Of alcoholism, I mean. This case from the New York Times Magazine reads like an episode of TV’s House:

Her Legs Would Barely Follow Her Brain. Then She Saw Double

I’ve run across four or five cases of Wernicke’s, usually in hospital settings (too sick for rehab), and mostly in the form of Wernicke-Korsakoff’s Syndrome (WKS). It’s not easy to forget.

The three main symptoms involve double vision, ataxia (lack of muscle control), and pronounced memory deficits. If not discovered and treated promptly, it results in death in perhaps one out of five cases. Those who do survive ordinarily have permanent brain damage.

The cause: a pronounced deficiency in vitamin B1 (thiamine). It’s usually a disease among chronic alcoholics, especially where they’ve stopped eating for extended periods — often simply because they can’t keep food down.

The first and most memorable case for me arrived the day after Christmas. A 50 year old female with clear cognitive problems. She happened to be a retired professional athlete of some distinction, although at this point confined to a wheelchair based on lack of balance. She was unable to recall new information. She recognized her husband and grown children and her longtime physician, but no matter how many times a staff member introduced themselves, she was never able to recall our faces, names, or frankly, where she was at present. It was as if her day began anew every few minutes. The neuro consultant explained it in terms of an alcoholic brain syndrome found among so-called ‘maintenance’ drinkers– those who drink mainly to keep off withdrawal symptoms and whose systems had reached the point where they were unable to eat.

According to her physician, she’d been through detox many times in the past and neither he nor the family had expected that this time things would be different. But something like Wernicke’s can sneak up on a person.

I don’t know what happened to her after she was transferred to an institution for long-term care. I do remember reading a draft plan for rehabilitation where none of the medical team seemed at all sure she’d ever leave the institution. The damage, they thought, would be permanent.

The head nurse remarked that it was probably for the best: she’d never be fully aware of her own situation.

It’s ironic that the two common substances we chose to legalize happen to be the most directly damaging to the human body. Alcohol and tobacco – you really can’t beat them for death and destruction. But they’d been around for a long time and I guess We the People got accustomed to having them. In spite of the many adverse consequences.

One good thing: today more of us seem aware of the hazards when a relative or loved one with an alcohol problem stops eating. I’ve been lucky enough to help several families get someone into a medical facility for appropriate care, preventing a fatality.

That wasn’t always true. Every so often I’d encounter a family who’d let the situation go too far, in the belief that treatment was futile unless and until the drinker decided they ‘wanted’ to quit.

Exactly whose brain would the drinker use to make that decision? Because their own clearly wasn’t up to the task.