Excerpt: 'The End of My Addiction'

I was terrified of living without alcohol. Without it, I would be an anxious wreck. Admitting my problem drinking to most of my friends and my colleagues terrified me, too. I feared being ostracized, and since I felt that drinking should be under my control I felt ostracism would be justified. (Naively, I assumed that very few physicians had a drinking problem. I didn't yet know that about 10 percent of physicians, like roughly 10 percent of the general population, will become dependent on alcohol at some point in their lives, that many more in each group are problem drinkers, and that according to the British Medical Association, physicians are three times more likely than the general population to have liver cirrhosis from alcohol abuse.)2

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Through the next two months after my appearance in the ER, I clung to abstinence. I called my new AA sponsor regularly, and worked overtime in my practice so that I had no free time for drinking. And in June, I went off to the Swiss Alps, which, since my childhood, had been a magical place for me. But hiking in the mountains and quiet evenings after a good dinner failed to restore my spirits as usual. I had been sober for sixty-three days, but there was no peace in me. My drinking had threatened my career, even my life. I needed to talk to someone about it.

I decided to call André Gadaud, whom I'd met in 1984 when he became France's consul general in New York. After other high-level diplomatic postings, André had become the French ambassador to Switzerland. He was also what they call in AA a "civilian," that is, a non–problem drinker. We'd always had a great rapport, and I thought sharing my secret with him might help me.

André generously offered to drive from the French embassy in Bern and meet me for lunch at the Hotel Quellenhof in Bad Ragaz, a luxurious thermal resort town. As we sat down to lunch, André said, "Let's order champagne and have a toast, since we haven't seen each other in several years."

"I'd rather not have champagne," I said.

"Why not? It's been so long!"

I did not know how to say no, so I gave in. It felt impossible to refuse champagne when it was proposed by a French ambassador, and then it felt equally impossible to reveal that my drinking had become a serious issue. I worried that André would assume I was not exercising enough willpower and lose respect for me. It seemed better to keep quiet and not risk ruining our visit or possibly even our friendship.

After lunch, during which I restricted myself to only one glass of champagne, André and I walked for hours in the mountains, talking about everything except my problem, before he had to drive back to Bern. That evening, I went to a pizzeria for dinner. When the waiter asked if I wanted a drink, I immediately started craving alcohol. The glass of champagne at lunch had reactivated the whole cycle, which I knew would be hard to fight.

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The craving became stronger, growing in my chest, in my throat. Some cravings are more violent than others. Although cravings have an emotional component, the physical part was the hardest to bear for me. An AA acronym, HALT, sums up the states—Hungry, Angry, Lonely, Tired—in which cravings strengthen. I was experiencing all four. I was jet-lagged, lonely and angry because my friend had left without my being able to mention why I had called, and hungry because my food was very slow to arrive.

Just to take the edge off, I ordered a double vodka tonic, assuring myself that a single drink would forestall a major binge. It almost worked. After dinner, I felt somewhat soothed. But as I walked back to the hotel, I passed a bar and the craving struck again with irresistible force.

I entered the bar and ordered a double vodka tonic. Another customer came over. "I heard you play the piano here last summer," he said. "You were terrific. Would you please play again?"

As I sat down at the piano, a wave of anxiety swept over me. What if I didn't play well? Another vodka tonic materialized, offered, I was told, by the customer who'd asked me to play. After gulping it down, I felt great—relaxed, personable, happy. I played with confidence; people danced and applauded. After two more vodka tonics, I returned to my hotel and fell into a peaceful, refreshing sleep.

I awoke feeling good, but in the late afternoon I went out and bought a bottle of vodka. And I drank it, launching myself on a binge.

With great effort, I ended the binge and managed to dry out in time for my flight home to New York.

My failure to stay sober on vacation frightened me. I called my office assistant, Erdie, and told her to cancel all appointments.

"For how long?" Erdie asked.

"Until the end of the summer," I said.

"But why, Doctor Ameisen?"

I hesitated a moment, and then said, "Because I'm an alcoholic, Erdie."

She laughed and said, "But seriously, Doc, why?"

"I am serious, Erdie."

Over the next several weeks, I decided, I would either manage to arrest my downward slide or ease myself out of my practice until I regained control.

Almost immediately, I began drinking heavily every evening. Finally, I managed to wrench myself out of the abyss and stop. I grew ill, vomiting and aching all over, but as usual staved off acute withdrawal with B vitamins, gallons of fluids for hydration, and Valium. I was usually well supplied with Valium, which my physician prescribed for my anxiety, and since I had started bingeing, I had always made sure to have some on hand so that I could detox myself.

Detoxing from alcohol takes around five days. A day into this regimen, I called my girlfriend, Joan, who proved immensely empathetic and encouraging, even though we were having a rocky time over my inability to make a long-term commitment.

The next morning, August 19, 1997, I realized I had run out of Valium and could not remember when I had taken the last pill. With Joan's help, I searched the apartment repeatedly, desperate to find at least a couple of pills, but there were none in the bathroom medicine cabinet, on the nightstand by my bed, in the kitchen drawer, or anywhere else. The doctors I knew and trusted were away, and I could not imagine explaining to another doctor why I needed a prescription on an emergency basis.

Joan did not understand my concern. "Why do you need Valium so badly?" she asked.

I explained that withdrawal from alcohol can easily become a medical emergency with delirium tremens (the DTs), seizures, loss of consciousness, hallucinations, major spikes in blood pressure, and even death. The risk of serious, and potentially lethal, medical consequences is much higher in acute withdrawal from alcohol than in withdrawal from any other drug of abuse.