"Sometimes you can only find heaven by slowly backing away from hell"
-Carrie Fisher
My doctor looked at me with her kind and insightful eyes. She's known me since I was 3 months pregnant with my first child- that's 14 years of caring for my family's medical needs. She was supportive when a few years earlier, I dissolved into tears in her office and finally admitted that my mind had been taken over by terrifying intrusive thoughts. That I was scared and jumpy all the time. That I had a neverending sense of doom, certain that my life was more than I deserved and the other shoe would drop at any moment. She was calm, reassuring and offered me help in the form of a referral and some medication.
Coming to her as a messy mom again, someone who wasn't coping the way I thought I should be was no small feat. I felt humiliated. By the time I sat in her exam room, arms crossed and shoulders slumped, I'd already been through a storm of questioning, judging and shaming myself. I'd already been curled on the bathroom floor googling "Am I an alcoholic?" from my phone. Alcoholic. That word is terrifying. It's the kind of word that gets whispered behind backs at family reunions. It's a dirty word and no one would voluntarily sign up to become one. By the time I'd come to her, willing to ask for help or resources or simply assurance that I wasn't alone, I'd already been trying to manage this quietly, on my own, for years- and I had failed. I'd come to believe that drinking moderately was something that others could do easily, something that I'd have to master in order to be normal in this world. Master it? I could barely fake it. Bringing this to my physician was intimidating for me, I saw this as the first step in losing something. They way I saw it, I only stood to lose. Loss of my crutch, my social lubricant, my daily comfort after surviving another day of shouldering my long list of responsibilities and worries, another day of living inside my hectic mind. She was going to tell me to stop drinking, I frigging knew it.
I never wanted to come to her clinic and say these words out loud. When I did, she met me with a warm gaze. The words that followed though, weren't what I'd expected and, if I'm honest, they weren't what I needed either.
I've lived a life of privilege. I've been able to easily access information without barriers, I've got a post-secondary education and the good fortune of working in a field that teaches me something new every day. The bulk of my work is in healthcare settings and, as a result, I have a better grasp on general medical knowlege than the average Joe. Rather than considering my background and what I do for a living, my doctor immediately began rattling off all the risks that my drinking was posing to my health.
"Your liver....blah blah....your increased risk of cancer....blah blah blah..." I know she intended to be helpful, of course she did. In the span of 10 minutes, I'd been subjected to a sermon on the perils of alcohol use. Facts I already knew, facts that had driven me to this moment in time- defeated in my family doctor's office, confessing that I'd become a boozebag. I considered myself bright and educated, how could I have gotten into this mess without knowing how?! I didn't know how this had happened. I was a "normal" drinker for a long time and then I wasn't anymore. She asked if I'd been to AA and I told her I had. I'd been to AA but it felt wrong to me, it felt like the wrong tool for me and I couldn't see myself making gains there. Fifteen minutes into my appointment and my doctor was talking about an in-patient, 3 week long treatment in a rehab facility and I was shutting down internally. A rehab centre? I mean, was SHE drunk? Rehab is for child stars who've hit the skids or A-list celebrities who need a good reason to cancel appearances. Stints in rehab centres were for lushes who drank for breakfast, that wasn't me. I see now that the term "high-functioning alcoholic" is an oxymoron, everyone who's lost control in their relationship with alcohol is limping through life in some way. Still, I considered myself "high functioning". I NEVER drank during the day from Monday to Friday, I made certain that no one in my professional circles would ever have guessed that I was losing my footing with booze. Rehab was for people who's drinking left them with DUI's or legal consequences, I didn't fit the profile. Incredulous, and with no intent to actually consider it, I asked her how on earth I could even do an in-patient rehab? I have 3 kids, what would I say to them about my sudden absence? What about my husband? "Hey sweetcheeks, sorry about leaving you all in the lurch, I gotta hit up a rehab facility. You sure picked yourself a winner!" I have a job, what would I tell my employer? Here, she promised support and documentation- which I may have appreciated if I hadn't already rejected the whole idea entirely. I left her office only slightly better off than when I'd walked in. Yes, I still had a problem with alcohol but now I knew what I was closed-minded to and that's something.
I've thought quite a bit about how I wish she'd handled her side of our conversation, what I'd have liked her to say or offer me. Here's how I wish it had gone.
First, I wish she'd have said nothing and taken a breath. I wish she'd acknowledged how hard saying these words aloud were and how likely it was that I'd been mired down in the pit for awhile already, before coming to her. I wish she'd looked at me in my entirety and recongnized that listing off all the hazards of boozing would probably be redundant for me. I wish she'd seen me wholly as a mom of 3, who she'd already identified as a woman with a lifelong anxiety disorder. A woman who was chasing her anxiety meds down with a substance known to cause anxiety. A woman who had only just FINALLY been identified as having ADHD and had likely been self-medicating to numb a frantic, swirling, self-conscious mind for years. A woman who was trying to cope and had simply put the wrong tool to use. I wish she'd said something like "This happens. This happens to people who look like they have it all together on the outside. Not everyone in this situation ends up on a park bench, clutching a bottle in a paper bag. Still, you don't need to lose everything in order to need and deserve help." I wish she'd said that this is happening to women at a terrifying rate. I wish she'd said that being an anxious soul who's now living through a global pandemic probably didn't help matters any. I wish she'd said that if I wasn't willing to consider an inpatient facility and I genuinely hated AA, she just didn't know what to do for me. Sometimes, it's ok to say "I don't know exactly what to do and I'd like to take a beat to look into this some more. Can we follow up on this next week?"
Alcohol use disorder in women spiked by 83.7% over a timeframe of 11 years (this info was from 2002-2013). Now, that figure is American but I think it stands to reason that our trends in Canada would be similiar. Also, that statistic represents a timeframe BEFORE a global pandemic, I can't be the only one who's drinking amped up under the stress of job loss and the fear of a worldwide virus? In fact, Harvard released an article about the drastic spike in women drinking their covid blues away. In this paragraph they speak to why that's happening:
"...This is in part due to changing social norms around female alcohol consumption and the alcohol industry’s targeted marketing to women. The pandemic has further increased rates of alcohol use in women. According to a RAND Corporation study, during the pandemic women have increased their heavy drinking days by 41% compared to before the pandemic. Additional research has shown that the psychological stress related to COVID-19 was associated with greater drinking for women, but not men."
I have to wonder how many insta perfect mommies are googling "Am I an alcoholic?" from their cool, tile bathroom floors while they're awake, gripped by hangxiety at 3am. How many moms are chuckling on the surface while they slip on their "Chardonnay all day" t-shirts, while a small voice inside them whimpers "I'm not sure it's funny anymore"? How many of those moms are starting to feel a small drumbeat of fear inside them that they're slipping into a scary habit?
Mamas- please, don't ignore that drumbeat. It's only there to help you march out to the other side of this. Whatever the "other side" looks like for you. Maybe that's moderation, maybe it's cutting back, maybe it's quitting altogether. Maybe it's making no change at all to your drinking habits, but knowing that you've checked in with yourself. It's your choice to make! If you choose to quit or cut back, know that life on the other side isn't necessarily white-knuckling, deprivation and loss. It can be discovery, gains and new found freedom and control.
Doctors, med students, nurses- Please start from a place of gratitude that a human soul is trusting you with the rustiest, roughest, scariest corner of their soul. Open your minds to the idea that AA and rehab are only 2 tools in a world brimming with other creative solutions to a widespread problem. Now, AA and rehab have been shown to be successful, please know that I'm not knocking them simply because they weren't a fit for ME. Those programs are a lifeline for others and should absolutely still be on the table! How exciting that the world keeps changing and new tools are surfacing as we learn more about addiction! Be curious about those tools and how they could serve your practice, your patients, or someone in your own personal life. Look into the SMART recovery program. Learn the names "Allan Carr", "Heidi Whitaker" and "Annie Grace", add them to your aresnal of medical kick-assery.
The next time a patient whispers "I think I'm an alcoholic", you'll be ready to link arms and help her slay her internal booze bitch.
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