25 Years in Emergency Medicine




25 years ago today- on July 6th, 1995, I walked into an ER and worked my first shift ever as a full-fledged emergency physician. Bill Clinton was in his first term as president, we were mourning the loss of Kurt Cobain, and the world of email and going "online" was still new. I was 28 years old, fresh out of residency, infused with the latest and greatest knowledge and skills, and full of piss and vinegar. You could have fired me out of a cannon. I was ready to take on the world; I had "arrived."  I thought I knew something.

Turns out, I  was a child who didn't know shit.

A quarter century and 4200 shifts later, I now know better. I may have had book smarts and enthusiasm, but I lacked emotional maturity. I could manage a difficult airway, calculate pediatric infusion rates, and juggle multiple traumas at once, but had absolutely no understanding of either myself or the humanity around me. 

I felt supercharged...entitled. My sense of entitlement led to behaviors that fed my ego, fed my disease. I became a condescending, snarky, arrogant asshole. But I had a mahogany wet bar stocked with all the top shelf stuff. BFD.

We were still newlyweds, still young, and in love. I had the opportunity of a lifetime, the chance to shine, and took it. We built a home life, had children. I immersed myself in active fatherhood. I became president of my hospital's medical staff. I established a merry little band of missionaries who went to Haiti and served an impoverished orphanage. 

Then I fucked it all up.

While I was doing it “all,” my alcoholism took crept up on me like a panther, then pounced.  It was subtle at first- beers at picnics, cocktails at professional gatherings. It eventually morphed into a drink after work, then two. Then it was every night after the kids went to bed. Eventually I abandoned the mixers, the social excuses...and then the glass entirely. In the end, I was gulping cheap vodka from a plastic bottle all night long while isolated in the windowless basement where I moved. This took 20 years. Then one day I went over the proverbial cliff, crashing  and burning in epic fashion, taking all those I loved down with me.

If I said these last four years in recovery have been rainbows and unicorns, I would be lying. No longer using my general anesthetic, I have been forced to feel the pain of decades of bad behavior and poor choices. I am divorced. To keep my medical license, I am tethered to a professionals’ monitoring program. My teenage children don’t speak to me. I am enduring the negative consequences of  my drinking career to this day.

But that's OK, it had to be that way. Nothing happens in God’s world by mistake. The “gift of desperation,” as they say in AA.

I am surviving. I am growing. I am healing. I am making living amends to those I love, one day at a time. 

...and I'm back to practicing the wonderful, godforsaken medical specialty I have loved since the nineties.

Comments

Post a Comment

Popular posts from this blog

Intubating Alcoholics

Image
In the past week I have put three alcoholics on life support. The first one was 39 years old. He arrived to the emergency department by EMS unconscious with almost no blood pressure. I placed my ultrasound probe on his heart and saw it was beating alright,  just very little blood was entering his ventricles. This is because he was bleeding to death. When I intubated him I saw pooled blood in the back of his throat. His liver was so far gone, so cirrhotic, that blood could not easily pass through it, and the backup and created high vein pressures on sensitive areas like his esophagus and stomach, whose linings themselves were eroded from the caustic effects of constant boozing. He was literally hemorrhaging internally, and it took many units of blood to even get a pressure back. He made it to the ICU, and later that night, died. We later learned from family that he had moved back to town "to get sober." Case two was  a 53 year old chronic alcoholic who came to me con...
Read more

Whiskey on the Walls

Image
Alcoholics in long-term recovery maintain a keen awareness  of any booze in our immediate vicinity. Whether sober a week or twenty years, we keep a heightened sensitivity to its presence in a room. So when my hospital chose to line the hallways with it, needless to say the hair on the back of my neck stood on end. These days hand sanitizer has become as ubiquitous as cellphones, face masks, and Bradley Cooper; you can't swing a dead cat without hitting a dispenser. Companies simply cannot keep up with the demand. This being the case, a local valley distillery came up with the brilliant idea to temporarily convert its operations from whiskey to full-time sanitizer production, and began to supply local medical facilities. My hospital has been buying the stuff in bulk, restocking its depleted stores,  and filling all its dispensers with it. Here's the problem. Distilleries using equipment which had been continuously producing hard liquor for years can't magically c...
Read more

Baby Soul

Image
It’s  Baby Soul Day! In my younger teen years, I worshipped the iconic band Rush. At age 14 I was small, nerdy, intellectual, and afraid of my own shadow. Geddy Lee's voice, Alex Lifeson's guitar, and Neal Peart's lyrics encapsulated perfectly how I felt growing up in 1980s suburban North Jersey surrounded by big studly Italian boys and athletic Irish kids.  Neither the albums  Moving Pictures nor  Signals left my turntable *ever* unless I was simply swapping out one for the other. I hid in my room, pretending how I was going to somehow be cool, be accepted, break out. 30 years later, as I felt myself inevitably sinking in alcoholic quicksand, I read Neal Peart's memoir  Ghost Rider . Having lost his daughter to a car crash and wife to cancer within the same year, the legendary drummer one morning mounted his motorcycle and embarked on a two-year tour of the Americas, riding wherever the wind (his HP?) took him. While journaling his geographic advent...
Read more