You can say I'm sorry it didn't work out the way you wanted it to. You can say I think you're right, you do need a liver transplant.
You can't say The lead doctor has a point: the meds might help, you might improve; more important, you do have to demonstrate your willingness to go to therapy, AA, whatever. You can say I wish things were different, but you can't say but I understand why they aren't.
You can say I'm sorry you're feeling so awful; I hope it gets better. I know on top of everything that hernia is making things so much worse. You can't say I spent how many summers in Kansas to help you recuperate from hernia surgery you never had, that you canceled again and again? You can't say I knew that even ten years ago you didn't want anyone to get a look at that liver of yours. You can't say There were hundreds of chances to fix it before it got to be the size of a fucking volleyball, you had people lined up to take care of you. And you chose alcohol over those people.
You can say You're tired but you can't sleep, I know. It's hard to eat, I know. You can't say The torment in your body is probably nothing compared to what's roiling in your head.
You can say I know it's hard to get out to AA meetings but you can't say because you're embarrassed or because you still can't admit you have a problem? Why did I have to badger you even today to get you to tell me about the counseling requirement? And why wouldn't you say that it was alcohol counseling until I asked you point blank? You can say six months until reevaluation, that isn't too long.
You can't say you brought this on yourself. It's your fault. It's your fault. I hate that you are suffering but my expectations for you are no less than those I have for my four-year-old -- that you will experience the consequences of your choices and learn from them. I won't make excuses for you. It is hard to get up off the recliner and choke down a hamburger when you feel miserable but if you want to live this is what you have to do. It sucks to admit you have a problem but trust me, everybody else in the world is well aware. It doesn't diminish our love for you or our admiration of your better qualities, but believe me, you ain't foolin' nobody but yourself.
You can say It's tough work. You can't say but if you put half the effort into survival that you put into covering up your drinking you'll make it okay. You can say I love you.
You can't say I can't do this for you. You threw yourself down that hole, and I'll reach down as far as I can, but you have to scrabble your way on up. I can't haul you out on my own. I won't even try.