist had asked Sam to come in for his appointment without having fasted. The GI specialist asked Sam what he had eaten for breakfast and Sam replied, “My usual three or four doughnuts.” The doctor ordered a blood test and this time Sam’s alcohol level was high even though he continued to insist that he had not been drinking.

The specialist also had him come back for an endoscopy to do a gastric culture  to determine whether or not Sam had an infection. The laboratory would have the culture results in a week or two . . .

To be continued . . .

Come back to next Thursday to find out what some people have guessed the diagnosis might be.  

Marie Savard, M.D., a former Medical Contributor for ABC News and a frequent keynote speaker around the world, is one of the most trusted voices on women's health, wellness, and patient empowerment. She is the author of four books, including one that made the Wall Street Journal list of the best health books of 2009: "Ask Dr. Marie: What Women Need to Know about Hormones, Libido, and the Medical Problems No One Talks About." Dr. Marie earned a B.S. in Nursing and an M.D. degree at the University of Pennsylvania. She has served as Director of the Center for Women's Health at the Medical College of Pennsylvania, technical advisor to the United Nations' Fourth World Conference on Women in Beijing, advisor to the American Board of Internal Medicine Subcommittee on Clinical Competency in Women's Health, health columnist for Woman's Day magazine, and senior medical consultant to Lifetime Television's Strong Medicine. Please visit

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