"I told you, I did not fall," said Mrs. Garcia. "I woke up like this." Could she have forgotten the blow? At age 83, Mrs. Garcia suffered from a host of ailments, including diabetes, and was back in the hospital just one day after recovering from a severe respiratory infection. Maybe she was beginning to show signs of Alzheimer's as well. Then again, she had woken up in bed, not on the floor. The left side of her face—purple, red, and swollen—had clearly taken a thumping. Could it be from the Coumadin, a drug she was taking to reduce her susceptibility to blood clots? The anticoagulant can sometimes cause spontaneous bleeding. But Mrs. Garcia had more than just a shiner; an X ray showed that the zygomatic arch, the bony jug handle that straddles the hinge of the jaw, was fractured. Too much Coumadin wouldn't explain that.
"Mrs. Garcia, you left the hospital yesterday, is that right?"
"Yes, doctor," she replied.