Friday, February 26, 2010

Never Say Die

I went with X and his mother to the gastroenterologist today.  We waited in the standard, windowless, harshly lit room making small talk about low-sodium diets and looking at the posters of diseased innards on the wall.  X on the exam table, Mama in the rolling chair and me perched atop the biohazard waste can. 

In came the doctor.  He is a soft looking man with a stern tone who I like for the most part despite his lack of attention during the latest hospital stay.  He took command of the room.

X now has advanced cirrhosis.  The Spontaneous Bacterial Peritonitis he suffered was serious.  If he doesn't get on an antibiotic regimen, he'll get it again.  Any minor infection could morph into a potentially life-threatening situation.  That dental work coming up next week to fix your head full of rotten teeth?  Double up on the meds before you go in.
If you're familiar with stages of cirrhosis, his Childs score is a B.  If you (like me) were not familiar with this until just now, the Childs-Pugh score measures severity of cirrhosis and ranges from A to C.  Level A has a 10-15 year life expectancy.  Level C has 1-3 months to live.  A person at Level B, our level, has a 2-5 year life expectancy and is a likely candidate for liver transplant. 

Important note: 2-5 year life expectancy and likely candidate for transplantation if the patient practices 100% abstinence from alcohol.  Therein lies the rub.

Now, X swears up one side and down the other he "ain't had a drink since November."  Ummm...yeahright.  I know this to be untrue but I have held my tongue in hospitals and doctors' offices for months because...what?  What do you say?  What good would it do?  I didn't know, so I kept quiet.  Til they said Li. Ver. Trans. Plant. and "Any questions?"  (that's my cue)

Me: Um, X, hate to do it but I gotta rat you out here.  Doctor, we have issues with abstinence.
Dr.: I know.
X: WHAT?!?!?!  I ain't had a drink since November!
Me: X, that is's not...  That. is. a. lie.

I went on a tear.  He can't even be considered for transplantation until he's at least 6 months sober, in a program, with a sponsor and a supportive network at home (alluding to the part where Mama would have to put away her World's Greatest Enabler shot glass collection).  Alcoholism is a psychological disease as well as a physical one.  He needs help...but even if he went to rehab...remember last year when he was going to go to rehab?  Even their relapse rate was huge.  The Innards Doc chimed in with "Yes, there is a high rate of recitivism."  At that, Mama's face was one big question mark.  I said, "Means he'll probly go back to drinkin'."  She feigned shock, "Oh.  Really?!"  I hate fake shock when you're not trying to be funny.

X was in the background still holding firm that he ain't had a drink since November.   Yes dear, I like parallel universes're not in one right now.  Wake the fuck up.

Innards Doc referred him for a transplant consult anyway.  (I bet you a million dollars I will not be invited to that appointment.)  Said he probably wouldn't need a liver transplant for at least six months so from here on he should abstain 100% from alcohol.  No problem doc, I don't know what she's talking about.  I ain't had a drink, not one drop since November. 

After the appointment I pulled Mama aside in the hallway.  "Sorry if I crossed a line in there.  I just couldn't listen to that anymore." 
"No, you're okay.  I 'm just scared he believes what he said in there.  He knows it ain't true but it seemed like he believed it, don't it?"
"Uh, yeah."
And our conversation was cut short because X popped out into the hallway at that point.

The car ride home was about as fun as you might expect.  In the same breath he denied drinking, he admitted to New Years and Superbowl.  But he didn't get drunk, so it didn't count. 

Bartender, I'll have a shot of Hepatic Encephalopathy with a Denial back.

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