This interrupted case study utilizes real patient data and provides students an opportunity to apply knowledge of human metabolism and hormonal control to a complex real-world scenario. The story begins with the discovery of an unconscious patient who is determined to be simultaneously starving (having failed to eat for several days) and in a prolonged state of ethanol intoxication. Understanding the clinical outcome for this patient hinges on students synthesizing their understanding of a number of metabolic pathways and physiological principles that are frequently taught in isolation. The case thus provides much-needed practice in connecting multiple aspects of cellular-level metabolism to physiological (organ- and organism-level) outcomes. It is designed for advanced undergraduate biochemistry or physiology students who have already learned basic intermediary metabolism and the physiologic regulation of these metabolic pathways in different tissues by insulin and glucagon. The case works particularly well as a culminating exercise when students learn ethanol metabolism after learning many basic pathways of intermediary metabolism.