LIVES OF MEN

LIVES OF MEN

And Eric started to cry, almost uncontrollably, as he tried to tell us of a dream he had.  It was a recurring dream about drinking. Powerful it was, because it was filled with a sense of yearning that he had not felt in years. Frightful it was, not because of the feeling of compulsion to drink but because it took him to places that he could never enjoy again, doing things he could never do again. 

The things he could never do had nothing to do with drinking, but had everything to do with a chronic illness that his wife has and that he struggles with along with her every day. Yearning for years and times gone by and for things done and remaining undone. Things promised and because of circumstances cannot be fulfilled.

And these dreams make him profoundly sad. Had he been drinking he would not have to suffer these dreams, these sleeping/waking dreams of conditions he cannot do anything about. Ordinarily and in the past he had been able to shunt these feelings of loss aside. But the grinding years and the grinding condition of his wife bubbled up this morning and overwhelmed him.

Until I joined AA I had never seen another man cry except for a brief moment at a funeral. But never as routine evocations of sadness, guilt, grief or frankly joy. And yet here, tears as an outlet for deep emotional expressions of men are on view  daily.

Tearfulness is also more likely to be seen in a room of men than in a mixed meeting. There is a natural disinclination for men to cry in front of women even if the reverse sentiments are not necessarily shared. But that has less to do with a sense of discomfiture than a sense of manly comfort when men are among men, confessing and explaining failures, faults, sins and triumphs among those who will know, almost instinctively the truth of what is being said. And if it does not ring true, the men in the room will let you know by some means that will straighten you out.

Truth, only truth, is condoned in these meetings. Half truths, lying, boasting, those are not likely to be countenanced with any degree of humor. We do not tolerate fools and braggarts.

What do men talk about when they are getting sober?

Initially, we often rail against the forces of circumstance that brought us to the dismal places we find ourselves. We complain how hard it is to stay sober. We gripe and grouse about how unfair our families have been to us, how misunderstood we have been.  Often enough, these laments are heard with some tough sympathy, for we have been there, but we are skeptical and we do not hesitate to show and speak our skepticism.

Gentle sympathetic chides are meant to keep the newcomer returning to the meetings but we are trying to get that man past the point where his life is filled with the "poor me isms" to the point beyond when a bit more perspective can be applied to his life's canvas.

But that takes time, and that is not always easy to accumulate with so many years of drinking and drugging.  And with that history our man hoods and sense of self as men has been whittled down to a dull nub which seems as if it will never be able to sharpened again. Our selves seem destined for the emotional dispose-all that our drinking has taken our lives to.

But given the time the "poor me's" the "fuckits", the "I don't giveadamns", and the "it was never my fault by hers, (his, my boss, my father's, my sixth cousin four times removed), will gradually decrease. Time will permit some shape to form where only warped and distorted perceptions existed. Then some reality will seep into the darkness of the cave of misconstrued and ill conceived misrepresentations.

How then does our view of ourselves as men change?

For me, the provider, the quiet absorber of anxiety, fear for the future, worry about fiscal security, pay for the house, pay for the kid, pay for the household, pay for the child's education, all of these took a toll and I had no idea where it would take me.  Frankly, I was ill prepared for the roll of "Provider, father, husband". I don't know how one gets prepped for such life roles but I certainly went from ill prepared to completely at sea.

And when I did not know what else to do, I drank. I drank to dull the fear of all that responsibility. (Of course, one remembers that I did not always drink to escape but when the need came, it sure was an obvious anesthetic and boy did it work well).

Jack said that when he went away to Viet Nam, he was quite happy to shoot things. The sharp focus of war made the pain of daily life a hazy dreamlike miasma that seemed less real than the blood and guts home and family survival.  But the noise in his head, how was he going to quiet that down?  

Well, there was heroin, cocaine and that good old standby - vodka. And that worked for about ten years, in and out of jail houses, institutions, psychiatrist offices, treatment for PTSD. But he kept going back to drinking.

Until he found AA and let it all out.

And cried, and cried, and cried.

What do we want to be men about? We want to be fathers to our children, husbands to our wives, and providers to our families. We want to be just like any other normal man who does not have to wake up to these demons every day, running from dreams of regret, from vacations untaken with spouses sound of body and mind who can enjoy the rest of their lives with us. We don't want to be guilty for being absent for so many years when we did have sound bodies and could have spent some times on the top of the Grand Tetons with a glass of a full bodied Shiraz in our hands.

But that time is gone and sometimes we are only left with our memories and the time we have left with the people whom we love. And the best we can do is learn to live the best we can, every day by meeting other men and finding out how it was that they did what it is that we need to do.

And sometimes that means that we need to come to meetings and share about painful things that we did and did not do.

At other times all we may be able to do is cry, cry, cry.

©  res 6/20/12

GETTING IT

GETTING IT

When doctors and nurses have become addicted to drugs and alcohol the prescribed remedy is often detoxification followed by rehabilitation in a medical facility. Weeks, perhaps months of slow remediation follows in which modern psychological tools are applied to try to help the 'professional' gently return to a productive life and career. Cognitive behavioral therapy, psychosocial interventions, psychotherapies are techniques that have been shown to be very effective instruments when administered appropriately and for an suitable period of time. Too often, in fact, that interval is cut short long before its has become maximally effective.

Beyond personal therapy, many rehabilitation facilities add medication, meditation, contemplation, yoga, exercise, swim therapy as well as twelve step meetings to this armamentarium. Some rehabilitation institutes have proprietary methods of treatment which may or may not have any proven value while other institutes rely almost exclusively on AA work.

Among the so called support step meetings are the ones called Caduceus meetings, so named for the double snake medical symbol of healing. It is in these meetings that medical professionals can share, without fear of public exposure, worries about their addictive habits and how they are dealing with their difficulties. The freedom from fear of reprisals makes these forums safe places where solutions to personal problems, many of which often have to deal with governmental and legal authorities, can be openly discussed in a congenial atmosphere. Here there is a give and take in which similar experiences, emotional as well as life's, are shared and frustrations can be aired in a friendly and sympathetic environment.

Groups with traditions based solidly in the AA Traditions often are truly meaningful and garner a lot of trust among physicians. I have personally found these to have been very helpful and observed them to be  useful to the physician struggling in recovery.  It is often good to have a group of peers who are willing to lay it on the line for you, "call you out" as it were, when you appear to be struggling with the program and perhaps are in denial about your addiction.

I you lose your perspective on what is important, what you cannot or should not worry about in your day to day practice among your professionals, when to try to forgive people despite your sense of betrayal, this you won't get in a Medical Staff Meeting or a Morbidity and Mortality Conference, but will find great solace among your fellow Caduceus members. Feeling at sea emotionally is not unusual early in recovery and it may be something only other  professionals  who had similarly suffered with  in early sobriety can empathize.

Early on we all suffered with the delusion that we are smarter and know better than anyone who came before us. We think, perhaps, that we are unique in suffering our cravings for alcohol and drugs and that nobody understands the intensity with which we suffer. And with that superior thinking comes the sense that we can conquer it all alone so that ... "You all might need this program because you all are drunks but I  certainly don't belong here!"

This became much clearer the other evening at the Caduceus meeting that  is held at a prestigious rehab facility. From time to time, people at the center, professionals who are at the facility from out of state, sit in on our meetings to get a sense of what it will be like to attend a Caduceus meeting.  And it was there that I met a physician who was in his third week of hospitalization, having been admitted ostensibly to treat his chronic pain but in reality it turned into a detoxification treatment  for his opiate habit.

And it was rough, make no mistake about it, since at five weeks now, he was still having withdrawal symptoms - muscle spasms, mild cravings, vague stomach nausea and sleep problems. But he was finally, with his sixth week coming up,  looking forward to returning  home then going back to work.

For weeks we had listened patiently to his story which, quite frankly, was like every other addict. I call it the 'banality of addiction' after Hannah Arendt's phrase.  That should have been comforting to him.  Amad told us his story in its gritty and boring detail and when he got finished Jason, (another doc in recovery) gave his  brief, hair raising tour of his addiction, right down to the same gateway drug that they both used and Amad sort of blushed at the fact that he was not so unique after all.

After several meetings and listening to the waning  litany of symptoms and with very few spontaneous bursts of cheer and laughter we were inclined, finally, to ask about how he was planning his return to "civilian" life. Jack said "So Amad, what's your program of sobriety going to be like?"

And Amad answered, "Well, I have a good exercise program, I like to run, and especially swim and do a Nordic track. I meditate twice a day... and I decided not to take any more narcotic pills.  I also decided not to drink any alcohol at all for the time being. I thought that was a good idea, even though I'm not an alcoholic I feel it might not be a great idea just now. Of course, later, I'm not sure... "

And Jack asked about a sponsor...

"I do have a sponsor, my pharmacist, who used to use drugs also, he agreed to be my sponsor. And I have my general physician who agreed to take me back; I have a psychiatrist, I think the people here will try to coordinate a program with him."

So I chimed in, "but I don't hear anything about meetings. What about AA meetings. Do you have a schedule of meetings?  Do you have an "Alcoholics Anonymous" book?  Or have you tried the "Living Sober" book, it has some great pointers on how to stay sober without really trying."

"Oh AA meetings, I think I can fit about one a week into my schedule, I guess", Amad said with some finality.

I was going to proffer some advice and I looked at Jack who similarly, mid sentence, stopped himself and muffled a comment. We both just stifled our opinions. This wasn't the first time that Jack or I or others had wanted to proffer some opinions on how Amad might try to structure a more spiritual program. But we were talking to a surgeon here. So I guess we had to take baby steps.

And from listening to Amad, I could also tell that he was still paying more attention to his drugs than to his sobriety. He could probably do with a few more weeks in this place until he could stop worrying about the sensations that he was feeling from the withdrawal of the opiates. Until that happened he was at risk. All the other things we may have been talking about might just be so much air.

Which is not to say that Amad's plan would not work for him eventually. He might find that after a bit his plan would in fact feel sort of empty. That the cravings would not go away without some more soulful fulfilling alternatives to drugs.  Then he might ask someone in the program, hopefully, what  could be done and he would then get an answer that would work.

The meeting broke up with the Serenity Prayer which Amad had yet to learn and we left the room, the three of us walking down the corridor which forked at the end leading to separate exits. Amad took the one to the left to the hospital campus and Jack and I exited right to the parking lot.

As Jack and I shook hands and parted  he shrugged and said, "he just doesn't get it, does he?"

"Not so much", I replied.

And I walked off into the night.

©  res 5/30/2012