Drinking to Death

I have had three patients die from liver failure due to alcohol in the last month alone. These patients come in fairly often, but this is statistically far higher than normal for my unit.

I've been wanting a book that lists diseases and what symptoms are to be expected when dying from that disease, because there are clearly some consistencies. These three patients (all coincidentally? men), had huge bloated bellies (called ascites) and grotesquely swollen scrotums; they were all confused; they were jaundiced (look yellow); they bled very easily and a lot. I know the physiology behind some of these symptoms. The liver creates clotting factors which prevent bleeding. Without the liver, the body's ability to create clots (think scabs) is impaired. This site explains some of the other symptoms pretty well.

Every time I've had a drink in the last few weeks, I've thought of these three men. S (my partner) asked me, "How many drinks do you think they had to have to die of liver disease?" Truth is, I don't know. All three were very young. None of them were eligible for a liver transplant, probably at least somewhat due to their alcoholism.

Although I tend to be a bit uncomfortable around drunk people (at least when I am sober), I tend to be very compassionate with these patients. Perhaps it's the alcoholics in my own family whose ends I envision in these patient's eyes.

The end of this post has some good tips for preventing liver disease, as well as some comments on palliative care for people dying of liver disease.

At some point, if I can't find a book on disease-specific experiences of death, perhaps I'll have to write one. But if anyone runs into one in their local bookstore, please let me know! :-)