t was nearing a weekend when I inherited the care of a distressed elderly man. The hospital bed had been pushed against the wall to guard against falls. His hair was plastered in sweat and his limbs jerked involuntarily as he mumbled incoherently. He looked tired, uncomfortable and dehydrated and he was incapable of providing a history although the differential diagnosis ranged from delirium to an unrecognized surgical emergency. Mostly, what struck me was that he had unalleviated distress.
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