The first step

By Dr. Jim Ferguson

“Wine gladdens the hearts of men.” Psalm 104:15

Another week, another column. I sometimes ask myself, why do I continue after eleven years? Surely, I’ve said enough. But, the beat goes on.

As a doctor I’ve treated hundreds, if not thousands, of people who abuse alcohol and drugs like opioids. I’ve seen liver failure from cirrhosis and treated DTs (delirium tremens). I’ve managed overdoses and endocarditis (heart valve infections from illicit drug injection). However, it took a Christian writer to teach me about alcoholism.

I’m curious by nature and the things that interest me usually show up in this column. I enjoy learning and recently organized a philosophical group (book club) euphemistically dubbed the Salon, after 17th and 18th century French literary and philosophical groups. However, we are not hoity toity nor do we wear powdered wigs! But, neither do any of my other three reading groups. I love to share the experience of movies and books with other people. Everyone’s perspective is unique and therefore reading and discussing a book within a group is insightful and brings me joy.

Many times I’ve mentioned my favorite writer of Christian apologetics, Phillip Yancey. I wish my prose were as beautiful as his. I believe the chapter on alcoholism in his book “What Good is God?” should be required reading in medical school. There is no medical science or physiology, just Grace and the human experience (humanism).

We hear much these days about the opioid crisis. Previously, our focus was on the abuses of alcohol. And everyone knows an alcoholic. I use the present tense because even people who are on the proverbial wagon (not using alcohol or drugs) are “recovering.” Having a drinking problem is not like being treated for pneumonia. Abstinence and appropriate antibiotics will get you out of detox or the hospital. However, though that battle may be won, the war for sobriety is daily and lifelong.

Undoubtedly, the first fermented beverage, beer, existed before the first documented usage in the Mesopotamian culture of ancient Sumaria around 3000 BC – not to be confused with Samaria of Biblical times. Fermentation of grapes for wine occurred much later, and the discovery of the distillation process by Arabs, to produce spirits, came in the centuries after Christ – before Mohammed banned alcoholic drink in the seventh century AD.

Many times I’ve been asked if wine has medicinal value because studies of Frenchmen and Italians seem to show less coronary artery disease than, for instance, Germans who drink beer and Americans. It is said that Martin Luther scheduled church at eleven on Sundays, not for ecclesiastical purposes, but so he could drink till the wee hours on Saturday night and still begin services before noon the next day.

The purported value of the polyphenol and antioxidant, resveratrol, in red wine is at best conjectural. Some studies have shown equal benefits with beer, which has lower levels of polyphenols. The bottom line is if you choose to drink, do so in moderation, for social reasons and not for medicinal value.

Prior to the modern era, water was often contaminated and alcohol in fermented beverages was safer. This is not a valid reason for drinking in modern America. Interestingly, both the Salvation Army and Alcoholics Anonymous (AA) were founded to combat alcoholism. In 1934 Bill Wilson, the founder of AA, met a friend named Ebby who emphasized a spiritual conversion experience as a necessary step for sobriety. Wilson eventually had his own conversion experience while drying out in a hospital, and together with another alcoholic and proctologist (!) named Bob Smith, came up with the now famous 12-step program, the cornerstone of recovery. In fact, successful treatment programs now emphasize not only physical and psychological, but also the spiritual aspects of addiction. And NA, or narcotics anonymous, like many other addiction programs also utilizes the 12-step system.

Yancey tells the poignant story of a cab driver who was addicted to crack cocaine. She told him, “Crack isn’t for people to feel good; it’s for people to feel nothing.” I have seen many people and patients who drink or use drugs to numb the pain in their lives. I don’t pity these poor souls with addiction, I feel for them. That is the difference between sympathy and empathy.

Years ago I wrote an essay entitled “The Rat Park” which describes a classic research study of the same name. In the study mice were addicted to cocaine and trained in a task to receive the drug they craved. However, when offered an entertaining playground and socialization with other female mice rather than solitary confinement in a cage, they quit using the numbing drug.

I chafe at the notion that I have achieved some measure of wisdom as I’ve grown older. I have greater insight, but have not achieved any measure of true wisdom. As a younger doctor I remember referring to “the man in room 432 with pneumonia.” Now, I perceive that man as my patient – if not friend – with a wife and children and a life beyond room 432 who has pneumonia. With Yancey’s insight I now see alcoholism and drug addiction with a newer set of eyes and augmented empathy. This does not mean I don’t believe we are not all accountable for our choices. However, a poem by Emily Dickinson better expresses what I’m trying to say:

“If I can stop one Heart from breaking,

I shall not live in vain

If I can ease one Life the Aching,

Or cool one Pain,

Or help one fainting Robin

Unto his Nest again,

I shall not live in vain.”

Alcoholism and drug addiction are incurable diseases. However, they can be combated successfully with the proverbial “hand up rather than a hand out.” People are far more complex creatures then mice. We are created in God’s image and given freedom of choice and reason. We require more than play, sex and enough food as in The Rat Park. The 12-step plan for humans requires the spiritual component.

In the fifth century Augustine of Hippo said it best in the opening paragraph of his monumental work, “The Confessions.” He said, “Our souls remain restless until they rest in thee, Oh Lord.” How true that is, then and now.

 

 

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