I’m a Nurse in an Alcoholic Ward

Anonymous

The author–a onetime alcoholic–has nursed 5000 drunks through the fading hours of their most spectacular sprees. Here is what she has faced in salvaging doctors, lawyers, ministers, priests, housewives and stenographers from drink and the devil

A redheaded woman in a mess is really a One thing has begun to be a little mess, and five years ago I was just that. Like irritating, but only because of its monotony. well over 100,000 others, I found my way to About every third male patient, when he first sobriety through Alcoholics Anonymous. AA comes in, takes a bleary gander at the white says that if you want to stay sober you have to uniform and the red hair and croaks out a sally help somebody else get sober. that’s supposed to brighten everybody up– Since I was a nurse, it seemed logical “H’r’r’m’m’m, do you go with the room?” They that the best way to meet this requirement would usually apologize the next day. be to find a job in an alcoholic ward. Yes, most alcoholics are nice. In no other That’s how it happens that during the branch of nursing within my experience are such past five years I’ve nursed more than 5000 respect, consideration and gratitude accorded alcoholics through the fading hours of their most the nurse by the patients. Even the most berserk spectacular sprees, in the AA ward of were likable before they ran afoul of firewater, Knickerbocker Hospital in New York City. and can be likable again. The recovered Helping other alcoholics to get well has become alcoholics I have known have been quicker to my life work. help and readier to forgive, possessed of a Friends look at me with frank disbelief livelier understanding and faster wit, than the when I tell them I love my work because I meet general run of people. After recovering, that is. so many nice people. That statement, applied to Drunk, they can be pretty dreary. men and women who have indulged in every The origin of our ward is closely folly, benign and malignant, may be a little hard connected with the origin of AA itself. AA was to swallow, but I really mean it. In five years only founded in 1935. By 1939 it was evident that, one patient has ever taken a swing at me, and it though the movement was reaching a pitifully was a woman patient, at that. Being female small percentage of the alcoholics who needed myself, and redheaded besides, I promptly help, it was nevertheless achieving greater socked her back. After that she was very co- success than anything else ever had. Sufferers operative. flocked to AA by the hundreds, many of them The only other violence was of my own needing immediate medical treatment. The AA instigation. A fresh, peppery little man—he came program of rehabilitation is based on about up to my shoulders–kept pestering me for understanding, friendliness, honesty and faith-a drink, and drinks are not served in alcoholic all things requiring maximum application of the wards. To stall, I told him he would first have to mental and moral faculties. Many desperate take his pill, which I knew would put him to drunks who wanted AA could never stay sober sleep. “No drink, no pill,” he said, and I retorted, long enough to do the necessary clear thinking. “No pill, no drink.” This kept up until my patience At this point a great team–the AA was gone. I turned the little fellow over, paddled founders.“ Bill,” a New York broker, and “Doctor his bottom and said, “Now, will you take the Bob,” an Akron physician–stepped forward with pill?” He took it nicely, and from then on we were an idea. Why not a place where sick alcoholics good friends. could be sobered up under expert care and at

1

the same time gain a foothold in AA? Private- weeks after their pictures had appeared in hospital officials, conditioned to believe that advertisements as endorsers of special brands drunks could mean only pandemonium, were of strong waters. Ministers and priests are chary. Then, in 1939, such a ward, of eight frequently our guests, as are doctors, lawyers, beds, was established at St. Thomas Hospital, in engineers, pilots, editors, housewives and Akron. In 1945, Knickerbocker, a private general stenographers. hospital with 200 beds and a forward-looking Contrary to a popular notion, the management, agreed to open its doors, and thus alcoholic is not just the man in the gutter. The the first AA ward in the East was born. The third scion of a Social Register family once inherited a floor of one wing, with a capacity of nineteen sizable fortune while recuperating in one of our beds, was given over to the experiment. beds. We’ve had a prominent judge, a famous The ward’s success surpassed its senator and a member of Parliament. Practically backers’ hopes. AA volunteers are on round-the- every race and nationality has been presented, clock duty, ready to discuss the temptations and and the patients’ occupations have spanned the techniques of the life of sobriety. Half our alphabet from auctioneer to zither player. Our patients, we estimate, go out from sample indicates that Irish stock is the most Knickerbocker into immediately successful AA susceptible to alcoholism, Jewish the least, and lives, and two thirds eventually find their way to that no ethnic group is immune. recovery. St. John’s Hospital, in Brooklyn, and Influx by occupations seems to be St. Michael’s, in Newark, have opened wards related to the calendar. Around mid-December after the St. Thomas-Knickerbocker pattern, and we get a lot of housewives in the women’s ward. other hospitals have the plan under Early in January the policemen begin coming in, consideration. and a little later that month the musicians. In February there’s a concentration of publishing I’ll never forget my first day on duty. I people–illustrators, writers, editors, advertising spotted a wistful-looking little man with a red men. March is the month for business face and blue eyes waiting outside the ward. He executives, great and small, and April brings a was alone, and I knew that no patient could be parade of salesmen. The rest of the year it’s an admitted to this particular ward unless odd assortment of bankers and peddlers, sailors accompanied by a member of AA. Eager to and tailors, stenographers, bookkeepers and demonstrate my efficiency, I said brightly, “Don’t storekeepers, with an age range from nineteen worry, we’ll take care of you. Where’s your to eighty-one. sponsor?” As for the seasonal tides within I took his bag and was about to remove occupations, one must remember that a person his hat when he turned kindly old eyes up at me is not an alcoholic just part of the time. If he’s an and said, quietly, “Relax, young lady; I’m Doctor alcoholic at all, he’s one all the time. He needs Silkworth.” only an occasion involving extra liquor and extra At that moment I wanted to sink through tension to set him off. These situations seem to the three floors to the basement and on down arise at different times of the year in different into bedrock. Dr. W. D. Silkworth was widely occupations. known as one of AA’s first medical advisers. Take the housewives. Around the middle Besides, he was the doctor in charge of the of December the kids are home for Christmas ward! Since then I’ve learned to tell the vacation. The weather is bad and they can’t be difference between doctor and patient, and out of doors all the time, so they’re underfoot possibly a few other things. You can’t work with and quarreling. There’s the endless business of a man like Doctor Silkworth–as I did until last Christmas shopping–what to get Uncle Fred, year–when, at the age of seventy-eight, he died- and did old Aunt Minnie give us anything last -without learning something. year, and how much to spend? This last factor The traffic in our ward is evidence that must be weighed against the family budget and alcoholism is no respecter of prestige. Two the husband’s disposition. On top of all that, the eminent men appeared for treatment just a few routine work must go on, but it’s the season to

2

be convivial. What is more helpful to the spirit of for help. They come from precinct lockups and joy than a little nip, particularly since people are flophouses, Bowery dives and penthouse suites, freer with their liquor at this time of year? Then suburban estates, country clubs and furnished there are lots of parties. And there’s the rooms. Nobody is ever brought to our ward haunting feeling, to a person having even a against his will. Indeed, they’re given to sketchy religious background, that Christmas understand by their sponsors that they’re lucky was supposed to mean something quite different to get in. We have no repeaters—patients are from all this. A woman who’d been walking the admitted once, and only once. Sponsors deliver alcoholic tightrope up to then might easily fall off them, their suitcases and eighty-five dollars in and land in Knickerbocker, with me. cash in advance, then leave. Now begins the Cops have a similar situation. During the five-day course. holidays they have more traffic, more shoppers, Once signed in, the patient’s first two more thefts, bigger crowds–in short, more police days are the most worrisome. It is in this period work of every kind. Bartenders are known to be that deep depressions due to remorse are most solicitous of the men in blue. When holiday likely to occur. The ward came near being business is good and weather bad, there’s no discontinued during its first month, when a lack of little nips to warm ye. Christmas and New depressed patient found his way to an unbarred Year’s tips to the officer on the beat are window and jumped three floors to his death. AA traditional, and they frequently come in the supporters quickly passed the hat, raising $1000 shape of a bottle. for strong steel screens. We’ve never had The alcoholic cop may be able to stay in another attempted suicide. No patient is harness through New Year’s Eve somehow, but admitted who shows signs of oncoming delirium he’s likely to be ready for expert care very early tremens or convulsions–these are sent to a in the year’s first month. The same goes for the municipal hospital equipped to handle disturbed orchestra lads. The holidays are the time when patients–but sometimes the doctors guess they play their biggest jobs, get their biggest tips wrong. Last year, among 1000 patients, we were and the most free liquor. caught with two cases of convulsions and a Why the publishing crowd comes in dozen of DT’s. during February, I don’t exactly know. My hunch is that the so-called “creative” folk may be a little Delirium tremens must be sheer hell. Its more sensitive to weather than the rest of us, onset is marked by acute nervousness. First and those February doldrums in these latitudes come the auditory hallucinations; then, usually would get almost anybody down. One February the visual. The patient hears his name being we had quite a delegation from the editorial staff called, or a violent argument in progress, or nonof a famous, and somewhat snippy, national existent loud music. Then he begins to see magazine. I guess those creative imaginations things. I’ve had patients ask me in all got going on how nice it would be in the tropics, seriousness to watch where I stepped so I and local reality seemed just too grim. But as I wouldn’t squash the strawberries. One say, you have to be an alcoholic first, before the demanded to know how the geese got into his weather can do much about it one way or the room. These visions are sometimes, but not other. always, frightening. The strawberry and goose In many industries, orders are placed for people were quite calm about what they saw. the whole year in one of the early spring months. Heaven knows what fiends and horrors they’re These are tense times for executives and seeing when they scream. The worst case I ever salesmen. If it turns out to be a big year, they’re saw was a man who was convinced he was exuberant; if it is a bad year, they’re gloomy; and being run down by a train. Most patients, during both states of mind are sure to bring action from DT’s, have moments when they know that what the alcoholics. they’re seeing is not real–and times when On entry, our patients are a beaten and they’re completely convinced of its reality. penitent lot. They’ve been picked up by AA’s No one condemns the alcoholic as he, wherever they happened to be when they called when the remorse is on, condemns himself. We

3

give them vitamins to re-establish nutritional People sometimes wonder how we AA’s balance, fruit juices to combat dehydration, and can extract so much comedy from our own bromides and belladonna for jagged nerves. By tragedies. Alcoholism is tragically foolish and, the third day they’re beginning to take an believe me, there’s very little comedy when the interest in the world again, and that’s where drinker first realizes the full consequences of his Duffy’s Tavern gets in its wonderful work. drinking. (Duffy’s Tavern is a kind of clubroom in the After the calamity is honestly faced up to, men’s division, where patients meet and talk.) though, and a new life has begun, we figure there’s no use brooding over it. The five days are planned as a chain of One of our patients, a New York healing that will lead back into a life of sober politician, took a route to Knickerbocker which is usefulness. The first couple of days there’s typical of some of the more flamboyant toots. nothing much to do but medicate and feed them He’d been drinking for several weeks and had and maintain an attitude of good-natured obviously had more than enough when he understanding. This in itself, for people who are stepped into a bar where he was well known and accustomed to contempt, hostility and despair ordered a drink. when they’re “on one,” is an important part of the “O.K.,” said the bartender, noting his treatment. condition, “but first you better go out and get a I have a couple of devices of my own for ham sandwich and a cup of black coffee.” maintaining morale. Every patient gets a The politician discussed this step with nickname. “Cuddles,” “Peaches,” “Saint another drinker. Concluding that it was sound, Anthony, ” “Pontius Pilate,” “Napoleon,” they set out for a nearby diner. On the way, they “Pinhead” and “Windy” are my favorites, and I got to talking about the races in Florida. use them over and over. We also make a good “Let’s go,” said the politician. sport of treatment with the B-complex needle. “O.K.,” said the friend. They took a cab to This is inserted in the part of the anatomy La Guardia Airport and in a short time were in scientifically known as the gluteus maximus. Miami. The politician, besides being a follower of When I come into Duffy’s with the needles, the races, had a wide acquaintance in the New calling, “All right, boys, bottoms up!” I can York and Miami police departments. A always count on an assortment of grunts, policeman recognized him as soon as he groans, grouses–and laughs. stepped off the plane–his heavy overcoat and On the third day, patients are derby were easily spotted in the Florida sun. encouraged to move around. In the women’s “Look, chief, you’re drunk,” said the cop. ward, there’s visiting from room to room and “You’d better go home.” talks with AA’s from the outside; and, for the “I guess I am a little, at that”’ said the men, socializing in Duffy’s Tavern. The patient amiable politico, and stepped aboard the next begins to realize he’s not alone in his plight. If northbound plane. Back in New York the same others can endure it, he guesses that he can bartender was on duty at the same bar. too. The fog begins to clear, and memory, at “Where’d you go for that sandwich?” he least partly, returns. said, spoofing. “Florida?” One time a husky tugboat captain who’d “Yeah,” the politician said, and in a been staring gloomily out the window of Duffy’s couple of hours the bartender was drunk’ too, suddenly snapped his fingers and exclaimed, loudly asserting that it could not be. Meanwhile “Nyack!” the AA alarm had been sent out for the ward “What do you mean, ‘Nyack!’?” asked a boss, and a pair of AA’s who’d been scouting mounted policemen. New York for him closed in. “That’s where I left my tugboat, ten days ago!” the skipper replied. The silliest story I ever heard in Duffy’s “Hey, I just remembered,” said the cop. was about a party I nicknamed Old Number “You know where I left my horse? Van Cortlandt Seven. His wife, to bring him off a prolonged Park.” binge, had removed all his clothing except his

4

underwear, while he slept and had locked his Our ward takes certain precautions. closet door. When he awoke he was faced with Nobody can be discharged unless he has been the problem of how to get out and get a drink. signed out, in person, by his sponsor and has He found a pair of tennis sneakers, ripped a been safely conducted to his home. He’s square of cloth from the sheet, painted a big encouraged to attend the weekly meetings of his figure “7” on it, pinned it on his back and local AA group. There he learns that other men stepped out onto the avenue as a cross-country and women of his community–some of whom he runner, headed for his favorite saloon. knows and respects–have somehow found the AA volunteers, many of them graduates courage to deal with situations at least as of the ward themselves, drop in at Duffy’s and disastrous as his own. He digs in. In almost swap yam for yam. In this way many patients exactly half the cases, he’s back in a few realize for the first time what alcohol has been months as an AA volunteer, ready to help others doing to their lives and glimpse a way out. One back along the path to sobriety. man convinced his wife that the best plan for Of course, we have our casualties. Every their security in old age was to sell their home now and then I hear of somebody who once and invest the proceeds in “a sound business”— spent five days with us and who is now dead, a bar and grill. He quit the office job he’d held for either of convulsions in some other hospital or a thirty years and went into the liquor business. He suicide somewhere. These are the sudden ones; drank up the establishment–capital, surplus and the slowly dying are just as pathetic. There’s a profits–in a year. Facing up to what he’d done, nice old gentleman who lives in a big house by he resolved, in Duffy’s, to start clean. Now he’s the seashore, alone except for a butler and one of our most effective volunteers. He hasn’t maid. He doesn’t need AA, he says. Every time got his home back yet, but he’s back at his old he gets tanked he calls me up and begs me to job, pays the rent provides meals and stays marry him. In this condition there’s no use trying sober. to talk any sense into his head, so all I can do is One wealthy suburban housewife, kid him along. It’s kind of hard, though, when I mother of six school-age children, was the worst know for a certainty that one of the lonesome brat of the lot. Everything was “simply too much” little drinking bouts of his is going, pretty soon, to for her. The children were too noisy and be his last. demanding, her husband too busy and The reasons for failure are among the preoccupied, household routine too dull, the many mysteries connected with this baffling cares of community living too numerous—she disease that researchers are still trying to had to get drunk, for solace. Our ward, followed unravel. Some people seem incapable, drunk or through by AA brought a change. Now she not sober, of the clear thinking necessary to grasp only has ample time for her home, her husband and apply the AA program of living. There are and her children but is also a skillful AA worker, physiological, neurological, racial and cultural president of her PTA and a truly wonderful influences that are only beginning to be person. understood. The fifth and final day of our treatment But one of the greatest hazards, in my brings its own special hazards. The patient’s opinion, is pride. Many thousands with otherwise head is clear, his strength has returned and he sound minds are enduring alcoholic torture has found new and understanding friends. Now rather than humble themselves to share the he must face the world outside, the mess he has companionship of the genial ex-tanks of high himself created. He slept poorly the night before. and low estate who make up their local AA This uneasiness is so common that we even groups. They, and those who care for them, pay have a fancy name for it–“predischarge tension” a terrible price for such pride. I know a “self- Discharge day is the despair of many alcoholic made” business executive who came home wards. To many patients, the shambles outside drunk one night and was exasperated when he seems beyond solution–they streak to the found his wife and daughter asleep. “Just to get nearest bar, the deadly cycle begins all over a rise out of them,” he fired a bullet into the wall, again, and much good work is undone.

5

lay down and played dead. He says he’s not an never understand. The blowoff came in 1945. alcoholic! He told me he was through and packed me off to Reno. My own story? Humdrum enough. I was It was a devastating blow to my pride. I born in New York City, attended Catholic grade thought I’d been the one who was putting up and high schools until I was eighteen, then spent with him. I learned, suddenly, that he’d been three years in nurse’s training at St. Mary’s tolerating me. During the next two years I Hospital, in Passaic, New Jersey. I was a happy- worked in a Reno department store, toured in go-lucky kid, and the glamour of the nurse’s cap Hawaii and visited San Francisco. I returned to wore off when I discovered the discipline and my own family in New York in 1947, completely effort it took to win one. When I met a big, hearty licked. I now found that I couldn’t drink at all and, at that time, thoroughly enchanting Swiss, I without getting drunk. Therefore, I had to be gave up nurse’s training and took an office job in careful. My life was made up of stretches of New York to be near him. We fought hilariously sobriety punctuated, at ever-closer intervals, by for seven years and then were married. short, despairing binges. When my brother-in- Sometime during that period I found time to law told my about AA, I was ready. finish my nurse’s training, but I never worked at it. My first AA meeting was, in many ways, My husband was a man who worked a disappointment. There was a strictly “lowhard, played hard and drank hard, though he bottom” panel that night, that is to say, the was not an alcoholic. At the time unaware of any speakers were not Harvard and Wellesley distinction between the mere heavy drinker and graduates–“bottom,” in AA parlance, means the the alcoholic, I drank with him. His recreational lowest state of alcoholic squalor a person will passions were hunting and fishing. I went along accept. Their drinking had carried them so much on his sporting trips, enjoying them thoroughly– farther along Hobo Highway than mine that we up to a point. That point was when I’d got seemed to have little in common. It left me with liquored up and was feeling sorry for myself. I a conviction, though, that these people had the was “neglected,” and I began to make spiteful answer. The Twelve Steps of AA won me remarks. My patients tell me I have a ready immediately–admit our frailty, seek God’s tongue even when sober, and in those days I guidance, repent our misdeeds, make amends, must have been something. Our quarrels, once take a moral inventory, help others. Here was more or less good-humored, grew increasingly religion actually lived. Many are successful in AA bitter. My drinking, I now realize, was showing without believing in God. To me, the highest definite alcoholic symptoms. power has always been the same God I used to I was bored most of the time, and know in church. Here I also learned, “once an drinking seemed a handy antidote. We had had alcoholic, always an alcoholic,” which explains no children. I lacked the initiative to practice why, even after five sober years, I say that I am, nursing, and time hung on my hands. A couple present tense, an alcoholic. We stay sober one of the girls would drop in at our apartment during day at a time, never forgetting that we are the morning. We’d talk for a while, then have a alcoholics and therefore cannot take the first drink. I’d nibble at the bottle during the day and drink. would be pretty well along by the time my After a month of daily increasing husband came home. A few drinks with him and happiness I was struck with an overwhelming a party that night and I’d either be blind, stupid, sense of gratitude. I was grateful to that lonely quarrelsome drunk or passed out. handful of men who formulated the AA principles How many times I’ve heard those of recovery and set them down; grateful to the admonitions that haunt every alcoholic: “Why thousands of alcoholics who, in the face of every don’t you just have a few and enjoy them? Why conceivable difficulty and temptation, had picked don’t you drink as we do?” Why couldn’t I stop, up these tenets and doggedly clung to them, once I started? I didn’t know. Exactly how my fighting to hang on to their sobriety so it could be husband and I stuck it out for eleven years I’ll

6

passed on to me. I felt I must do something in come to us physical, mental and moral wrecks. return. They leave encouraged but still uncertain. Then, When I learned about the AA ward at months later, they come back–bright-eyed, rosy- ‘Knickerbocker I knew what that something cheeked, eager to help; job back, family back, would have to be. I was a trained nurse. During going concerns again, ready to pass on, with all the years I had frittered away, that training dividends, what’s been given to them. had seemed meaningless. Now it made sense–I To know that I had some small part in was meant to work in that ward. I bombarded this rebirth is a blessing far beyond what I the supervising nurse with telephone calls by deserve. The failures, the lost ones? Well, day, and prayers to God at night, and three they’re sad, of course. However, we must months later I got the job. accentuate the positive. But for the grace of These five years have brought deep God, all of us might have been lost. satisfactions. I can’t convey how much it means to me to see the transformations in people. They

Source: Saturday Evening Post, October 18, 1952

7