Self Examination

Each issue, Esquire commissions an unsparing inspection of Will Self’s body. This month: the liver

One of my father’s nicknames for me when I was a child was Bilious. No, really: Bilious. The derivation was dual: on the one hand the consonance of the word with my own name — William — and on the other… well, I can only assume that my very presence in his life made my poor old man feel rather cross; either that, or he viewed me as being excessively ill-tempered. Of course, what strikes me now concerning this epithet, is quite how dated it was even in the Sixties. True, my father was born in 1919, but the Galenic medical theory of the four humours — from which the expression bilious undoubtedly derives — had by then long since been discredited. And yet, not only did he call me Bilious, Dad would also declare himself, on some occasions, to be feeling “bilious” while on others he was a tad “liverish”: states of mind and body that were both once attributed to an excess of bile, the greenish fluid so necessary for human digestion, which the liver produces in large quantities.

Yes, that’s the liver’s job — along with purifying our blood — and for the most part it seems to get along with it pretty well; so well, that I confess I’ve never consciously “felt” my liver at all. This despite the fact that a) it’s the largest internal organ in the human body: a great mass of tissue, waiting to be chopped up, mixed with onion, garlic and herbs, and served as pâté; while b) what with excessive consumption of alcohol and cocaine, my own liver should by rights be completely necrotic; and undoubtedly would be, were it not for c) the bizarre fact that the liver is also the only human organ capable of almost complete regeneration. Yes, that’s right: you can souse your liver to within an

26 inch of complete cirrhosis, but so long as you then can-the-cans it’ll eventually heal and regain full detoxifying capacity. Which is just as well, considering the amount of alcohol many of us drink.

My parents included: both steady imbibers, if not outright boozers. Of course, we can’t be certain that it was their drinking that did for them — there are so many other mutagens kicking around in our poisonous environment — but nevertheless, it was liver cancer that fulfilled the fatal contract. Some years after my father died, I published a book actually called Liver and subtitled A Fictional Organ with a Surface Anatomy of Four Lobes. The “lobes” referred to the four stories collected in the volume, which were homologous to the respective parts of the liver itself.

The first, “Foie Humain”, is the tale of an alien visitor to Earth, who performs his own strange version of gavage, the process whereby a goose is force-fed with grain until its liver bursts, thus providing the tastiest pâté with the creamiest consistency. Rather than the poultry yard, the alien’s zone of operations is a Soho after-hours drinking club, where he treats the regulars to round after round, before spiriting away his chosen cirrhotic victim.

The second story, “Prometheus”, is a resetting of the famous myth in the context of London’s ad-land. A genius copywriter seizes inspiration from the gods and they exact this payment: his liver is ravaged on a daily basis by a vulture which circles Old Street roundabout in a widening gyre. The third is a gloomy meditation, inspired by my own parents’ liverish ends, in which an elderly hepatic cancer victim travels to Zurich to obtain an assisted suicide.

But it’s the final story in the collection, “Birdy Num-Num”, that speaks most to my bilious condition, for it’s a tale of intravenous drug addicts told from the point of view of the hepatitis C virus which infests their livers. I won’t trouble you with the narrative — and indeed, not a lot happens in the tale, beyond comings, goings and shooting-uppings — because it’s more a rumination on the very weirdness of our contemporary lives, lived out as they are within the worldview of medical science. For my generation, hepatitis C, a genetically shape-shifting virus which attacks the liver, has been far more devastating than HIV. Transmitted by blood-to-blood contact, these ghastly little virions can lay low in the liver for years, gradually destroying it, and often a victim will only become aware of the disease’s progress when it’s too late. Treatments for hep’ C (as we ageing hepcats style it) have advanced in step with those for HIV, and involve a similar suite of antiretroviral drugs, including the seductively named Interferon. Almost all my peers who shared needles — and many of those who simply made the mistake of pushing a blood-stained bill up their hooters to honk a line of coke — ended up with this malevolent parasite making free with their personal pâté.

Not Muggins, though. No, really, I know I’ve been lucky in life: the great Polish science fiction writer Stanisław Lem once calculated the odds against his being born at all at over a billion to one; but I’ve reason to believe the odds against my life — and my liver — enduring this long, have been considerably wider. But yes, I’m not only immune to hep’ C, but hep’ B as well; while since I last drank an alcoholic beverage on 25 October 1999, that great-big, on-board chemical refinery of mine has had plenty of time to mend its cracked pipes. I wonder — no doubt preposterously, but then preposterous wondering is my métier — whether the very unseen and unfelt nature of my liver is directly related to its longevity, this phoenix organ that roosts between my belly and my diaphragm?

All the other parts of me have a tendency to wither under my basilisk stare, but my liver just keeps on rising to greet the dawn of another day on earth. Recently, it’s occurred to me that I may, in fact, be little else but a sort of incubator for this indestructible organ, and that far from succumbing to the disease that did for my parents, it’ll be some minor and undistinguished malady that’ll do for me, such as a septic toe, while my liver, unaffected, will carry on regardless. Who knows, once my censorious mind is out of the picture it may take up drinking again — in which case it’s trebles all round!

All other parts of me have a tendency to wither under my basilisk stare, but my liver just keeps on rising to greet the dawn of another day on earth. I may, in fact, be little else but a sort of incubator for this indestructible organ