1. Introduction:
Some years ago while I was working as a health care assistant in operating theatres a student nurse from Ireland consumed alcohol excessively during her 21st birthday party. The next day she attended the accident and emergency department but was sent away diagnosed with a hangover. Normal doses of self-administered paracetamol overloaded her liver due to her dehydrated state and she subsequently underwent a liver transplant. Unfortunately she then had a stroke and died in the intensive care unit. Her 18 year old sister who was also a student nurse went back to Ireland in a state of distress. My last shift in theatres before I departed to University ended with an alcoholic man bleeding to death. I still remember the distinctive smell of blood which at first could not be seen. The surgeon tried to look for the source of his bleed with an endoscope, but there was so much blood that his view was obscured. As his blood pressure dropped we put him in a head-down tilt. That was when I first saw the blood as it gushed out of his mouth looking like chopped liver. I was at his waist level when we turned him on his side to clear his airway and I found myself covered with blood as he was bleeding from his rectum too.