Double-Barreled Hope for Alcoholics
Here's an ally against the chemistryof 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. Their selves 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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