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Ravaged by alcohol abuse, retired firefighter makes a solemn promise as he fights liver disease, and for his life.
RACINE — The liver is an amazingly resilient organ, one of the few in the body that can regenerate itself, like a salamander that can regrow a severed tail.
It also is the largest solid organ in the body. About the size of a football, it weighs more than 3 pounds in the average adult.
The reddish-brown organ performs hundreds of jobs for the body — making immune agents to battle infection, converting food into chemicals, storing vitamins and minerals, producing proteins that regulate blood clotting, and creating bile — a substance essential for digestion, to name a few.
It also has the job of removing poisons from the blood.
But when exposed to a chronic onslaught of alcohol, the liver can’t keep up with the job of breaking down and metabolizing the poison. Fat begins to accumulate inside the liver cells, and the organ becomes enlarged, causing abdominal pain.
If alcohol continues to flood the organ, its cells begin to die and rubbery scar tissue takes their place.
The nonfunctioning scar tissue builds and the liver begins to lose its function. Once the useless, knotty tissue reaches critical mass, the liver has reached the point of no return. That’s cirrhosis.
From there forward, the disease will progress. Going dry will only slow it down.
After four decades of heavy drinking, Jon Sustachek’s liver had reached this point.
Two weeks before Christmas in 2005, after a couple months of round-the-clock drinking, the critically ill Racine man, a retired firefighter, made a fateful decision. He called 911.
In an emergency department bed at All Saints Hospital in Racine, a team of strangers did what Jon, then 61, was unable to do on his own: save his life, at least for a while.
As IV fluids coursed into his body, re-hydrating him, his failed kidneys came back online. Antibiotics battled the pneumonia in his lungs. Vitamins combated anemia and malnourishment. Benzodiazepines quieted his delirium tremens, calming his nervous system as it screamed for the alcohol it had come to depend on. And potent laxatives helped remove the ammonia from his body.
Jon, gratefully, has no memory of those agonizing days, when his body was forcibly detoxified. But for family members and friends who stood at his bedside, it was a horrific sight.
Jon’s two adult daughters were the first to arrive at the hospital. They got there days after Jon was brought in, after discovering his empty house and snow-covered truck in the driveway.
“I was a wreck and I knew what I was going to see — a yellow man with a big belly, wetting the bed and picking at bugs at the wall,” recalls Jennifer Rosenbaum, 36, a nurse. “It was that and worse.”
Restraints held Jon to the bed. He tossed and turned, mumbling incoherently, his vacant eyes staring into space.
Jennifer had seen her share of bloated, hallucinating drunks in this very emergency room. She had worked here for seven years. Some patients had blood-alcohol levels as high as 0.50 percent. A lot of them died.
Rosenbaum, who now works at a family-practice clinic in Racine, had left the ER in October, two months before Jon was brought there. “That was a blessing in disguise,” she says.
As the toxins gradually cleared from Jon’s brain, lucidity returned like a dimmer switch slowly being turned brighter. Jon returned from the fog to the sounds of his sobbing daughters. Without alcohol to numb him, the emotional pain was searing.
“I woke up and found out how they felt about me, that they really loved me,” recalls Jon, now 64.
Jon pondered his future and reflected on his past. He realized he had a choice to make. Continue to drink and die. Or stop drinking and start living as he was dying, with the hope of finding some measure of healing and perhaps even a second chance, a chance at reconciliation and redemption, in the time he has left.
Even to be considered for the liver transplant he needed, Jon would have to stay sober and prove it — something he never before had attempted seriously in 40-plus years of drinking. He had been too proud to get help or too ashamed, he doesn’t know which. “I figured I could do it on my own.”
But, it was different now. Jon was too sick even to crave alcohol. His resolve and stubbornness took hold. Nearly 20 years before, he had quit smoking suddenly, giving up a two- to three-pack-a-day habit. It wasn’t for health reasons, but rather because smoking was becoming socially unacceptable. So he made up his mind and just stopped, never lighting up again. He would do the same now, he told himself. It wouldn’t be easy. While alcohol addiction may start with voluntary behavior, the brain eventually craves the drug as it does food or water.
But, it was time to make amends. He wasn’t ready to die. He made a quiet promise to himself, a promise for his children.
‘It’s an epidemic’
Wisconsin has a culture of drinking that is second to none.
True to our heritage, either German or Eastern European, many of us find no shortage of excuses to imbibe. We drink at bars, church functions, charity events, community festivals and even youth-league baseball games.
Alcohol at once benefits the state and costs it. Economically, it is a boon to Wisconsin. The state’s 3,000 drinking establishments, employing some 14,000 people, ring up more than $600 million annually. And, in 2006, the brewing industry had a $3.35 billion impact on the state’s economy, including jobs for some 30,000 residents.
But drinking can exact a high toll. In 2005, at least 590 people died in Wisconsin as a direct result of alcohol use or abuse. Another 5,992 people were injured that year and some 80,000 people were arrested as a result of alcohol use or abuse.
The story of Wisconsin’s culture of drinking comes to life in people such as Jon Sustachek, whose decades of hard drinking illustrate many facets of that culture and how they are integrated in one life.
For every one alcoholic, the lives of least four other people are directly affected, according to Al-Anon, an international support group for families and friends of alcoholics.
Drinking with his buddies and colleagues in the Racine fire department, Jon was at once a facilitator and product of Wisconsin’s culture of alcohol. Now he was casualty too.
In such a culture, alcohol affects everyone, even those who don’t drink — from the innocent drivers and passengers killed in crashes with drunken drivers to the doctors who must work overtime trying to undo the harm done by alcohol abuse.
Nationally, about 1 in every 12 adults abuse alcohol or are alcoholics. In Wisconsin, it’s about 1 in 10 adults on average, the fifth-highest rate in the nation, according the National Survey on Drug Use and Health. And like Jon, Wisconsin residents are among the least likely to seek help for treatment.
Wisconsin is fifth-highest for people, some 9.3 percent, needing but not receiving treatment for an alcohol problem, the same survey shows.
Alcoholic liver disease accounts for some 13,000 deaths annually, and is the second most common reason for liver transplants, after hepatitis C. In 2005, the disease killed some 244 Wisconsin residents.
The disease is marked by a slow and painful descent to premature death, including weight loss, extreme fatigue, muscle tissue that wastes away, deadening nerves, numb limbs and a swollen belly. Once advanced cirrhosis sets in, the only chance for survival is a liver transplant.
Alcoholic cirrhosis usually develops after at least a decade of heavy drinking, which in women can be as few as two to three drinks per day, and as little as three to four drinks in men. The amount of alcohol and the time it takes for the disease to set in, however, varies greatly from person to person, says Dr. Jose Franco, a liver specialist at Froedtert & Medical College of Wisconsin in Milwaukee.
“You don’t get alcoholic cirrhosis overnight,” explains Franco. “Eventually, the scarring starts to occur after decades, and in some people, in as little as two decades. I’m seeing people dying in their 40s and 50s.”
Wisconsin’s penchant for excessive alcohol consumption is reflected in his busy medical practice, where he treats nearly 1,000 patients with alcoholic cirrhosis.
“In my opinion, it’s an epidemic in Wisconsin,” says Franco, who is also the medical director of liver transplantation at Froedtert. “In doing this every day, I do not see any progress being made.”
Rewinding a life
Lying in bed at the hospital, Jon was agitated. He tossed and turned. He didn’t know night from day.
When his daughter Jennifer talked to him, he stared right through her, she recalls.
Jennifer had treated patients like her dad; she knew the routine. But even as the nurse in her took over, her emotions misinterpreted his symptoms.
“I couldn’t separate it and realize that it was the withdrawal,” she says.
She felt powerless to reach him, to help him, to ease his suffering.
Jennifer, a petite blonde who had been a cheerleader in high school, stood vigil at Jon’s bedside with his older daughter, Monica, who perhaps has been more deeply affected by her father’s drinking than anyone else, family members say. (Now 39, Monica has not returned phone calls to be interviewed for this story.)
At Jon’s bedside, Monica and Jennifer began to make phone calls — calls to family and friends; to the people who over the years had been hurt by his drinking; to those who had worried helplessly about his drinking; to those whose relationships with Jon were either based on drinking or broken by it.
Soon, visitors and the bittersweet memories they brought flowed past Jon’s bedside in a steady stream — each embodying a certain time in his life, some standing for what seemed like other lifetimes altogether. It seemed like somebody had pushed the rewind button on Jon’s life.
Among the first to arrive at the hospital were Jon’s older brother, Harold “Pudge” Sustachek, and sister-in-law Mary Ann. Upon seeing Jon, they believed they would have to say their goodbyes.
The man in the bed was grayish green, recalls Mary Ann. He looked dead already.
“We were sure Jon was never going to come out of that hospital alive.”
Mary Ann has known Jon since they were children. She and Harold were 15 when they started dating. Jon was 8. By then, the brothers’ parents were allowing the boys to drink. The adults didn’t think there was anything wrong with children’s imbibing, Mary Ann recalls.
The boys’ father, Harold Sustachek, was an alcoholic. One of Mary Ann’s sadder memories of the man is also her last: She and Pudge found the man home alone and drunk. “He borrowed five bucks from Pudge to go buy another bottle of booze,” Mary Ann recalls. “And that was my last memory of him.”
The boys’ father died of a heart attack when he was 46. But in a Racine emergency room, his legacy lived on.
Leaving the hospital discouraged, Pudge and Mary Ann went home and prayed. Then they called their pastor.
Wasted years
Beyond the physical toll alcohol abuse exacts on the body, its devastation spills into families, with no statistic to measure the psychological pain that spouses, children and others must bear.
An estimated 6.6 million children live with an alcoholic parent, according to the National Institute on Alcohol Abuse and Alcoholism.
When a parent or spouse puts alcohol above the family’s needs, the ensuing drama, often freighted with neglect and abuse, can lead to emotional scars that might never heal.
The children of an alcoholic may feel guilty, as if their parent’s drinking is their fault somehow. They commonly experience anxiety, anger, depression and an inability to trust others, says Appleton clinical psychologist Rob Burkham.
In the developing psyche of children, the chaos, hurt and disappointments become integrated, informing how they feel about themselves and view others. Children adapt to the dysfunction and defense mechanisms take hold. Typically, they grow up to be either over-responsible or under-responsible, Burkham says.
Studies show that about 70 percent of children of alcoholics develop their own compulsive behavior, such as alcoholism, drug abuse or overeating. About half of them will marry alcoholics.
“I more or less adapted,” recalls Jennifer, who holds no ill will toward her dad. “We never were the family that could open up and talk about feelings and problems. We just ignored them.”
Jennifer covered up pain and problems with jokes. She grew up fiercely independent and learned to take care of herself.
And as an adult, she learned to take care of everyone else at the expense of her own needs.
That has been hard to change. Jennifer sought counseling. It is helping her understand the dynamics of growing up with an alcoholic.
From Jon’s bedside in the hospital, Jennifer phoned her mother, Sue Sustachek, Jon’s ex-wife. Jennifer told her what had happened but urged her to stay away. Don’t come to the hospital, Jennifer said. You don’t want to see him like this.
Having grown up with an abusive alcoholic father, Sue had vowed to never to become an alcoholic herself.
And then she fell in love with Jon.
Their teenage romance blossomed and they were married. But alcohol seeped into their life together. Eventually, Sue realized she couldn’t keep up with Jon’s drinking. And then she decided she didn’t even want to try.
While Jon always provided for the family financially, he put his drinking ahead of his life with them, and it took its toll, says Sue, now 61.
“The girls don’t know what’s normal,” she says. “They realize they didn’t have a normal upbringing. They grew up not knowing how they should be treated as a wife, where they should draw the line. ‘What should I put up with? Should I take this lying down?’”
Though Jon never was physically abusive, he was mentally abusive sometimes, Sue recalls.
On occasion, he wouldn’t speak to her for two weeks at a time. When the girls were toddlers, he walked out on the family several times.
“I don’t know if it was the alcohol or not, but he would get mad at me, pack his bags and leave for a week,” Sue recalls.
She and Jon stayed married for 34 years until she finally decided she could tolerate it no more.
One day in 1997, she delivered divorce papers to Jon at the fire station.
“The thing I am most sorry for is that I wasted so many years of my young life being unhappy,” Sue says.
She still lives in the same brick ranch home where they raised Jennifer and Monica — the house where a family was born and later came apart.
Prayer from a stranger
After two paramedics who once had been Jon’s colleagues rushed him to the emergency room, word traveled fast among those at the Racine Fire Department: One of their own had fallen.
Fellow firefighter Greg Christensen had fallen out of touch with Jon, but when he heard the news, he headed to the hospital.
Their friendship had formed years before when Christensen transferred to Jon’s fire station. They became fast friends, working calls together on Truck No. 3 and partying hard at NASCAR races in Michigan.
Christensen knows how it is: “If you don’t know how to handle the stress of the job, it’s easy to roll alcohol into it to relieve the stresses of work. Before you know it, you are caught up in it.”
Scared by his own heavy drinking, Christensen stopped several years ago.
But Jon’s drinking got worse, especially after Sue left him.
With alcohol no longer in common, their lives took divergent paths and they drifted apart.
Christensen couldn’t believe what he saw when he arrived at the hospital. This wasn’t the man he used to know. It was half of him.
“I had no idea his drinking had progressed to that point,” Christensen says. “I don’t think anyone knew.”
As the days wore on, Jon’s life replayed before him in the parade of family, friends and loved ones who passed through his hospital room.
The man in the bed lay contemplating the could-haves and should-haves.
And then one day a stranger appeared. She introduced herself as Kaye. The Rev. Kaye Glennon from Franksville United Methodist Church, where Pudge and Mary Ann worshipped.
Glennon was vibrant, kind and reassuring — not what Jon expected from a church leader. Religion never had been a part of his life. He considered himself agnostic.
But as he made small talk with Glennon, Jon found that he was cheering up.
And then, there beside the hospital bed where a man’s life of drinking had led, Glennon said a prayer for Jon.
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