Cheers



Reading an entertaining entry on a fellow blogger's blog reminded me of a lady I "nursed" while I was on student placement to The Merseyside alcohol dependency unit at The West Cheshire Psychiatric Hospital in the 1980s.Sylvia was one of those ex colonial types, with a cut glass accent, a weather beaten face and the kind of spirit that made Britain what it was during the 1930s and 1940s, an arrogant world power.
She was, opinionated and racist, in that old fashioned sort of way that made you smile at her rather than it provoking an angry response towards her, and she had spent her life of privilege in colonial Malaya , for 40 years pickled in pink gin.

God knows just why she had been admitted to the unit. She was far too long in the tooth at 83 to successfully give up alcohol, even I as a student realised that fact, but I suspect that she had been "encouraged " to enter rehab for a formal assessment, as it was suspected that she was suffering from the start of Korsakoff’s dementia.
People suffering from Korsakoff's dementia lack vitamin B 1 due to their alcoholism, and treatment , as I recall is a combination of vitamin supplements, good nutrition and plenty of rest in addition to the "talking therapies" which aim to explore the cause of their drinking behaviour.
"Talking Therapy" was not something that Sylvia took too seriously as I recall

People that have Korsakoff's, often have great gaps in their memory which they cover up with confabulating history accounts.
In one morning group session I remember one Liverpudlian patient asking her just how much she drank before her admission
In her best Maggie Smith delivery Sylvia announced loudly and with some conviction to the group
"If you must know ......I only ever had a few little drinkies after meals!"
The Liverpudlian, missed nothing from her vague reply
"and how many meals a day did you actually have?" he asked with a smile
"34!" Sylvia called out with a triumphant cackle


33 comments:

  1. Oh, her reply did make me laugh, John! xx

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    1. She was a hoot but she did eventually share a life of bordom and constant parties in the expat community

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  2. Barbara Anne1:52 pm

    Sylvia was asked the perfect question and her reply was brilliant!

    I've never heard of that type dementia and appreciate your explanation.

    Yes, maik this one as one for your book!

    Hugs!

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    1. As a student nurse on that unit, I grew up incredibly quickly

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  3. She sounds like a comic character, quick witted and funny, despite all.

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    1. She was the bette Davies of her community and indeed her family , there was a blurring of the lines between the real her and the actress

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  4. Oh gosh; my dad developed Wernicke-Korsakoff syndrome due to his heavy drinking over the decades after mum left us. It was heart breaking to see the state he was in, plus his dementia had masked the symptoms of his lung cancer until it was too late. Your Sylvia sounds like she was a hoot, though.

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    1. All dementia is sad, korsakoff’s especially so

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  5. Have you read Sergei Korsakov's "Eine psychische Störung combiniert mit multipler Neuritis" (1890)? It should be required reading for all medical staff dealing with victims of Wernicke-Korsakoff syndrome.

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    1. An old piece of research now YP
      No I’ve never heard of it
      Just seen his photograph
      A handsome devil

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  6. A post that is both entertaining, educational and tragic in its own way.

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  7. Sylvia sounds like a true character with lots of ready quick retorts. Drinking excessively brings health pitfalls and it is sad.

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  8. I knew one fellow in the beginning stages of this. He ran (believe it or not) a saw mill. He had just a handful of employees, most of them younger guys from the bar. Just enough to make him subject to OSHA oversight. He cut off a finger. OSHA came out to investigate. He showed them what happened and lopped of another finger doing it.

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  9. My Dad said - "can you get a bottle of whiskey for the sign writer - His writing is wobbly without "- I met him several times and you wouldn't have known x

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  10. Traveller5:24 pm

    “ Sylvia was one of those ex colonial types, with a cut glass accent, a weather beaten face and the kind of spirit that made Britain what it was during the 1930s and 1940s, an arrogant world power.”

    Bloody brilliant - an arrogant world power, so true. A pity the arrogance didn’t go when the world power went.

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  11. Anonymous5:52 pm

    Sad when you really can’t help them. Gigi

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  12. When I saw a patient in the ER who was having alcohol withdrawal, I usually gave them a liter of Ringers with infusion of several different vitamins. Back when I was practicing, I would interview them to see if they were really going to go through withdrawal, and if so, give them a rx of librium or a benzo to last 3 days.
    Now, at least here, few if any ED's will let the doc's prescribe and meds like these.

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    1. Reducing dose chlordiazepoxide . Thiamine and close observation

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    2. Anonymous5:16 pm

      Are you qualified to prescribe John?

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  13. This was a well-written post, John! I can almost hear Sylvia in all her gin-soaked superiority. I've never heard of Korsakoff's before -- interesting.

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  14. Great post John. My mum was alcohol dependent and also very "lady bountiful" in her manner. She was insistent that she did not drink to excess. Classic presentation with bottles hidden throughout the house. Her preferred tipple was gin but she also drank Baileys (4 litres a week) which she used to insist was a"food". My goodness I miss her.

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    1. My mother had an alcohol problem too
      I loved her but o don’t miss her

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  15. Great story, John. I shall have to remember it.

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  16. When I first started nursing, I worked on a unit where you were alcoholic and usually a smoker. The wisdom at the time was you weren't going dry out a 70yo but you could keep them safe.

    We served alcohol with morning meds. The med room looked like a bar. We also had the patients smoking supplies.

    Most were nice enough in their own way. A retired Mountie (yes, of Dudley Doright fame) scared me off the unit. He attacked a coworker on night shift, broke her arm in three places and nothing was done about him.

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  17. HIlarious response considering I probably would have been wincing at the rest of her opinions.

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  18. What answers will we give when we are old?

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  19. Anonymous4:08 pm

    Thanks John, I've met a few like that. At that age just pass the bottle and enjoy

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I love all comments Except abusive ones from arseholes