Reel Doctor Talk




How do you take your drink?

By Smitha R. Chadaga MD



The fact that I’m a proud nerd has been well established.  Further proof:  I saw Howards End the FIRST week it was in the movie theatre and for my high school graduation trip I convinced my English teacher to take me and a dozen other graduating seniors on a “Literary Tour of England”.  It is no wonder then that I have been drawn to Doctor Thorne on Amazon. And as expected the eponymous doctor (Tom Hollander) makes the rounds to see his patients.  During episode one Dr. Thorne often tells his friend Sir Roger (Ian McShane) that he will die if he continues to drink.  But just how do you die from alcohol? It all depends on how you take your drink.


There are quick ways of dying from alcohol via binge drinking: alcohol poisoning, drunk driving, and/or violence.  Sir Roger doesn't suffer these fates.


Then there are the long ways of dying via chronic damage causing liver disease, brain damage, heart failure, and/or cancer.  While it is not clear from what Sir Roger suffered he definitely was at high risk doing harm to his liver leading to cirrhosis.  Cirrhosis is caused by repeated insult to the liver leading to fibrosis and dysfunction.  This damage can be caused by a variety of disease processes including chronic alcohol use.  Without a functioning liver a patient can suffer from:


1.  high blood pressure in the liver, called portal hypertension, which can lead to enlarged blood vessels in the stomach which are prone to bleeding that is often life threatening

2.  fluid build up in the abdomen, called ascites, which easily gets infected

3.  life threatening bleeding because the liver stops making proteins that help patients clot

4.  kidney failure called hepatorenal syndrome

5.  brain dysfunction called hepatic encephalopathy


And if all that wasn’t bad enough you can also die if you stop drinking abruptly and go through alcohol withdrawal.


So skip the next round and go on your own "literary tour of England".