The brother of a 23-year-old HTC registered severe hemophilia A patient living in a remote coastal area of Bangladesh in the peak Covid19  pandemic in 2020 told me that his brother was slowly losing consciousness during lockdown.I asked him to move to Divisional town with a sea ambulance along with relevant documents and to contact at the emergency department of our tertiary care hospital & to HTC duty nurse and do the necessary CT scan urgently.He arrived in the city at evening and was admitted to the neurosurgery department with the necessary tests.Respective NeuroSurgery doctor on duty planning to do operative evacuation but  I suggested him to do APTT / CBC test & CFC infusion immediately & once again in the next morning and then come in to conclusion.Fortunately Next morning patient improved his GCS & thereby operation has been postponed.

Lesson:The patient’s history may change the medical outcome of the disease.