man’s shoulders. The middle of his left clavicle has a big step-off, resulting in one arm hanging slightly lower than the other. Even curled in a ball I can see it. It makes him look like he is leaning to one side, falling over in place. Maybe he fell out of bed at the adult home and no one reported it. It would not be the first time. Maybe that is why he is breathing fast—because he is in pain. Or maybe it is just an old injury and nothing more. The only way to know is to check it for tenderness.