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Source: 1965 Toronto International Convention – 1965 Toronto Int AA and Industry Migel Kinser, Tom V Part 2 of 2.mp3 File: 1965-toronto-international-convention-1965-toronto-int-aa-and-industry-migel-kinser-tom-v-part-2-of-2.mp3 Duration: 00:50:08
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Recently, I had the rather unusual experience of getting two unique items in the mail on the same day, as a matter of fact, came across my desk at the same time. One of these relatively unique items turned out to be a long-playing stereophonic record by a Florida comedian who had developed what he called Booze is the Only Answer Club, and he was busily engaged in proselyting his philosophy of life.
Perhaps he had something after all. His basic philosophy was that we live at such a high pace with so little relaxation and a great deal of tension and anxiety, and we institutionalize very little opportunity for people to relax, that the possibility of booze being the only answer was something he held out as realistic. At the same time, I received in the mail that day requests from three medical directors of very well-known companies for information about the basic impact of alcohol and alcohol problems on work behavior and on the organization and on how it would be possible for that organization to make a contribution, not just to the welfare of their employees, but to the welfare of the organization.
And I thought that this juxtaposition, you might say, these two things standing side by side, somewhat was in microcosm the history of our efforts to do something constructive about alcoholism since World War II. On the one hand, we've had the strident voices who've continued to retain the old prohibition angle, or the opposite of it, booze is the only answer. At the same time, there has been entering, largely because of AA's efforts, there has been entering the entire field a stream of professionally minded people, people who have seen, because of the example of AA, a realistic place in which to apply their professional knowledge and understanding.
This is one of the great accomplishments of AA, and also today one of your great dilemmas. You have set the stage for large numbers of freewheeling, extremely curious, able intellectuals and professionals who are today studying alcohol, alcoholism, and alcohol behavior as it was never studied before. One of the earliest groups to make a sizable impact with respect to studying alcoholism from their own professional standpoint has been the industrial physicians.
With all respect to the other pronouncements of the American Medical Association, it has been the industrial physicians who have primarily represented a very practical, knowledgeable, and above all, progressive approach. It has been among industrial physicians that I have learned a great deal, and I have discovered the greatest understanding of alcoholism. I think we are indeed fortunate to have with us this morning a representative of this trend, this trend which is now becoming very pronounced.
He is Dr. Luther A. Cloud, the Associate Medical Director of the Equitable Life Assurance Society of the United States, a company with a program that is well known and widely discussed. Not only is he a medical director of practical knowledge in an organization, you know it's one thing to be a doctor, it's another thing to understand an organization in which you work as a doctor. And so I think that we have with us this morning an individual who has both of those experiences, but to cap it off, he is currently chairman of the Industrial Medical Association's Committee on Problem Drinking.
Again, one of the more vigorous, practical, professionally oriented groups. It gives me great pleasure indeed to introduce as our cleanup speaker, so to speak, Dr. Luther Cloud. Thank you, Dr. Trice. Ladies and gentlemen, members and friends of AA, like the speakers that have preceded me, I too am very grateful for the opportunity to join with you today and in the days to come in this 30th anniversary celebration.
I am often called upon to speak to purely medical audiences.
[00:05:04]
Medical groups, for some reason, don't usually call their discussions panel discussions. They are rather fond of the term symposium or symposia. This is rather interesting because the word symposium of Greek origin means actually a drinking together. A drinking together, usually following a banquet, something of that kind, with music, singing, and conversation. And hence we have utilized this term today to mean a social gathering at which there is a free interchange of ideas.
I don't think this is the group to particularly join me in a social gathering involving drinking. But I do think it's a group to join in a free interchange of ideas because that exactly is what we are doing at a 30th anniversary celebration. I was interested in Dr. Trice's experience at the Rathskeller across the street last night. I didn't have a similar experience, however, I did attend a dance here, not as a participant.
I simply observed, but that was enough. And around 11 o'clock I felt the need for a little fresh air and also to look around Toronto. So I walked a few blocks from the hotel. I'm not quite sure I understand this yet, but I was quite surprised to pass a tavern, licensed under the Ontario province rules, and in the window to see a very nicely printed blue placard welcoming to Toronto the members of the 30th anniversary celebration.
I suppose we must assume this also welcomed you to the tavern. And there is such a thing as carrying hospitality even in Toronto a bit too far. We are here as a group to discuss a condition close to all of us, the condition of alcoholism which affects over 5 million individuals each year. And yet this is a very unique disease. It is as yet a disease, a health condition, without a definitive cure or without even a truly definitive mode of treatment.
Many years ago, Sir William Osler, one of the predominant physicians of history, described tuberculosis as a social disease. Many years ago, Sir William Osler, one of the predominant physicians of history, described tuberculosis as a social disease with medical complications. And I think in his day this was particularly true. Tuberculosis is, as we know, caused by a type of bacilli, a type of organism, but it was the society at the time, the health conditions, the environmental conditions, that really led to tuberculosis becoming the problem it was.
And today I think we can take this definition and apply it directly to alcoholism. This is a social condition, certainly with severe and crippling medical complications, but basically residing in the society as we know it today. I said that we don't have a definitive cure, a definitive mode of treatment. Perhaps far worse, I'm not sure that we have even a definitive definition of alcoholism. There are many definitions.
One I'm rather fond of is your own AA definition, that the alcoholic is one for whom one drink is too much and a thousand not enough. I think, however, that in industry particularly, we use the definition of alcoholic or problem drinker to mean an excessive drinker with a secondary dependence on alcohol to the extent that it interferes, that he allows his drinking to interfere with normal work performance or normal social adjustment.
Now this pretty well takes in the whole picture, doesn't it? Such problem drinkers, over two million in this country, and I'm now repeating something for emphasis that Tom said a moment ago, these two million employed workers cost us well over two billion dollars in economic loss. This is loss in time, in decreased work efficiency, in accidents and in loss of trained personnel. All of our current knowledge indicates that alcoholism is a chronic condition and that complete abstinence from alcohol is a prerequisite for successful rehabilitation.
In other words, this is a disease without, in quotes, cure. The disease which can be arrested, it's a disease which can become quiescent, but it's still, like diabetes and epilepsy and others, a disease that remains in force.
[00:10:04]
So continuity of treatment becomes necessarily an essential factor. The estimates of the incidence of problem drinkers in various industries range from one half to three and occasionally four percent. I was rather struck, and I made a note here of Mr. Kenseth's remarks. We had not met before this morning, so there was no particular planning about this, but he is in an organization, Algoma Steel, which has approximately 8,500 people employed.
I represent a large white-collar industry in New York City, which has a little over 8,000 people in one building. There is some dissimilarities, however. He comes from a town, he calls it a small town of 70,000. I can't quite claim this from New York, although we do have our small-town tendencies, I'm sure. But I think that the incidence, what we would find in terms of incidence, this three or four percent of employed alcoholics might very well be the same.
I have found it the same in other industries. Unfortunately, many of the alcoholics in industry are hidden under other categories of illness. Some are concealed, as you well know, for reasons of friendship, years of faithful service, ignorance, or the idea that there is no adequate way of treating this condition. This has often given rise to the erroneous concept that alcoholism need not be considered a problem in some industries.
My own experience, and that of others, indicates full well that unless there is a company program in progress, management can have no truly accurate estimate to the extent of the problem. This economic loss because of problem drinking touches all of us. The immediate loss to the company is readily apparent in terms of lost time, slowdowns, accidents, loss of trained personnel. A less apparent liability is the problem drinker who operates at a decreased efficiency.
Professor Trice mentioned this as the on-the-job absenteeism. But also the man who affects the morale of those about him, one who interferes with the good relationship which any company must have with the public it serves. And the cost, however, is even more spread than this. Much of the cost, the industrial cost, must be absorbed by the taxpayers themselves through increased taxes. If we are to have alcoholics and they are not to be rehabilitated, then institutions and hospitals and rest homes and etc. must be built.
And again, these are built with our tax money. There is another cost. We pay, we must pay, increased prices for the products we buy because this is truly the only way that industry itself can recap and absorb the cost occasioned by the problem drinker. But in terms of cost, however, this cannot be truly measured in dollars and cents. As you well know, the greatest and most irreplaceable costs are in the human intangibles, the things we cannot measure adequately in dollars and cents.
In common with other sick people, the alcoholic is unable to help himself without proper assistance and cannot be treated by disciplinary measures alone. The crippling aspects of this condition must be treated through rehabilitation and the proper preventive measures be provided to lessen the future incidence of the illness. Since the sum total of the life experiences of an individual must certainly contribute to his illness and his physical health be only one facet of the total problem, a multidisciplined approach including religious philosophy, sociology, economic, medical, psychiatric thinking must be utilized in the process of rehabilitation.
This condition is particularly acute in industry because it is more likely to develop in middle age or later and thus is found often among veteran employees in whom companies have a greater investment and for whom they feel a greater responsibility. My own experience in industry indicates and confirms studies which have shown that alcoholism is no respecter of its victim status, be it physical, vocational, social, intellectual, economic, or any other category.
Thus in industry, pure altruism combines with the hard facts of economic necessity in giving impetus to alcoholic programs. The opportunities for education and rehabilitation in alcoholism are also much greater within the framework of industry. greater within the framework of industry. Because here, stricken employees often have
[00:15:03]
a stable background in everything except their drinking habits. They usually have stayed married to one spouse. They are raising families. They are members of established church groups and are usually, except for their alcoholic excesses, respected in their communities and in their job relationships. The key to successful treatment of alcoholism is motivation, continuing the desire to remain sober. A person drinks excessively only because he gets something out of it. Unless he can find something to substitute for it, which he feels pretty sure will work, he's not very apt to stop drinking and he becomes increasingly reluctant to lay aside his glass crutch. In industry, we have built-in motivations which give us a head start, such as a job that the man needs, the things I mentioned above, the family and community respect that he wishes to keep. But you just can't say to an alcoholic, and this is what Tom brought out, you drink too much and we'll have to fire you if you don't stop. You must help him to find a substitute for this way of life. You must strengthen his positive motivations. As in all other health conditions that I know of, whatever they be, tuberculosis, heart disease, etc., early recognition of the illness is essential. Until we're able to come to grips with something, we're obviously unable to suggest or counsel or do anything about helping. The goals, therefore, must be to get to the problem drinker while he can be helped, and to motivate him to either seek out or to accept treatment when it is offered to him. The course of action in industry must be twofold, the education of company personnel, and at the same time, the establishment of adequate facilities for counseling plus some type of active therapy, be this AA or any other type. The program must therefore begin with indoctrination and education which is directed towards early recognition that a problem exists, simply that, that a problem exists. This education begins with top management and then down through successive levels of supervision. At the same time, community as well as plant facilities for aiding the employee must be surveyed and a cooperative plan of therapy instituted. To be most successful, a company program for dealing with alcoholics must take into consideration such factors as the socioeconomic background from which the employee comes, the basic motivation for his work, and must, in conjunction with departments such as personnel and others, attempt to understand the interpersonal relationships inherent in the employee's daily work. When a compulsion to drink has developed, the problem drinker will begin to leave his job to get a drink, to drink at noontime, to find excuses to have time off the job, et cetera. His fellow workers normally will begin to avoid him, and he becomes a loner and either drinks by himself or with casual off-the-job companions. In addition to his frequent absences and his lessened work effectiveness, the problem drinker begins to develop other problems, family discord, the loss of friends, debt begins to pile up, and the like. I don't know, I don't know that anybody knows where the thin line ends between the heavy, so-called social drinker, problem drinker, and the alcoholic, but I think we must recognize that this is not a static condition, it is a progressive condition.
Irresponsible or abnormal behavior on the job is frequently more important than the odor of alcohol on the breath in recognizing the problem drinker. We are in a sophisticated age where vodka is well known to many of us. We are also in an age where perhaps other tell-tale signs such as the odor of sensan, oil of violence, et cetera, is perhaps more important than the odor of alcohol. Those of us who are not guilt-ridden about our drinking, I think have no need to cover it up. It's the cover-up which is perhaps more important, or again, the abnormal behavior in a job or social situation.
In general, personnel in a supervisory capacity are in the best position to recognize these early signs of problem drinking among the employees with whom they work. This is where in industry the first responsibility must rest, with the supervisor. This is the same
[00:20:04]
as a safety program. It is not the responsibility of the medical department to uncover, so to speak, alcoholics. The doctor-patient relationship, so necessary if any therapy is to be of value, is jeopardized at the outset if the medical department assumes the role of policeman or enters into any disciplinary action. I have felt that when uncovered or when suspected or when discussed by supervision, problem drinkers should then be referred by supervisors to whatever the company program might be. In our case, it happens to be the medical department.
In another case, it would be the personnel department or to an AA advisor. But there should be a referral from supervisor to whatever the established procedure would be. In my particular organization, I feel there is no formal procedure for such a referral because circumstances will vary with each individual case. As a first step, however, the supervisor should in some way discuss the problem, whatever it may be, absenteeism, abnormal behavior, irresponsible behavior, with the employee, using his own personality, the supervisor's personality, as a therapeutic tool and urge him to seek out proper help.
He should be prepared, of course, for the mechanism of denial on the part of the employee, the use of multiple excuses for poor work performance and attendance. Accepted industrial practice today is, as Dr. Trice mentioned, to consider cases of alcoholism or problem drinking as a health problem and to encourage, again, some referral by supervisors to an established program. If a medical program is in operation, if this is an illness, it should be properly handled through the medical department.
I often think today that alcoholism is probably much in the same state that cancer or tuberculosis was at about 1900. People at that time were reluctant to admit that they had a cancerous or tuberculous patient in the family because it immediately gave an implication that their family tree was diseased or weak or that they came from poor stocks. Those of you, if there was anyone here who was around in 1900, perhaps remember this.
I think this was very true. So often the patient with cancer or tuberculosis was sort of relegated to the back room or the sanitarium rather than actually actively treated. Now, we know this isn't true today, and I think that today this is almost what has been happening with alcoholism. It's now coming out of the shadows into the sunlight. We are willing to say this is an illness, this is a health problem. To the alcoholic himself, of course, no matter what we call this condition, it will always be an intensely personal problem, as it should be.
There is no problem like the one you yourself have, and as such, this problem must evolve not only the individual but also his immediate environment, his family, and the environment of his work. Another concept which is gradually crept into our medical thinking is that most conditions today, be they of exceptionally poor health or conversely of exceptionally good health, are not divided arbitrarily into physical and emotional, but they are always complex interactions of mind and body. We think of this, I said, as a new concept, but actually it goes, like a symposium, back to the days of the Greeks and Romans, where so-called psychosomatic disease was prevalent, completely understood, and accepted as one component, not a divided type of illness.
Today we're returning to this, and if this is true, and I'm sure we would agree that it is, good health, as such, involves these complex interactions, then alcoholism, which is a condition of extremely poor health, must also involve both the physical and the emotional. The alcoholic cannot be considered unilaterally. This sick person, and again I emphasize the term sick, cannot be considered or treated in a vacuum. He didn't become sick alone, he became sick as a result of, again, an amazingly complex interaction. There were other environmental, situational stresses which provoked or added to his illness, and therefore he cannot be thought of without external pressures. We don't put people in a bottle or a glass and put them on the shelf.
What happens to all of you in some way today, I react to, and what I say you in some way react to. We are involved continuously in the old cliche statement, for whom the bell tolls, it tolls for you and I.
[00:25:03]
So again, the alcoholic did not become ill alone, he cannot recover alone. He needs the help of a society, the group in which he finds himself. Now this statement that I've just made is something Alcoholics Anonymous has understood from its very beginning, and in fact, knowing the AA history, from its very inception, members have been encouraged to bring their friends, their husbands, their relatives to open meetings.
It was quite apparent to AA, therefore, that the understanding of the recovery program an alcoholic was going through must be a most important factor in helping the alcoholic successfully maintain his complete sobriety. It would appear that the most necessary ingredient for treatment leading to positive rehabilitation is truly caring for the alcoholic. Accepting his condition as one of illness, rather than a moral deviation, and consider his illness without making moral judgments, and without rejection on ethical, religious, social, legal, or any other grounds.
A very fine physician from the Boston area, who died some years ago of cancer, at the time that he was dying, and knowing the disease he was dying of, wrote a very small monograph. This was called The Care of the Patient, and in this, and I quote, he stated, one of the essential qualities of the clinician is interest in humanity, for the secret of the care of the patient is in caring for the patient.
This organization, Alcoholics Anonymous, now celebrating its 30th anniversary, has not been a truly definitive mode of treatment, and as you know, has not been able to achieve permanent sobriety in all, perhaps not even the majority of its members. It has, however, done a most important thing. It has provided an atmosphere in which caring is not only possible, but a prerequisite for continued interaction.
We haven't, unfortunately, reached that point yet in our development, where interaction between adults is as workable as we would like it to be. There are too many built-in prejudices and misunderstandings and misconceptions, which means that we will have to, for some time, continue to rely on some professional type of treatment for the alcoholic, and in doing this, in treating, certainly, the medical complications of alcoholism, it seems to me that perhaps the single most important thing is that there be an accepting attitude on the part of the physician.
I didn't say sympathetic. I said accepting. Accepting in the sense that this is an ill person who has come to me for help, for whatever help I can give. Perhaps my help isn't as good as it should be. Perhaps I don't have the knowledge or the experience, but at least I shall try to accept this person. I do not reject him. And this, again, is what AA has been doing for 30 years, accepting, never rejecting.
I think this recognition of the alcoholic as a sick person who is desperately in need of help is perhaps the number one thing that we as medical, professional people can contribute. The physician often helps the alcoholic by no other method than being an understanding person to whom the alcoholic can talk without fear of criticism, rejection, or rebuke. Sometimes he is unfortunately the only person the alcoholic can turn to in this way.
But I think you can see where this leads. This accepting attitude, this listening without rebuke, can also be developed in a spouse, can be developed in an employer, and certainly can be developed in the family groups, just as it has been developed in the AA fellowship. Obviously, again, much understanding on the part of all is needed. I'm not naive enough to believe that simply understanding or simply loving a person is enough. It isn't.
Loving an individual doesn't keep them from dying of heart disease, or loving a person, no matter to what degree, doesn't heal ulcers or broken legs. Nor does love in itself, without understanding and without control, really do very much for an alcoholic. In fact, sometimes love becomes a smothering type of thing. Perhaps it's a misunderstood type of love, actually. I know very well that during the period when an alcoholic is attempting, with the help of his spouse, with the help of AA, with the help of whatever mechanism it may be, to control his somewhat uncontrollable urges, this is a pretty difficult…
[00:30:01]
I'm reminded of what I see on TV all the time. Certainly the alcoholic would much rather fight than switch. I think we have all gone through this at various stages in our rehabilitation. And the family has its fights and the employee has his disagreements and the doctor has a right to also disagree and argue with his alcoholic patient. Disagreement does not mean rejection. It simply means an understanding on the part of all adults.
So I don't think you have to really understand so much in the beginning as you have to really accept. AA has performed another important function. It has emphasized the importance of offering non-judgmental help to the alcoholic. It's provided for a frequent interchange of alcoholic experiences among those who suffer this condition. In showing that such a group interaction truly works and enables some alcoholics to achieve and maintain sobriety, this has indicated to my profession, the medical profession, a way in which group therapy may be helpful to the alcoholic.
So we have taken your lead in a sense. And psychiatrists and other medical personnel, with their formalized training and knowledge of the underlying dynamics of performance, have been able to sometimes structure group therapy in such a way that we could increase its overall effectiveness for the alcoholic individual. There are many alcoholics for whom continued membership and activity in AA is sufficient in itself to arrest their drinking condition.
There are perhaps an equal number of others who do not find this fellowship sufficient for their neurotic needs or are unable to emotionally join in and accept and react to the philosophy of AA. Although many alcoholics may cease their drinking due to their AA fellowship, many of them may persist in their neurotic alcoholic personality and become simply a non-drinking alcoholic, but still the same stubborn SOB that he was previously.
You notice it, people? Such an individual, although not drinking, remains unhappy, morose, dissatisfied with himself and others, and has not been able to make adequate adjustments to their environment. This again is the individual for whom AA has not been enough, and therefore there must be other ways. Penicillin is not the cure-all for pneumonia. People are intolerant of penicillin. They react to it, and we must find other ways to handle their chest condition.
Alcoholics Anonymous, since its inception, has by design and definition dealt with alcoholics, but it becomes increasingly apparent when one examines both the fellowship of AA and the results of those who have been successfully rehabilitated that the concepts involved in Alcoholics Anonymous can be carried far beyond the problem of excessive and compulsive drinking. The basic premises on which AA has been based, and which have been so successful in aiding so many, are simple basic concepts which would probably benefit many mature and intelligent persons who have never had a drink, or certainly who have never had a drinking problem.
The twelve steps and the traditions of AA might well provide a proper way of life for any Christian. It has been my general observation that alcoholics, those who have joined in heart and soul truly the fellowship of AA, have not only improved their lives by their maintenance of sobriety, but have really become better human beings, particularly as exemplified by their increased understanding and tolerance of others.
My chief interest today in the practice of medicine is in the broad area of mental health. Mental health is, perhaps like alcoholism, a most difficult entity to adequately describe, but at least four criteria must be considered in describing any so-called mentally healthy person. A mentally healthy person is flexible under internal and external stress. He treats others with tolerance and a recognition of their needs and defects.
He obtains pleasure from many sources. He has many outlets for self-gratification. And finally, he has a realistic self-evaluation and an acceptance of his own limitations. I don't wish to attempt to ingratiate myself with you by indicating that all recovered alcoholics are of necessity mentally healthy persons,
[00:35:00]
but only to indicate that in my experience, many such recovered alcoholics demonstrate very well to me these four criteria. Certainly flexibility is increased. The tolerance, understanding, and the recognition of the others becomes intensified. The recovered alcoholic who has previously turned only to alcohol for his pleasure gratification now finds many such outlets. And it is certainly most essential, point four, that the alcoholic make a realistic self-evaluation in regard to his ability to adequately control and accept his limitations, to seek out and accept help as it is offered, seeking that help from AA, the church, social workers, medicine, et cetera.
So again, I have been interested in the AA movement not only because it works pragmatically with alcoholics, but because I think it's a pretty good program just to enlarge upon. And I often have non-alcoholic individuals who are depressed, concerned, confused with their life, and I recommend to them reading the Twelve Steps and the Traditions of AA. Now, in industry, the complexity of the alcoholic problem is such that it is obviously necessary to have many avenues of referral for an employed alcoholic.
Certainly referral to AA is one of these avenues, but this may not be in truth sufficient, and therefore some knowledge of community facilities in terms of social agencies, religious affiliations, hospitals, physicians, et cetera, is essential. There appears in most cases no reason why several modalities of treatment may not be utilized concomitantly. Thus, I have often referred alcoholic patients to a physician, a psychiatrist, a clergyman, in addition to AA.
I have also felt that the simple referral of the alcoholic to AA does not in any way guarantee his attending a meeting. There's quite a slip between the office and the AA meeting. My mistrust of his inability to attend this first meeting is such that I now make it a rule to introduce the alcoholic to one of his fellow employees who is currently in AA and has maintained an adequate period of sobriety, and I then have this AA member tell him of his personal experience in AA.
I then arrange to have this fellow employee accompany him to his first meeting and to sponsor him and introduce him to people there. Usually the personal contact gives the AA member a sense of responsibility for this novice, and he will maintain a continued interest in his situation. Just as Mr. Kensett has a Jack K. who is helpful to him, and again the long arm of coincidence, there is a Jack B. who has for five years cooperated very closely with me.
I was extremely fortunate in that six years ago one of the first successful rehabilitations that we had was this very same Jack B. I say I was fortunate. I think he was fortunate too. But I was fortunate in that he combines a number of skills, some knowledge of the legal profession, some knowledge of people, some knowledge of personnel work, and as anyone who embraces AA completely certainly does, is willing at any time to cooperate and help.
Jack can do things that I can't do. He can leave the office and go to a person's home. He can talk with the spouse. He can talk with the children. He can take a person to a hospital and bring them back on a Sunday or whenever it may be. We did a little manipulating, and I have been able in an unofficial way to get complete concurrence from his boss, who is the senior vice president, and my boss, who is a senior medical director, that we can utilize in a rather freewheeling way this sort of AA relationship.
Now, although Jack has been, if not my right arm, certainly my left, in this for some time, we now have several other people, several men and one woman, and I hope soon to have another, who I feel, again, exemplify the AA approach enough, understand it enough, understand enough about their own sobriety that they are able to help others. So this becomes an extremely important function of any ongoing successful program.
We know that there are some industries which encourage and actually promote AA meetings
[00:40:03]
which are held on company property, usually providing a meeting room in the plant or office building for such a purpose. My own experience indicates that this is usually not advantageous, and I would prefer that AA members meet away from the company area and in their own neighborhood and geographical area. This is particularly true in a large metropolitan or urban area where community interaction is necessary to maintain an individual's identity.
It also provides for a greater degree of anonymity than would the meeting in the AA group within the organization's own area. However, again, one, certainly the Michigan Bell System in Detroit has AA-sponsored meetings, and they do very well. So I think it's a matter of tailoring this to the particular organization and to the community. Incidentally, in introducing an alcoholic to a fellow employee with some experience in AA and suggesting, as I do, that these two share their common problem and meet occasionally for informal discussion, be it at lunch or over coffee, there is then likely to be established a number of small, rather personal, which go on day after day, and I think this is perfectly legitimate.
It has been my impression that employees do best when they are involved in more than one type of therapy, namely a combination of AA and group therapy, a combination of AA and religious counseling, and in every case, a continuing supportive type of action or therapy has been offered by myself operating out of our employee's health center. In other words, I don't simply refer someone to an outside agency.
I maintain my own continuity of interest, if nothing else, and I think this is important. If only 20% of the 2 million employed alcoholics could be helped, just think of what enormous sources of economic manpower would be made available to us. This can be done effectively by learning what the situation is, by assessing the resources, by planned programs, by continuing education, and by thinking of prevention, which is very important.
We must view the problem not as one of isolated individuals, but as an industrial and business problem and part of a larger community problem. Happily, the results in an established program for alcoholics and industry are somewhat better than the aforementioned 20%. In a three-year survey of our own problem, we have noted what I call decided improvement in 70%. This leaves an unimproved segment of 30%, some of which have been of necessity discharged, others have voluntarily resigned, and there have been two deaths, one of a condition not related to alcoholism and one directly as a result of excessive drinking.
This 70% improvement rate compares well with that of other large industrial organizations who have had alcoholic programs. The DuPont Company, with an active program for 17 years, reports an overall improvement rate of 66%. Consolidated Edison of New York City, with a program in existence for 15 years, reports a comparable figure. This 65-70% rehabilitation rate is possible because the alcoholics employed in American industry are well-motivated, they care about their jobs, they are not skid-row alcoholics who are usually psychopaths.
The people with whom we work have a compulsion to drink, an inability to control their alcoholic intake. In all other ways, they are relatively law-abiding, decent, established citizens with the same desires and aspirations as everyone else. What we as doctors are attempting to do in alcoholism, as in other emotional and behavioral conditions, is to help the individual understand his individual problem.
Only then will he be somewhat equipped to cope with it. It is certainly no crime to be an alcoholic. The only crime, and here the word is also misused, is when the alcoholic jeopardizes his job, his family, and his life and won't do anything about it. For both the alcoholic and his employer, the ultimate cost of neglecting this problem will be far greater than any cost now of solving it. There are many misunderstandings and many half-truths surrounding the condition which we call alcoholism.
Out of all this, there emerges at least one obvious fact, at least one obvious fact to those of us who are in industry. Obvious fact to those of us who are in industry, and that is that if we talk of excessive drinking, it is certainly true, the family that drinks together, thinks together.
[00:45:15]
Thank you very much, Dr. Cloud. As I look back over our offering for this morning, I find that we certainly have very adequately covered AA's role. We have adequately covered the development of a program of longstanding. We have seen in an intense description of those particular characteristics of a professionally oriented industry program. I think there is one gap which I would like to quickly fill, and I assure you it will be for only two minutes.
I have recently encountered as an arbitrator the union. I have known they existed long before this. I have worked with them a great deal. I have, however, come to regard the joint efforts of union and management as indispensable, and although this has been mentioned once or twice this morning, I think it could bear underscoring. The union can walk the last mile with the alcoholic employee, and often does.
They can feel left out of the development of a management program, and often do, incidentally. They often feel somehow or another a matter of dirty collusion with management, and go through a series of progressive changes as they approach the possibility of participating in a alcoholism program. I would like to urge you people this morning to see to what extent you can begin to have an impact on unions.
I feel that we have been, in some ways, somewhat lopsided in our constant efforts to make headway with management. We often, as an appendage or a PS, underscore the union. I would like to emphasize that especially in those unionized companies, it is extremely important that this second rate, kind of second kind of citizen be reduced as an additive, or else you will find the resistance of the union so high that, in effect, you can make no headway.
I would like to also make one quick final point about AAs who are overzealous and come to work in slots in industry. Dr. Cloud mentioned those kinds of people who have become sober but have dried drunks all the time thereafter. When you get such a person in a position of alcoholic counselor, he can make himself such a pest in a variety of situations that actually he does the program far less of an advantage than a disadvantage.
I shall never forget a large company that I worked with, and we'll close on this note, who had such an overzealous person. He decided that he would get some, quote, educational material, unquote, and he therefore used some company money to set up some very large posters. They were constructed somewhat like recruiting signs out in front of a post office. You know, Uncle Sam wants you, the large finger like this pointing, and he put these up on the bulletin boards throughout the whole company.
Since this company was rather liberally supplied with taverns in the area, you can probably use your imagination and figure out what happened to many of these signs and posters. They became choice items. They were taken over, pasted up on the mirrors behind the bars, and all sorts of answers were posed for the question which he had posed underneath it, are you an alcoholic? And that was the question underneath.
Many, many an answer would come back written over there, no, but I'm working at it. We are at that point in which we will have five minutes, actually, to get started for lunch. And I think this would be a very adequate time for us to thank all the members of our panel who have worked with us this morning. I think I can do that collectively and save us a minute. And in the meantime, we can turn this over to Eve again for a final conclusion. Eve.
Thank you, Harry, and thank you, gentlemen. It's been a wonderful panel. We're all agreed. One announcement. It's been suggested that we're better off getting to Maple Leaf Gardens by subway. That while there is a lot of parking space out there, it's difficult to reach and difficult to get out of. The subway stops right in front of the hotel at Front Street. You get off at College Street Station, and then you'll all get to Maple Leaf Gardens in comfort tonight.
So have a wonderful rest of the day, and thanks so much for being with us this panel.