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