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Tommy Flanagan

My great-uncle Tommy Flanagan was the third Flanagan child, the oldest boy - no doubt bossed around by his two big sisters, but having the benefit of his mother till he was eleven years old.

In 1900, we caught him as an 8-year-old with his mom and dad and brothers and sisters. And then he disappears. Not even a photo remains. All we know is that at the age of 33 he died.

The Death Certificate arrived this week. Cause of death: Delirium tremens. From e-medicine:

Delirium tremens (DT) is a potentially fatal form of ethanol (alcohol) withdrawal...
Symptoms may begin a few hours after the cessation of ethanol, but may not peak until 48-72 hours. Emergency physicians must recognize that the presenting symptoms may not be severe and identify those at risk for developing DT. For patients in DT, early recognition and therapy are necessary to prevent significant morbidity and death. In the US: Only 5% of patients with ethanol withdrawal progress to DT.
Mortality/Morbidity: Mortality rate may be as high as 35% if untreated but is less than 5% with early recognition and treatment. Patients at greatest risk for death are those with extreme fever, fluid and electrolyte imbalance, or intercurrent illness such as pneumonia, hepatitis, or pancreatitis.

From Medline Plus:

Delirium tremens can occur after a period of heavy alcohol drinking, especially when the person does not eat enough food.

It may also be triggered by head injury, infection, or illness in people with a history of heavy use of alcohol. It is most common in people who have a history of experiencing alcohol withdrawal when alcohol is stopped, especially in those who drink the equivalent of 7 to 8 pints of beer (or 1 pint of "hard" alcohol) per day for several months, and in those with a history of habitual alcohol use or alcoholism that has existed for more than 10 years.

Symptoms occur because of the toxic effects of alcohol on the brain and nervous system. They may be severe and progress rapidly.

It is a hard diagnosis to face -- a decline into oblivion. Perhaps he had gone missing, maybe picked up off the streets and delivered to the overcrowded City Hospital on St. Louis' south side, far from home. Maybe he was sick with tuberculosis or hepatitis. Maybe he didn't get the DTs till he was there for a couple of days drying out, but too sick to leave.

The hospital didn't get much info on Tommy except that he was single and worked as a day laborer - the kind who stands outside of a mill or a factory and hopes someone points to him for work. Maybe that's where he collapsed on a sweltering day in July.

My mother recalls a story Kitty Mom told her. Apparently the hospital had enough information to notify my grandmother about her brother's whereabouts. She was just pregnant with her fourth child. She went to visit him and, in the throes of his misery, he asked for grapes. She left, expecting to return with grapes, but by 6:15 next morning he had passed away.

4.22.05 (revised 12.10.05)



For the basics, check the summary of the Flanagan kids and the timeline of their demise.