ABSTRACT
A very tall, friendly man stumbles into the emergency department with a young child and carrying what looks to be a large, long trumpet. He drinks from a strange substance from a bottle and has loud flatulence, causing other patients to stare. He tells you his hands and face are growing and he has had to buy a new, bigger hat. He has also started bumping into things due to bad eyesight. On examination he does have large spade-like hands, coarse facial features and his peripheral visual fields are affected on both eyes.
