Updated 02 April 2015

What's your diagnosis Case 3: strange behaviour and a bullet in the back?

Mr S struggles to fall asleep, is irritable and has a poor appetite. Some years back he had a bullet removed from his back. Get your stethoscopes out and try solve this mystery case.


Mr S (45), a factory worker and war veteran, has been feeling increasingly tired the past couple of weeks.  He struggles to fall asleep when he goes to bed, although he doesn't go to bed later than usual.

Mr S’s wife is particularly concerned about the fact that he is very irritable and has a poor appetite. What’s even more concerning is that Mr S almost drove into the garage wall while parking the car. He made nothing of it when she asked him.

But, strangely, when he dropped a mug the other day, he was particularly upset about the incident.  

A week ago Mr S had an episode of gout, which he has never had before. His doctor prescribed treatment and although not completely resolved, the symptoms are much better.

Except for an unsuccessful attempt to remove a bullet lodged in his back when he was shot at during the war, he has a clear surgical history. He doesn't take any chronic medication and has no known allergies.

On Wednesday, on their way to the mall, he asked his wife why they were not going to church as it was Sunday.

Mr S’s wife is very concerned and decides to take him to the doctor.

What could be wrong with him? Join the guesswork on our Facebook page, or comment below. 

NOTE: Health24's on-site GP Dr Owen Wiese will reveal new cases on Thursdays and we'll post the answer with the story on Mondays, or you can find out via the Daily Tip – sign up here.

If you liked this case try our previous case here.

Dr. Owen J. Wiese is Health24's resident doctor. After graduating from Stellenbosch University with additional qualifications in biochemistry and physiology he developed a keen interest in providing medical information through the media.


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