Body Horror: On the Slow Process of Falling Apart in Alcoholism

By John Teufel 12/06/17

You know what’s going on, even if you don’t want to admit it. You are dying, and these are but the outward signs of the inner decay you suspect is getting worse by the day.

Man with hands over his eyes.

Alcohol is a poison. I don’t mean that in the Women’s Temperance Union sense, I mean it literally - it’s a substance foreign to a human body that produces harms of varying types and degrees. The harms that seem to get the most attention either focus on the brain, the source of mental addiction and the most obvious victim when someone imbibes too much, or a bit lower, in the abdomen, where we are told that livers scar and calcify, and hearts turn clogged and weak.

These things are bad enough. But while the demon rum runs rampant on our brain cells and kidneys, it doesn’t spare the rest of us. Late-stage alcoholism brands the sufferer entirely, and affixes to him a gruesome variety of visible physical ailments. Some target the alcoholic’s sense of vanity; others, his very ability to go and be in the world. But make no mistake: for the serious drunk, there is a constant dialectic at play, whereby the rest of the world perceives your sickness, and your sickness perceives their perceptions, and the whole thing only resolves itself with another drink.

I lived to acquire and consume alcohol for around six straight years, beginning at the age of 24 and ceasing, periodically and in fits and starts, at 30. Over that period, I stood passively by while one body part or system after another began to sputter and break down. You try to put a good face on it - sometimes literally, with makeup and the careful avoidance of revealing clothing; sometimes metaphorically, by remembering to keep your hands shoved tightly in your pockets lest their ceaseless shaking become noticeable. But you know what’s going on, even if you don’t want to admit it. You are dying, and these are but the outward signs of the inner decay you suspect is getting worse by the day.

Not that this should be surprising, given my routines. I went from problem drinker to non-functioning alcoholic almost overnight. I would drink for days or weeks on end, only leaving the apartment to get another bottle. When not engaged in a true bender, I would drink on nights and weekends, almost like moonlighting as a drunk, while during the day I would scheme and ponder for the easiest, least shameful way to get wasted as early as possible.

Why—and even how—I did this, is for another time. Here I want only to speak on a fairly limited topic: the outward signs of severe alcoholism, and how the alcoholic does, or more often doesn’t, reckon with those signs and what they mean.

The earliest markers are annoyances. You’re sweating a lot, particularly in the mornings. You’re sweating so much, in fact, that people on the subway are looking at you, and the seat next to yours might even stay vacant, something actually insane given the overpacked NYC public transit system. The sweat is starting to get in your eyes and cloud your vision, and the salt is reddening them, so you look even more unhinged. You pack napkins and surreptitiously swipe them across your forehead, trying to stem the onslaught, and you are aware that this is how people with bits of paper all over their sweaty faces get that way, but you have no alternative. And of course, you smell like a whiskey straight.

I always felt my sweat would immediately announce me, would mark me in the eyes of all those who gazed upon me. “Shit,” people would probably inadvertently think, “That guy is sweaty.” Accurate. Would most people presume I was a drunk, coming off another bender and fiending for a sip? I doubt it - sobriety has led me to realize that most people don’t care about strangers enough to spend even a few seconds guessing at their health problems. But, but, they would certainly notice I’m oddly sweaty.1

The sweat came on fast in my drinking career, as noted. After my very first bender, in or around August of 2008, I went on a second date with a boy absolutely drenched. There was no third date. I didn’t know what was going on at the time and chalked it up to anxiety - literal flop sweat. It would be months before I made the fairly obvious connection that I would sweat when I wasn’t drinking, and the sweating would stop when I drank.

Shaky hands get a lot of play with chronic alcoholism. In fact, shaky hands are essentially shorthand in films for addiction - “Oh, his hands shake, he must be an alcoholic.” And your hands definitely do start to shake, once your body is sufficiently used to booze flowing through it and going into open rebellion when it’s not.

But other stuff shakes, too. Your feet shake if you let them hang free, so watch that leg-crossing. My head would shake if I turned my neck too far to one side, which was eminently disturbing both to me and the people around me. People will ignore the shaky hands because they know what it means, but when your fucking head is vibrating they feel obliged to mention it to you. “Nope, I’m fine, just a little tired” is why I look like a dashboard ornament.2

Unlike the sweating, you have some control over the shakes and how severely they present, which adds a whole other layer of fun to your worldly interactions. So for example, the head shakes could be avoided by not straining my neck muscles to one side all too much. This is how I learned that it is in fact very annoying to live without being able to look to your sides. My eyes did get a lot of darting exercise, though. To hide the hands, I would just keep them in my pockets all the time, which added a nice air of surliness to the already-present sweatiness I was constantly rocking.

The worst was when I found myself unavoidably having to lift something heavy. Muscular exertion of any sort would bring upon massive shakiness. Even when stone cold sober I have the strength of an out-of-shape 10 year old, and my body was so drained from the constant booze onslaught that to so much as lift a chair and move it would leave me gasping for air. Several times during my worst drinking years I moved apartments, and unless you hire movers you are essentially in for an entire day of heavy lifting. Picking up one end of a couch, my arms and legs would twitch back and forth so rapidly that inevitably, someone else present would tell me to relax, they’ll handle it. I think people just assumed I was very stereotypically gay and/or allergic to manual labor.

The earliest instance of muscle problems I can remember occurred maybe a year or so into my drinking career. I was down in Virginia, visiting family. My grandmother, who is dead now, was an avid and competitive Scrabble player. Competitive almost to the point of being an asshole about it - she would hum the Final Jeopardy music if she felt we were taking too long to form a word. But she had every right to be cocky, she was a dynamo Scrabbler. To this day, I’ve never played against anyone better.

Anyway, one afternoon, she, my sister, my aunt, and I were enjoying a game. Or rather, they were enjoying it, while I was having an interior meltdown and trying not to show it. Having gone without a drink since passing out at around 4 a.m. the night before, my body was in open rebellion. My muscles were seizing up, unused to performing dexterous tasks without the lubricant of booze. I couldn’t hold the Scrabble tiles, and I certainly couldn’t place them on the board without disturbing all the carefully laid words around them. It was, I imagine, how individuals with Parkinsons disease feel in situations like this. And I was terrified, and trying not to show it.

I remember, in a shaky voice, saying something to my sister seated next to me like, “Something is wrong with me...I feel strange.” Even though this particular manifestation had never occurred before, I knew it was somehow related to alcohol. I had to think quickly. It was around 3 p.m.….normally too early for a drink, but this was a sort of vacation. Before anyone could object, I walked to the liquor cabinet and carefully, with hands like frozen cuts of meat, made a strong, strong gin and tonic. Minutes after the first swallow, I was back to normal.

Another memory from that same trip makes me realize that this was probably a marker in my downward descent, when the physical side effects of a booze-filled life were first starting to become apparent. I hadn’t shaved in a week or so (shaving was very annoying during a bender because it required a level of concentration I just couldn’t handle) and had a healthy growth of stubble. Beneath the stubble, I could perceive, or thought I could perceive (is there a difference?) a deep, black and blue discoloring on my chin.

I was horrified. This, I was convinced, was a bruise indicative of liver failure. Its existence, buried beneath a quarter inch of thick dark facial hair, consumed me. After I noticed it, it was all I could think about. I even asked my father, himself a recovering alcoholic, if he could see it. He could not. The anxiety caused by the phantom bruise was terrible, and (but?) it gave me a reason to double down on my drinking whenever possible.

I still don’t know if the bruise, my own personal yellow wallpaper, was actually there or not. By the time I shaved it was gone, if it had ever been there at all or been a mundane hallucination. I would have far more direct and actual experiences with scary bruising soon enough. This was still early in my downfall and I had a ways to go before death. It is possible that, given everything else happening with my face, I was biased toward imagining realities even worse than what was actually going on.

What was going on with my face, you ask? Oh god, a lot. I drank so much in that one year period that I already was presenting as a seasoned, elderly alcoholic, perhaps of the English variety. My skin was “ruddy,” a polite way of saying severely red. I was very bloated, too, and had constant bags under my eyes.

You are probably familiar with this aspect of alcoholism. Like the shaky hands, society has adopted facial bloat as a recognizable form of alcohol abuse. Think of the bum toting a paper bag with a bottle in it, or late-stage Chris Farley. Combined with the overwhelming redness, this caused my face to become somehow less… distinguishable, would be the best way to put it. Prior to alcohol abuse, I had a face, nothing so special but also recognizably a face, with cheekbones and a chin and a jawline hovering over a neck. Alcohol erases and blurs these distinctions, like someone recreated your visage with putty. Your red, sagging and inset eyes become the face’s center of gravity, two holes pressed deep into a lump of dough. Even your lips become thinner, as the flesh around them asserts itself further, both pushing them inward and beginning to match them in redness.3

I tried to deal with this using makeup. Even before alcoholism, I was no stranger to the magic of concealer. I used it in college sometimes, and I would add a little eyeliner here and there to really kick things up a notch. But the drunk years were a long way from college, and the makeup was only making me look more bizarre. For one, the aforementioned sweating meant that any applied makeup had a very limited lifespan, at least on my face. So while my sweat would have an interesting and unusual flesh-colored tone to it, I can’t say that was really what I was going for.

All of this combined to worsen my hermitude, which was already profound. I avoided cameras like I was afraid they would steal my soul, or at least shine too glaring a light on it. (There are very few pictures of me in existence from these years - I would simply refuse to be photographed.) The liquor drove me inside, where the only consistent companion was, you guessed it, liquor.

As the years crept on without any truce between my body and my booze, my physical woes became more than cosmetic. I started to bruise frequently - large, dark marks on my legs, arms, and stomach, with no seeming cause. Every time I discovered a new one, I became convinced, not unreasonably, that I was dying. My solution was to make sure I never looked at that bruise again. Probably not what a doctor would recommend, but at least I was being proactive. I stopped wearing shorts. Even around the apartment, I would wear long sleeves and pants. In the shower, I stared straight ahead and just assumed my lower body was being properly soaped and rinsed.

But even without seeing the bruises, I knew they were there. They remained etched on my mind. They started to haunt my sober thoughts. In the rare moments when I was lucid, I pondered only my own death and destruction. The lone times I could stop thinking about those bruises, what they meant, what they indicated about what was going on inside me, was when I was drunk. So I stayed drunk. 

It got worse. I woke up one morning, in the midst of a long bender, to find that my body had burst open at the seams at two points: on my thigh and my ankle. Huge, gaping sores stared back at me, throbbing and itching. And I remember feeling relief. “Ah!” I thought. “Alcohol doesn’t cause this type of thing, so maybe my health problems are all from some other horrible thing!” Only later, in sobriety, did I learn that in cases of severe alcohol poisoning, the body will create open wounds in a desperate attempt to drain some of the foreign agent from the blood.4

My midsection had become disturbingly bloated. Not fat, exactly - to me, fat implies at least some measure of health and sustenance. But just, severely rotund, very jiggly. Like I had a tube of water just beneath my skin. Actually, due to the patterns I was immersed in, my body went through radical changes from week to week. During benders, I would be bouncy and bloated. Then, when I was going through withdrawals and trying not to drink, I found it impossible to eat for days on end and would become emaciated. Never was there a healthy medium. Every step an adventure.

We are in the late stages, now. We are somewhere in 2014, I would imagine, when I found myself in the detox ward at Coney Island Hospital in south Brooklyn, having missed my law school final exams to be told by a doctor that my pancreas was failing and I was going to die if I kept drinking. Time flies - we’ve already passed the seizures, the first few trips to detox, the ambulances, the time I had a tooth pulled and the anesthetic wasn’t enough to knock me out, so accustomed was I to being inebriated. We are around the time my ailments stopped being entirely physical, and started manifesting in hallucinations - in seeing rats running around the floor of my apartment. We are even beyond the times the alcohol stopped making me drunk - imagine how scary that feeling was.

As I write this I have been without a drink for around 25 months. I look much better, you’ll be happy to hear, though my insides will forever carry the scars from this sort of living. I’ve put together sober time before only to lose it (though never close to this much) and one thing that shocks me is how quickly the ugliness, the destruction, comes back. Hours into a relapse and I’ll be that same sickly person on the subway who nobody wants to sit next to. It’s one of the many motivating forces keeping me off the bottle now, so for that I’m grateful.

It’s interesting. Once, in the midst of everything, I stepped outside of a Smith & Wollensky in midtown to have a cigarette. I was in the deep curve of a bender and had to go be out in the world for some unavoidable reason. A homeless woman in torn clothes pushing a shopping cart approached me and said, “You look like you are really going through some shit right now.” She was so, so right. I went back inside, thoroughly shaken, and ordered another whiskey straight.


People, not just drunks, sweat when they drink because their heart rate increases and their blood vessels dilate. Why withdrawal causes sweating is more complex. Oversimplifying: sweating is the body’s way of telling the chronic drinker that he needs a drink, that his chemical equilibrium has been disrupted. The alcoholic associates the cessation of sweating with alcohol consumption, and drinks accordingly. It is a tricky way your body encourages relapse, and is a good example of how physical addiction manifests.

Alcoholics shake for different reasons. Shaking - technically a physiologic tremor - can be caused by sheer anxiety, a common symptom of alcohol withdrawal. Alcohol is also a nervous system depressant, and if the alcoholic remains in a physically depressed state for a long time, the body becomes used to it. Without alcohol, the nervous system can’t properly process the surplus of information it is receiving. This would explain why my shaking got worse in times of physical exertion. In severe cases, shaking can be indicative of the delirium tremens, something every serious drunk lives in fear of.

Alcohol ravages the face. For one, mixed drinks can be full of sugar, so heavy drinkers gain weight and develop acne. Excessive alcohol intake also affects the body's absorption of certain important vitamins which, along with burst capillaries, contribute to the constantly bloodshot eyes of a drunk. Red, bloated skin is caused by enlarged blood vessels which leak fluid into the skin, along with broken capillaries. Chronic alcoholics also develop frequent, severe flushing, which is caused by acetaldehyde, a byproduct of alcohol, triggering histamines in the body. And of course, alcohol massively dehydrates the skin - and most drunks aren’t overly concerned about drinking water.

Bruising has many causes in an alcoholic’s body. Most simply, alcoholics fall a lot. Alcohol also thins the blood, which makes the skin more susceptible to bruising. Most disturbingly, severe bruising is indicative of a compromised or possibly diseased liver. The liver is what produces the body’s clotting chemicals. When it is under siege from booze, it’s too busy defending itself to produce those, which means the blood cannot clot properly. And eventually, the liver scars too much to produce much of anything anymore. At that point, the drinker develops cirrhosis, which is right up there with the DTs in terms of alcoholic nightmares - the point of no return. True death.

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John Teufel is a lawyer and writer based in New York. He likes to write and think about sobriety, philosophy, true crime, politics, and "jokes." He imagines himself to be witty. He is grateful to be sober as of whenever he wrote this bio and hopes to stay that way. He is new-ish to Twitter but figuring it out, follow him at @JohnTeufelNYC.