The doctors call it Nonalcoholic Steatohepatitis and it is not really that big a deal... until it is.
Nonalcoholic steatohepatitis or NASH is a common, often “silent” liver disease. It resembles alcoholic liver disease, but occurs in people who drink little or no alcohol. The major feature in NASH is fat in the liver, along with inflammation and damage. Most people with NASH feel well and are not aware that they have a liver problem. Nevertheless, NASH can be severe and can lead to cirrhosis, in which the liver is permanently damaged and scarred and no longer able to work properly.
NASH.
If there were genuine television cop show justice in the world, that reference alone would bring to mind the Don Johnson/Cheech Marin cop dramedy "Nash Bridges," which would inevitably trigger hazy reminisces of "Miami Vice," subsequently collapsing into a tautological psycho-pathetic pity party featuring me dramatically brooding and endlessly replaying the time I got stood up for senior prom in '89 and spent the night watching a "Miami Vice" re-run, the one with Willie Nelson, where Willie is an old Texas Ranger.
That, or the Korean War dramedy "M.A.S.H.," featuring Alan Alda as Hawkeye Pierce.
Did you ever notice on M.A.S.H. that Hawkeye and Trapper John -- later it was B.J. Honneycutt -- would occasionally drink? And by "occasionally," I mean all the time. If you didn't, then you missed a pretty big part of the show. After all, those guys had a still in their tent.
So, about the drinking.
I have managed to involve myself in two worlds -- writing and politics -- in which drinking, frequently to excess, is not only considered a badge of honor, a drink in your hand is the ticket in the front door.
And here's a thing about NASH: you can't drink alcohol anymore.
Ever.*
Writing and politics go hand in hand with booze, and if you don't believe me, spend about a forty-five quality seconds with Google. I started a collection of drinking references from famous writers, from writing websites, from folks who write about writing, from bloggers, from Twitter feeds, from Facebook. I can't post it all, because there are far, far too many references. The only thing which eclipses references to writers, writing and drinking is politics, politicians, campaigns and drinking. Even Obama had "the beer summit".
Okay, before you feel too sorry for me, a couple of things you should know.
One: though I do have NASH, I am completely fine. Do not feel bad for me, and do not let me guilt you into feeling bad for me. I feel really good, actually. In the last year or so I've lost a bit of weight and I feel as good as I've felt in a long time. My case of NASH is a very mild one, and the doctors are mostly doing their due diligence in checking me out to make sure there's nothing else going on.
Be warned: if you turn me into some kind of charity case or make a big sympathy production out this, I reserve the right to thank you privately and torment you publicly. With respect to my physical well-being, I am fine.
Two, the drinking thing is not really that big a hit for me, so don't be fooled. I'm not sitting on the street corner pouring out a refrigerator full of 40s giving much love to my homies. I don't have a recycle bin full of just-emptied vodka bottles. There's no wall of empty beer cans in my bedroom. I'm not donating a crate of whiskey glasses to Goodwill.
The truth is, I haven't been much of a drinker in a long time. Well, the truth is, I wasn't much of a drinker in the past, either -- at least not comparatively.
When you've been told that you can't drink, you start to notice how much people do drink. Which, because I am nothing if not self-centered, leads to some stories.
# # # #
THIS IS NOT A LETTER ABOUT AIDS/HIV. That was bannered across the top of the letter I received in 1998 after I tried to give blood for the first time. It was a Red Cross blood drive at the White House, and it happened to fall during a brief stint in which I was working on getting healthier. I'd come out of the gym, and saw the sign.
A month later, that letter showed up in my mailbox.
They went on to mention my liver enzyme levels being out of whack, and noting that though they deeply appreciated my platelet-based contribution, they would ask that I no longer donate blood. Ever.
They'd keep me on a little list, they said, just in case.
When you get a letter like that, you tend to follow up with your doctor, even if you are twenty-seven and think you're bullet-proof -- which is exactly what you tell anyone who will listen. And so it was off to the doctor I went, for what I was sure would be a routine visit and a complete and utter dismissal of the Red Cross letter.
I am a lucky man. The only time I've spent the night in the hospital is when Emeline was born, and, I guess when I was born. I am lucky, and I know it. I went to the emergency room when I flipped my go-cart and scraped all the skin off my knee. I was probably twelve or thirteen. I went to the emergency room in college when, during the course of a lively -- and yes, drunken -- Friday night game of kill-the-man, I gashed open my eyelid on either my friend Dave's boot heel, or a patch of ice that was in what turned out to be a cow pasture (different, longer, bettter story for another time). I've taken people to the hospital before, and when I do, I'm always thankful for how healthy I turned out to be.
My doctor did not dismiss the Red Cross letter, and several blood tests and an ultrasound (make all the pregnancy jokes you care to) later, I was diagnosed with "fatty liver" -- a sort of generic NASH.
Think about fat, how you get fat, and what fat really is and does. Yes, you see it on your neighbor's beer gut. You see it on the thighs of the girl at the pool. You see it on most Americans, actually. But it's more than just a deposit of stuff on our butt, our thighs and our guts. It can find its way into our organs. Think about a person with clogged arteries. What are clogged arteries, really, other than what amounts to a fat heart?
Same thing can happen to your liver. It happened to mine.
The doctor told me to cut back on my drinking, avoid acetaminophen (which is hard on your liver) and start exercising regularly. I did all of that. Except the drinking and exercising part.
# # # #
Actually what I did was ignore it for about 12 years.
I have a new doc here, and she's fantastic. The enzyme levels caused her more concern than my last doctor, and so she started looking at bloodwork, and referred me to a gastroenterologist. He did some tests and referred me to a hepatologist.
The hepatologist was the one who called it something -- NASH -- and he looked me right in the eye and said, stop drinking.
I crinkled my nose. Not because I was so desperate for a drink, but because... well, who wants to ever be told anything so definitive? So final? He noticed my discomfort and explained it to me.
"Look," he said, "it's easier to just stop completely. Can you have a drink? Sure. But if you have one, it's much easier to justify another, and another, and another. New Years. Weddings. Birthdays. Better to just stop."
He took a pause, then said, "So stop."
# # # #
And so stop I will. And so stop I have.
I can only think of one instance in the future in which not drinking will prove a challenge: my daughter's wedding. You think I'm not going to have some booze in the glass when I give my daughter away, you're out of your mind.
Of course, Emmy is fourteen months old so I have a little while on that one.
# # # #
I'll miss the some of the social aspects of drinking, which is what I've always enjoyed about it, anyway. Sitting at D.C. Coast with my friends drinking expensive martinis. Watching a Rays game at the Trop with a cold Coors Light. Hanging out at the campaign headquarters doing shots of real moonshine with the staff. Going to get beers and bar food with my buddies after working an eleven or twelve hour day at the White House.
It's easy to see why drinking goes so well with writing and politics. It gives you some of your best stories. The law firm representative who interviewed me for a job over dinner and got blitzed on an entire bottle of wine (I had a glass of the stuff, and then was too nervous to eat, much less finish drinking). The kamikazes I drank at a party when I was at Arkansas State, and the guys who drove me home in a car I kept trying to exit as it sped down the highway.
# # # #
I was 17, it was just south of Boston, it was cold, and she was hot. 'Hot' like she was a model once. Reddish hair and porcelain skin, lips that dripped innocence and sin all at once.
I wanted very much to have sex with her, and knew almost nothing about how to make that happen.
As luck would have it, the opportunity never presented itself because of alcohol.
It was a party in our friend Jodi's room. Me and my friend Dave were getting drunk, along with everyone else. He had a big bottle of vodka and I had a big bottle of Jack Daniels.
We were sitting around listening to music and drinking and doing what idiot eighteen year-old college students do in a dorm room on a cold Massachusetts night. This loser named Brandon was there as well.
We were all very drunk, and Brandon was trying to play very deep, very angst-y guitar. It was mesmerizing either because it was horrible, or because we had nothing better to do.
Annie was there. She was a Northeastern U. student and a friend of Jodi's maybe from Connecticut. I shall never forget the sort of college gallantry of my friend Dave that night. We were there partying, and I could not stop staring at this beautiful girl, Annie. We didn't have girls that gorgeous on the Curry campus. They all had a cromagnon foreheads and extra teeth. Their knuckles scraped the ground and shit. They communicated in a simplistic series of grunts. They groomed each other with their brown, gnarly fingernails. Yes, I dated one once, for a not inconsiderable amount of time.
So there I was, awkwardly trying to pick up Annie, and this Brandon kid was all over her. I'm sure I remember him tossing his Flock of Seagulls hair around and trying to make up a song about Annie. It was totally embarassing. For him, I mean. But I was getting the idea that I didn't have a chance with this girl, because my hair was bad. And I didn't have a guitar.
And I sighed, inwardly, knowing that Brandon would get lucky with her, and I wouldn't.
"Hey," Dave said to Brandon. "Let's go get my bass. We'll jam."
"Oh... okay," said Brandon, his uneccesarily large ego not wanting to to pass up an opportunity to embarrass himself in front of someone with infinitely more talent. He left with Dave, at least for a short time. It was the opening I needed.
Annie and I struggled up off the floor and headed towards Mayflower dorm on the other side of campus.
We got down the stairs with some drunken difficulty, the effects of the booze starting to hit us now that we were up and moving.
She said, "I don't feel so good, an' I gotta pee."
I said, "Just throw up right over here."
She threw up.
We walked another twenty yards.
She said, "I don't feel so good, an' I gotta pee."
I said, "throw up in this trash can."
She threw up.
We walked another twenty yards.
She said, "I don't feel so good, an' I gotta pee."
I said, "Throw up in these bushes."
She threw up.
We walked another twenty yards.
She said, "I don't feel so good, an' I gotta pee."
I said, "Here's another trash can. Throw up here."
She threw up.
We walked another twenty yards.
She said, "I don't feel so good."
I said, "Don't you have to pee, too?"
She said, "Not anymore."
She had, in fact, wet herself.
So we finally made it to Mayflower dormitory. To say things had taken a turn for the socially awkward would be an understatement.
After about thirty minutes of pretty intensive barfing as well as a pretty aggressive urine stench, I suppose it was easy to be a gentleman.
She threw her panties out the window, and I stood guard outside the bathroom while she cleaned up.
She passed out on my bunk, me under a blanket on our floor.
I saw her once or twice after that and it was always unbelievably awkward, strange. Not that I blame her. She was amazingly smart, unbelievably beautiful, funny, and could never, ever surmount her humiliation of having peed herself in my presence on a strange college campus that cold, cold Massachusetts night.
I have always blamed booze for ruining it.
# # # #
The day my divorce from my first wife became official, I bought a big bottle of gin and some tonic and brought it home to my parents. Maybe it's corny or even taboo to share drinking stories about your parents, but that is one of the nicest evenings I've ever had. Sitting on their deck, looking out at the property, the pond, the field, the woods, just drinking an ice-cold gin and tonic with enough lime and talking not so much about the past as about the future.
# # # #
I remember my very first drink: a can of Budweiser in a park not far from the house where I grew up in Little Rock. I managed to choke down about three-quarters of it before I wandered off into the woods where I poured it out.
My last drink, as it happened, was a beer as well. I don't even remember the kind. It doesn't much matter.
The truth is, I won't miss it. I am sharper at work when I haven't had a drink the night before. I write more clearly (this blog post notwithstanding). I think more clearly, which is what politics certainly requires.
I expect the socialization piece will come together, too. There's nothing that says I can't still go to a happy hour. Maybe now I'm just the designated driver every time.
If you happen to read this and you see me out at a restaurant or bar or somewhere where it is appropriate to drink, do me one favor and don't feel bad about having a drink in front of me. It's okay. I promise, I'm not coveting your drink, though I reserve the right to laugh at you and judge you later if you make an ass of yourself. Don't worry, it's happened to me plenty of times.
Giving up alcohol is totally worth it if it makes my writing any better. I'm out of the political scene enough that I suppose it won't much affect that world.
But I am not giving it up for the writing and the politics. I'm giving it up because I fully intend to relish that big glass of champagne on Emeline's wedding day.
It'll taste sweet, and sparkly, and just a few gulps will get me loaded, and there's no doubt I'll fall apart and make an ass of myself giving away my little girl.
But then I'll be fine once the wedding is over.
After all, you should know that I am completely bullet proof.
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* To be fair, it's not that you can't drink "ever," it's that drinking alcoholic beverages is a really, really bad idea, and the doctor tells you not to do it. Drinking any amount of alcohol will counter whatever good you're trying to do to reduce the fat in your liver and minimize the effects of the "steatohepatitis" piece, which is the inflammation. Taking a single drink won't kill you -- but it won't help you. And when you have one, you're more likely to make excuses about having another ("But it's my birthday!" "...it's New Years!" "...it's my anniversary!" "...it's Saturday!").
This has been cross-posted at my blog for writing, essays, and fiction, Clintonaut.
