APRIL 23, 2011

THE WRECKAGE WE CAN’T RECLAIM

Four years ago, John was confronted by his parents and his girlfriend about his drinking. The parents threatened that they could no longer enable his lifestyle. The girlfriend insisted reluctantly that she would have to leave him; he had demonstrated time and again that alcohol was more important to him than their relationship.

John called their bluff.

They weren’t bluffing.

A year later, John hit bottom, found AA and the miracle of sobriety. Over time he came to recognize that he had lost the love of his life, but there was no repairing their relationship.

Another year later, John’s former love was killed in an automobile accident by a drunk driver. I remember him sharing that at a meeting the following week and saying a silent prayer that his support system and sobriety were strong enough to withstand the pain.

They were. Last night he shared that it had been two years since losing her. The pain is still there, but not the need to drink.

We can’t reclaim the wreckage of our former lives. We can only resolve not to create any more.

jh

APRIL 21, 2011 BLOG

WHERE WAS YOUR DOCTOR LAST NIGHT?

In what seems a fitting revelation for Alcohol Awareness Month, an article this month in the Archives of Surgery reports that surgeons are impaired the day after a night of drinking.

Anthony Gallagher of the Royal College of Surgeons in Ireland was the lead author of the article.

Surgeons were asked to do a mock operation on a laparoscopic surgery simulator the day after drinking.

Only one of the surgeons failed the pre-operative breathalyzer test and there were few hangovers in the group, but both novice and expert surgeons made errors in the simulated surgery. The frequency of the errors peaked in the noon hour the day after the drinking bout.

The author states that the message seems to be that surgeons should not drink excessively the night before operating. A recommendation may be forthcoming to address the issue.

COMMENT: It seems intuitive that surgical performance would be suboptimal the day after a drinking bout, but that has never before been demonstrated. Since alcohol is not present in large amounts (except in the failed breathalyzer surgeon?) the effect may be produced by metabolites of the alcohol, by other volatile chemicals in the liquor produced by the brewing or distillation process, or by persistent alteration in neurotransmitters.

I went to London for a “firm” or course in pathology in my senior summer in medical school. I was astonished that there was a bar in the doctors’ lounge in the hospital! It was acceptable for interns and residents to drink when they were on call. This study may call that practice in to question.

I could have guessed the result of that study. I remember all too well our training in phlebotomies in the first year of med school. We practiced starting IVs on each other. My clinical partner for that lab had a dreadful hangover from a bender the night before. Against my better judgment I let him attempt (the operative word) an IV on my left arm. I wore a huge bruise and hematoma for almost three weeks. The lab partner ended up a neurosurgeon. Just kidding. He went into psychiatry.

jh

APRlL 6, 2011 BLOG

QUIETING THE “YOU SUCK” VOICE

Jake woke up with the barrel of a 38 magnum in his mouth. It was cocked, loaded, and covered with saliva. He had blacked out and had no memory of what happened the previous night. From the gun in his hand, it was clear that the drunk guy had tried to kill him.

He shook uncontrollably and then vomited all over the floor.

He had been seeing more and more of the drunk guy.  He usually showed up at the end of the evening and leered at him in a knowing and frightening way. Jake had never seen him before a couple of years ago. He arrived about the time the “you suck” voice came back.

The “you suck” voice started with the old man.  He drank double scotches before dinner. Jake would sit at the dinner table, looking down, hoping that he wouldn’t get mean until Jake had gone upstairs to pretend to do his homework. Most nights he wouldn’t get there before the old man would pick a fight, argue with him about almost anything, and then lay on the wood.

“You are never going to amount to anything. You are worthless. You suck.”

He must have heard those words a thousand times. When the old man died the words never did. Everywhere he went, everything he did, night and day, he heard the voice.

He never wanted to be a drunk like the old man. He joined the Navy and was sent to basic training. He studied to be a radar specialist. He liked it and he was good at it. But the voice told him different.

On liberty he went out with his mates. They were all drinking. One beer wouldn’t hurt. It went down cold and fresh. Then, another. Then, one more.

On the fourth beer, an amazing thing happened.

The “you suck” voice went away.

It was a miracle. He had found the answer. He knew he shouldn’t but he did anyway. He drank. He would be careful. He was never going to be a drunk like the old man.

But he became one.

After ten hard years of drinking, one night the voice came back. He drank more but it wouldn’t leave him. That’s when he became aware of the leering drunk guy, the one who wanted to kill him.

The cold steel of the 38 changed everything. He didn’t want to die. Miserable, pitiful as he had become, he didn’t want the drunk guy to win.

He remembered the words of his last girl friend, just before she slammed the door in his face.

“You need to go to AA.”

He was beaten. There was nowhere else to go. So he went, and he listened. He got a sponsor and he worked the twelve steps, and he started sponsoring other pitiful drunks just like he had been.

Last week he celebrated fourteen years of sobriety. He’s been sober as long as he drank.

And the “you suck” voice is gone.

Jake was psychologically abused for years by his alcoholic father. In childhood, when the brain is forming, that kind of abuse results in decreased dopamine receptors. That predisposed Jake to becoming an alcoholic himself.

There are untold thousands of Jakes across our country  tonight, sitting at the dinner table and trying not to hear the hurtful words of their drunken fathers or mothers.

If you know a Jake, put a stop to it.

Silence the “you suck” voice. Stop the nightmare before it begins.

APRIL IS CHILD ABUSE PREVENTION MONTH.

-jh-