This case delves into the intricate unraveling of a seemingly straightforward fall in a 75-year-old legally blind male. What began as trauma evaluation quickly evolved into a layered clinical puzzle—uncovering severe dysphagia, fractures, subclinical alcohol withdrawal, and ultimately, an unexpected diagnosis of advanced head and neck cancer. Through this single patient, we explore how chronic alcoholism, malnutrition, and limited social support silently sculpt clinical outcomes. The conversation connects pathophysiology with real-world care priorities, from early recognition of withdrawal to navigating the transition from curative intent to compassionate, patient-centered comfort care.