Mostly, I was lying to myself.
I was quite
successful through college, medical school, and residency in Boston. Accolades,
recognition, and honors followed. I rarely drank. Maybe it began socially.
Maybe the long hours. Frequent nights on call without sleep demanded by my
specialty contributed. In time, the practice I loved so much demanded more than
I could give without compromising my ability to be the husband and father I
wanted to be. I was calmer when I drank. I socialized more enjoyably. I could fall
asleep without reworking the pains of life.
I could control my
drinking; it wasn’t a problem. No family member or friend ever voiced concern.
I never had an OUI; I never had a “blackout”. I was okay, or so I thought.
It was a busy
evening on-call. With all active issues resolved, I drove the seven minutes
home around midnight. All was quiet except my thoughts. I couldn’t sleep, but I
knew how to treat that with a drink or two. From an alcohol-induced sleep, I
was abruptly stirred by the phone ringing. It was 2:00 AM and two urgent
patients needed to be seen. I hurried back to the hospital after brushing my
teeth and nearly swallowing a mouthful of toothpaste. I couldn’t have alcohol
on my breath. Later that morning, I learned that a patient complained about me
smelling like alcohol. I was terrified. Would I lose my license? I thought to
myself, “If you can successfully navigate through this, you’ll never drink
again!”
I learned that if I
cooperated with an assessment and plan through Physician Health Services (PHS),
this episode might not be reported to the Board of Registration in Medicine. My
best lies were unsuccessful at avoiding a three-day inpatient evaluation. I
minimized my problem to the evaluators and never admitted that I was an
alcoholic. I returned home with a discharge diagnosis of being “on the cusp of
alcohol dependence.” To resume practice, PHS presented a support system
including a three-year contract of abstinence from alcohol (verified by random
drug and alcohol testing), support groups including one just for physicians,
and a monthly meeting with a PHS associate director with expertise in addiction
medicine, by training and by personal experience. Invaluable tools to guide me
to success.
But no, thinking I
was so smart, I did the minimum to comply, and endured the three years. I never
admitted that I was an alcoholic. At the end of my monitoring contract I soon
resumed “controlled” drinking — just wine with dinner, then a cocktail or two
on weekends before and/or after the wine with dinner. Then I hid a bottle of
vodka under a tarp in the garage. My visits to the garage became more and more
frequent and secretive. This time I would hide it better. No one would know.
Six years after
completing my first PHS contract, I again found myself in the PHS office “on
the cusp” of losing my profession and livelihood. My lies no longer convinced
anyone. After three days of intensive evaluation, I finally said to myself and
others, “I am an alcoholic.” After three months of intensive inpatient rehab
with other physicians, pilots, notable entertainers, attorneys, and judges, I
could fully acknowledge my alcoholism: “I’m not an idiot, I’m not alone, but I
need a program to seek a daily reprieve from my alcoholism, and I need to be
honest.”
PHS again proposed a
three-year contract of monitored sobriety, support groups, and an associate
director to help navigate the good and bad days. Instead of tolerating the
program, this time I embraced it. Miraculously, I had my career, my family, and
my health. It felt right.
Eighteen months to
the day after my last drink, I had a sudden massive upper GI bleed, a known
complication of alcoholism. I rapidly lost consciousness. In the ER, in
Trendelenburg, I heard the nurse say, “BP undetectable.” The ER doc, a colleague
and dear friend, told me through the shadows that he was going to put me to
sleep, as another doc started central lines. My family gathered as they were
told I wouldn’t survive the next 12 hours. Ten days later, I was extubated. I
learned that I had received 46 units of blood in the first 24 hours, and coded
three times.
Why would this
happen after I was confronting my alcoholism? Is this going to happen again,
but without such a miraculous outcome?
I can’t and don’t
need to answer these questions. I know I woke up this beautiful morning. I know
I have the support of PHS, the support of other alcoholics, some professionals,
some without work or home, some with 40+ years of sobriety, some who have gone
their first 24 hours without drinking.
When I was first
reported, I resented those who filed the report, and I resented those in PHS
who tried to help me. I lied to all of them to save myself. In fact, they have
saved my life because mostly, I was lying to myself.
