Almost ‘Chopped Liver’

by Gary A. Aumiller, PH.D.  ABPP

This story is told with the permission and review of my patient, John.

John is a retired cop, one year younger than I am.  He is pale white sometimes and other times he looks remarkably normal.  Sometimes he looks weak, sometimes like the man that plays golf a couple of times a week in retirement.  He is well-liked by most everyone that comes in contact with him.

“So why are you here?  I assume you didn’t come in for a golf lesson.”  I am not the greatest golfer.  I had known this man from police golf tournaments.

“I need a liver doc.  My brother and sister are both willing to give me part of their livers but the hospital in the city won’t do the operation because I failed a blood test.”  (A quarter of a liver from someone else will regenerate and handle the functionality of natural liver.  Live donors are the way to go in liver transplants these days).

“I didn’t know you could fail a blood test, John!“

But, this test he failed.  What he was saying was he had drunk the night before he was going for final preparations for a liver transplant.  He celebrated with a couple of glasses of wine, which gave him a bad reading on a surprise blood test and they decided the operation wasn’t worth the risk if he was going to drink.  They said they would re-consider him if he got help and he was still around after 8-10 months.

A race against time to save a life.  The Model for End-Stage Liver Disease Test (MELD) is a test which is used for telling when someone needs a liver transplant.  It was in the mid to upper 20’s with a 50% plus mortality rate in the year.  His liver was shot.  There was a good chance he would die within the year.  He essentially was on the down cycle.

Why would someone drink when their liver was about to be replaced?  I asked the staff from Marworth Treatment Center, an alcohol and drug rehab in Pennsylvania with a first responder program used by many departments in the east.  They responded that’s what they mean when they talk about the insanity in the Second Step of AA.  When people are taking a drug like alcohol that they know will eventually kill them, that is insanity.  The Second step for AA is to trust that a power greater than themselves can restore them to “sanity.”   I guess it was just never pointed out with such an obvious case.

So, John started treatment.  We worked on ceasing his drinking and getting a better sense of who he was as a sober man.  We worked on a variety of relapse prevention techniques to keep him “on the wagon.”  We hand selected videos for him to watch that covered topics from Mindfulness during Treatment, to Recovery from Trauma and Alcohol, to Staying Motivated, to the Father Martin videos on the 12 Steps, forgiveness and relapse.  I sent him off to meetings.  We talked about the horrific things he saw and experienced in his career.  We also did 96-hour urine test once a week.  Our goal was to build a paper trail of his treatments so that the next place he interviewed would see him as a man in recovery.  The battle cry was “focus on the goal of a new liver.”

I also prayed for him as I do for many of my patients.  Never underestimate the power of prayer.

A funny thing happened.  In the process of “therapy for a liver,” my patient absorbed the material and lost his desire to drink.  He was never one to turn down a beer or two, but he learned that his choir practices and social drinking had built up and taken a toll.  In fact, he learned that the toll may be different for him than it is for others who drank the same amount as he did.  He may just be prone to problems more than his colleagues.

He has another hospital willing to evaluate him for a liver and his appointment is soon.  His medical information is all in order and we will see what happens.  But he got his new MELD Score from the physician who referred him for a new liver initially and his number was down to 12.  We were shocked when the scores came in.  Just by learning about himself in psychotherapy for four months and working in a positive direction, he got a lot better and his liver did too.  He looked at me and said “I feel better, doc, I physically feel better.”  His doctor told him he may be denied a liver again, this time because he is not a candidate for a transplant with a MELD score in that range.

I’ve seen it time and time again.  Have something reduce the stress and the physical problems start to melt away.  John had a reaction to therapy that was unexpected from either of us.  It is amazing what a break from his daily routine can do for you.

I do not know how the tests for the next liver transplant will come out.  If you are so inclined, please pray for John regardless of the results of the tests.  That may do him a lot of good also.

Please share this article from down below.

Please join the email list on the top of the sidebar and you can get these sent to your email.  Also follow me on Twitter for other articles and ideas, and YouTube at https://www.youtube.com/channel/UCfjNw0510ipr3bX587IvAHg .

Feel free to donate if you like the site.