Patients Are People, Too The Memoirs of Trester Smith Harris, M.D.

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Chapter 10
Alcoholism

Men take alcohol to help solve their problems, and soon alcohol becomes their number one problem. Over nine million Americans are alcoholics and as each one of these touches many other lives, there are many people involved. The French have a tremendous problem with alcoholics, and it has in recent years become an immense problem in Russia. Every country, new and old, has had a dilemma with some kind of alcoholic drink. All have figured a way to make a booze. Many in the early New England states were in the business of rum running, and many a young New Englander’s life has been ruined by strong drink.

There is a physical susceptibility inherited to alcoholism. It is especially strong in North American Indians, Irish, Scandinavians, French, English, and Germans. It does not seem to be in Spaniards, Jews, Italians, and Greeks. Recent investigation reveals this to be due to the fact that certain people (about twenty percent) have an inherited enzyme dysfunction which makes them metabolize the alcoholic byproducts, thus making it an addictive drug to them. These drinkers lose the effects of their “alcoholic glow,” thus making them restless and extremely thirsty for more alcohol.

Some people have a warped personality to begin with and others got that way with drink. For the ones who are ill equipped to deal with life’s exigencies, they consider drink as an escape, but they can’t escape forever: They have to face reality at some time.

There is a great variety of intoxicants, but those who drink beer and wine can become just as alcoholic and uncontrollable as those who drink high proof liquors. I’ll never forget the evening a fellow came into my office, dressed in old dungarees and a blue shirt, with a bottle of wine. He confessed he was an M.D. from the University of Tennessee. He named the fraternity he belonged to and gave enough information to prove he went to medical school. He had gotten on cheap wine, lost his practice, his wife had left him and he was in a pitiful state. I never saw him again so there is no knowledge of his outcome. I hope it was favorable.

The Italians drink wine with their meals and seldom become intoxicated. Wine is introduced to the children early and is apparently a way of life. Jews drink with religious celebrations but are taught to stop at the right time. Many Jews drink habitually but seldom become alcoholics. The French drink considerable wine, before meals, after meals, and in between times. The rate of intoxication is high among the French, and the recent drive to substitute soft drinks and milk has failed miserably.

Our American society has a tendency to revolve around alcoholic drinks. To many, there can be no entertainment without cocktails, and the intermission features cocktails. One drink is supposed to restore a man, two will relieve him of his worries, and three will make him reckless. If only they wouldn’t carry it too far, for there is nothing pretty about a drunken man, and a drunken woman is a disgrace.

It is said that one drink will make a new man out of one, and then the new man requires a drink.

There are many excuses for alcoholism. A very eloquent inebriate at a party one time insisted that he drank because of psychic trauma following the fact that he had been nursed with a bottle during the flat-chested flapper era of the twenties. He informed the group that his frustration stemmed from not having experienced the warmth of a mother’s breast, and was further exasperated and frustrated as an infant by having to use an old rubber nipple that tended to invert itself as a partial vacuum developed in the bottle. Now, he claimed, every time he saw a full bottle, it reminded him of his mother, and the sight of an empty bottle reminded him of his father.

Another woman cirrhosis patient said that she had drunk a fifth of whisky a day for thirty-three years. When I asked her why she drank so much, she said that the only way she could put up with her husband was to keep tipsy all the time. She was about as explicit as a young man of thirty-six who had been drunk on wine since the age of fifteen. He said it made him sharper and he could enjoy life more.

Cirrhosis is the third highest cause of death in New York City in the age group twenty-five to forty-four. It is fourth highest in the group forty-five to sixty-five. There are around one half million alcoholics in New York alone. San Francisco has the dubious distinction of having the highest rate in the nation, and Boston is second.

For those who have been in the Bowery in New York and have seen the human derelicts lying on the sidewalk and in the doorways, there is good news. The New York police are going to take them as they fall and put them in a center overnight so they won’t freeze to death.

Alcoholism is not confined to the metropolitan areas, however. Many are the housewives in the better areas who drink all day long while the hubby is away. This secret drinking is on the increase, and more and more wives are involved.

Alcoholism is no more a disease than a headache is. It is a symptom of an underlying problem or group of problems, financial, emotional, marital, or other. It may result from a frustration or series of frustrations, which frequently take the blame for many things. It is self-inflicted and springs from a severe weakness of will power, thriving on rationalization.

Many people reach the point where they seem to enjoy their dissolute life. They make no effort to be helpful or to help themselves. One of the tricks is to go to a bar, have a few drinks, and pick up a floozie. It is strange that a man who wants to make a fool of himself only has to go one block or less to find some woman to help him.

One fellow insisted he was not an alcoholic. “I have quit twenty times,” he vowed. “I can quit any time I want to.” But he had an auto accident while driving drunk, lost his car, and wound up in a hospital.

The effects of alcohol are peculiar. It makes some people cry a great deal. Others become belligerent and want to fight somebody. Others become very affectionate and want to put their arms around you, tell you how wonderful you are to the point of becoming a nuisance. With some there is a tendency to tell things they should not, and still others swear volubly. There is a tendency to sing, too. In Mexico there is a saying, “We have sung together,” meaning “Yes, I know him well—we have been drunk together.”

I’ll never forget a mother who called me in to see her daughter whom the police had brought home drunk. She had on the thinnest of dresses, nothing more, and her speech was as thick as her dress should have been. I had never seen her before, but she tried to pull me down in bed with her, requiring both her mother and me to rescue me. The unfortunate thing is that we can’t do the patient any good unless the patient really wants to quit enough to try. No medicine alone will do it, nor will psychiatry help unless the patient is anxious to quit.

Doctors, as a rule, do not like to care for alcoholic patients, for several reasons. In the first place, they are hard to handle, and do not follow orders. The main reason though, is that a doctor likes to be successful in his diagnosing and handling a case. He feels that by functioning well, being competent in his treatment of a case and getting a cure gives a feeling of intense satisfaction and bolsters his ego. In the case of treating an alcoholic, it is far different. There is nothing taught in medical school, one learns nothing in internship or residency, and then there are no books that are of any help. In fact, nothing is known about successfully treating drunks, so a doctor must go it alone in an unknown field to achieve what may be considered a questionable degree of success. Since real success is rare, the poor doctor is frustrated in his inability to really do the patient any permanent good.

Another problem is the patient’s family, especially the wife of an alcoholic. She wants results. She insists you do something, until she learns that it is hopeless unless the patient himself decides to do something about it. We can sympathize with her, but that is of little help. We do consider an alcoholic as entirely responsible for his drinking, and he can be helped only if he is willing and anxious to be helped.

Some alcoholics seem to enjoy their “illness” and the attention which is showered upon them. This really makes it more difficult still to treat them. If he is a breadwinner, as is usually the case, we must help him on the job as much as possible for the family’s sake. He must be extremely careful about his driving while drunk, for everyone’s sake. If a doctor doesn’t have the necessary patience and feeling for an alcoholic, he should send the patient to one who does.

Many a doctor has become an alcoholic, stating that he was so tired and overworked that he just couldn’t relax without a drink. That is a pretty thin story. No one has been more tired and overworked than I, and all I had to do was close my eyes, and restful sleep was the natural outcome.

One of the difficulties which is new to this generation is alcoholism among children. Many children of six, eight, nine and ten are developing this trend, and AA has groups to treat these kids. They are being given alcohol in the homes and are learning to sneak liquors from the parents. Many parents seem to think alcohol will safely take the place of drugs in our modern day culture.

In Tahiti, at the hotels, the wine boy is always a young child. I have seen the wine-boy at our hotel empty all the goblets by drinking the remainder, and he became so intoxicated he could not play croquet afterwards. In Spain, the wine boy is likewise a lad, and in France, the same holds true. Thus these children have a wonderful opportunity to become alcoholics.

At private parties in this country, I have seen liquor given to three-year-old girls, and then there was laughter at the antics of the children. Surely this is a generation of alcoholics, and for the children it starts in the home.

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