Self Ex­am­i­na­tion

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

Esquire (UK) - - Will Self -

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

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