Estoy sobria.

 As we turned, and walked out of his room, he called after us, "I know how to hide a body!" 

He had been a homicide detective, and a good one. He prided himself boasting his impeccable track record, not a single open case left to his name. A pretty history and quite fascinating, I'll agree, but it covers up the ugly truth. The alcohol. What started as his escape became his crutch and the ultimate linchpin in the string of events leading him to us and that hospital bed. 

We all liked him. He was motivated and wanted to get better. Perhaps, maybe, we actually helped him. Here in New York that's not the usual story of alcohol cirrhosis. There never was a written rule, but in the past there was an unspoken requirement of 6 months sobriety prior to any liver transplant. We have not kept to that ideal in years. The main reason... these patients won't leave the hospital alive without a new liver. A ballerina. A lawer. A CEO. A father. A son. the list goes on and on. So... we transplant them, essentially providing a second chance at life. Once they wake up and their encephalopathy clears and they finally realize what happened to them.... we hope they are motivated and want to get better as our homicide detective friend. The transplant team I work with here will fight tooth and nail for these patients. They are determined to keep them alive, protect them, and support them. Will many of them go home and ultimately return to the alcohol. Yes, and it's a slap in the face....no, more than that, a kick in the gut. But it's the known risk of transplanting the patient who drank him or herself into hepatic encephalopathy oblivion. I hate alcohol.

One of our patients was transplanted for cancer rather than alcohol. He woke up from surgery feeling so good! Was in such a good mood that when we discussed the projected post op hospital course with him and mentioned going home soon. He was so excited he invited us all for a celebratory bottle of wine! I reactively froze out of fear for his future and the future of his brand new liver. Had to remind myself that a celebratory bottle of wine for this patient was just that and nothing more. Unclentched my throat in time to join in with a nervous half laugh, and subsequently was able to unclentch my fists before anyone noticed.  I wanted to smack him. Being honest, the term that came to my mind right then was "idiot".  Don't joke with a transplant surgeon about drinking alcohol fresh transplant, no matter what your etiology, they could have a heart attack! But smacking him probably wouldn't have gone over well, so I refrained.  

Love and prayers!