Boxer Bruce

Bruce Andrews, an 18 year old single male, presents to your office for follow-up from an emergency room visit. He presented to the ER 4 days ago with a swollen, sore right hand after an argument with an acquaintance outside a bar.

An x-ray showed the following:

He got tired of waiting in the ER and left.

After addressing the care of the fracture, you wonder if substance use may have contributed to his behaviour.

If you only have time to ask one question, what would it be?