"Rum and Coke, Del?"
Del responded to the sweet woman behind the bar, "Nah, I just
come from the doctor. He says I got the sugar.
I gotta cut down. Gimme a draft instead."
The effect of ethanol (ETOH) on muscle metabolism was assessed in
both normal (NC) and noninsulin-dependent (NIDDM) subjects in the basal
state and during isoglycemic hyperinsulinemia (450 pmol/L) clamp studies
carried out either with systemic (NC, n = 5; NIDDM, n = 5) or
intrabrachially (NC, n = 5; NIDDM, n = 5)ETOH infusion. On a repeat
study, each subject underwent the same experimental procedures, except
that saline was infused instead of ETOH. (1)
Sometimes, perhaps, having a little too much information
is a bad thing. Del is like so many customers of the neighborhood bar. He's
retired on a good pension from a company he punched a clock
for for about thirty years, day in and day out, without fail. He's saved a
little money and his wife worked for awhile too. So they've enough money for
their little home in the nearby blue collar neighborhood. Next to the houses
that but for the color of the paint would look just like theirs; the grass neatly trimmed, so
are the hedges. The occasional lawn jockey or ceramic gnome graces a bit of
landscape creativity (annual plantings and the like).
You go to my head, like a sip of sparkling Burgundy brew,
And I find the very mention of you, like the kicker in a Julep or two...
— "You Go To My Head" by J. Fred Coots and Haven Gillespie
Some of these lovely
people bought their homes forty years ago for what it costs to buy a decent
luxury car today. They can't afford the luxury cars, though. They opt for the
Ford Crown Victoria or the occasional Buick or Chrysler New Yorker (except
for Eddie down the street who won the lottery in '87 and has bought a new
Cadillac every three years ever since).
The ladies in this crowd visit the hairdresser once a week. The
men have gone to Phil's barber shop on Newfield Street for as long as they can
remember. They play bingo at the church Monday nights. And they go out for a
cocktail every other day or so.
During ETOH, FGU was depressed by 81% in NC (delta = 3.32 mumol/min.100
mL tissue) and by 48% (P < 0.05) in NIDDM (delta = 1.21 mumol/min.100
mL tissue). Local ETOH infusion did not affect FGU in either NC
(1.18 +/- 0.23 vs. 1.1 +/= 0.11 mumol/min.100 mL tissue in the
baseline condition and 4.12 +/- 0.65 vs. 3.97 +/- 0.35 in
insulin-stimulated conditions) or NIDDM (1.05 +/- 0.29 vs. 1.1 +/-
0.19 mumol/min.100 mL tissue in baseline condition and 2.72 +/- 0.82
vs. 2.83 +/- 0.51 in insulin-stimulated conditions) subjects. (1)
The other thing they have in common is that their medicine cabinets are full
of pills. Pills for high blood pressure. Pills to lower blood sugar. Pills to
sedate. Pills to reduce inflammation. Pills to help with the myriad ills that
befall humans of a certain age. They often say a cheerful hello upon meeting at
the pharmacy and share concerns about children and grandchildren,
and concerns about the cost of all of their pills.
Roll out the barrel, we'll have a barrel of fun...
— "Beer Barrel Polka" by Vladimir Timm, Jaromir
Vejvoda, and Zeman Vaclav with English Lyric by Lew Brown
Now, years ago, the neighborhood used to socialize quite a bit. When Charlie
and Arlene lived down the street, they'd have wonderful cook-outs and
roll their bar out of the kitchen onto the patio behind the
house. Charlie was a real party lover. Arlene was a great cook. The great old
records from Sinatra and Jerry Vale would be playing. If Patch
and Irene came over they'd bring their Polka records and everyone would dance
and have a ball. Yeah, the neighborhood couples would come over on a Saturday
evening and Charlie would be behind his bar, making drinks in cute glasses with
different color fish on each one (so that you'd know whose drink was whose). The
bunch would go through a bottle of J&B and a bottle of Four
Roses in an evening. Charlie and Arlene would go through a fifth of Canadian
Club.
Three years ago Charlie went into the hospital and never came out. Arlene
said that she didn't understand what the doctors said was wrong with
Charlie. Some of the guys from the V.A. would sneak him a little hooch
once in awhile and he'd savor it as if it was nectar from Heaven. After they
buried Charlie, Arlene sold the house and went to live with her daughter out
west somewhere. She kept in touch for a little while, but now she doesn't even
send Christmas cards.
Oh, yeah I'm drinkin' again, and thinkin' of when you loved
me,
I'm havin' a few, and wishin' that you were here...
— "Drinking Again" by Johnny Mercer and Doris
Tauber
While they boys are out golfing, there's a few of the girls who get together
at Marie's house and have an "eye opener." They take turns
each week getting a bottle of Smirnoff. If they don't consume the whole
thing they skip a week and then the next gal picks up her turn the following
week. They used to mix the vodka with tomato juice but now that most of them
have to take the stomach acid pills, they changed to Ginger Ale. Just a bunch of
the gals sitting around the kitchen table having a drink and a smoke and talking
about good times.
It was at the Friday afternoon Senior Center luncheon that they all noticed
it first: "Drinking and Seniors: A talk with Dr. Malcolm Greenbaum."
In summary, systemic ETOH infusion impairs both
body and forearm glucose uptake in NC and NIDDM subjects;
this effect was more apparent in NC than in NIDDM at both
the whole body and forearm level. (1)
They had a laugh down at the bar that night at the expense of Dr. Greenbaum.
"What's left for Seniors if we can't have a little pop now and then?" Estelle
cackled a bit until her smokers' cough caught up with her. Marie gave her a
tissue.
The other day, my doctor told me if I keep drinking like
this, I won't live to a ripe old age.
I told him, look, I see a lot more old drunks than I see old doctors!
— Comedian Joe E. Lewis from his album It Is Now Post Time
(Reprise LP No. 5001)
Three days later, on her way to Marie's, Estelle drove her car through a red
light and into the fence of the condominium complex on Fenn Road. She was taken
to the hospital.
Tony drove to the hospital as soon as he could after he heard the message on
their answering machine. He sat with a man who looked young enough to be his
grandson, perhaps. The man said he was the Intern treating his wife.
"Intern. What's that? I wanna talk to a doctor."
The man replied to Tony, "I am your wife's doctor, sir..."
Tony's son had always told him that if anything bad happened, get the people
who're asking him to make decisions to write everything down on paper. The paper
revealed the same strange words that the young doctor had confused Tony with:
'Acute EtOH withdrawal' 'impending renal failure' 'abdominal fluid
accumulation.'
Tony took the paper to Dr. Clarke's office right away.
"Has your wife been drinking to excess lately, Tony?" Dr. Clarke's voice
sounded almost apologetic, and was soft. He took a long time to get the question
out of his mouth.
It's time to go home now and I've got an aching head,
So I give her the car keys and she helps me to bed.
And then I tell her, as I turn out the light,
I say, "My darling, you were wonderful tonight.
— "Wonderful Tonight" by Eric Clapton
"Nope. No. I'm the drinker in the family, doc. And I've been takin' it
easy since you said I got the sugar."
"For someone your wife's age, if she has, let's say, three or four drinks in
the course of the evening, it's as if she's taken 2 cups of sugar and eaten it,
Tony..."
After Tony got Estelle home the next day, he went to the cabinet in the den
and poured himself an anisette, and tried not to think about things.
(1) CITATION: Avogaro, A.; Valerio, A.; Miola, M.; Crepaldi, C.;
Pavan, P.; Tiengo, A.; del Prato, S.; "Ethanol impairs insulin-mediated glucose
uptake by an indirect mechanism." Journal of Clinical Endocrinology and
Metabolism; Italy, June, 1996 81(6):2285-90.