Encephalopathy

The reason as to why I have no clear memory of the days and deeds leading to my transplant, a period of at least five days, is encephalopathy. In a nutshell encephalopathy is the occurrence of “confusion, altered level of consciousness and coma as a result of liver failure” - when the liver ceases to function correctly otherwise harmful toxic nitrogenous substances fail to be neutralised, the effect of which, as experienced first hand, causes severe memory loss and confusion. In general encephalopathy is reversible and can be treated. However, in the context of acute liver failure the advent of the condition forewarned of a liver lost. Sitting crossed legged on the hospital bed, surrounded by recently made revision notes for an imminent university exam on the foundations of East Asian history, one of the many faces of the upper echelons of the Royal Free’s liver team asked me to sit-up straight, close my eyes and raise my arms, with clenched fists, in front of my person. I often think about the point at which I opened my eyes and discovered I had utterly failed what should have been one of life’s hitherto easiest assessments. Even though I hadn’t been informed what this result denoted it was painfully evident on the consultant’s face. Verification imbued with pity; a sealed fate. The true curse was that the path irrevocably paved would become, in essence, well tread by many...but not me, at least in a dualist sense of me. To put in perspective, I actually have no recollection of being told that, unless what had become lost was made new, I would be dead within days. Encephalopathy was the precursor to death, my encounter with my end, yet tangible only posthumously... well, at least posthumously in the respect of my organic organ.

This said, however, I do have a couple of memories-come-hazy-flashbacks of my person during the encephalopathy induced confusion. I do recall frantically, and not so subtly, insisting to my little brother that the nurses were patronising me. I believe this logic heralded from a unprecedented want of juice, a want ultimately denied due to some water only or nil-by-mouth regime; exactly which I am unsure. I also maintain that I experienced a spell of clarity as I was literally being put under anaesthetic. This said, such a memory seems perhaps too favourable and I fear perhaps it is the product of dream or medicine-induced hallucination. As it happens, due to the fact that in my encephalopathic state I had become somewhat deviant and unresponsive to request and reason, I am told it was decided I should be anaesthetised whilst the wait for a possible donor continued. I vividly recollect, however, simply knowing that I was have my consciousness medically surrendered. I was suddenly surrounded my medical staff, being put into a slumber I did not understand and I was scared. I don’t intend to preach fear but I cannot feel that which I felt during that heartbeat moment of lucidity. It scarred me, and if again I ever glimpse this fear I know I will break, run, shatter and not have the strength to become whole again. I wanted my parents, so simple, so desperate, I wanted my makers to just make it right.