Medical Effects of Alcohol

BEALE AIR FORCE BASE,Calif. -- Alcohol has a long list of obvious physical effects on the human body. We have heard for years how it delays the reaction time you need to drive safely. TV and movies vividly give us examples of how alcohol takes away the coordination you need to walk straight and to speak clearly. It gives some people the hiccups. And most people know it can lead to vomiting and in some cases cause people to pass out.

Alcohol is also well known for its effects on your behavior. As a physician, my career has been stoked by a fascination with human behavior. Stop and think sometimes why people do what they do. Why do people act that way, or say those things? The answer is usually a product of the influences other people have on our life, both current and past. But another factor in the equation of our behavior is our inhibitions. Our inhibitions are those skills that we learned to use to modify our behavior under certain circumstances. Many people subconsciously rely on their inhibitions to keep them out of trouble. For example, you might think your co-worker is a jerk, but your inhibitions keep you from telling him. Your bladder might be completely full, but your inhibitions make you wait until you can find a bathroom to empty it.

I want to discuss human behavior and inhibitions because one of the most important, and not so obvious things that alcohol does to your mind is it removes your inhibitions. It takes away that natural defense that keeps people out of trouble. With enough alcohol you have virtually no control over your own behavior. This factor is why so many sexually transmitted diseases, including HIV, are contracted under the influence of alcohol. This is also why so many Article 15s and courts-martial are alcohol related. And this is why you need a sober wingman when you drink alcohol. You need to rely on your wingman's inhibitions to protect you from your own unchecked behavior.

Misuse of alcohol has many other ugly effects. I want to share some of my unique and graphic experiences from medical training with hopes to further discourage misuse of alcohol. As a medical student I saw many examples of the damage caused by alcohol misuse. One memorable example was the first patient who I witnessed die. This man walked into the emergency department with a complaint of vomiting blood. We discovered that his chronic alcohol misuse had caused liver damage. A damaged liver reduces the ability for our blood to naturally clot. The same liver damage sometimes causes the veins in the stomach and the esophagus to become large and fragile. In this man's case his veins ruptured and we couldn't get the bleeding to stop. He bled to death through his mouth. What a terrible way to die. He never left the emergency room alive.

Another vivid illustration during my training was during gross anatomy lab. Most cadavers are older people but this one was young. He also had many physical findings consistent with chronic alcohol misuse. But perhaps the most chilling finding on the corpse of this man in his 30s was a tattoo on his arm that said "live hard, die young." Indeed he did.

The influence of alcohol is strong in our culture. Although alcohol is associated with lost careers and failed relationships, we can't blame alcohol itself. These occurrences most often begin with the initial bad choice to misuse alcohol without a sober wingman to replace our lost inhibitions. Our challenge is to use it wisely, if at all, so we don't end up as a lesson for future medical students.