What drives a child to drink?
By the time Madeline Hanshaw's son Gary Reinbach was 13 he was drinking heavily. This week, aged just 22, he died of liver failure. Here, she defends herself – and her son's memory – against those who have been quick to pass judgment
Madeleine Hanshaw, with sons Luke and Tyler, said she hopes Gary's story will be a lesson to others. Photograph: Christian Sinibaldi
Madeline Hanshaw is standing in her kitchen. The washing is whirling around the machine, there are coffee cups in the sink, and outside kids are playing noisily in the sunshine. It could be an ordinary day: but Hanshaw is wondering how life will ever be ordinary again. "My baby is dead," she says. "That's going to be in my heart every day for the rest of my life."
Hanshaw, 44, is crying now. A week ago, she is saying, she still hoped that Gary – "Gal", she calls him – would pull through. "I believed in the doctors," she says. "I thought they'd find a liver for him somehow. I thought he'd make it."
Gary Reinbach was denied a transplant because, under guidelines drawn up by the Liver Advisory Group, patients who are likely to return to a damaging pattern of alcohol consumption aren't deemed suitable candidates.
So Gal didn't make it: last Sunday, a day after Hanshaw had gone public with her plea to doctors to make a liver available to him, her 22-year-old alcoholic son died at London's University College hospital (UCH). His last hours, she says, were truly terrible. "He didn't want to die. He kept saying that. I really think that if they'd given him a second chance, he'd have changed his ways.
Gary Reinbach had shown promise as a young boy. Photograph: Christian Sinibaldi
"He was talking about going back to college, training, making a new life for himself." She pauses. "That isn't going to happen now."
Talking to Hanshaw you get the feeling that – though Gary was desperately ill in hospital for 10 weeks before he died – neither she, nor he, believed it would come to this. She still seems unable to believe that drink could have made his liver pack up while he was so young. She is adamant she didn't realise he was drinking at 13 – "don't you think I'd have done something about it if I'd known?" – and says that, when she did realise he was drinking heavily from the age of about 16, she did all she could to persuade him to stop. "But he was a young lad, and what young lad listens to his mum? I thought it was just a phase. I thought he'd come to his senses, stop drinking and move on."
What neither she nor Gary was prepared for was the suddenness, and severity, of liver failure. "One moment he was just a heavy drinker, the next he was losing weight and being sick every morning. Then one day I noticed a yellow tint in his eyes, and I told him to get to the doctor." He did – and a few days later he was in hospital, first at Queen's hospital near his home in Dagenham, Essex, then at UCH. "By then he knew it was bad, but he still thought he could get through. He was asking me to call Alcoholics Anonymous so he could start to turn his life around," says Hanshaw.
As she shows me the death certificate – Gary died, it says, of "multi-organ failure" caused by "alcoholic hepatitis" – one of Hanshaw's two younger sons, Luke, 18, arrives. Luke, too, says he never for a second thought Gary would die. "Everyone round here is shocked," he says. "What I keep asking myself is, how come alcohol isn't illegal, when it killed my brother?
"My mates used to drink, but they're not drinking now. They've had enough – no one else wants to die like Gary died."
What Luke and his mates have discovered the hard way is what liver specialists like Dr Nick Sheron, of Southampton General hospital, have been saying for some time: that young people who abuse alcohol heavily will suffer the same consequences that older people who've been abusing it for many years do; in other words, their livers will fail.
"I became a liver specialist 15 years ago, and I remember how shocked I was when I first saw a man of 23 with liver failure. But this year already I've seen five people with it in their early 20s. Gary isn't going to be the last death. We're going to see a lot more young people in this state over the next few years.
"The mistake people are making is to think this problem can't get much worse. It can. We're already seeing heavier drinking in very young people and that can lead, as it did in the case of Gary Reinbach, to early liver failure."
But Sheron says even he is shocked by figures out this week which show that, among 11-15-year-olds who drink (ie, who have had alcohol in the past week), consumption has gone up from 5.3 units a week in 1990 to 12.7 in 2007 and 14.6 last year – an almost threefold increase in consumption in under two decades.
"We're aware of a trend towards greater consumption in youngsters who drink," he says. "It escalates – what you see is someone who starts having alcohol in their early teens, and then they start to drink more and more on more and more days of the week. It starts with the weekend binge, and then it spreads to Thursday nights and then Wednesday nights. And then they're drinking heavily on a daily basis – a recipe for liver disease."
From talking to Hanshaw, that seems very much to have been how Gary's drinking progressed. But the big question is, why? What makes a child who's doing reasonably well (Hanshaw says her boy more than held his own at primary school, though his secondary school career was inevitably blighted by his alcohol use) descend into an alcoholic daze?
Inevitably, there isn't one single reason: as Sheron points out, the reasons for alcohol misuse are always multifactorial. But availability is crucial: what a lot of people don't realise, says Sheron, is how much easier it is for kids today to not only get their hands on alcohol, but to get their hands on stronger alcohol. "Compared with 1980, beer is 170% more affordable," he says. "But wine is 280% more affordable … and spirits are 350% more affordable. It's not just that it's got cheaper: the strongest stuff has got more affordable than the weaker stuff."
So how did Gary, who reportedly got through three bottles of vodka a day at the height of his addiction, get his alcohol? "What happens is that an older kid buys them their first booze or they get it from girls who've got adult men to buy it for them," says Hanshaw. "Then they get a taste for it, and they're away – and they find ways to get it, of course they do."
But availability is only part of the jigsaw: drinking yourself into a daily stupor requires a fairly heavy dissatisfaction with life as well. Hanshaw says Gary was bored – "there's nothing for them to do round here, I think he drank to help him get through the boredom". But she feels, too, that he was deeply affected by her marriage break-up when he was 11, and that alcohol provided some solace. "I think the fact that his dad and I broke up had a lot to do with it," she says. "But then again, plenty of kids have parents that break up." She also points to the fact that Gary was a hot shot at tae kwon do, and might even have become one of the youngest black belts in the country.
"But when we split up we moved away from where the classes were held, and it was too difficult for him to get to them. I think that was a big disappointment, yes: when we had arguments, he'd always throw that one back at me."
It's pretty heartbreaking, this idea of an 11-year-old lad suddenly wrenched from the life he knew and deposited in this ground-floor flat on a rundown estate, his dream stolen from him and the world suddenly seeming to offer only disappointment.
Hanshaw says she feels both she and her dead son have been unjustly vilified in the press over the last few days. For the first time during our chat, there is an edge of anger in her voice. "I know people are blaming me and I know people are blaming him, but what I say is – you don't know me, and you didn't know my son. I did my best for him, just like any other mother. Yes, his dad and I split up, but we're still friends, he's been down here this week. It wasn't the worst break-up."
One of the things that has hurt her most has been that some people have said that it was right that her son wasn't deemed eligible for the liver transplant that might have saved his life. "I've heard people have said that reading about Gal makes them feel like ripping up their donor cards. Well, rip them up! We wouldn't want a liver from anyone like them anyway." She pauses.
"At the end of the day, I'm just a mum who was trying to keep her child alive. You'd do anything … I'd do anything …"
She had heard that a transplant would have given Gary a 75% chance of recovery. She did all she could for him in what turned out to be his final weeks. "I was at the hospital every day."
Now, she says, she'd just like other mothers, and other young people like Gary, to know the reality of heavy drinking. "If they could have seen my Gary lying there, so ill and so swollen … if they could have heard how much he wanted to live. If I'd known then what I know now I'd have done something, anything, to stop him drinking but I didn't know it could turn out this bad. And I didn't know how to stop it."
How to stop young alcoholism is the $64,000 question: and according to Sheron the answer, like the problem, is multifactorial. "There isn't one single reason for it, and there isn't one single solution to it," he says.
One thing he will be pinned down on is cheap alcohol marketed directly at young people. "We've got to look at the fact that there are almost no controls on this," he says. "It's being pushed through the internet, through mobile phones, through all channels."
But for Gary Reinbach, there was to be no second chance. "I'm not saying he was the perfect son," says his mother. "But I'll tell you this: he didn't deserve to die like that, at 22. No one does. And I hope to goodness others learn from it, because I don't want any other mother to go through what I'm going through."