How Alcohol killed him mercilessly : A real clinical story

This is a true  clinical story

Years , years back when I went to see a young man admitted to our ward—-

“Doc! She would make a wonderful queen, and my heart just couldn’t accept her hands with anyone else. Hence I resorted to boozing – goblet after goblet” the nicely-clad 27 year old  male at Postgraduate Institute of medical education & Research (PGI )Chandigarh Hospital, where I was working as a physician several years ago, said to me.

Well, I didn’t want to question him further, in case of a breach of the boundaries of the patient-doctor relationship.

Over the past few days, this young man’s eyes had turned deep yellow, and he was clearly sick.

A golden yellow colour in the eyes sends frightening signals to the treating physician’s mind.

Yes, it means that either the liver is endangered by obstruction of its outlets, or it has been affected by disease or poison.

Soon our team of physicians were treating him with great sympathy and empathy.

An ultrasound of the abdomen was performed. This ruled out any blockage in the pathway of the liver.

Any hindrance in the pathway of the liver is to be treated as an emergency and could be life-threatening.

Blood samples were sent to peep into the severity of his liver damage.

In the silliest hour of the day, the laboratory reports were ready for our interpretation.

I touched the patient’s forehead. His forehead felt moist to my hands as if dew drops were on his rose -like innocent face.

However, he looked very ill. His anxious eyes were deeply tainted yellow.

“Doc! When will I be alright? he mumbled.

“We will do our best to help you”, said I.

Explaining to his mother what was going on was the most challenging next part of this clinical encounter for me.

His blood tests revealed that the damage to the liver due to his over-indulgence in wine was serious.

The clotting ability of his blood was in shambles, and even a minor injury could have resulted in torrential bleeding.

It seemed that the wine in his veins had stabbed his liver!

“Mom! There is no obstruction in the pathways of his liver but unfortunately, the wine has marred his liver, and our fingers are crossed.

However, we will try our best, for the rest only time will tell .”

With utmost care, I explained the unfortunate blood results to his worried mother.

“Doc! do something and help him out, he is too dear to me”, she replied.

Well, even though medicine has progressed by leaps and bounds over the past decades, we are still miles far away from a definitive cure for so many diseases, including severe alcoholic hepatitis as was the case with this young man.

Unfortunately, he showed minimal improvement, and his case record file went on growing thicker.

Days later he showed signs of abdominal distension, due to his progressive liver cell failure.

“The ascites” an unwanted fluid in the abdomen.

“Mama! there is water surrounding his tummy, and it is mandatory to draw this water out and evaluate it, lest it should harbour any germs” said Dr Nikhil my friend and batchmate at PGI Chandigarh who was with treating team of the patient.

“Doc! What fluid are you talking about and where has it come from?

Please don’t pierce his tummy, he had a lot of potatoes last night, and it is simply the gas in his tummy” she said while stroking his abdomen affectionately.

Finally, the father of the patient gave us his consent for the procedure, and no sooner had we pricked his abdomen than straw coloured fluid, gushed out.

The analysis of the fluid showed features of severe infection, (spontaneous bacterial peritonitis, SBP), which was yet another sign that the liver was losing its battle day by day.

We started the patient on antibiotics, but that was simply whipping the tired horse.

Drugs don’t help unless your own body machinery is fit.

A cascade of complications, all well known in liver failure, started one after another, despite our best efforts to help him.

Progressively he became unresponsive.

“Doc trust me; he will get up soon from his sleep,” his mother said.

“One day when he was tiny, it so happened that he slept for such a long time in the cradle and that day doc everyone except me was scared.

I was confident that he was alright and even now I am equally so”. She further elaborated. The cradle story seemed as fresh in her mind as if she was recounting a story that was only a few weeks old.

It seems to be true of all mothers, that the mother never feels her child has grown more mature at any stage of one’s life.

Contrary to her belief, we were confident that his liver was failing further as he was showing signs of being unable to detoxify nasty ammonia from his gut.

The poisonous ammonia was suppressing and sedating his brain (hepatic encephalopathy) from which trauma only a new liver could arouse him

Who would donate his liver and who will be the daring surgeon to operate upon her beloved son?

Where in such conditions could that 14-hour long surgery (Liver transplantation) be carried out, at the expense of millions of dollars?

You felt correctly it was asking for the moon and simply absurd.

The next day the treating team decided to shift him to the intensive care unit (ICU) of the hospital.

A feeding tube was inserted into his stomach in order to safeguard his lungs, while swallowing, as he had lost control of normal swallowing process, which is highly coordinated in a healthy individual.

The monsoon (seasonal torrential rains) was in its youth and heavy rains were thrashing doors and windows everywhere in the beautiful city of Chandigarh.

His mother, partially soaked in rain, came from a nearby tenanted accommodation with  some homemade preparation in her hand for her handsome son.

“Doc! what is this pipe in his nose? She shook his body ,

“Look my son! Look what I have prepared, your favourite dish”.

Her son had become as deaf as a stone.

He was breathing, but not responding at all.

Streams of tears started from her eyes, as if the outward torrential rains had found their outlet through her brain into her eyes.

She was seen to be desperate for the first time during the 19 day-long stay in hospital of her sick son.

In ICU, despite our best efforts and all available treatment, he never woke up from that deep sleep.

One fine day our team was on its rounds in ICU and suddenly the alarm from his monitor alerted one and all. The ECG monitor was showing disturbed lines, indicating that heart had deceived his ailing body. Cardiopulmonary resuscitation (CPR) was done but the angel of death kissed his face and his soul quietly flew back to infinity.

It was a routine for his mother to wait outside the ICU gate in order to learn about his daily progress.

On that day, she hurriedly approached us as usual, and, for us, breaking this bad news to her was an uphill task.

With steel hearts we shared the news of his departure to her.

She was speechless with grief. The spring of her tears had dried up, and she couldn’t even cry! Later, his family carried his body in its heavy coffin back to their home.

For parents, their children ‘s coffins are the heaviest of all!

Dear Reader: That young man left forever, but with a message for the living world, which is “Never ever destroy yourself with alcohol. It is a poison.”

Alcoholism has destroyed millions and devastated billions all over the world.

Planners feel that the money added to the exchequer from the tax on this poison is attractive but that is simply their illusion.

It is actually a social evil, and it must have destroyed billions of families all over the world since its first use by mankind thousands of years ago. 

Behind most traffic accidents all over the world, this is the one most easily preventable cause. Never ever touch this poison, once it catches you it is hard to get rid of its cruel arms. It spares no organ in the precious machinery of our human body  and no dose is safe. Let us vow to teach everyone about its harmful effects and to help all those who are in its cruel lap.