It’s May, and a friend I haven’t seen for ages emails me out of the blue about an alcohol ink painting class she’s interested in. Do I want to go with her? My first thought is that it’s one of those paint & sip, wine & design numbers. I’m six months sober at this point (and someday I’ll unpack the fact that I quit drinking, after a lifetime in enthusiastic pursuit of intoxication, so I can donate my liver to my husband).
I tell her I’m not drinking, expecting that she’ll want to go with someone better suited. You know, someone fun.
My friend patiently advises that alcohol ink is actually the painting medium, and that there’s probably no cheese to go with the no wine, so we should plan on dinner before. She has her eye on a new place not far from the paint studio.
I’m absolutely atrophying as a human being, in a hyper-vigilant holding pattern, waiting to land. I realize that I don’t want to go, I need to.
It’s May, and I seldom leave the house for anything but work, groceries, and walking the dogs.
I’ve been trying since October to jump the hoops to get John onto a liver transplant list. This has been complicated by the fact that the very first thing he did, on that first intake visit, was fail a tox screen. He’d mentioned the marijuana, so that wasn’t a surprise. But he tested positive for ethanol, too. He was sober, and I’d have bet my life on it, but he had been drinking a lot of alcohol-free beer*, the kind that *contains up to 0.5% alcohol by volume. Enough to sink a screen, I’m afraid.
We needed six months of clean tox screens going forward, and a record of regular substance abuse counselling, before the transplant team would re-present his case to their surgeons. The wait would be easier if the hepatic encephalopathy, an insidious form of alcoholic dementia, weren’t so scary. Or if anyone were even looking at it as a symptom (it’s so clinically slippery that it’s not even part of the calculus for how badly a patient needs a liver).
So instead, it was just me, reading everything I could find about it. And discovering things like the first-year life expectancy for patients with hepatic encephalopathy is 40%. In other words, three out of five people die in the first twelve months. That’s especially distressing when I realize that John’s delayed diagnosis was based on symptoms which started in May… of last year.
I have not shared the odds with John.
But I hear a clock ticking every second of every day, a clock that I can’t see so I have no idea when the alarm is going to go off. I’m waiting for that sudden shriek any second, in a permanent flinch.
Dinner is nice, al fresco. My friend is even quieter than I am. I feel like maybe I’ve forgotten how to talk to people when there isn’t work or illness to discuss, all my neural pathways eroded to channel those flows.
Afterward, we get to the painting class, which turns out to be running longer than we’d realized. I text John to give him my updated ETA.
Alcohol inks are vibrant, highly fluid, and highly reactive: with each other, with simple tools like breath and gravity, and also simple chemicals like isopropyl. There’s nary a paint brush in sight; they aren’t necessary.
I’m shy at first. I’m textual, not visual, I’ve told myself so many times. But today I’m a little sick of hearing from myself about things I’m not good at.
We paint, one drop at a time, and tilt and blow and watch the pigments shift and collide and bloom, taking on a life of their own before our eyes.
It’s one of the best times I’ve had not knowing what to expect next.
We finish, and carrying our speedily dried paintings (mine looks like a piece of a coral reef, I’ve decided, and I love it), we say goodnight and get into our separate cars.
I check my phone before turning over the ignition. John hasn’t answered my text from more than two hours ago.
I tell myself there’s no reason to panic. I mean this is the first time I’ve gone out in months, for barely four hours. What could have possibly happened in that time?
It’s not a sixth sense. It’s statistics colliding with experience.
I get home, and the house is completely dark.
He probably fell asleep in the basement. There’s a dull throb of dread, though. I fumble with the keys, because the porch is dark, and because my hands are shaking.
Once I’m in, I can see a dim light seeping out from under the closed basement door. It’s not usually closed. I open the door, and I call down the stairs as I go.
He’s lying still on the couch, the dogs there with him, but he’s not responding to my voice.
This happens sometimes.
We’ve been able to manage the hepatic encephalopathy a bit better lately. I’d read a PubMed study suggesting that probiotics help the challenged guts of alcoholics to clear ammonia, the toxin that ends up polluting the brain and causing the dementia. We try it, and it helps. Most of the time. (It’s a vital hint that likely won’t see clinical uptake for another decade: that’s 4.5 million new cirrhotic livers a year, 70% of which will give rise to encephalopathy, which is 60% fatal in that first year, which is 1.9 million more dead people, what is special about John in the face of numbers like this, and I try not to feel like I’m losing my mind in every waking second and many of my sleeping ones). It looks like, right now, he’s somewhere between somnolent Stage 3 and comatose Stage 4. My heart rate is accelerating, pulse pounding in my ears, but I’m trying to keep my voice calm as I call to him.
I confirm that he’s breathing first, and touch him, while calling his name.
He finally comes to slowly and says, “Don’t be mad…”
Why does he think I’ll be mad?
“…I fell down the stairs and broke the wall.”
“Oh, my god, what?”
I turn to look at the wall at the base of the stairs, and sure enough, there’s a huge caved-in spot in the drywall. I’d walked straight past it, without even noticing it, in my acute focus on his prone form.
(Six months later, as John and I are in the hospital recovering from the transplant surgeries, my dad will patch the drywall, and carefully paint it, so you won’t be able to see the damage at all. Then, he’ll tell John, “Six inches over and you’d have hit the stud.”)
A Batman print is leaning against the wall on the floor; the frame is broken and the glass is mostly gone, shards glinting on the floor in the light.
“Baby, are you okay?”
“Yeah, I get that part, what happened?”
“I tripped on Bats, and hit my head.”
I come closer.
“I threw up too.”
“I tried to clean it up.”
I can still smell it, and realize that’s because he’s missed the vomit that got on his shirt.
He’s got massive bruises on his arms, and a huge welt on the top of his forehead.
“Can we get you upstairs?”
I won’t notice it until later (I’d missed it in my earlier vague panic, and I miss it again now in my present specific panic), but a pink post-it note is stuck to the outside of the basement door. John had written:
My bright painting, suggestive of colorful living undersea coral, lies forgotten on the kitchen island, as I help him up the two flights of stairs to his bedroom.
He takes off his vomit-stained shirt, and his entire right rib cage is a bruise. He gets out his pajamas, takes off his pants, and his right shin is purple from ankle to knee. He’s slow and lethargic as he moves, but is willing to show me the injuries.
“Can I see your eyes?”
He looks at me. His pupils aren’t the same size.
“We need to get you to the hospital.”
It’s amazing how spunky a concussed encephalope can get when medical attention is suggested.
“I’m not going to the hospital.”
The subsequent back and forth is too stupid to detail.
I do ask him to say our address, and he responds with what he seems to think is an excellent recitation of the four digits, one by anguished one. The smug look that caps his dramatic reading makes me realize with certainty: man, he is really fucking out of it.
All I can think about, standing there in his bedroom, are sneaky epidural or subdural hematomas: all seems fine after a blow to the skull, while a quiet bleed slowly suffocates the brain, insidiously squeezing it to death against its own bony case.
At one point in the escalating stupidity, not to be outdone, I literally get down on my knees, begging him to let me call an ambulance. I’m not religious, but I’ve certainly knelt in a church, and reached out to the unknown with thoughts, hopes, prayers…
But I have never done that before with a human being in front of me.
I won’t again.
It’s a terrible position, especially when your most desperate prayer is ignored in real time.
Why does he think I’ll be mad?
Unheard, I clamber up from the floor, and something snaps.
I hit him. I mean, I don’t punch him in the face or lay him out flat. But I punch him in the arm, as hard as I can.
I’m mad. I’m trying to get his attention. I’m terrified. I don’t know what to do. He’s not listening.
I have so many excuses.
And I have no excuse.
He looks surprised for a moment.
I have his attention.
When he starts to turn away, I hit him again, a punch to the chest.
And I hate myself.
I wonder now if John even remembers.
I wonder if I’m the only person who knows.
After two blows, I manage to collect myself into something less reactive. I tell him, “Fine, we won’t go to the hospital, I’ll stay up and I’ll wake you up every half-hour to make sure you can still see and that you’re still breathing.”
And I did.
It was the least I could do. It was the most he would let me do.
John does continue to see and breathe into the next day, and I manage to get him to our GP, who insists on a CT scan, which amazingly comes up clear. At least John’s pupils have returned to the same size.
In less than a month, I’ll take him for the tox screen that he needs for the six-month re-presentation of his case with the transplant team. He seems completely normal. But his BAC comes back at 0.25%. (A BAC of 0.08% will get you a DUI in all fifty states of the U.S., plus the District of Columbia; a fairly permissive amount with respect to most other countries.)
I insist to the team that there’s been a mistake, and for a long time, I believe it. I wasn’t yet checking the recycling, or the trash, or the woods behind the house. No one believes me, of course.
And just like that, the clock ticking louder and louder, we’re back to square one.
I understand the drive to dispose of artifacts of bad times, objects permeated by events that have unfolded in their presence, tainted by association. I have done just that with several items that remained after John was gone.
But the alcohol ink painting from that night hangs prominently in my house now. I see it every day.
I keep it because it’s beautiful.
And it’s a reminder.
We all fall.
If you are the loved one of an alcoholic, please consider joining our Echoes of Recovery group. We’ll be here for you when you fall.