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Book Reviews
As physicians, we have special knowledge about alcoholism: We see the havoc it wreaks on the human body and its organs. If we care for or have contact with relatives of our alcoholic patients, we even see the devastating effects of alcoholism on families and interpersonal relationships. Each of us has seen alcohol dissolve a person into nothing--much as an ice cube dissolves into a glass of scotch whiskey. Slowly but surely, alcohol surrounds and isolates its subjects until, little by little, they give up more and more of themselves until nothing but alcohol remains. All too often, we look up from the printed pages of our textbooks past the bridge of our nose and down at our alcoholic patients. We understand the need to educate them about the many reasons they shouldn't drink, but do we know any of the real reasons they do drink? Should we know? Should we open ourselves to be educated by our alcoholic patients on why they do drink? Dry is the alarmingly open and shockingly honest autobiography of Augusten Burroughs, an alcoholic man who, through this imaginative re-creation, just might provide the insight we physicians need to understand the complexity surrounding alcoholism. Although I have been fortunate never to have been afflicted myself, I come from a family embattled by alcoholism; and so, as an intimate participant in this war, I can relate to (and perhaps understand) my patients better than can someone who has been blessed not to have had this familial experience. Dry gives us a shockingly open account of the life of an alcoholic as well as a brief-but-helpful glimpse into the life that preceded it. "When I was thirteen, my crazy mother gave me away to her lunatic psychiatrist, who adopted me. I then lived a life of squalor, pedophiles, no school and free pills ....1:p2 "I am thirteen years old, in bed with Neil ..., who is thirty-three ... Neil is a friend of my parents and he is the 'adopted' son and patient of their psychiatrist, whom I now live with. I have known [him] since I was five .... I look past him at the ceiling and see the thin black cracks in the plaster. I go inside one of the cracks. I leave my body on the bed, let [him] do anything he wants to with it."1:p51 Mr Burroughs goes on to painfully describe the scenario when he was six and his alcoholic father burned his forehead with the butt of a lit cigarette. Honestly, how many of us physicians even consider these scenarios as possibilities, let alone probabilities (as suggested by recent research2 conducted by Dr Vincent Felitti at Kaiser Permanente in San Diego) in the childhoods of our alcoholic patients? Aren't we more often likely to look at them with enmity or disdain instead of empathy? Contempt instead of compassion? These adverse childhood experiences have deep consequences on the psyche of recipients. Mr Burroughs tells us just what effect it had on him:
In the book, Mr Burroughs chronicles his recovery and the importance of dealing with these events and the emotions they birthed. It is no wonder that so few people afflicted with alcoholism are able to leave the life of addiction and why doing so requires nothing less than a herculean effort. If we as physicians caring for these patients take more interest in their past and in the roots of their addiction, might we be better equipped to start these patients on their road to recovery? This possibility is something each of us should consider and is the reason why each of us physicians might have something to learn by reading this book. Dry just might give us the added insight that will increase our empathy and compassion toward the many patients who need it to escape from their dark past back into the light of sobriety. For those who can tolerate its explicit content, Dry provides worthwhile reading. References
Gregorio D Saccone, MD, is an Internist at the Inglewood Medical Center in Southern California.
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