The way I see it
My very first drink loosened my previous, ever present inhibitions. Medical school facilitated my growing reliance on this chemical. Six years later, after qualifying, I found an identity to hide behind, at least during the day. I was the all knowing, devoted, and respected professional, who daily appeared red eyed and trembling. But I was forgiven by supervisors because I worked hard. After all, I was in my house jobs.
Then I worked as a casualty officer, on the front line, mistakenly believing that I could cope with the stress, long hours, and unpredictability and daily masking my sensitivity to the extremes of human pain and suffering—until I left work.
There was always an excuse to reward myself after a stressful day, such as spending the whole shift in “resus” or informing relatives of a patient’s death. The next morning, I would wake up in a state of anxiety and make the short walk into the hospital hung over, overflowing with fear of the repercussions of possible mistakes made the previous day, smiling at staff members but inside suffering extreme angst of impending doom.
I knew I had a problem, but self disclosure could result in suspension. Besides, as a doctor, with my “insight” and knowledge, I assumed immunity to addiction. The loss of work could end with me living on the streets, so I attempted to scramble through. But as any alcoholic knows, it always gets worse.
Active alcoholism and working in casualty don’t go hand in hand. After a large binge at a training course soon after my mother died, I decided that enough was enough. The hospital, extremely generously, decided to help me and sent me to “rehab.” I worked up to the morning I entered the facility, and found it difficult to be a patient. For the first two weeks, the nurses in rehab were my “colleagues” and my fellow addict peers were “the patients.”
Finally, I admitted I was an alcoholic, smashing through the self composed fallacy. The second I picked up that first drink, the only way I could stop drinking would be physical incapacity. I also had to face the consequences of my habit: the drink driving, the accidents, and the effect on my family, work, finances, and so on.
I left treatment after six weeks with a heightened self awareness but to the minefield of the outside world. I began to attend daily meetings of Alcoholics Anonymous and was ready to go back to work. At least so I thought. There was a nagging doubt at the back of my mind. I just was not ready to stop drinking yet.
After six weeks of intensive therapy on how to spend the rest of your life not drinking, and the revelation of what will happen to you if you do, I strongly advise anyone not to do the following:
I went out and did some further “research.” This research consisted of three horrific weeks drinking vodka on my sofa, tormented with the conflict of compulsion to drink against the knowledge that the habit would lead me to jail, psychiatric ward, or, the more attractive option, death. Then one night I was caught driving four times over the limit. Convinced that I would end up in prison, let alone never work as a doctor again, I made the most important decision of my life: I asked for help. Via the Sick Doctors Trust, I entered another rehabilitation facility on 23 September 2002, and, God willing, since that date I have not had a drink.
I have now returned to work as a medical senior house officer after a long absence. I wake up in the morning with a clear head, without a trace of fear, humiliation, or self loathing and with full recognition of the previous day’s events. Some days the feelings are better than anything alcohol could ever achieve.
Don’t get me wrong—recovery is not easy. The early days were painful and accompanied by the return of suppressed emotions. There were further consequences of my drinking, such as the magistrates’ court (I received a driving ban of two years) and the General Medical Council (who after a health committee hearing have allowed me to continue to practise under medical supervision, in recognition of my commitment to recovery).
I went to daily meetings of Alcoholics Anonymous and clung on to the hope glimpsed in the eyes of people in the fellowship who had succeeded on a daily basis to stay sober and had been blessed with happiness. I persisted and a minor miracle occurred: after a few weeks’ sobriety, my compulsion to drink lifted, the most potent force in my life removed. The freedom experienced was genuine, and I still feel it today. I am, however, in early days, and attend Alcoholics Anonymous meetings regularly.
Alcoholics Anonymous is not a religious group or sect, just a bunch of ex-drunks who share their experiences. I had tried everything to cut down or cut out my addiction, and the fellowship was my last chance.
In no way do I blame my profession for this illness, but it is so difficult for healthcare workers to seek help because of the fear of the repercussions of disclosure. If one person can read this, recognise that they are not alone, and overcome the unwillingness to ask for help, then these misspent years of my life may well have been worth while.
The author wishes to remain anonymous.
BMJ Career Focus 2003;327:s78 (6 September).
Sick Doctors Trust: www.sick-doctors-trust.co.uk
National Counselling Service for Sick Doctors: www.ncssd.org.uk