No Half Measures
By Anthony M. Harrington, M.D.
I was an alcoholic long before I took my first drink.
For as long as I can remember, I’ve always felt apart from everyone else. I realize that isn’t exactly a unique way for a kid to feel, but all I know is that I’ve felt a tension inside of me that was never satisfied, never released, and never at ease. I was always pretending to be something I wasn’t or finding that life around me was unacceptable in some way.
Growing up, I was raised by my grandmother. I never met my father and my mother also had this disease and it landed her in jail during most of my upbringing and eventually led to her death. Some studies quote that a person is four times as likely to be an alcoholic if a close relative is one - maybe that’s part of what happened to me, maybe not.
Luckily for me, my grandma stepped in to save me from foster care and gave me a secure and safe childhood in the suburbs of Kansas City. Despite feeling safe and rescued from an unknown fate, I had this restlessness inside of me - like I absolutely had to be somewhere at a particular time, but I couldn’t figure out when or where it was.
When I was 14, I had my first drink of alcohol. From the beginning, it felt like I was exhaling for the first time. As soon as I finished the first drink, I was immediately thinking about the next one. That’s something that never changed throughout my drinking career, alcohol triggered something within me that craved the next drink before I could even put the first one down. Not only did I not want to stop once I started, I also couldn’t wait for the next time I would have access to it. The feeling of ease of comfort made it seem like alcohol was the solution to all my problems - it made me feel part of the world around me or at least put me in a state of mind that allowed me to not care if I belonged or not.
Consequences came early from excessive use. I would do something embarrassing or get into arguments with friends, or even to the point that police would have to intervene. I didn’t take any of this seriously at the time, even though I could see it as a warning that I might end up like my mother. I rationalized it all though, I was young and young people do dumb things. When I was sober, I would feel like I had the worst luck in the world and that everyone was against me. No matter what trouble or conflict I would get into, I would soon talk myself into drinking again. I would say to myself, “well, tonight I’ll just have a few” or “it’ll be different next time”.
I eventually found myself graduated from high school with no prospects on the horizon. There was one thing that I knew I didn’t want to happen; I refused to end up like my mother. So, while drinking with a friend who just got back from basic training, I decided to enlist myself in the United States Marine Corps.
The forced sobriety that came during the 13 weeks of basic training and 4 weeks of combat training felt like a fresh start. That feeling of apartness was back, but I was always too tired to think much about it. Unfortunately, this was short-lived once I was out of training and afforded a little bit of liberty. As soon as I was able, I was drinking again to make up for lost time. So began a pattern of my disease that would last the next eleven years: work hard and play harder. Consequences seemed to meet me at every turn, but I was smart and a hard worker and managed to complete active duty with an honorable discharge and a ranking of Corporal.
Thanks to the GI Bill, I was accepted into the University of Colorado. There the story continued: drink hard, make mistakes, study hard to make up for lost time, and manage to come out on the other side. It was in undergrad that I developed a passion for neurosciences and becoming a professional actually seemed like a possibility. I never presumed that being a physician was in the cards for me, but I was determined that if I could push myself to the limit, I could make it and prove everyone wrong that doubted me. That’s exactly what I did. Despite my best efforts to sabotage myself with daily binge drinking, physical injuries, and everything else, I made it into medical school at the University of Kansas.
Things changed at the beginning of my fourth year of medical school, I met my wife. This would become the first time I had a relationship of any significant meaning. Sure, there were relationships before and they felt meaningful in the moment, but soon enough I would push them away - either intentionally or unintentionally. When my wife and I started dating, I knew it was different from the beginning and I was doing my best not to screw things up.
It’s easy to hide your true self until you start to live with other people. She and her son moved with me to Colorado for neurology residency and that was when I started to circle the drain into the bottom of my alcoholism. My new cycle would involve starting off with a few drinks, going over a predetermined amount, fighting with the love of my life, drinking for oblivion, waking up full of regret and shame…and repeat.
Pleas were made to cut down, to ask for help, but I would always say that I couldn’t. I couldn’t ask for help with addiction, because I’m a resident. Because I’m a doctor. What will people say? What would it do for my chances of getting a good position after training? I had seen what happened to those who got in trouble for alcohol or drug use, their careers were torched even when it happened outside of their profession. No way. Not after I’ve worked so hard to get here.
I tried therapy with a counselor on campus - but I knew all the right things to say and which things not to say. Hard to help someone when they’re only giving half truths. The real truth was that I didn’t actually want to stop, I just wanted people off my back so I could drink in peace. I didn’t think I was hurting anyone but myself, so why should anyone else care what I did outside of work? Nevermind the pain I caused to everyone that loved me.
Then a night came that would end up being my bottom and my jumping off point. This started off with the typical cycle of overdrinking, fighting, and taking everything too far. This was it. I woke up in the shame of what I had become…I had become my mother. Someone that would completely tear their family apart for a drink, someone that would destroy their lives out of their own selfishness. I didn’t know what to do. I knew I couldn’t go through life sober and that if I continued drinking it would kill me or get me to the point where I would wish I was dead.
Out of fear of losing my family and career, a plan was made to monitor me closely without having to go into an inpatient rehabilitation stay. Staying sober without real outside help is called white-knuckle sobriety for a reason. It was miserable. Life around me was getting a little better, anything was better than how it was going, but I certainly wasn’t. I was just waiting for the heat to die down so that I could once again feel that ease and comfort.
During this time, I would go to online programs of recovery once a week. The meetings were fine, but there was no way their program would work for a person like me. I was unique, I was different. About four months away from my last drink, I brought up the possibility of trying to moderate my alcohol use again to my spouse. This, of course, led to an argument and so I went to one of these meetings online afterwards with a head full of anger.
Somehow, despite all the noise in my head, a message got through. A man shared about the last time he tried to go back to drinking with the aim of moderation, and how terrible it went. He talked about the same things I was thinking and the same things I was feeling. He described my nonsense justifications right down to the exact phrasing. For whatever reason, I knew the same thing would happen to me and something clicked in my brain.
I couldn’t do this alone. At the time, I didn’t agree with the majority of the things these people talked about, but I couldn’t do it alone anymore. I was giving up.
If I was truly going to do this, I had to do it all the way. I knew that I couldn’t skip anything and that I couldn’t do it halfway. I didn’t drink with reservations, so I had to approach the solution the same way. Don’t get me wrong, I fought and doubted everything that was told to me in the beginning, but I still took the actions that were suggested.
The thing that really helped me early on was doing my own research. Being the nerd that I am, I looked up the evidence behind 12-step facilitation programs compared to other methods of recovery. I came across a Cochrane review that had just been released that compared it to cognitive behavioral therapy and other professional therapies. 12-step facilitation programs were more effective with statistical significance compared to other methods. For me, that was enough to completely buy-in to the message that was being offered. It was a higher power that I could get behind.
Through the process of recovering, I had to clear away my past and straighten myself out spiritually in order to heal mentally and physically. This was about much more than an addiction to alcohol, it was about the underlying feeling of dis-ease. Recovering didn’t happen all at once, it was a slow process that has had many mistakes and an endless amount of hope and inspiration. Now, I can be a part of rather than apart from everyone else. I can look anyone in the eyes without shame or fear - it is a freedom that I never thought would be possible. I continue to work on this program and improve myself everyday. I will never be perfect at it, I don’t even want to be, I just want to be better than the day before.
My life at home began to improve significantly after going all into my recovery. Over time, trust was built and a family has grown. In addition to a great relationship with my spouse and stepson, we’ve also been lucky enough to bring two babies into this world.
As for medicine, I made it through residency and fellowship without having to divulge everything about myself. I’m fortunate enough now to be in a position where I can be open about recovery and lend out a hand to those who might need it. I know what it's like to be afraid of being found out, of carrying this disease while trying to take care of patients and maintaining a personal life.
We’ve all met countless people that have had their lives destroyed by alcohol and drug use, including our colleagues in healthcare. Yet, we still allow it to be stigmatized in a profession that prides itself on helping others. Why is that? Would we feel the same fear about asking for help if we had an alternative diagnosis that would affect our personal and professional lives? Why, for example, is it okay for licensing to ask personal health questions even when they haven’t affected your patient care? I feel that we must speak out against this in order for people to get the help they need. The problem will exist whether we try to ignore it or not, the difference is that we could give someone a chance of recovering before they ruin their lives or hurt someone else.
The archaic notion that alcoholism and drug addiction comes down to willpower and moral standing needs to be smashed, just like my old ideas that I was unique or could control my drinking on my own. Studies have shown that about 10% of the general population has the disease of alcoholism or other substance use disorder - that percentage has shown to be higher amongst physicians and healthcare professionals.
The mission of helping others also means helping each other. If you find that you’re struggling like I was, ask for help. If you see someone struggling, don’t be afraid to say something - you could be saving their lives.
There is a way out. We just have to be honest, open, and willing.
Anthony M. Harrington, M.D.
Dr. Harrington grew up in Overland Park, KS and served for four years on active duty in the United States Marine Corps after high school. Undergraduate degree at the University of Colorado where he discovered his passion for medicine and neurosciences.
Next, he went to medical school at the U of Kansas, neurology residency at the U of Colorado, and fellowship at the U of Michigan. He is now back home in Kansas City, fulfilling his dream of being a Neurohospitalist.
