A “bear hugger” or “Bair Hugger” — used to bring up body temperature once it drops too low. Here, it warms up my mother who is feeling frozen due to her cirrhosis and other infections.

Cirrhosis and Climate Change: Too Wet or Too Dry, We Die

Cirrhosis Diaries, Post 6.

In the seventh ring of hell, you sit in a hospital emergency intake room and listen to your mother beg, in an ever fainter voice, for more blankets to “cover her up,” and she mumbles nonstop for hours in a twilight.

If you leave the room to escape this sound, you worry that you won’t be there in case she takes a turn even further down.

If you stay, you have to find that place inside yourself to manufacture your own internal anesthesia.

This time in the emergency room, I have come with an exercise mat and a pillow. I have already relinquished the blanket as part of my mother’s plea to “cover me up.” Maybe she has finally faded back into a kind of slumber.

Five weeks ago she was diagnosed with fatty liver disease which has progressed into cirrhosis of the liver. Knowing what I know now, she has been cirrhosing probably for 17 or 18 months and probably had NASH for five or six years, if not longer. Her symptoms were obvious, but she is old, and poor, and female, so doctors ignored these symptoms or treated each individually.

Over the last week I have started the first few paragraphs of a reflection on what friendship really means, and, about the kindness of strangers. More upbeat reflections on the last few weeks.

But I have had a helluva month…and you don’t want to know all the details.

Let me talk about this instead.

Walking down the hill this afternoon from the paddock with our goats that recently kidded and our young and adolescent females, I tromped through a bit of our low wetland that goes along the smaller of two creeks.

The ground here is soggy.

Cirrhosis, I have learned, is a precarious dance of wet and dry, just like the soil we are made from and to which we will return. Too wet, and life slows, bogs down, bloats up, rots, stifles, gurgles, burps, warms, bacteria trapped and heating up, exuding gases; life stagnates.

A month ago, between the hospital my mother was in and the skilled nursing facility she entered, someone somewhere majorly screwed up and forgot to add a diuretic to her protocol. My mother blew up like a balloon, the skin on her legs exploding with gallons of fluid over the next few days.

A month later, here I am, standing at the nurses’ station in the Emergency Room at Iredell Memorial Hospital in Statesville, NC while two nurses clean my mother up in Room 3. Starting last week, after a month pumped full of diuretics, my mother became too dry… she has shriveled up, her blood pressure too low, and her life frozen; she has become dusty, sparse, scarce, her color vanishing, the energy for intake and holding onto the necessary nutrients depleted, even her jaundice drained a shade light sand.

The nurses are going to bring in a “bear hugger “ to warm her back up. I comment to the nurse that with my goats, I can fight a high temperature, but a low temperature is a very bad sign. I had a goat early last year that went south this way; I could not get her warmed up.

The nurse explains to me that with humans, “we have our ways.” This “bear hugger “ is blow up and will be placed on top of her, under the blankets, to make her body temperature rise. It looks like a swimming flotation raft with a large white shop vac tube popping out.

Apparently, my mother also has a urinary tract infection again. The hospital is testing to see whether it has turned septic, that is, whether this poison has entered the rest of her.

Like our climate, the ravage of my mother’s body, and its contents and remaining shell salvage, stem from a storm so raging, so ubiquitous, that we all ignore what it wreaks. We have acclimated to living in its eye, even as the eye sucks to the surface the substrate and pushes rapids and tides to new slams.

Like the balance of wet and dry in our world which has tipped to engulf us, the hows and whys of how we got here began long ago — out of our hands, yet here we sit, with the outcome and the adjustment in our laps.

My mother became a yo-yo dieter as a means to control a self-esteem savagely (yes, I use that word again so soon) damaged by sexual violence in her teens. I yo-yo dieted with her as a child (yes, as a child) and got off that rocking, swinging toy when I was not quite 15. That is a long story to tell and I will save it for a later day. I am too damn tired to go through all of it here, but yes, I also did prescription diet pills as a child (yes, the amphetamine kind), over the counter Dexatrim, laxatives, and did my last round of prescription diet pills (yes, three times from a doctor) when I was 14 (the doctor was arrested about that time for having a diet pill mill, so my mother and I certainly weren’t alone in our county). I have no idea how often my mother had taken diet pills, but she routinely gained and lost 30–50 pounds every couple of years throughout my entire life until some time in her early 70s.

But trauma cannot be all that is blamed — a much broader brush to swipe: a culture of Twiggy thinness from the 1960s into the 1980s. Television ads nonstop in the 1980s for diet pills. All kinds of fad diets and Weight Watchers…. Dieting was a very popular lower middle class past-time for massive amounts of women, and my mother and her friends routinely went through any range of those routines.

My mother went through the motions of a female body deemed most valued for its size and shape according to others, non-stop judged by its inches lost or its pounds gained. Until I was up in high school, I rarely left the house without being turned around, looked up and down by my mother, to measure if what I had on indeed made me look fat or thin.

Am I stretching this comparison of the ravaged and discarded female body, my mother’s, with our earth?

I am not a hippy at all. Talking of earth with a capital “E” or earth mother sends me straight into a punk rock faux heave.

In 2018 I read the full IPCC report on our climate. I had been waiting for some kind of definitive conceptualization of how screwed we are, of how far we had gone. On social media, I was mostly talking to myself…the big Debbie Downer no one wanted to engage with.

I remember the pain of this climate realization; it is not unlike the pain I feel now watching my mother suffer. Both sufferings I did not cause but am not just an observer in.

Fast forward to a global movement… where we know what it is we are ignoring and we watch the planet drown, and people and animals drowning or burning, our individual and collective follies revealed.

What has been done to our bodies, and what we are doing to them, and what we are being encouraged to do….What we do to the soil, to the earth place where we reside or visit, and what we are being prompted to do.

I often think that my great grandparents, born in the 19th Century, could walk into a grocery store now and not recognize 95% of what is in there as “food.”

We run ourselves dry, race the earth and ourselves aground, ragged and unable to clamber to any place of any higher altitude or aspiration.

We drift along, with our pains and sorrows.

We drown in the convenience of the useless, stuffing ourselves and clobbering each other with the nutrientless.

Spent and savage (yes, that worst word), we go on (ex)(s)pending cheap energy and even cheaper time like we and it last forever.



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Crystal Cook Marshall

Crystal Cook Marshall

Farmer, writer, STS researcher, social entrepreneur, systems rethinker