Mrs. Penn, age 44, is admitted to the hospital for diagnostic studies. Her physician suspects peptic ulcer as the cause of her symptoms. At the time of her admission, Mrs. Penn appears pale, underweight, and in generally poor health. Diagnostic tests ordered by her physician include a complete blood count, gastric analysis, and an upper gastrointestinal (GI) series. The evening before the gastric analysis is scheduled, you tell Mrs. Penn that, in preparation for the x-ray examination, she will not be allowed to eat or drink anything after midnight. She becomes very apprehensive and tells you she has never heard of a GI series. She asks what they will do to her in the x-ray department and why she has to have the test. Mrs. Penn tells you that she has recently been divorced from an alcoholic husband and she wonders if the emotional upsets she has suffered have any bearing on her present physical condition. Mrs. Penn's physician initially decided to treat the ulcer medically. He ordered a bland diet and Maalox every other hour. Because of continued tension in Mrs. Penn's daily life and her obvious inability to stay within the limits of her diet even in the hospital, the doctor has now decided to perform a subtotal gastrectomy, vagotomy, and jejunostomy. Before her surgery, a nasogastric tube will be inserted and gastric decompression will be accomplished by attaching the tube to suction.