June 1975

Voyage of Discovery h y George Iiolodner, MD

holic patient precipitated a visit to cally that 1 decided to make alcohol- The road of experience takes many turnings me by an AA member and a visit by ism my major area of specialization. me to an AA meeting. Another jolt. I assembled a staff, and together we do ences which led to major changes in Here were professed alcoholics who designed what seems to be an ideal I I ~ A V E made a discovery -I not understand alcoholism. There my thinking. The first was personal. have been other diseases which baf- An old and close friend of my wife’s’ were no longer acting like alcoholics. The notion that what I had regarded program for treating the illness-allowing for continuity of care through Ilcd me. The difference with alco- and mine began to receive psy- as immutable could in fact change detoxification, intensive orientation, holism is that I went for years chotherapy for personal problems. sent more ripples through my con- and followup care, in a setting which believing that I understood it. In From her descriptions, the therapy ceptions. I began to see alcoholism fits in with work schedules and almy thinking, only psychological and sounded quite appropriate and prop- as something from which one could lows active family participation and social factors were involved. Al- erly executed. Her improvement was recover. This was reinforced by my AA involvement. Our program is coholics wcre persons with severe limited, however, and over the years, friend, who, in the meanwhile, was young, growing, and exciting for us personality problems. They gener- her life became more turbulent. improving and was beginning to put to watch. ally functioned at low perfornlance What a jolt I felt when she was her life back together again. My story is my own, but I do not Icvels, and their niotivation for treat- admitted to an alcoholic rehabili- Clearly, the time had arrived for think that I am so different from ment was to be viewed with sus- tation facility and subsequently be- some postgraduate education in al- other doctors. Most of us have picion. Their spouses colluded with came involved with Alcoholics coholism. Fortunately, the opportw chosen this profession because we then1 to maintain their dysfunction. Anonymous. Over the years of nity also arrived in the person of an enjoy helping sick people become Not a very flattering portrait. As knowing her, I had never seen her alcoholism counselor who was work- and stay healthy. Most of us find you might expect, 1 did my utmost intoxicated. She worked in a highly ing with the Navy’s expanded alco- that our patients ultimately become to avoid alcoholics. What I think is functional capacity, and in no way fit holism rehabilitation program. He our most reliable teachers. In my important about such notions is that into any of my stereotypes about became a willing tutor and helped belief, when more physicians begin I was not unique in this and that who alcoholics were. Readjustment guide me around the walls and to realize that they do not undcrthese attitudes developed within me number one was under way. I would blockades I encountered from alco- stand alcoholism, they will open while I was receiving training in have to begin to rethink the issue of holics, their families, and their physi- themselves increasingly to the Iesexcellent medical institutions. Even who alcoholics were. cians. I attended more AA meetings, sons of their patients and will thus more important to me now is my My next experiences suggested began finding articles and persons be starting on the path to a new new awareness that my conceptions some things about who alcoholics knowledgeable about alcoholism, understanding of a highly treatable were misconceptions. could become. While I was serving and slowly began to understand the illness. Then, perhaps, the sad “cold A few years ago, I had experi- in the Navy, my interest in an alco- disease concept of alcoholism. war” between doctors and alcoholics My attitudes changed so dramati- will bcconle history.