Death in a Bottle.


Just as the year has different Seasons, each with their own set of personal characteristics, I have different sides to my personality. You may have gathered from most of my blog posts that I am a by and large a pretty relaxed guy who likes a joke. There are times though when, just like the Seasons, I see a shift in my personality. This week saw that shift and I guess to a degree, this week’s blog will reflect that. Let’s call it the Winter of my personality – slightly darker and little more severe.

Now most Friday’s after a long week at work, I like to have a whisky as I sit back, relax and reflect on the week that has just once again moved like a freight train from underneath me at breakneck speed. This week though when I got back to my flat, I just stared at the bottle of whisky and felt nothing but disgust. Right there and then, I hated alcohol.


A very good question. Well in a nutshell, in this single week in the intensive care unit I saw three young men and women die a horrible death from decompensated alcoholic liver disease. All three were under the age of 50 years. What a tragic and terrible waste of promising life.

In fact, every year over 5,000 people die in this way and over the past 30 yrs this has risen by 450%.

Let me give you a little idea of what decompensated alcohol liver disease does to the body: your liver shrivels up and stops making proteins, sugars and chemical factors that help your blood clot when you bleed, it puts pressure on your kidneys so that they stop working, it forces the massive consumption of your muscles for fuel so you literally waste away, fluid that should be kept within your blood vessels and cells actively leaks into your tissues and abdomen giving you a huge ‘ascitic’ tummy and puffy limbs, and the build-up of a break-down product called ammonia causes an encephalopathy – which basically means that you become confused and lose your sense of self.

Now imagine that you are a family member at your loved ones bedside? What do you see? Someone who certainly doesn’t resemble your loved one that’s for sure. Instead you will see someone who is utterly wasted with no muscle mass, bleeding from various orifices, with a huge bloated tense tummy, yellow skin and eyes from jaundice (the build-up of a chemical called bilirubin) and unable to any make sense to you as they are confused – that is of course if we haven’t already intubated them and are helping them breath via a ventilator as their lungs have also failed. The chances of recovery once they come into the intensive care unit with this picture of what is ultimately known as multiple organ failure is incredibly poor.

Even more heart-breaking is that fact that you discover that they continued to drink right up to their hospital admission. For them, alcohol has grabbed hold of them like a serpent slowly squeezing the life out of its prey.

So where’s the root cause of it all? Well, yes it is most definitely multifactorial – I don’t disagree with you there. But you don’t need to be too switched on to see that the relationship between society and alcohol has become increasingly promiscuous. Friday night, Saturday night, any night in fact, in any major city is an opportunity to get wasted. You could rub two five pound notes together in a bar and get you and five of your mates drunk. In essence, drinking is a national past-time now.

Now don’t get me wrong, readers, I like a drink. Indeed a small amount of alcohol within the daily recommended volumes (for men that’s less than 21 units a week with at least two days without drinking; for women that’s less than 14 units a week with at least two days without drinking), is good for you for it is thought to distress us, reduce our blood pressure and thereby reduce the risk of strokes or heart disease. Problem is, moderation is not part of the British culture when it comes to alcohol. The fall-out from this is that we see families destroyed, violence, financial trouble, social unrest and over 800,000 alcohol-related admissions to the NHS each year at a cost of over £2.5 billion.

Of course, drinking is also on a spectrum. For the vast majority of us, we sit healthily on it. It is those that sit on the extreme right of it, consuming way in excess, which see themselves in A&E and then guests in our intensive care units. But it is not just them is it. It’s the families of these people. Often strained to breaking point after having tried to rescue their little boy or little girl from the grips of what is a horrible unrelenting illness. I had to watch these families go through hell this week – the final part of their journey you might say before perhaps they can begin to rebuild their family units now that their loved ones are finally, at the very least, at peace.

And to be clear, yes, you did hear me right – I did say illness. Alcoholism, alcohol dependence, and alcohol binges, are all an addiction that destroys the body and mind. It is an illness and as such we need to support and care for people that suffer from it. I know that many people find this an unpalatable notion – especially when alcohol has the power to transform an individual from the kind, gentle and reasonable person into a monster.  I argue this to you however – if we don’t – how will it ever get better for them or their families. I bet my bottom dollar you know somebody who drinks too much. I know I do.

Alcohol and the devastating effects it produces is an issue for us all. It is the collective responsibility of individuals, families, society, governments and providers. Until we come together and tackle it with iron-clad tools to beat it and transform our relationship with alcohol, I will and many other doctors will continue to see people come to us. Sadly by then, it is just too late.

And on that note, I do hope now you may see why I didn’t feel like that whisky last Friday night.

Have a great week everyone – Spring is on it’s way.

Dr Nick

P.S. If you or anyone you know wants more support I recommend checking out the link below:


4 thoughts on “Death in a Bottle.

  1. Since 1972 my brother has consumed vast quantities of alcohol ( mainly beer) and he is a now a sprightly 66 year old who cycles everywhere, Can you explain why he,s still alive, everybody,s amazed by him

  2. Unfortunately I can relate to this post rather more than I would like to, having lost my own Dad in this exact way, although he never made it to hospital. It is comforting to read your take on the subject of alcohol and to hear the understanding and compassion you have as a Doctor despite also having to deal with the results and witness the devastation first hand. I am also able to enjoy the occasional drink but recognise how dangerous it can be for others. You are so right, it is absolutely a collective responsibility for us all in addressing this very serious problem. I really hope that soon others will see too. Thank you.

  3. Thanks for sharing this article, I read “The science of alcohol: How does it affect your liver and heart?” which was featured in the Independent this provided me with more information about your blog and I found the information on here very valuable, that I have shared some of it on my post which I wrote about drinking recently too. Would be cool if you can check it out too. Either way love your blog!!

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