Mrs SBG, a sprightly eighty year old, lived alone in south Bombay. She became short of breath over a two week period. She had chronic obstructive pulmonary disease which was related with inhalers. Her blood gases showed severe hypoxia as well as hypercapnia. Though her sensorium was mildly lethargic, she had appropriate judgement. She had bilateral crackles in the lungs and pitting edema up to the knees.