Author: patrick

The first time I drank alcohol was at about the age of 12 at a party. I had always felt awkward, not really “one of the in crowd” and a party always made me feel worse. So skulking under the stairs I found two litre bottles of woodpecker cider and decided to try some. I drank both bottles, passed out, missed the whole party.

At my sister’s hen party (I was 13), too much Pernod resulted in alcohol poisoning and a terrified junior doctor sitting up with me all night. I learned that night, never to drink Pernod again, unfortunately, I did not learn not to drink alcohol again!

At 15, I was drinking brandy and Babycham, regularly passing out by the end of the evening. At 17, I found religion and became a very charismatic Christian. I didn’t drink alcohol from then and throughout my university years, until a rather unfortunate incident with a wayward minister and a disbelieving church. I lost my faith and within a couple of weeks I had found Gordons to fill the gaping hole.

For the next 30 years, the pattern was of periods of heavy drinking, and periods when I had more control. But certainly drinking alcohol most days, which I considered as quite normal. I surrounded myself with a heavy drinking crowd of people. Thus, I did not consider that my drinking was at all abnormal. The pattern became, that I would have a couple of stiff gins as I was getting ready to go out ( I was deeply self-conscious with a very low self-esteem, gin gave me confidence and courage). I would drink so heavily, that I would often have to curl up and have a “little sleepy” before reviving to carry on. If not going out, I would drink wine or gin every night, after all as a hard-working GP, I deserved it at the end of the day. I could drive to work with the worst of hangovers, but even towards the latter stages of my drinking, I never drank at work.

I divorced and remarried, my new husband only drank occasionally. So, I had to start hiding my gin, in all kinds of ingenious hiding places, I vaguely knew that hiding alcohol was a bad sign but I justified it by considering that it was my husband who was abnormal, if he drank normally, I would not have to hide my drinking. It amazes me now to realise, that despite being a doctor, I really had no insight into my alcoholism at all.

As the disease progressed, I would wake in the early hours with palpitations and “the shakes” and I put this neatly down to the menopause. I got frequent bouts of vomiting and gastritis, and I became anxious, restless and more and more depressed. I stole fluoxetine from the dispensary shelf and started self-medicating.

I did not lose my job, my house, my licence, my children, my new husband, though I was on the brink of losing all those things. What I lost was my mind. I would sit with my head in my hands in between patients, willing myself to go on, imagining the cool glass of wine I could have when I got home. Having no insight, that by this point, that cool glass of wine was in reality half or more of a litre of gin.
Looking back, what surprises me the most about my alcoholism, is my total lack of insight into my condition. I earnestly believed my own stories of denial. I had little awareness of the negative effect I was having on my family and all those around me. I remain amazed at how I managed to carry off this acting role of popular caring GP while leading this double despairing life in the evenings.

One evening, driving home from work, it just suddenly hit me: a moment of clarity out of the blue and I said out loud “My God, you are sick, you’re really sick, you’ve got to stop drinking”. The next few days and weeks, I realised that I actually couldn’t stop. I would wake in the morning, determined not to drink that day and by the evening, I would be pouring the gin, knowing I didn’t want it but pouring and drinking it anyway. Without it, I would be pacing the floor, agitated and restless. Alcohol was once the answer to all my problems, until the day when it became the author of my problems.I felt so isolated, realising that as an alcoholic doctor, there were few places I could turn to for help, without risking the GMC becoming aware and my losing my job and credibility. Fortunately, there is so much help available nowadays for doctors.

I needed help but was petrified of the consequences of speaking out. Trembling, I phoned the Sick Doctors Trust and that was my first tentative step towards alcohol detoxification and recovery.

What I just couldn’t understand was that even though I thought I was only a binge drinker and so didn’t drink every day, I was still an alcoholic.

I only understood when it was explained to me that for that period of time of maybe 3 or 4 weeks, I was driven by the overwhelming compulsion to carry on drinking, despite not always wanting to, certainly not always needing to, and that I had lost any control over it, that I realised I did have a problem. I thought you had to drink every day to be an alcoholic.

I could not see until it was spelled out to me in no uncertain terms by my family, that once I started, there was a complete inability to control it, and I was continuing to drink despite causing problems with the family such as all the broken promises to my children, the dinner parties I ruined by my behaviour and other negative consequences.

When I started on a binge, I became a different and not very nice person. I could never just have one drink despite the best intentions.

A 25 year-old Foundation Doctor realised she had an alcohol problem following a talk given by a member of the Sick Doctors Trust as part of their weekly teaching programme in the hospital they both worked in.

She contacted the member who arranged for admission to a detox unit (quite far away from home, at the doctor’s request). Following admission, she self-reported to the GMC, who did not suspend her, but after a Fitness to Practice hearing, gave her undertakings, including attendance at the local British Doctors and Dentists Group.

She was discharged from GMC follow-up after 2 years, and remains sober five years on, having remained on her training programme.

A 35 year old SPR5 approached a consultant involved with the Sick Doctors Trust at the same hospital for advice and to talk about his drinking.

Over the previous two years, he and his friends noticed a change in that he often became violent when drunk. This had resulted in physical injury, fortunately only to himself, on two occasions. However, the injuries were visible and provoked questions at work. He had always been a beer drinker, but had recently started drinking wine once back at home after a night out.

There were also some issues outside work, to which he attributed his increased consumption. There was no history of memory loss when drunk, neither did he have any withdrawal symptoms. He was not a daily drinker, had never drunk during the day or at work, and did not suffer particularly for not drinking when on-call but did suffer bad hangovers, resulting in some days off sick.

He was referred to a treatment centre for a formal assessment. It was decided that he had not crossed the line from alcohol abuse to alcohol dependence and he was given advice and some coping strategies.

Since then he has remained well, drinks only moderately, does not go out as often, and is now well established as a consultant.

I must have done every available alcohol or addiction questionnaire on the internet to justify my intake. Even though every single one scored me as an addict, my denial prevented me from both seeing and accepting that I was in trouble.

Several times I kept a drink and diazepam diary, when trying to cut down during a week’s leave. I even lied when recording my intake, and as I was living on my own at that time, there was no-one else to see it, but couldn’t record the real amounts as that would be admitting to an unacceptably high intake.

The friends I used to drink heavily with as a student had all settled down now and drank sensibly, so I assumed I would reach that stage as a natural course of events too. Because I had never drunk spirits, never had a drink in the morning, never drunk at or before work, never had bad withdrawals, and no demonstrable liver problems in my blood tests, I thought I was only a mild case, if I was a ‘case’ at all.

I was a doctor, and so must be a different kind of addict – just a mild case who didn’t need to do all the recommended stuff. Given time, things would all work out by themselves and I’d grow out of it. How wrong I was. I still subscribed to the thought that addiction was ‘dirty’ and that it only happened to people with defective personalities.

But it was what went on in my head, and the absolute despair at the end of my drinking that was described by members of AA (when I eventually got there!), that was enough to eventually convince me that I didn’t have to qualify as the worst alcoholic ever before I needed treatment.

It took a long time to break down my professional pride and accept that addiction is now recognised as an illness, and as such, deserves treatment like any other chronic illness. Anon

A 25 year old trainee surgeon was on a night out with friends in the city centre. He used cocaine very occasionally and only at weekends with friends who were not medical, and drank socially. Unfortunately following an incident outside a club, his group was searched and he was found to be in possession of a small amount of cocaine.

This led to an appearance in the local Magistrates’ Court, and as happens to any doctor appearing in court for any offence, he was reported to the GMC. This was followed by an appearance at a GMC Fitness to Practise hearing, and by nature of the offence he was presumed to be an addiction problem, and dealt with under health procedures.

He was suspended from his job, initially for twelve months and referred for psychiatric opinions and to the British Doctors and Dentists Group. Regular hair testing for drugs of abuse was carried out, plus bloods for CDT levels indicating recent alcohol consumption. Since abstinence from all mood altering substances is required in cases of addiction, this meant that even though he was not an addict and only had the cocaine for recreational use on that one occasion, he could no longer even enjoy a social drink.

His testing remained negative over an eighteen month period and he was eventually allowed back to work, after considerable disruption to his training.

This case serves as a reminder of the consequences of using street drugs – even if only for social use, they are still illegal and possession of even a small amount for personal use is taken very seriously by the GMC. In its medical Student Guidance, probity is emphasised and doctors are required to ‘comply with the laws of the UK’.

Also the GMC publication ‘Good Medical Practice’ states: ‘You must inform the GMC without delay if, anywhere in the world, you have accepted a caution, been charged with or found guilty of a criminal offence, or if another professional body has made a finding against your registration as a result of fitness to practise procedures.’