Can a doctor tell a patient is an alcoholic just by looking at him?

Or her.

We know that alcoholism can change a person’s looks over time. But could a doctor take one look at a new patient and know that that person is an alcoholic?

And if so, does the doctor say something about it, even if the patient came to him for treatment of something unrelated?

Dr. James Harriott, upon meeting one person in particular (Ewan Ross?) took one look at the guy’s nose and thought, “whiskey!” I only mention it because the correlation between alcohol and a bulbous ‘whiskey nose’ is evidently a myth. Still, as I recall, Herriott was correct in his initial assessment.

A doctor may instantly suspect, but all the visible tell-tale signs may have other causes.

I know long term abuse of alcohol will definitely show up in liver enzymes, and of course there’s toxicology test that can be run. But I don’t know… when my husband fell off the sobriety wagon, he fell HARD…drank a bottle of vodka and passed out. I thought he was dead and the doctors did not suspect alcohol…they were thinking other causes. It wasn’t until he came to a bit in the ER that I was able to get a confession from him, after which I advised the doctors to not bother with the rest of the tests they were about to start due to his ‘snycope’.