This post might be disturbing to some people. I'm sorry if it is. This is a very honest post, and maybe not everybody should choose to read it, I dunno. As a medical student, I thought I was prepared to see patients die. I have to be careful of anything I say or even allude to due to HIPAA regulations, but let me just say I had an emotional week with a patient in End Stage Liver Disease, and I found out that I wasn't ready. I hope the message taken from this is that you don't have to experience anything you're about to read about. Also, no two people have the same medical course or experience the same complications, and I have seen very little of the horrors (or triumphs) of medicine in my very short experience. Thanks.

Hi. I've displayed a lot of troubled drinking over the last few years. It got a little out of control. But I'm not here today to talk about my own drinking per se, but rather to share what I've seen as a medical student rounding on the inpatients of a county hospital over the last couple of months.

Of the many many people that have to stay in our hospital, almost all of them are there for self-administered problems. Some are meth and heroine. And some are attributable to cigarettes. Many are due to long-standing bad dietary habits. But I cannot believe the amount of alcoholic-induced disease on my floor of the hospital. Acute pancreatitis with alcohol withdrawal presents every day to our emergency room. This is not smalltime...necrotizing pancreatitis from alcohol toxicity will kill you rather quickly but also very painfully as your pancreas, which creates the enzymes that break down the food proteins in your gut, dissolves and eats your body from the inside out. In the meantime you won't be able to eat or drink anything...even a tiny sip of water will irritate your pancreas enough to cause you unbearable nausea and pain.

But then there are also the people there with liver cirrhosis from extended alcohol abuse. And it is so ugly to watch as liver function continues to decline. While the body is incredible at self-healing, there is no bringing a liver back from the cirrhotic stage. It's all useless rope and fiber. And the liver is really damn important. Once the liver goes, everything else follows. Your body loses the ability to create proteins. You can't make the basic proteins your blood needs to maintain osmotic pressure and fluid just leaks out of all of your blood vessels into your tissues, and then you have to come in and we stick a HUGE ASS needle in your giant waterbed of an abdomen or into your lungs and suck all of it out for you so you don't drown in your own fluids. And then all the ammonia your liver can't process anymore gets in your brain, and you get brought in by ambulance because you've gone crazy and don't even know how to form words or move your body. And then you start backing up fluid behind your hard as a rock liver and the pressure makes the blood vessels in your esophagus burst, and you bleed into your stomach until you're shitting black bloody slime and you pass out from blood loss. Or you start wasting away like a cancer patient because of malnourishment, because your gut can no longer properly absorb nutrients from your food, and also because remember all that ammonia you had in your brain? You are taking a medicine that makes you **** out all that ammonia to keep you alive, but you also have to **** about every ten minutes, and god help you if you're not within 2 minutes of a toilet. Hard quality of life at that point. Also, you have a gallstone formed of all the dead/destroyed blood cells in your body due to your liver dysfunction. It hurts like a mofo, but your doctors are hesitant to take it out because the gallbladder is right next to your liver and your liver is fragile as can be. Your kidneys are going to start failing next because of hepatorenal syndrome. Your kidneys will be maxed out in their efforts to regulate your electrolytes and fluid levels that have become totally ****** by your liver being an ******* and not doing its job. Your sodium level is dropping, your potassium level is peaking, and the only thing your kidneys know what to do in response to your blood vessels leaking into your tissues is to just keep pumping more and more fluids back into you. You'll be treated with diuretics which will help prolong the time until we have to shove that giant needle and tube inside of you to pull out more fluid that's pooling there. But besides pooping every ten minutes, now you'll also have to **** every five. All of this is putting a lot of strain on your heart too, of course, which is trying to keep blood moving to your tissues but your blood is so thin and you're so anemic that it's having a hard time keeping up and starts getting dilated and weaker and the blood moving through your lungs gets congested and just stays there. And then one of these days all that fluid, that's just pooling inside of you, not moving, gets infected. Because your immune system is about as good as an advanced AIDS patient's. Instead of the HIV destroying your immune system cells, though, you just weren't able to make them in the first place. So now you have a septic bacterial infection in your hugely swollen abdomen for no apparent reason...it just happens cause your system is **** now. And you'll be living in this crappy hospital bed and the doctors will be pumping you full of the strongest antibiotics they've got and you have a tube draining fluid out of your chest wall and every few days the ammonia gets too high and you forget who you are again or your sodium plummets again and you fall into a coma or your potassium spikes and now you're probably gonna have a heart attack and you can't even get out of bed to avoid shitting your diaper and you're on oxygen because your lungs are so congested and meanwhile your medical team is calling the kidney doctor to consult about your failing kidneys and the medical student has been tasked with calling your next of kin to ask them if they know if you are DNR status (Do Not Resuscitate) or not and they had better call a family meeting because even if you make it through this hospital visit your statistical 3 month survival rate at this point is approximately 40%.

And it didn't have to happen. Up until the cirrhosis occurs, liver injury is reversible. Fatty liver disease caused by alcohol abuse happens first. And your liver turns to ****. But the liver can completely heal...if you don't drink anymore. But at this point and beyond, one drink is enough to cause exponentially more damage to the remaining healthy liver. It's a really crappy and avoidable way to die. Don't do it. Get the help you need. Counseling, a friend, a program, a sponsor, medical therapy, whatever it is. I promise you any intervention you undertake will cost far less than a single hospitalization will.