Twenty years ago, in England, I was “on call” in internal medicine.
It was New Year’s morning—the strange, suspended hour after celebration when the consequences are only beginning. The corridors still smelt faintly of disinfectant and stale alcohol, that peculiar hospital cocktail that lingers after festive nights.
He was brought in with red stains over his sheets. Young. Far too young to be dying. An alcoholic, they said, almost as an aside, as though the label explained everything and required no further elaboration. He was vomiting blood—bright and alarming—everywhere. On the trolley. On the floor. On himself. It was chaotic, visceral, ugly.
We moved quickly. Or at least it felt like we did. Gloves. Suction. Cannulas. Fluids. Shouted instructions that were half protocol, half panic. His blood pressure was low. His pulse fast and thready. His eyes darted wildly between us, terrified and confused, like a trapped animal that knows something is terribly wrong but cannot articulate it.
Someone asked his name. Someone else asked how much he drank. Someone else was already calling for blood. I remember the metallic smell, the sound of retching, the way blood looks darker when it pools on white tiles. I remember thinking—briefly, guiltily—this is a lot of blood.
“Upper gastrointestinal bleed”. The words form easily in the mouth of a doctor. Clinical. Detached. Safe. But standing there, ankle-deep in consequence, those words felt thin. We suspected varices. Ruptured. Years of alcohol silently scarring a young liver until one morning, after one more drink, the pressure became too much. A ballooning vein finally gave way.
Medicine teaches you to be efficient in crisis. There is no time for philosophy at the bedside of a bleeding patient. But somewhere in the background of my mind, another voice was whispering: This did not begin today.
Alcoholic. Such a small word for such a large life.
We tried. Of course we tried.
Drugs to constrict vessels. Fluids to replace what was pouring out of him. Blood transfusions running as fast as gravity would allow. Someone called gastro. Someone called ICU. Someone kept checking the monitor, as though willing it to stabilise might make it so.
He arrested shortly after. CPR. Adrenaline. Defibrillator pads slapped on skin already slick with blood and sweat. Time fractures in those moments—compressions counted, drugs pushed, cycles completed.
But death does not negotiate. We stopped eventually. Silence returned to the room, heavier now. Someone switched off a pump. I stood there longer than I needed to.
I noticed it when I stepped back.
Blood on my shoes.
Blood on my gown.
It had soaked through the fabric at the cuffs, crept into the seams.
Someone had to tell his family. That job usually falls to the most senior doctor in the room, but sometimes it falls to whoever is still standing there when the room empties. Whoever looks least likely to break.
He had a mother. Of course he did. I do not remember her words. I remember the silence between them.
We tell ourselves that alcohol-related deaths are somehow earned. That they are the price of choices. That they are predictable, almost deserved.
It is a lie we cling to because the alternative is too uncomfortable. The truth is messier. Addiction is not a moral failure. It is a disease that hides in plain sight, applauded when convenient, ignored when dangerous. We celebrate excess, mock restraint and then act surprised when bodies fail.
Alcohol plays the long game. It seeps quietly into ordinary evenings. It embeds itself in rituals, jokes, bonding, stress relief. It is celebrated, advertised, normalised. Then, slowly, it rewires reward systems, erodes judgement and scars organs that do not complain until it is almost too late.
Later that day, after handover, after paperwork, after the hospital slowly woke into the new year, I walked outside. England was grey, as it often is. Damp cold.
I went home.
I took off my shoes carefully.
There was still blood on them.
At the time, I was young too. Junior. Still operating under the illusion that medicine is mostly about interventions—about the dramatic moments where hands move fast and lives are saved.
In the years since, I have seen many deaths. Medicine guarantees that. Some are peaceful. Some are tragic. Some feel inevitable. But that one returns to me every January, uninvited.
We pretend that calendars reset biology. That resolutions erase physiology. That a fresh year somehow cleanses the damage of the old one. Hospitals know better. New Year’s Day is not renewal; it is reckoning. It is when excess arrives at the door wearing symptoms.
Alcohol-related admissions spike. Violence spikes. Accidents spike. The festive lie—that drinking is harmless fun—collides with anatomy.
Every New Year now, when people speak lightly about “one more drink” or about “starting properly next week”, I think of blood on white tiles in an English hospital. I think of a life ending while the rest of the world slept off celebration. I think of how thin the line can be between habit and catastrophe.
This is not a sermon. I usually leave that for reverends like my father. It is simply a memory, carried forward.
Because 20 years later, that New Year’s morning still reminds me why medicine is not just about saving lives—but about recognising, early enough, the slow deaths we have normalised.
