Name: Mary Little Weasel

Age: 34

Occupation: administrative assistant in Tribal Health office

Case report: Ms. Little Weasel is a 34-year-old woman referred the first time by her doctor. There is a history of alcoholism in the family, an abusive father and an alcoholic mother. Her grandmother raised her. She has been diagnosed with cirrhosis. Mary has struggled with depression and a series of relationship problems.

HER STORY:

She wakes up bleary-eyed, her mouth is parched, and her head is throbbing. “Where am I? How did I get here?” Slowly she opens her eyes. She is in bed, somehow she has ended up here. She searches her memory, but can recall nothing about the drive home or whose bed she has ended up in this time. She gets up and finds the bathroom. The woman looking back at her has mascara streaks and a red puffy face. At one time she was considered the prettiest girl on the rez. She used to have long black hair that reached her waist but something happened a while ago, an accident she can’t recall. Somehow she woke up with a lot less hair than before. So now it is cut short; she has glasses, which have been lost on many occasions. So half the time she just walks around blind. It doesn’t really matter though because she is usually half-shot, and everything is blurry with or without her glasses. The alcohol has aged her face, and she easily looks twenty years older than her 34 years. She turns around and throws up into the toilet. “How did I get here?” she asks herself. She stumbles to the kitchen and grabs a bottle of beer from the top shelf and guzzles it down. “There, the throbbing has subsided a bit.”

Mary came to us several times; this was not her first visit to our facility. She would make it through her brief stint with sobriety and then get back on the bottle as soon as she left treatment.

Jackie: Do you want to get us started or do you want me to?

Mary: I’m not an alcoholic if that is what you are implying…I just happen to like to drink. I got a little out of control one night. I wasn’t drinking any more than anyone else. I didn’t hurt anyone. I can stop if I want to. I just don’t want to.

Two years later:

This time I saw something different in Mary’s eyes. She was scared; no longer was the tough attitude so prevalent. No biting remarks about how she didn’t need this place—how we were just wasting her time.

Jackie: Do you want to get us started or do you want me to?

Mary: I woke up in a hospital bed, I couldn’t figure out how I had gotten there. I…I couldn’t remember what had happened the night before. We had just gone out drinking like usual. I know this is not my first time in treatment. I have been here before spouting off about how I am not an alcoholic and I can stop if I want to but…look at my hands they are shaking…I need help or I am not going to live to see my daughter grow up. They told me I have cirrhosis…I am in pain…I don’t want to die; I can’t go through that. I can’t put my daughter through that. For the past two years I have been in and out of hospitals; I felt like I was going to die when they told me I couldn’t drink anymore…But actually I will die if I keep drinking.

Jackie: This ordeal sounds very painful. How are you handling the shock of this news?

Mary: I don’t know. I just don’t know…they say I am killing myself. I am only functioning with a small portion of my liver…they say I will die if I keep up this lifestyle.

Jackie: How are you going to be able to change your lifestyle?

Mary: I really want this. I want to be sober. I am determined to change my ways if it will allow me to see my daughter grow up.

Jackie: It sounds like this is very important to you. I understand that your daughter is very special, and it is important for you to show her that you can be sober.

Mary: Oh yes. I have been so caught up in myself for these past years; I have neglected my child. I have done what I promised myself I would never do, especially after watching what alcohol has done to my mother and father. I am an alcoholic.

Jackie: Mary you should be very proud of yourself. You have matured drastically since the first time you came into my office. It is very important for you to keep coming to see me and attend A.A. meetings. You also need a strong support system, friends and family to help you make it through.

One year later Mary came to see me again:

Jackie: Well, hello Mary, how are you doing this afternoon?

She looks so much better. Her face is clear and so are her dark brown eyes. She smiles at me shyly and takes a seat on the chair where she has spent many hours this past year crying and pouring out her heart.

Mary: I am doing okay. I’m still sober, one year exactly from last Wednesday. It has been difficult but my daughter has helped me through it. She is graduating this spring.

Jackie: Wow, that is great! What brings you here this afternoon?

Mary: Actually I am here because of someone else. My sister, you see, it turns out she has cirrhosis too. But she won’t get help, so that she can stop drinking. She thinks her problem isn’t as serious as mine was. I am so scared that she is just going to kill herself—drink herself to death.

Jackie: How are you coping?

Mary: I haven’t been doing very well. I feel so hopeless. She is in such a terrible state, but I seems there is nothing I can do. I have told her about this treatment center and how helpful it was. But it seems she is angry with me, and well…she won’t talk about it. Sometimes I get so angry with her, but now that I know she is dying I just want to be there for her (Crying).

Jackie: This is a very emotional subject. You care about your sister deeply. All that you can do is be there for her when she needs you, but after that it is up to her. You know that from all the A.A. meetings right?

Mary: Yeah, I know. (Pauses) You know what I find crazy? My sister and I are serious alcoholics. But so were both of our husbands, my ex and her current husband. But we are the ones who have developed this horrible disease.

Jackie: It may seem that way, but as you know, anyone who is a chronic alcoholic will eventually face the health consequences. However, research does show that women develop alcohol-related health problems at a much faster rate compared to men who drink the same amount.

Mary: Really?

Jackie: Yes, and actually there are several differences in the way men and women drink, and the problems they will encounter as alcoholics. In fact, tonight there is a meeting with Vera, she is moderating a discussion about women and alcohol. You should check it out.

Mary: That sounds interesting.

Go with Mary to the meeting: women more vulnerable to alcohol effects.

Learn more about cirrhosis and alcohol related health problems