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Booze: Where it can lead...
Alcoholism in General
Member Name: chrispitts
Alcoholism in General
Date: 23/07/02, updated on 23/07/02 (246 review reads)
Medical students have a reputation for being heavy drinkers. Within my first week at Medical School, in 1992, I discovered why...
Many students drink. Actually, why limit it to students... many people drink. A lot. I can remember getting absolutely hammered on a regular occasion at the student bar, which was conveniently 2 floors above the lecture theatres. After 2 weeks, I drank so much "Green Monster Punch" (God only knows what was in it, but it was served from a huge bucket...) that I ended up throwing up all over the bar floor, almost gaining the year's first ban. Rag week (a rite of passage with the feeble excuse of raising money for charity) was a veritable orgy of drunken behaviour - one of my colleagues was arrested in central London for climbing up the outside of a block of flats. Another was admitted to hospital (fortunately not ours!) having set fire to his pubic hair by spraying lighter fluid on his private parts... As to what I got up to... anyway, moving swiftly on.
On the last weekend of Rag Week, having drunk heavily all week, I managed a personal "best" - 90(ish) units in 2 nights. I didn't get out of bed for days, and was lucky to avoid having my stomach pumped (something which many of my colleagues unfortunately had to endure).
I also remember the hospital controversy when 2 semi-comatose students were dragged down to A&E (a short walk along the corridor), only to be told by the recently qualified doctors on call to "Sod off back upstairs - there's drinking to be done".
Many students continued their heavy drinking throughout med school (I'm still not sure what the link is between field sports like rugby and hockey with drinking...), but most of my closest friends cut back once we hit the wards. However, we still exceeded the "safe limit" on a regular basis.
Then, I qualified (not sure how, bearing in mind how many lectures were missed due to hangovers!
). And then, the reality of drinking hit me.
And now, I'll slip in just a little apology. I feel like an imposter here - I haven't suffered from alcohol addiction. Neither have my loved ones. But I have seen lots of people who have, so bear with me, please!
My first job as a doctor was with a gastroenterology medicine firm. They deal with bowels... and livers... and pancreas. We had 3 dedicated "acute alcohol beds", for people with acute pancreatitis and liver failure. People came in, and suffered, and died. On a regular basis.
I don't know how many of you have seen people in end-stage liver failure. But for those of you who haven't, let me give a brief overview.
The skin is yellow. Not a little bit yellowish. Bright yellow. Imagine Bart Simpson on TV with the contrast turned right up. That yellow. The whites of the eyes are also dark yellow. That's due to the build up of bile salts in the blood.
The abdomen is huge - like a balloon. In fact, it's not filled with air, but fluid. Litres and litres of fluid - we call this "ascites". Often, because we can't prevent the buildup of fluid, our only option is to stick a needle in, and drain off the fluid with a syringe. You can only take a bit at a time. What's a bit? About 3-4 litres. Sometimes up to 7 or 8. But don't worry, there's plenty more.
The limbs are usually wasted. That's because the muscles start wasting away. Usually, chronic alcoholics are malnourished, so their faces look gaunt, almost skeletal.
Oh, and then there's the incontinence, the delerium (imagining spiders crawling on the skin is the classic)... believe me, it's not pleasant.
So how does alcohol do that then?
First, alcohol causes an accumulation of fat in the liver cells (so called "Fatty Liver"). Because this impairs the function of the liver cells, blood tests would be abnormal, but
this is reversible, and if someone stops drinking, it'll return to normal.
However, fatty liver can then progress to more permanent scarring of the liver, and cirrhosis, which is irrerversible. By this stage, the liver function is permanently impaired, and, depending on how much of the liver is cirrhosed, people may become symptomatic.
Alcohol can also cause an inflammation of the liver "alcoholic hepatitis", which can also lead to liver scarring and cirrhosis.
And that's just the liver. Add to that the acute pancreatitis - (severe abdominal pain, with the possibility of coma and death), Korsakoff's Psychosis - (Confusion, Hallucinations, Amnesia) and bleeding oesophageal varices - (sudden rupture of the blood vessels inside the oesophagus - leading to rapid and violent vomiting of large amounts of fresh blood, and the possibility... you guessed it... of death), and you haven't got a very pretty picture at all.
Just 2 months ago, one of our patients died from chronic alcohol abuse. She was in her mid-40s. She had 3 children. The youngest was only 8. The oldest spends all her time in the pub now...
This isn't taken from a book. This is real life. This is what I've seen with my own eyes. It's happening around us all the time.
As for me. I'm now a lightweight - I can only stomach about 2 pints before I feel I've had enough. What about you?...
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