If our insides could speak: Alcoholic Cirrhosis from the liver’s point of view

Her shriveled silhouette lay still among the shadows as the probe peered beyond the slatted ivory cage.[1] Fifteen years earlier one might have remarked on her beautiful, blemish-free skin, a youthful and smooth mahogany-brown. This was in stark contrast to her now scarred and disfigured body; evidence of the brutality she had endured at the hands of her husband. It seemed like a complicated story riddled with shame and resentment. She wouldn’t say what set it off, but it was clear that it resulted in her being subject to years of malnourishment, abuse, and neglect.

A good house wife, she had done her best to not let the clutter accumulate, the paint yellow, or the pipes rust.[2] In the early years it was easy, for no one stared too long into the eyes, and being a proper lady, she held her tongue.[3] In moments where things became increasingly hard to bear, she withdrew further into herself, drawing upon the poems she had heard a lifetime ago, reflecting on that line that resonated so deeply and now carried a different meaning: “We’re built like drums. We couldn’t make songs if we’d never been hit. It was a desperate theory” (Gibson, lines 7-8).

She remembered the first hit, although her naivety prevented her from labeling it as such back then. She had picked up on a subtlety, an essence if you will. Maybe it was a foreign scent lingering on his collar or a different taste on his lips? Whatever it was, something had been off when he greeted her in the corridor that night.[4] She opted to remain silent. After all, she couldn’t fully justify her suspicion.

Instead, she gave him the benefit of the doubt, but remained vigilant for the next few months. The pattern became evident rather quickly: he was more absent and less coherent. Her heart broke when she found incriminating correspondences to someone by the name of Alice Hall hidden among the bills.[5] They met a few times per week it seemed, sometimes at her place, and other times he would do the unspeakable and bring her here.[6] If he had wanted the affair to remain a secret, he should have tried a bit harder. He left a trail of bread crumbs from their evenings together, always hidden under the daily post in the recycling bins, as if she wouldn’t see.[7] Didn’t he know it was her job to take out the trash?

Within months, he and Alice were meeting every day, often multiple times per day. Their lives had become so intertwined. She feared that soon, she herself would no longer be enough for him.

Eventually that day came. Things were falling apart and appearances could no longer be maintained. Skin so taut it neared translucent, about to burst over a belly laden with fluid but deprived of nutrients. Vessels so engorged they looked gluttonous despite a raging resentment of an ever-increasing capacity. Complexion yellow, legs swollen, mind altered.  It was in this moment, the hardest of all, that she returned to the poem she had heard a lifetime ago. Perhaps she was built like a drum, for she had been beaten repeatedly and made music. But what happens when the drum skin breaks?

References

1.     Gibson, Andrea. “Good Light.” Lord of the Butterflies, Button Poetry, 2018, pp. 17-20.  

[1] Describing the liver as if looking with an ultrasound probe through the rib (ivory) cage
[2] Referencing ammonia/toxin accumulation, jaundice, and variceal bleeding, respectively.
[3] Scleral icterus and sublingual jaundice are some of the first places you can see discoloration.
[4] Corridor is a metaphor for the portal vein bringing blood containing alcohol from the GI tract.
[5] The incriminating correspondences are receipts documenting alcohol purchases, which is why they are hidden among the bills. Alice Hall is a play on alcohol. 
[6] Her place is referencing going to bars or going out for drinks in general, as opposed to drinking at home.
[7] Alcohol bottles disposed of in the recycling bin.