By Jean Colley
Editor, WSMA Reports
He attended talks on the issue of chemical dependency among physicians but did not link those lectures to his own situation. “Denial is absolutely bulletproof,” he said. As he describes it, his drinking “went from something I enjoyed, to something I enjoyed the most, to the only thing I enjoyed. It was getting to the point where it was the only thing.”
Physicians are “not supposed” to have addictions to drugs and alcohol, he said. “There’s an incredible sense of isolation that comes from that. There’s also the fear of exposure and revelation of your problems.
“Doctors are so identified with their ‘physicianhood’ that anything that might separate them from that is to be rejected absolutely and denied.”
Each time Dr. Andrew awoke on the carpet after passing out from drinking, he would resolve to change. He remembered thinking, “This time it won’t happen, this time I’ll only drink this much, or this time I won’t drink tonight. But the insanity takes over, and you think, just a little bit more, just a little bit more. I couldn’t not drink.”
Dr. Andrew saw a psychiatrist for a year for a drinking-related anxiety disorder, but never told the psychiatrist about his drinking. Nor did the psychiatrist ever ask, he said. “I think he was uncomfortable with the idea of chemically dependent physicians.”
But his business manager and a fellow physician, both children of alcoholics, recognized what was happening. They looked into what the Washington Physicians Health Program has to offer and then told Dr. Andrew he needed to get help. Dr. Andrew agreed to talk to the WPHP program director who advised him to seek a medical evaluation at Hazelden Springbrook in Newberg, OR, a facility that specializes in treating health professionals with chemical dependency. (WPHP also refers to several other similar centers around the country.)
When Hazelden Springbrook recommended three months of inpatient treatment, Dr. Andrew didn’t argue. “I went off to treatment like a lamb,” he said. “I was at the point where I couldn’t imagine life without alcohol or with alcohol. I was at my wit’s end; I was at a point of surrender and ready to try something new.” Nonetheless, treatment initially wasn’t what he had expected. During his second day, he was presented with a copy of the Alcoholics Anonymous book, the “Big Book.” He remembers saying, “‘You don’t understand, I need something more intellectual, something like a drinking-like-a-gentleman seminar.”
AA turned out to be crucial to Dr. Andrew’s recovery. Treatment centers strongly encourage attendance at AA or other 12-step groups and a big part of treatment is group therapy using the 12 steps of AA as part of the discussion. Even though Dr. Andrew was ready to quit and ready to change, giving up alcohol was one of the hardest things he’d ever done. Physiological detoxification went on for a year as his brain adjusted to the absence of alcohol. “The other thing is,” he said, “if you stop drinking or drugging, you feel anger better, shame better. You feel things you haven’t felt for a long time.”
After inpatient treatment, as a client of WPHP he was required to attend local weekly WPHP-facilitated meetings of physicians, submit to random urine testing, and meet with a worksite monitor who knew his situation and could communicate with WPHP. At the WPHP meetings he found other physicians in recovery with whom he could discuss openly not only the personal intimate challenges of recovery, but medical practice issues ranging from return to work to credentialing to malpractice insurance. “There are unique challenges for physicians in recovery,” he noted, and the meetings are also a way for physicians to avoid isolating themselves.
Part of recovery is finding new strategies to fill the hours formerly spent in drinking. Dr. Andrew said he needed “a total program” and took up exercise and new sports with a vengeance. “You can’t replace something that is all-consuming with something that is not all-consuming,” he commented. “You have to fill up [your life] with a lot.”
His medical practice colleagues pitched in while he was away in treatment. “Because WPHP had a plan of monitoring, my practice knew what to do with me,” he said. “They had an expectation that I would return to work and do a good job for them, with minimal disruption to the practice.” He again chaired his department and served on the executive committee. He never experienced problems with hospital credentialing, insurers or his malpractice carrier.
In the five and a half years since entering treatment, he has had no relapses. He has chosen to continue to submit to random urine tests and to attend WPHP meetings monthly even though he has officially completed the program. Recently he applied for a job in another state. On the application forms, he disclosed his addiction and recovery. WPHP wrote a letter attesting to his continuing recovery and compliance with treatment. To his delight, he got the job. “It means a lot when WPHP sends a letter like that,” he said. “It’s a significant thing. Because of their success and seriousness WPHP has legitimacy intrastate and interstate.”
He was asked how his life has changed since he began the recovery process. “The only thing that changes is everything. I have days now I just couldn’t have imagined. My level of general content, serenity and happiness is better than any I’ve ever known.”
Reprinted from November/December 2006 WSMA Reports with permission of Jean Colley and the Washington State Medical Association
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