Double-Barreled Hope for Alcoholics
Here's an ally against the chemistry of alcoholism
by Paul de Kruif
Jail is still our main medicine for chronic alcoholics, though actually
they're not criminals but sick people. That they're not inherently wicked
has been proved by Alcoholics Anonymous; after recovery the vast majority
of AAs turn out to be superior citizens. As to how alcoholics are sick,
science at last has a hot clue. In many cases their desperate stages,
such as delirium tremens, reveal them to be suffering from a glandular
deficiency--rapidly correctable by certain hormones which seem to
overcome the excessive desire for alcohol.
This promises to bring many more far-gone victims within reach of the
spiritual medicine of Alcoholics Anonymous. Such is the double-barreled
hope for some 750,000 sick human beings still largely treated as pariahs
and criminals as well as for the almost three million excessive drinkers
who are in danger of someday becoming alcoholics. What sets these
unfortunates off from the 48-odd million social drinkers who can take it
or leave it alone?
Many real alcoholics start off as ordinary drinkers. Doctors have no
blood test to warn them of deadly future danger. But sooner or later
(social drinkers please note) the body chemistry of some people goes
haywire. Then they cannot stop. They fight it. Desperately they swear
off--for an hour, a day, a month, a year or more. Then they're sure
they've got to have a drink. They do not really want it, but take more
and more until they're insanely plastered.
Against this sickness doctors admit that until recently, they've been
largely powerless. Psychiatrists have failed to prevent it from causing
the insanity of 10 to 25 percent of our hospitalized mental patients.
Deaths? In addition to the thousands caused by acute alcoholism and DTs,
thousands more masquerade as heart disease, pneumonia and suicide.
The most effective agency for curing these sick people has been not
medical but spiritual. Alcoholics Anonymous has shown that when men and
women sincerely reach out for the help of a Power greater than
themselves, they can overcome the craving for drink. For chronic
alcoholism is a strange disease. To recover from it you first have to go
almost crazy or nearly die. This was the discovery of Bill, Alcoholics
Anonymous No.1. In 1934 he had been given up by his doctor as hopeless.
Shaking and bleary-eyed, Bill was visited by an old drinking crony who
had got religion, gone dry, looked as if resurrected.
"But I don't believe in God," Bill argued.
'Why not try your own idea of Him?" asked his friend "It's only being
willing to believe in a Power greater than yourself."
Himself powerless, that hit Bill where he lived He went back to the
hospital where they had failed to cure him, and again went through what
alcoholics call the de-goofing routine. He lay on his bed absolutely
helpless, hopeless and all alone. Then he said out loud: "If there's a
God, let Him show Himself now." For the first time in his life Bill knew
he was nothing.
Suddenly it was as if a horrible cloud had lifted; it was as if he lay in
warm, bright sunlight. Everything was okay. It scared him. He rang for
his physician, Dr. William D. Silkworth of New York, who had given him
up. "You said I was going to go nuts, Doc. Is this it?" The doctor looked
at the new light in Bill's eyes as he told the intensity of his happiness.
"Something's happened to you, Bill," he said. "I don't understand it. But
if you're nuts, you'd better hang on to it."
Dr.Silkworth was a great man who had failed with all human science and
was humble enough to use God for a medicine. From now on out for Bill it
was God alone. That night Bill asked, "Aren't there thousands of hopeless
drunks who might be glad to have what's been so freely given to me?" That
was 16 years ago. Bill had been saved to start Alcoholics Anonymous.
Miracles become medically respectable only when they pile up into big
statistics, scientifically authentic. By 1944 there were about 20,000
active AAs, all former derelicts, all now sober and working. What struck
me then, and has since, was not so much that the AAs I met were dry but
that they were a new kind of human being.
Earl, whom I've known intimately for years; is the founder of a powerful
AA fellowship in a large city. Unmarked by his years in the gutter, he is
serene and radiates reliability. Busy with his work, he still spends half
his time salvaging drunks, never refusing calls day or night. He's a kind
of Sermon on the Mount, walking.
"How did you get this way?" I asked.
"It isn't only me, we all had to get this way to save our lives," said
Earl, smiling.
Earl's cure didn't begin like Bill's at all. Earl had no blitz
conversion. Beat up by years of terrific drinking, frantic, his brain
revolving, sleepless, half-starved, in black despair, snarling to himself
that he'd lick this thing, but now licked by it and on the ropes, Earl
met a man who had helped Bill found AA. This man, Dr. Bob, gave Earl no
pep talk, no piety. He only told him the tragicomic story of his own
sickness. "That's me, that's the way I drink, exactly," said Earl.
"You're the first man I've ever met who really knows the score."
To Dr. Bob, Earl admitted for the first time that he was an alcoholic,
incurable by himself. Though he had been too big for God, Earl now
mumbled that a Power greater than himself was all that might save him.
Was it Dr. Bob? No, Dr. Bob was only a man who understood him. So Earl
began confessing his years of cruelty to his wife, his little girl, his
father. He poured out his resentments that had driven all his friends
away. He ruthlessly wrote down his crimes, like a dead beat who at last
faces his debts.
Before he had half-recovered, Earl began to work to save hopeless drunks
who were going to die. He saw his own half-formed faith help to drag
doomed men from asylums and the undertaker's doorstep. This made his
alcoholic craving fade without his fighting it; his hatred of others
vanished automatically, without his battling it. Dr. Bob, other AAs, Earl
himself? They were only instruments for something beyond human.
Theirselves were nothing.
So Earl began to get humility. He hasn't had a drink for 13 years.
He was AA No. 13 when his life was saved in 1937. Now there are close to
100,000 ex-doomed who are active members of AA in 3000 fellowships.
Chronic alcoholism is unique as a disease in that its successful doctors
are simply its ex-victims who have nearly died themselves. That's the
secret of AA's astonishing growth. They are only laymen, but what
doctors! They take their drunken patients into their homes. They offer
encouragement in getting jobs and straightening out financial troubles.
They do not complain when saving a souse means losing their sleep, and
then interrupts their business next day. They comfort the drunks' frantic
wives. They make incessant trips to police courts, jails, hospitals and
asylums.
Of course the AAs have a secret weapon: it's only by curing all these
others that they keep on saving their own lives. They know they
themselves are only one drink from being drunkards; their helping others
alone insures their own sobriety. It builds up their faith--which they
know, without works, will die.
Like all good doctors they're alert to danger signals. The way some AAs
have relapsed into deadly alcoholism confirms the faith of all AAs that
they are instruments of a higher Power. When an AA thinks his abstinence
has taught him to handle his liquor, when he thinks he can run his own
show, he's a goner. Yet AA's record of recoveries is amazing. Of those
sincerely willing to stop drinking, 50 percent do so at once; 25 percent
make solid recoveries after a few elapses. Failures are most frequent
among victims who have been forced in by anxious relatives or employers.
Patients-open-minded as only the dying can be--must come in on their own.
AA has the practically unanimous approval of the medical profession;
thousands of physicians now send patients who are beyond medical help.
Dr. Harry M. Tiebout, noted psychiatrist of Greenwich, Conn., explains
the character structure of alcoholics. They're egocentrics. He says their
truly accepting God changes their deep inner brain pattern and brings
sobriety.
Even so, AAs admit they've only scratched the surface of alcohol's mass
tragedy. They can tell of many heartbreaking failures.
Here medical science bids fair to come to the rescue. While Dr. James J.
Smith was studying thousands of alcoholics brought for emergency
treatment (not cure) to Bellevue Hospital, New York, he spied a chemical
hope against delirium tremens. What threatens the lives of DTs? Not
merely their seeing snakes or purple crocodiles. Dr. Smith found the
blood of DTs dangerously thick, their blood sugar perilously low. About
to die, they breathe extremely fast, have a feeble, super-rapid pulse and
a fever that may shoot up as high as 110.
It dawned on Dr. Smith that these ominous signs somewhat resembled the
often fatal crisis of Addison's disease. In this disease there is a
failure of the adrenal glands just over the kidneys, mysterious little
hormone factories absolutely essential to human life. Not so long ago
victims lived for only a short while. But now they can be kept in pretty
fair health, even working, by injections of hormones from the cortex, or
outer layer, of the adrenal glands of slaughtered cattle.
Jim Smith put two and two together. He shot big doses of adrenal cortical
extract (ACE) into DT victims in their terminal stages. It was
resurrection. Within 24 hours they lost the nightmare visions that often
drive DTs to suicide.
Their shakes disappeared and their hearts again beat strongly and slowly.
Their fevers rapidly cooled to normal. Dr. Smith then shot ACE into
victims of alcoholic insanity who suffer neuritis and incessantly invent
tall stories. Within 24 hours their pain, their crazy confabulations and
their wild excitement were down to zero.
Injections of ACE soothed the hang-over heebie-jeebies that drive chronic
alcoholics to take a hair of the dog that bit them It calmed the fearful
tension that comes on before the new binges of periodic alcoholics. In
1947, Dr. Smith reported the good news that, in general, alcoholism seems
chemical. By last May Dr. Smith, as Director of Research on Alcoholism at
the New York University-Bellevue Medical Center, was able to confirm his
findings in a report at the annual meeting of the Medical Society of the
State of New York.
Meanwhile, Dr. John W. Tintera of Yonkers, N.Y., and Dr. Harold W. Lovell
of New York, after an independent investigation, had reported in 1949
that ACE practically eliminates the agonizing drying-out period that
baffles alcoholics who are fighting to keep from drinking again In
victims who had been alcoholic for ten and even 20 years, injections of
ACE magically cut down the craving that is the Gethsemane of these
sufferers.
The ACE treatment of alcoholism may be a two-edged weapon. It may
threaten Alcoholics Anonymous, who with their nearly 100,000 active
members are right now the most successful doctors of chronic alcoholism
Shots of ACE seem so much easier than the AA's search for God.
But Drs. Tintera and Lovell urge all their hormone-treated patients to
join AA And Dr. Smith does not consider ACE a cure for alcoholism "Even
with this treatment," he says, "the alcoholic cannot drink" (i.e.,
without a relapse). The hormone treatment is still new and experimental,
while scores of thousands of AAs have been dry for years.
Actually, the AAs have a powerful ally in the adrenal hormones. They know
they are bodily sick. They're the first to admit that the new AA will
fare better if doctors put him in such physical condition that he can
think straight and no longer crave liquor.
What of the 25 percent of Alcoholics Anonymous who fail to keep dry? What
of the hundreds of thousands of chronic alcoholics who will not admit
their deadly peril and who refuse to go to AA for help? They are
inaccessible because they are not thinking straight, the AAs say. ACE can
begin to transform them.
Here's the power of the adrenal cortex hormones--they clear the fog out
of alcoholic brains. Then the straight-thinking upper brain has a chance
to send its messages to the lower brain This part controls the pituitary
gland, which in turn by its hormone secretion governs the wonderful
life-boosting little adrenals. Mens sana in corpore sano--a sound mind in
a healthy body. This slogan of the ancient philosophers is now the joint
battle cry of the hormone doctors and the AAs.
Although ACE is safe in the hands of any competent physician, it is
limited in amount and expensive. But an AA will tell you that God is
always on hand and will help for the asking.
Source: Reader's Digest, October 1950
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