They call you clever Carol for a reason, and it’s not because your name is Carol. You want this patient optimised to be stable enough for a scope, before the scope fixes the problem.

You bring the patient over once his obs are stable and a VBG shows an Hb > 70 g/L.

Whilst the patient is being scoped, the endoscopist congratulates you for having read http://www.nejm.org/doi/full/10.1056/NEJMoa1211801

If only she knew that the patient literally had to sing you the diagnosis.