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Previous Volume 350:2329-2332 June 3, 2004 Number 23 Next

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We met him in the winter of 1996, when he had severe frostbite in both feet. Forty-eight years old and homeless, he had been living in shelters and on the streets since his early 20s. Saddled with a severe anxiety disorder that could be quieted only by sufficient alcohol, he was known in every emergency department in the city, with frequent medical complications, more than 50 admissions to detoxification units, and only two extended periods of sobriety during the past decade. During the months after we met him, the first and second toes of his left foot autoamputated, horrifying both . . . [Full Text of this Article]

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From the Departments of Internal Medicine, Brigham and Women's Hospital (B.D.L.), Massachusetts General Hospital (J.J.O.), and Harvard Medical School (B.D.L., J.J.O.) — all in Boston.

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