I'm a Nurse in an Alcoholic Ward
Saturday Evening Post, October 18, 1952
Anonymous
The author--a onetime alcoholic--has nursed 5000 drunks through the
fading hours of their most spectacular sprees.Here is what she has faced
in salvaging doctors, lawyers,ministers, priests, housewives and
stenographers from drink and the devil
A redheaded woman in a mess is really a mess, and five years ago I was
just that. Like well over 100,000 others, I found my way to sobriety
through Alcoholics Anonymous. AA says that if you want to stay sober you
have to help somebody else get sober.
Since I was a nurse, it seemed logical that the best way to meet this
requirement would be to find a job in an alcoholic ward.
That's how it happens that during the past five years I've nursed more
than 5000 alcoholics through the fading hours of their most spectacular
sprees, in the AA ward of Knickerbocker Hospital in New York City.
Helping other alcoholics to get well has become my life work.
Friends look at me with frank disbelief when I tell them I love my work
because I meet so many nice people. That statement, applied to men and
women who have indulged in every folly, benign and malignant, may be a
little hard to swallow, but I really mean it. In five years only one
patient has ever taken a swing at me, and it was a woman patient, at
that. Being female myself, and redheaded besides, I promptly socked her
back. After that she was very co-operative.
The only other violence was of my own instigation. A fresh, peppery
little man-he came about up to my shoulders--kept pestering me for a
drink, and drinks are not served in alcoholic wards. To stall, I told him
he would first have to take his pill, which I knew would put him to
sleep. "No drink, no pill," he said, and I retorted, "No pill, no drink."
This kept up until my patience was gone. I turned the little fellow over,
paddled his bottom and said, "Now, will you take the pill?" He took it
nicely, and from then on we were good friends.
One thing has begun to be a little irritating, but only because of its
monotony. About every third male patient, when he first comes in, takes a
bleary gander at the white uniform and the red hair and croaks out a
sally that's supposed to brighten everybody up--"H'r'r'm'm'm, do you go
with the room?" They usually apologize the next day.
Yes, most alcoholics are nice. In no other branch of nursing within my
experience are such respect, consideration and gratitude accorded the
nurse by the patients. Even the most berserk were likable before they ran
afoul of firewater, and can be likable again. The recovered alcoholics I
have known have been quicker to help and readier to forgive, possessed of
a livelier understanding and faster wit, than the general run of people.
After recovering, that is. Drunk, they can be pretty dreary.
The origin of our ward is closely connected with the origin of AA itself.
AA was founded in 1935. By 1939 it was evident that, though the movement
was reaching a pitifully small percentage of the alcoholics who needed
help, it was nevertheless achieving greater success than anything else
ever had. Sufferers flocked to AA by the hundreds, many of them needing
immediate medical treatment. The AA program of rehabilitation is
based on understanding, friendliness, honesty and faith--all things
requiring maximum application of the mental and moral faculties. Many
desperate drunks who wanted AA could never stay sober long enough to do
the necessary clear thinking.
At this point a great team--the AA founders." Bill," a New York broker,
and "Doctor Bob," an Akron physician--stepped forward with an idea. Why
not a place where sick alcoholics could be sobered up under expert care
and at the same time gain a foothold in AA? Private-hospital officials,
conditioned to believe that drunks could mean only pandemonium, were
chary. Then, in 1939, such a ward, of eight beds, was established at St.
Thomas Hospital, in Akron. In 1945, Knickerbocker, a private general
hospital with 200 beds and a forward-looking management, agreed to open
its doors, and thus the first AA ward in the East was born. The third
floor of one wing, with a capacity of nineteen beds, was given over to
the experiment.
The ward's success surpassed its backers' hopes. AA volunteers are on
round-the-clock duty, ready to discuss the temptations and techniques of
the life of sobriety. Half our patients, we estimate, go out from
Knickerbocker into immediately successful AA lives, and two thirds
eventually find their way to recovery. St. John's Hospital, in Brooklyn,
and St. Michael's, in Newark, have opened wards after the St.
Thomas-Knickerbocker pattern, and other hospitals have the plan under
consideration.
I'll never forget my first day on duty. I spotted a wistful-looking
little man with a red face and blue eyes waiting outside the ward. He was
alone, and I knew that no patient could be admitted to this particular
ward unless accompanied by a member of AA. Eager to
demonstrate my efficiency, I said brightly, "Don't worry, we'll take care
of you. Where's your sponsor?"
I took his bag and was about to remove his hat when he turned kindly old
eyes up at me and said, quietly, "Relax, young lady; I'm Doctor
Silkworth."
At that moment I wanted to sink through the three floors to the basement
and on down into bedrock. Dr. W. D. Silkworth was widely known as one of
AA's first medical advisers. Besides, he was the doctor in charge of the
ward! Since then I've learned to tell the difference between doctor and
patient, and possibly a few other things. You can't work with a man like
Doctor Silkworth--as I did until last year--when, at the age of
seventy-eight, he died--without learning something.
The traffic in our ward is evidence that alcoholism is no respecter of
prestige. Two eminent men appeared for treatment just a few weeks after
their pictures had appeared in advertisements as endorsers of special
brands of strong waters. Ministers and priests are frequently our guests,
as are doctors, lawyers, engineers, pilots, editors, housewives
and stenographers.
Contrary to a popular notion, the alcoholic is not just the man in the
gutter. The scion of a Social Register family once inherited a sizable
fortune while recuperating in one of our beds. We've had a prominent
judge, a famous senator and a member of Parliament. Practically every
race and nationality has been presented, and the patients' occupations
have spanned the alphabet from auctioneer to zither player. Our sample
indicates that Irish stock is the most susceptible to alcoholism, Jewish
the least, and that no ethnic group is immune.
Influx by occupations seems to be related to the calendar. Around
mid-December we get a lot of housewives in the women's ward. Early in
January the policemen begin coming in, and a little later that month the
musicians. In February there's a concentration of publishing
people--illustrators, writers, editors, advertising men. March is the
month for business executives, great and small, and April brings a parade
of salesmen. The rest of the year it's an odd assortment of bankers and
peddlers, sailors and tailors, stenographers, bookkeepers and
storekeepers, with an age range from nineteen to eighty-one.
As for the seasonal tides within occupations, one must remember that a
person is not an alcoholic just part of the time. If he's an alcoholic at
all, he's one all the time. He needs only an occasion involving extra
liquor and extra tension to set him off. These situations seem to arise
at different times of the year in different occupations.
Take the housewives. Around the middle of December the kids are home for
Christmas vacation. The weather is bad and they can't be out of doors all
the time, so they're underfoot and quarreling. There's the endless
business of Christmas shopping--what to get Uncle Fred, and did old Aunt
Minnie give us anything last year, and how much to spend? This last
factor must be weighed against the family budget and the husband's
disposition. On top of all that, the routine work must go on, but it's
the season to be convivial. What is more helpful to the spirit of joy
than a little nip, particularly since people are freer with their liquor
at this time of year? Then there are lots of parties. And there's the
haunting feeling, to a person having even a sketchy religious background,
that Christmas was supposed to mean something quite different from all
this. A woman who'd been walking the alcoholic tightrope up to then might
easily fall off and land in Knickerbocker, with me.
Cops have a similar situation. During the holidays they have more
traffic, more shoppers, more thefts, bigger crowds--in short, more police
work of every kind. Bartenders are known to be solicitous of the men in
blue. When holiday business is good and weather bad, there's no lack of
little nips to warm ye. Christmas and New Year's tips to the officer on
the beat are traditional, and they frequently come in the shape of a
bottle.
The alcoholic cop may be able to stay in harness through New Year's Eve
somehow, but he's likely to be ready for expert care very early in the
year's first month. The same goes for the orchestra lads. The holidays
are the time when they play their biggest jobs, get their biggest tips
and the most free liquor.
Why the publishing crowd comes in during February, I don't exactly know.
My hunch is that the so-called "creative" folk may be a little more
sensitive to weather than the rest of us, and those February doldrums in
these latitudes would get almost anybody down. One February we had quite
a delegation from the editorial staff of a famous, and somewhat snippy,
national magazine. I guess those creative imaginations got going on how
nice it would be in the tropics, and local reality seemed just too grim.
But as I say, you have to be an alcoholic first, before the weather can
do much about it one way or the other.
In many industries, orders are placed for the whole year in one of the
early spring months. These are tense times for executives and salesmen.
If it turns out to be a big year, they're exuberant; if it is a bad year,
they're gloomy; and both states of mind are sure to bring action from the
alcoholics.
On entry, our patients are a beaten and penitent lot. They've been picked
up by AA's wherever they happened to be when they called for help. They
come from precinct lockups and flophouses, Bowery dives and penthouse
suites, suburban estates, country clubs and furnished rooms. Nobody is
ever brought to our ward against his will. Indeed, they're given to
understand by their sponsors that they're lucky to get in. We
have no repeaters-patients are admitted once, and only once. Sponsors
deliver them, their suitcases and eighty-five dollars in cash in advance,
then leave. Now begins the five-day course.
Once signed in, the patient's first two days are the most worrisome. It
is in this period that deep depressions due to remorse are most likely to
occur. The ward came near being discontinued during its first month, when
a depressed patient found his way to an unbarred window and jumped three
floors to his death. AA supporters quickly passed the hat, raising $1000
for strong steel screens. We've never had another attempted suicide. No
patient is admitted who shows signs of oncoming delirium tremens or
convulsions--these are sent to a municipal hospital equipped to handle
disturbed patients--but sometimes the doctors guess wrong. Last year,
among 1000 patients, we were caught with two cases of convulsions and a
dozen of DT's.
Delirium tremens must be sheer hell. Its onset is marked by acute
nervousness. First come the auditory hallucinations; then, usually the
visual. The patient hears his name being called, or a violent argument in
progress, or non-existent loud music. Then he begins to see things. I've
had patients ask me in all seriousness to watch where I stepped so
I wouldn't squash the strawberries. One demanded to know how the geese
got into his room. These visions are sometimes, but not always,
frightening. The strawberry and goose people were quite calm about what
they saw. Heaven knows what fiends and horrors they're seeing when they
scream. The worst case I ever saw was a man who was convinced he was
being run down by a train. Most patients, during DT's, have moments when
they know that what they're seeing is not real--and times when they're
completely convinced of its reality.
No one condemns the alcoholic as he, when the remorse is on, condemns
himself. We give them vitamins to re-establish nutritional balance, fruit
juices to combat dehydration, and bromides and belladonna for jagged
nerves. By the third day they're beginning to take an interest in the
world again, and that's where Duffy's Tavern gets in its wonderful
work. (Duffy's Tavern is a kind of clubroom in the men's division, where
patients meet and talk.)
The five days are planned as a chain of healing that will lead back into
a life of sober usefulness. The first couple of days there's nothing much
to do but medicate and feed them and maintain an attitude of good-natured
understanding. This in itself, for people who are accustomed to contempt,
hostility and despair when they're "on one," is
an important part of the treatment.
I have a couple of devices of my own for maintaining morale. Every
patient gets a nickname. "Cuddles," "Peaches," "Saint Anthony," " Pontius
Pilate," "Napoleon," "Pinhead" and "Windy" are my favorites, and I use
them over and over. We also make a good sport of treatment with the
B-complex needle. This is inserted in the part of the anatomy
scientifically known as the gluteus maximus. When I come into Duffy's
with the needles, calling, "All right, boys, bottoms up!" I can always
count on an assortment of grunts, groans, grouses--and laughs.
On the third day, patients are encouraged to move around. In the women's
ward, there's visiting from room to room and talks with AA's from the
outside; and, for the men, socializing in Duffy's Tavern. The patient
begins to realize he's not alone in his plight. If others can endure it,
he guesses that he can too. The fog begins to clear, and memory, at least
partly, returns.
One time a husky tugboat captain who'd been staring gloomily out the
window of duffy's suddenly snapped his fingers and exclaimed," Nyack!"
"What do you mean, 'Nyack!'?" asked a mounted policemen.
"That's where I left my tugboat, ten days ago!" the skipper replied.
"Hey, I just remembered," said the cop. "You know where I left my horse?
Van Cortlandt Park."
People sometimes wonder how we AA's can extract so much comedy from our
own tragedies. Alcoholism is tragically foolish and, believe me, there's
very little comedy when the drinker first realizes the full consequences
of his drinking.
After the calamity is honestly faced up to, though, and a new life has
begun, we figure there's no use brooding over it.
One of our patients, a New York politician, took a route to Knickerbocker
which is typical of some of the more flamboyant toots. He'd been drinking
for several weeks and had obviously had more than enough when he stepped
into a bar where he was well known and ordered a drink.
"O.K.," said the bartender, noting his condition, "but first you better
go out and get a ham sandwich and a cup of black coffee."
The politician discussed this step with another drinker. Concluding that
it was sound, they set out for a nearby diner. On the way, they got to
talking about the races in Florida.
"Let's go," said the politician.
"O.K.," said the friend. They took a cab to La Guardia Airport and in a
short time were in Miami. The politician, besides being a follower of the
races, had a wide acquaintance in the New York and Miami police
departments. A policeman recognized him as soon as he stepped off the
plane--his heavy overcoat and derby were easily spotted in the Florida
sun.
"Look, chief, you're drunk," said the cop.
"You'd better go home."
"I guess I am a little, at that"' said the amiable politico, and stepped
aboard the next northbound plane. Back in New York the same bartender was
on duty at the same bar.
"Where'd you go for that sandwich?" he said, spoofing. "Florida?"
"Yeah," the politician said, and in a couple of hours the bartender was
drunk' too, loudly asserting that it could not be. Meanwhile the AA alarm
had been sent out for the ward boss, and a pair of AA's who'd been
scouting New York for him closed in.
The silliest story I ever heard in Duffy's was about a party I nicknamed
Old Number Seven. His wife, to bring him off a prolonged binge, had
removed all his clothing except his underwear, while he slept and had
locked his closet door. When he awoke he was faced with the problem of
how to get out and get a drink. He found a pair of tennis sneakers,
ripped a square of cloth from the sheet, painted a big figure "7" on it,
pinned it on his back and stepped out onto the avenue as a cross-country
runner, headed for his favorite saloon.
AA volunteers, many of them graduates of the ward themselves, drop in at
Duffy's and swap yam for yam. In this way many patients realize for the
first time what alcohol has been doing to their lives and glimpse a way
out. One man convinced his wife that the best plan for their security in
old age was to sell their home and invest the proceeds in "a sound
business"-a bar and grill. He quit the office job he'd held for thirty
years and went into the liquor business. He drank up the
establishment--capital, surplus and profits--in a year. Facing up to what
he'd done, he resolved, in Duffy's, to start clean. Now he's one of
our most effective volunteers. He hasn't got his home back yet, but he's
back at his old job, pays the rent provides meals and stays sober.
One wealthy suburban housewife, mother of six school-age children, was
the worst brat of the lot. Everything was "simply too much" for her. The
children were too noisy and demanding, her husband too busy and
preoccupied, household routine too dull, the cares of community living
too numerous-she had to get drunk, for solace. Our ward, followed
through by AA brought a change. Now she not only has ample time for her
home, her husband and her children but is also a skillful AA worker,
president of her PTA and a truly wonderful person.
The fifth and final day of our treatment brings its own special hazards.
The patient's head is clear, his strength has returned and he has found
new and understanding friends. Now he must face the world outside, the
mess he has himself created. He slept poorly the night before. This
uneasiness is so common that we even have a fancy name for
it--"predischarge tension" Discharge day is the despair of many alcoholic
wards. To many patients, the shambles outside seems beyond solution--they
streak to the nearest bar, the deadly cycle begins all over again, and
much good work is undone.
Our ward takes certain precautions. Nobody can be discharged unless he
has been signed out, in person, by his sponsor and has been safely
conducted to his home. He's encouraged to attend the weekly meetings of
his local AA group. There he learns that other men and women of his
community--some of whom he knows and respects--have somehow found the
courage to deal with situations at least as disastrous as his own. He
digs in. In almost exactly half the cases, he's back in a few months as
an AA volunteer, ready to help others back along the path to sobriety.
Of course, we have our casualties. Every now and then I hear of somebody
who once spent five days with us and who is now dead, either of
convulsions in some other hospital or a suicide somewhere. These are the
sudden ones; the slowly dying are just as pathetic. There's a nice old
gentleman who lives in a big house by the seashore, alone except for a
butler and maid. He doesn't need AA, he says. Every time he gets tanked
he calls me up and begs me to marry him. In this condition there's no use
trying to talk any sense into his head, so all I can do is kid him along.
It's kind of hard, though, when I know for a certainty that one of the
lonesome little drinking bouts of his is going, pretty soon, to be his
last.
The reasons for failure are among the many mysteries connected with this
baffling disease that researchers are still trying to unravel. Some
people seem incapable, drunk or sober, of the clear thinking necessary to
grasp and apply the AA program of living. There are physiological,
neurological, racial and cultural influences that are only beginning to
be understood.
But one of the greatest hazards, in my opinion, is pride. Many thousands
with otherwise sound minds are enduring alcoholic torture rather than
humble themselves to share the companionship of the genial ex-tanks of
high and low estate who make up their local AA groups. They, and those
who care for them, pay a terrible price for such pride. I know a
" self-made" business executive who came home drunk one night and was
exasperated when he found his wife and daughter asleep. "Just to get a
rise out of them," he fired a bullet into the wall, lay down and played
dead. He says he's not an alcoholic!
My own story? Humdrum enough. I was born in New York City, attended
Catholic grade and high schools until I was eighteen, then spent three
years in nurse's training at St. Mary's Hospital, in Passaic, New Jersey.
I was a happy-go-lucky kid, and the glamour of the nurse's cap wore off
when I discovered the discipline and effort it took to win one.
When I met a big, hearty and, at that time, thoroughly enchanting Swiss,
I gave up nurse's training and took an office job in New York to be near
him. We fought hilariously for seven years and then were married.
Sometime during that period I found time to finish my nurse's training,
but I never worked at it.
My husband was a man who worked hard, played hard and drank hard, though
he was not an alcoholic. At the time unaware of any distinction between
the mere heavy drinker and the alcoholic, I drank with him. His
recreational passions were hunting and fishing. I went along on his
sporting trips, enjoying them thoroughly--up to a point. That point was
when I'd got liquored up and was feeling sorry for myself. I was"
neglected," and I began to make spiteful remarks. My patients tell me I
have a ready tongue even when sober, and in those days I must have been
something. Our quarrels, once more or less good-humored, grew
increasingly bitter. My drinking, I now realize, was showing definite
alcoholic symptoms.
I was bored most of the time, and drinking seemed a handy antidote. We
had had no children. I lacked the initiative to practice nursing, and
time hung on my hands. A couple of the girls would drop in at our
apartment during the morning. We'd talk for a while, then have a drink.
I'd nibble at the bottle during the day and would be pretty well along
by the time my husband came home. A few drinks with him and a party that
night and I'd either be blind, stupid, quarrelsome drunk or passed out.
How many times I've heard those admonitions that haunt every alcoholic:"
Why don't you just have a few and enjoy them? Why don't you drink as we
do?" Why couldn't I stop, once I started? I didn't know. Exactly how my
husband and I stuck it out for eleven years I'll never understand. The
blowoff came in 1945. He told me he was through and packed me off to Reno.
It was a devastating blow to my pride. I thought I'd been the one who was
putting up with him. I learned, suddenly, that he'd been tolerating me.
During the next two years I worked in a Reno department store, toured in
Hawaii and visited San Francisco. I returned to my own family in New York
in 1947, completely licked. I now found that I couldn't
drink at all without getting drunk. Therefore, I had to be careful. My
life was made up of stretches of sobriety punctuated, at ever-closer
intervals, by short, despairing binges. When my brother-in-law told my
about AA, I was ready.
My first AA meeting was, in many ways, a disappointment. There was a
strictly "low-bottom" panel that night, that is to say, the speakers were
not Harvard and Wellesley graduates--"bottom," in AA parlance, means the
lowest state of alcoholic squalor a person will accept. Their drinking
had carried them so much farther along Hobo Highway than mine
that we seemed to have little in common. It left me with a conviction,
though, that these people had the answer. The Twelve Steps of AA won me
immediately--admit our frailty, seek God's guidance, repent our misdeeds,
make amends, take a moral inventory, help others. Here was religion
actually lived. Many are successful in AA without believing in
God. To me, the highest power has always been the same God I used to know
in church. Here I also learned, "once an alcoholic, always an alcoholic,"
which explains why, even after five sober years, I say that I am, present
tense, an alcoholic. We stay sober one day at a time, never forgetting
that we are alcoholics and therefore cannot take the
first drink.
After a month of daily increasing happiness I was struck with an
overwhelming sense of gratitude. I was grateful to that lonely handful of
men who formulated the AA principles of recovery and set them down;
grateful to the thousands of alcoholics who, in the face of every
conceivable difficulty and temptation, had picked up these tenets and
doggedly clung to them, fighting to hang on to their sobriety so it could
be passed on to me. I felt I must do something in return.
When I learned about the AA ward at 'Knickerbocker I knew what that
something would have to be. I was a trained nurse. During all the years I
had frittered away, that training had seemed meaningless. Now it made
sense--I was meant to work in that ward. I bombarded the supervising
nurse with telephone calls by day, and prayers to God at night, and three
months later I got the job.
These five years have brought deep satisfactions. I can't convey how much
it means to me to see the transformations in people. They come to us
physical, mental and moral wrecks. They leave encouraged but still
uncertain. Then, months later, they come back--bright-eyed, rosy-cheeked,
eager to help; job back, family back, going concerns
again, ready to pass on, with dividends, what's been given to them.
To know that I had some small part in this rebirth is a blessing far
beyond what I deserve. The failures, the lost ones? Well, they're sad, of
course. However, we must accentuate the positive. But for the grace of
God, all of us might have been lost.
Source: Saturday Evening Post, October 18, 1952
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