Hard chaw gone

cw: suicide

All happy families are alike; each unhappy 
family is unhappy in its own way. Leo Tolstoy. 

Apparently this phenomenon is known as the Anna Karenina principle. It's probably true for healthy and sick bodies. Take blood pressure: it is driven up if a) the heart beats faster b) pushes more through each beat c) fluid builds up in the finite circulatory system d) the walls of the blood vessels constrict , so that the finite fluid volume is squeezed e) some other effect I may have forgotten. "Normal" blood pressure is maintained by a complex and multiply-redundant system [ACE, ADH, ANP, ANS, ARB etc] of hormones, neurotransmitters, receptors and ligands. Doctors have a rather large pharmacopeia [at least 9 different statins] from which to prescribe. The skill is working out which part of the system is banjaxed and targeting that without jerking around the bits which are doing their best under adverse circumstances.

I've been ear-booking a memoir, O Brother by John Niven [Guardian review], which is disc-harrowing and redemptive by turns. Niven and his wee brother Gary were raised in the 1970s among the dispossessed of Irvine, a New Town SW of Glasgow. There was plenty of scope, and many role-models, for having dumb-ass, often violent, adventures on the move fast and break things spectrum. It was easy enough to get aff their heids with glue, Bucky and vodka - and later (with more money) ecstasy and cocaine. Yet these boys had quite divergent life-courses: 

• John pushed himself to, and through, college [1st class hons, no less] and became [eventually, much struggle] a successful author and screen-writer with fast cars and nice suitings.
• Gary became a woefully inept drug dealer; serving time for possession with intent to supply. 

One late-onset tonk the brothers had in common was being afflicted with cluster headaches - a rare [1/1000] crushingly painful, episodic condition. This was seriously and serially mis-diagnosed in the boy who was left behind in Irvine: his GP clocked "headache" and prescribed Nurofen. John, in London, with college education and access to Google, got both diagnosis and access to treatment (insofar as there is effective treatment!). happy heads are alike; each unhappy head is achy in its own way and aspirin won't blatt a brain tumour.

Poor wee Gary, broke and broken, finally managed to off himself . . . while in hospital [having called 911 after another evening of suicidal ideation and dead-end despair]. It shouldn't happen under those circumstances. But my father shouldn't have died "unexpectedly" in hospital after falling downstairs and being subjected to a succession of 'hilariously' inappropriate medical interventions. My brother and I went to identify the body half expecting to meet The Other Mr Scientist on the hospital books whose treatments had been shuffled and intercalated with the Da's. There was an outside chance that our father was on a trolley awaiting an MRI in the other hospital in the same Trust. Oh, and they lost his medical records! 

Gary was kept on life-support for four [4!] days after he'd killed himself. X-rays, and oxygen and intubation and MRI were readily available for the dead. But simple care-and-attention were not there for the living. The family never faulted the coal-face staff at the ER and ICU - they were kind, professional and effective. The System and The Management; not so much. John and his surviving sister went, through three [3!] FoI requests, after the transcript of Gary's 911 call. They sued the hospital for negligence and cover-up and won.

It was a Pyrrhic victory. No amount of win, no amount of compo, could bring back the wild beloved boy who never grew up. It took ten years of process before John the Writer could get their story down on paper. By that time, John was able to record that all of Gary's pals were dead. Some additional back-story in Holyrood.

Tolstoy's quote in the original Russian: Все счастливые семьи похожи друг на друга, каждая несчастливая семья несчастлива по-своему.