The Case of the Thirsty Writer Who Lives No More

Albert Lowenfels, MD

Disclosures

January 03, 2011

The Case

The patient was a 40-year-old male writer who had been brought by his uncle to the hospital in an unconscious state. At the time of admission, acquaintances and relatives provided some details concerning the present illness. He had apparently been traveling for several days, but his exact actions were unknown until he appeared in a tavern, apparently in distress and drunk. His clothing was soiled, and he had no money. Physical examination revealed a thin individual, about 5' 7" tall, who was breathing but unconscious and unresponsive. After about 10 hours, he regained consciousness but was unable to respond to questions or to provide any coherent background information. He was diaphoretic and was having hallucinations. Several observers noted that his eyelids were twitching and that he had tremors of his limbs. The patient remained delirious for approximately 48 hours, but in the final few hours of his life he became calmer and able to talk. He died approximately 4 days after the onset of this illness.

Personal History

The patient had been married, but his wife died at age 24 from tuberculosis. Both his biological father and brother were believed to be alcoholics. The patient started drinking while in college and continued while attending a military academy. He had periods of sobriety interspersed with bouts of heavy drinking. On rare occasions, he may have used opium.

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