Late-Stage Alcoholism: The Gruesome Reality

I came across this terrifying, yet oddly mesmerizing, 184-year-old quote while reading Ch. 6 of Under the Influence by James Milam & Katherine Ketcham.

“Among all sources of disease, alcohol stands preeminent as a destroyer….This pestilent principle generally seeks for asylum where it may practice its deadliest deeds in some important and vital organ of the body. It sometimes makes the brain more particularly the seat of its venom, and victim of its cruelties. At another time, it hides itself in the inmost recess of the heart, or coils around it like a serpent; now it fixes upon the lungs; now upon the kidneys, upon the liver; the bladder; the pancreas, the intestines or the skin. It can agitate the heart until it throbs and bursts, or it can reduce pulsation until it becomes impalpable. It can distract the head until the brain ‘sweats blood,’ and horrified reason flies away and leaves the man a maniac or a madman….I never knew a person become insane who was not in the habit of taking a portion of alcohol daily.” — Rev. Benjamin Parsons, 1840

The rest of the reverend’s essay depicts the gruesome realities of alcoholism in equally visceral language, but these lines stood out to me the most. I was surprised at how closely it echoed my dad’s experiences when I first read it a year or two after his passing. Much of Under the Influence mirrors my dad’s final year of life.

When I compared the book to Dad’s hospital records and saw how everything lined up, I felt like such a fool. His records were unbelievably painful to read, but I was determined to get through all 2,989 pages, lest I miss something important or, gods forbid, I hadn’t adequately flogged myself for not being there for him.

Late Stage Alcoholism a screenshot of an emergency department provider note covering general chemistry labs with typed notes explaining what some of the sections mean like CK+Isoenzymes carbon dioxide calcium AST ALT and anion gap levels
Dad’s general chemistry labs from May 15, 2021. He went to the ER after falling multiple times, eventually falling into the bushes. Despite refusing medical attention, the police were called, and it was concluded that he lacked the capacity to decide.

Discovering that Dad had been admitted to the hospital just three days before his death was devastating.

He’d also been to the hospital twice in May, the first for two days and the second for a week, only three days after being discharged. I was in Washington getting engaged to my boyfriend. To keep that moment special for me, my mom and little sister refrained from telling me about his hospitalization until I got home. By the time I did, Dad was already back in the hospital again. So, I just assumed he’d never left, and it was all one long stay.

515 if he goes home he will die
According to the medical decision-making section of his records, Dad’s ex-wife expresses concern that if he returns home, he will die.

After my sister informed me of Dad’s whereabouts, I contacted the hospital to inquire about his status. I was naïve enough to believe that his perilous situation would finally be addressed when the nurse assured me that an elder abuse investigation had been opened, but nothing would come of it. It was up to Dad to decide whether to pursue that course of action, and his current mental state was not exactly filling him with determination.

His ex-wife told me her concerns after Dad was checked out by his new fiancée. But I failed to grasp the seriousness of his condition. Would that have made a difference? I have to wonder if I brushed his ex off because Dad had conditioned me not to believe her.

Maybe the truth’s even bleaker: I’d given him up as hopeless. Or maybe I was just so preoccupied with getting Dad away from what I perceived as “the problem” that I neglected to ask more vital questions.

a screenshot of a text message thread between a daughter and her father's girlfriend, discussing him being detoxed from alcohol at home
In this text thread, my sister (blue) communicates with Dad’s fiancée (grey). She hadn’t reached out to me since our last unproductive conversation, but Libby wisely knew the best way to keep tabs on Dad was by keeping things friendly with her.

We were encouraged to believe that Dad was “pretty darn healthy” by the woman who took over his care from us. Perhaps if I had a more magnanimous and lenient disposition, I could’ve entertained the possibility that the doctors neglected to tell her about the gravity of Dad’s swiftly declining health. But I can’t do that because I remember what it was like when I was the person sitting with Dad at the hospital. His doctors might’ve only told us half of what they should have, which I’d only understand once we subpoenaed his hospital records after his death, but they did keep us informed at a bare minimum.

Putting all that aside, Dad’s chosen paramour was once a registered nurse. She lost her license for HIPPA violations, but we can’t overlook the years of study and expertise she gained. As a former RN, she should’ve recognized that Dad was far from pretty darn healthy.

screenshot of an assessment plan for inpatient with toxic metabolic encephalopathy a medical condition where the brain doesn't function properly because of toxic substances in the body or metabolic imbalances.
On May 20, 2021, Dad is re-admitted to the hospital with toxic metabolic encephalopathy, a medical condition where the brain doesn’t function properly because of toxic substances in the body or metabolic imbalances.
a screenshot of a person's hospital record showing the problem of severe malnutrition, code NI-5.2, with the stiology of decreased intakes, diagnosis of alcoholism, and signs/symptoms of 11% weight loss in less than 3 months.
On May 21, 2021, the same day that Dad’s fiancée texts my sister, he’s “pretty darn healthy,” Dad is given a nutrition evaluation because of the troubling state of his labs and his significant weight loss.

One of Dad’s old friends visited him before he left the hospital; afterward, she told Dad’s recent ex-wife that her number, along with many others, had been blocked in his phone, making it impossible for certain people to reach him. (My recurring nightmare: what if Dad had tried reaching out to me, couldn’t, and thought I was ignoring him?)

When I heard that, I quickly texted him my love, telling him, while I still could, that I had gotten engaged and how heartbroken I was that he hadn’t been involved with any of it. I told him he could still come live with me while he recovered, but I couldn’t watch him die like this.

a screenshot showing various chemistry labs for one person over the span of several days for the purpose of comparison
I’ll be the first person to admit that I’m not a doctor or a nurse, so these numbers mean little to me, but all those little red arrows frighten me.

Six days after his last hospital visit in May, on the 1st of June, Dad’s fiancée of 35 days was in a car accident while driving Dad’s rental car.

She made a run for it, hiding out with one of her two boyfriends. The same one who would later bail her out of jail. This man was the first person she called after the accident, according to the police report; she did not call my dad, her husband-to-be, yet the very next day she still married him. In secret. My sister and I would not know they had actually gotten married until after Dad’s death. We found out with everyone else when she posted a massive photo dump on his Facebook wall.

Given Dad’s uncanny resemblance to the Grim Reaper in their wedding pictures, it’s no surprise that she opted to keep the photos under wraps or that she waited until his passing to reveal their secret marriage. (This woman was chronically online so there’s no excuse for her not posting them sooner.)

I’m grateful someone warned my mom about her post so she could tell me about my dad’s death in person before I saw it on Facebook.

Late Stage Alcoholism a screenshot of receipts showing alcoholic purchases in April of 2021 with descriptions
One of many pages I created during my “research phase” of this project. I tried cataloging all Dad’s alcohol purchases by the likelihood that he was the one who bought the alcohol, if he signed for it himself, and if staff members took advantage of his inebriated state by overcharging him. In later months, he was almost always overcharged.

Four days before his death, Dad’s brand-new wife is allegedly spotted out in a white dress at the Coronation Ball, a local event, with her second side piece. We live in a small town where everybody knows everybody, so it’s easy to find these things out if you have the gumption. It’s the night before Dad calls 911 for the final time.

On the 12th of June, Dad goes to the hospital one last time.

This visit nearly breaks me when I find out about it. When we finally receive the hospital records, I’m at a loss. I can’t understand how the doctors could have let such a seriously ill man leave. They could have saved him. He was right there.

a patient history from a hospital stay in 2021 showing a patient history of alcohol or ETOH intoxication
From Dad’s visit to the ER on June 12, 2021, just three days before he’d be found at his kitchen sink. Note that his wife states he hadn’t been talking normally for the past two weeks, during which time they got married.

At this visit, Dad’s alcohol level was 497, which commonly leads to coma, respiratory arrest, hypotension, and even death. Yet an hour after receiving this critically high test result, his doctor allowed his wife to check him out and take him home.

To die alone.

screenshots of lab results for someone's dad that show ethanol readings over time, highlighting the abnormal results, comparing them
Dad’s ethanol readings, or the amount of alcohol in his system; note that the only time his levels aren’t “H” (high) or “HH” (critically abnormal) is in March after his stroke, which is a couple months after he got back from rehab.

Resources:

Milam, James Robert, and Katherine Ketcham. Under the Influence. Bantam, 1983.

Parsons, Benjamin. “ANTI-BACCHUS; AN ESSAY ON THE CRIMES, DISASTERS, AND OTHER EVILS CONNECTED WITH THE USE OF INTOXICATING DRINKS.” IN THIS WORK THE CHARACTERS OF THE WINES OF SCRIPTURES IS SETTLED IN ACCORDANCE WITH THE INDUCTIONS OF SCIENCE AND THE FACTS OF HISTORY, J. Snow, London, 1840, pp. 34–35. books.google.com/books?id=NOxhAAAAcAAJ&pg=PA34&lpg=PA34&dq.


Hotlines:

  • National Helpline for Substance Abuse and Mental Health Services Administration (SAMHSA): 1-800-662-HELP (4357)

Websites:



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author avatar
Kinsey Keys
aspiring memoirist rummaging through my noggin, stubbornly clutching the past to my chest like it’s a newborn babe starved for mother's milk.

3 Comments Add yours

  1. cherylcorey says:

    This is an epic warning. But also a reality check- we are all

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