Memory Loss from Alcohol Abuse: A Cautionary Tale
Consider taking Vitamin B-1 if you drink
The waiter dropped off our drinks with chips and salsa, and my brother Dan hoisted his mug, took a big swig, then looked at it and looked back at me. “Hey, did you know I’m not supposed to drink?”
No shit. “I’m sure it’s not the best idea, but did someone officially tell you not to?”
“Yep, the doctor. Apparently, I have a vitamin B1 deficiency, and alcohol makes it worse. I have to take this giant horse pill every day now.”
I frowned. “Should you not have that beer then?” I had believed the damage was done and there was no point in depriving him of one of his few pleasures, so I usually let him order a couple when I took him out. We were celebrating his birthday, but I would cut him off if I had to. I didn’t want to clean up the mess of yet another medical crisis or eviction.
“Nah, it’s fine. I’m getting supplements, so one beer won’t hurt.” He dug into the chips and salsa like a bear into fresh meat. He always complained the nursing home didn’t feed him enough.
“So will this treatment reverse your condition?” That would be a miracle.
“I don’t know, that’s a good question.” He pulled out his phone, in which he kept copious notes of events and conversations. Without his notes, he couldn’t trust his memory, and I couldn’t trust anything he told me.
For six months after arriving at the nursing home where he’d lived for almost two years, Dan repeatedly ranted to everyone he spoke with: “My sister took me to a drunk tank to force me to stop drinking and just dumped me off there with nothing.” He would describe meeting me in the parking lot of a nearby shopping center and riding out to an inpatient substance abuse rehabilitation facility, including details like what we talked about, where we stopped for lunch along the way, and what he ate.
Not a single detail of his story ever happened.
Memory is funny: it can seem so real even when entirely made up. Dan’s memory of being at “the drunk tank” was accurate, but I hadn’t taken him there.
I would have if he’d let me. He was a chronic alcoholic who’d lost his wife, his home, his job, and his health — he’d blown out his pancreas on a binge in his early forties, developed poorly controlled hypertension and diabetes, and had a massive heart attack just after his 50th birthday. I hated watching him drink himself to death, but I’d been in Al-Anon for thirteen years by then and knew I couldn’t force him to do anything.
Where I had taken Dan was to the emergency room, because he was repeating himself over and over and not remembering conversations we’d just had. I had ignored it for a couple of months, assuming he was just drunk again, but something about our exchanges that morning bothered me, and it was only 9 AM. We left the home he was being evicted from and didn’t stop anywhere.
At the ER, his blood pressure was 257/127, and the doctor said he should be dead. It took 36 hours to stabilize him, and they found three lesions in his brain — possible stroke damage. He was in the hospital for six days and remembers nothing.
The hospital tried to release him, but I refused to take him. “You can’t let him go! He’ll turn on the stove and then forget and burn the house down,” I’d said, “or he’ll pass out in the street from not remembering to take his meds and end up right back here.”
Apparently, those were magic words, and the case manager found him the spot in rehab. I didn’t think it would work out — he’d have to follow rules, show up on time for meetings and medication and counseling, and eventually find a job, all of which would require a functioning short-term memory. But he was no longer emergent so the hospital couldn’t keep him, and the rehab center was the only facility the case manager could find with an open bed.
The hospital transported him to “the drunk tank” via ambulance. He lasted ten days then passed out in the hallway, shitting himself in the process, which he had also done in the ER and which he fortunately doesn’t remember. But apparently, ten days was long enough for the place to imprint in his long-term memory.
The rehab facility shipped him back to the hospital, saying he needed the kind of 24/7 medical care they were not equipped to provide. A week later, the case manager found him a bed in a skilled nursing facility. He doesn’t remember the second hospital stay, either.
Across the table, Dan looked up from his phone. “It’s called ‘Korsakoff syndrome.’”
I recognized the term from my years studying clinical psychology and thought it was bad but couldn’t remember the specifics. I pulled out my own phone and found Merriam-Webster’s definition:
“Korsakoff syndrome, also Korsakoff’s psychosis: a chronic memory disorder… caused by brain damage related to a severe deficiency of thiamine (as that associated with alcoholism or malnutrition)… characterized by an impaired ability to form new memories and by memory loss for which the patient often attempts to compensate through confabulation. NOTE: Korsakoff syndrome is frequently preceded by Wernicke’s encephalopathy.”
Wernicke’s is treatable if caught early. Once it progresses to Korsakoff’s, it’s too late. The disorder has become increasingly rare with so much of our food fortified with vitamins now, and I could not fathom how much he’d been drinking to develop it anyway.
One cruelty of my brother’s condition is that the rest of his brain functions seem as sharp as ever, including his long-term memory, and he feels great because the nursing home feeds and medicates him consistently and he almost never drinks anymore, so he thinks he’s fine and must take our word for it that he’s not. Spend ten minutes with him, and you’ll agree there’s nothing wrong with him. Spend another ten, and you’ll feel confused — didn’t you just have that conversation? Spend ten more, and it’s obvious.
Dan knows the truth now; we’ve discussed it hundreds of times, and everyone else has told him the same thing, over and over, so it finally stuck. But he still doesn’t remember the events, only being told of them. His memory of the trip to the drunk tank with me remains vivid though he knows it’s false.
How bizarre it must feel living in such an uncertain reality. Ironically, he articulates his disorientation well: “It’s so weird. They tell me it’s normal in my condition: it’s called confabulation. Your brain doesn’t like holes, so if the memory isn’t there, it will fill the gap. I know it didn’t happen, but to me, it’s still so real.”
“Well, happy birthday!” I lifted my own mug in salute. “And cheers!”
“Cheers!” he said. “Thanks for springing me for a while.”
“Of course!”
He took another drink, looked at the mug in his hand, and said, “Hey, did you know I’m not supposed to drink?”
And around we go. But to Dan, this is a new conversation, so I treat it that way, too. “No, why?”
“Apparently, I have a vitamin B1 deficiency and alcohol makes it worse. I have to take this giant horse pill every day now.”
“Oh, that’s interesting. I’m glad they finally figured something out.”
Dan was only 53 years old on that birthday, yet he’s confined to a nursing home for the rest of his life. I am relieved he’s safe, but I hate that he’ll never be independent again. I’m not saying it’s unfair — Dan made choices, and he’s living with the consequences. I’m just saying it sucks.
I can’t help but wonder if his life would be different if he’d known to take Vitamin B-1 while he was drinking. Then again, he heard and ignored many other warnings about the effects of excessive alcohol use, so I don’t know why I think he might have heeded this one other than we loved ones of alcoholics often engage in wishful thinking. But I hope telling his story might save one family from the same hell.
