Dying From Chronic Alcohol Poisoning
Bruce Anderson was gazing at death as he stared up at me with terror in his eyes. His lids were drawn back, and the globes almost bulged out of their sockets. His sclerae (the whites of his eyes) were the color of a crook-necked squash, jaundiced from the bilirubin (a yellow pigmented breakdown product of hemoglobin) in his bloodstream that a failing liver could not metabolize and remove.
Bruce was in hard restraints, heavy leather hand and ankle cuffs strapped to the frame of the bed so he couldn’t flail about or pull out the tubes and IVs that were keeping him alive. A tube used to irrigate his stomach with ice water protruded from one of Bruce’s nostrils. The tube was taped to the noseguard of a football helmet strapped to his head. He shook violently from delirium tremens (DTs), the chill of the ice water that was being flushed down the tube, and shock, having lost a third of his blood volume to gastrointestinal bleeding.
Bruce, an alcoholic in the end stages of liver failure, was bleeding from esophageal varices (varicose veins bulging into the esophagus caused by a scarred liver). It was his first bleed. There was a fifty-fifty chance it would be his last. His beard was caked with clotted blood, his hair was matted, and his arms were covered with large purple bruises.
How did this happen to him?