46 years-old patient, from Senegal, 10 years living in Spain.  Consults for asthenia, nausea and epigastralgia for three months. Not high fever or infective symptoms.Blood test with a bicytopenia. Anemia with Hemoglobine 4,1 and plaquets 52000.We sent to the hospital for transfusion and further studies. Hematology took care of the patient suspecting a severnot autoimmunne severe hemolysis with non filiated cause.They ran a marrow bone biopsy with erythrocyte inclusions thath could also be parasitaries The patient escaped form hospital because he couldn't miss workWe contact the patient, he went back to the hospital to finish studies, but rejected to stay there because of his personal situation. He still had some blood tests and an body-Scan to do. At the hospital he had the scan done, but we agreed to run the rest of the estudies in an outpatient manner.Some patients just cannot afford to be ill, their personal situation doesn't allowed, what to do them with those patient? We, family doctors, play a keyrole here, trying to keep in touch and trying to do a follow-up of the patient.some people has difficult backgrounds, so we have to make sure we can help them the best we can not leave the patient behind and give thme the best attention according to their circumstancies.