The anatomy lesson of Dr Moore

Drink - Victoria Moore gets red-faced at the surgery

For the first time in years, I went to see a doctor. I try to avoid doctors because I consider them to be people who will tell me that I am diseased, rather than people who heal. Anyway, the doctor asked me about my alcohol consumption, which I already knew to be way too high.

On that particular day, I had tasted six wines the night before and drunk a shot of very nice tequila for breakfast (I was interviewing someone about his new off-licence - it wasn't my fault), so I drew a deep breath and confessed to 30 units a week. "You do know it should be no more than 14," said my doctor. I nodded, and no more was said. But it prompted me to look at some of the short-term effects (I could not face the long-term ones) that alcohol has on the body.

Alcohol is absorbed through the stomach lining (about 20 per cent) and the small intestine. It can take as little as five or ten minutes to reach the bloodstream, which then takes it on a sort of hooligan's tour of the cells of almost all the organs in the body.

We are all familiar with the effects of alcohol, if not in ourselves, then at least in other people. First comes that cosy feeling of warmth and mild relaxation that has you curling comfortably into your chair. Then, as relaxation deepens, you slough off the residues of the working day and remember that you are a human being with a spiritual life and a limitless capacity for love. This is about the point at which judgement becomes impaired. If you are at an office party, this is also the point at which you should stop drinking, because your inhibitions will be in steady decline and you are probably just one vodka tonic away from either photocopying your bottom or telling your boss that you have never much liked his taste in ties, but that you still find him very attractive anyway.

After this, you will experience increased impairment of judgement and muscular performance, slowing of reflexes, staggering gait, slurred speech, double vision, memory and comprehension loss, inability to stand, vomiting, incontinence and unconsciousness. In roughly that order. This all happens thanks to ethanol, the substance that causes a desperate battle between the brain, which keeps wanting more, and the liver, which recognises its toxicity and, at great cost (cell death and inflammation) to itself, gallantly does its level best to remove it from the bloodstream. At least 90 per cent of the alcohol you drink is metabolised out of the body in this way. A very small proportion is secreted by the kidneys and passes out as urine; an even tinier amount is exhaled through the lungs.

Because our bodies contain less water (and more fat) than men of the same weight, women absorb alcohol more quickly. And we absorb alcohol even more rapidly in the two weeks before menstruating. This is why women should never embark on drinking competitions with men unless they are prepared to cheat.

You can often tell when someone has been tippling just a bit, because his or her face goes red. This can be caused by alcohol-triggered rosacea, or because, when enzymes in the liver break down the alcohol, they first convert it to acetaldehyde, a toxic, cancer-linked chemical that, in people with an enzyme imbalance, is not itself broken down straight away and causes a telling flush to spread across the cheeks.

When it first reaches the brain, in low concentrations, alcohol seems to act as a stimulant. After a while, it begins to act as a depressant. It is thought that the initial and woefully short excitement phase may be caused by alcohol suppressing inhibitory brain centres, hence relieving anxiety and so on, rather than by activating others to a state of previously unimaginable euphoria. In any case, it is the effect of alcohol on the brain centres that control your muscles, rather than its direct effect on the muscles themselves, that gets you into the sorts of trouble described above.

Alcohol also impairs the body's ability to tighten blood vessels. This is quite important because, when you stand up to make that long trip to the bar, you rely on your blood vessels to constrict in order to maintain blood pressure. If they do not, gravity acts to reduce the flow of blood to the heart. This, according to an American study, is why you pass out. When you pass out, the body continues to absorb alcohol, which can lead to such high levels of alcohol in the blood that they cause death. This is to be avoided at all costs. The lesson is straightforward: if you cannot stay away from the bottle, then stay away from the doctor.

This article first appeared in the 09 October 2000 issue of the New Statesman, Schools that teach children to lie