This case involves a forty-nine-year-old male patient who presented to a new family physician complaining of severe indigestion after eating. The doctor counseled the patient in his office and prescribed Nexium, a PPI heartburn medication that would prevent excessive acid reflux. The patient had a significant family history of gastric cancer but the doctor neglected to extract a detailed medical history or perform a full physical exam during the initial visit. Several months later, the reflux became worse and was associated with nausea, vomiting, and weight loss. The physician became alarmed and sent the patient for imaging of the upper digestive tract. A biopsy taken during the investigation was sent to pathology and showed diffuse Linitis plastica.