So, antibiotcs in twice daily, walk, pushing protein drinks like a car salesman, yet still, episodes of profound shortness of breath, all hours of day and night, concerning, little energy for much activity, little food intake, ongoing poor balance. Final culture results from the drainage- nada, nothing…. so, check wound infection from the all-causes list. Time to head back in for an evaluation- he was ill, sallow, undernourished and short of breath, and I didn’t know exactly why, although I had a million postulates and prognostications, but I needed more information, more labs, more tests. So, back to the PCP we go. He, the PCP agrees that it was time to delve further, to up the ante, to undergo more testing and involve a specialist, such as a pulmonologist, maybe cardiologist. But. It was a Friday. How best to accelerate care in the setting of looming urgent medical concern? You guessed it. Back to the ER we go, a different ER; we were taking the tour.