Osler's Razor

I have a sibling who is now 37. His entire life he has valued drinking over everything else. People said he had to "grow up" and pushed it aside and he was great at lying about it (and everything else). Then he got married and had a child and now he is drunk around the child. I am so scared for his son. My brother takes him to baseball games and has five beers. That is what this boy sees. That is the worst part.
 

People could write a book on what my drinking has done to them

-Brennan
 

Dear Professor Osler,
Thank you for writing this post. The stories of the ruin alcohol has brought to my family and friends could fill several volumes. Jane Brody wrote a piece this past May on high functioning alcoholics. I encourage you and your readers to take a look at it.
 

Thank you for your candor, Prof. It is huge to me, because my own mother was an alcoholic. When she came to pick me up at school, she thought no one noticed her drinking. It made high school so hard, and even now we are not close. She says she can't understand why, no matter how many times I tell her that she humiliated me in public. They just don't understand. I think the children of alcoholics suffer the worst, once they figure out the lies that go with it (I was about 14 when it all became clear). I know it hurt her when I told people "I don't have a Mom," but that is what I wanted to be true. I just hope that your acquaintance does not have kids.
 

You never really know what you are going to get from this blog, do you?
 

An alcoholic family member just tried to kill herself last week. I had hoped that this would finally convince her that her abuse of alcohol is literally trying to kill her.

I was wrong. She remains defiant.
 

I am pretty sure that I know the "acquaintance" you are talking about. Drinking has already devastated her life, and she doesn't even seem to know it. She has a lot of ex-good-friends who don't want to be around her much any more, and few or no current close friends from what I can see. It is really sad.

And yes, she does have a child.
 

Yes, that's still my rule and whenever I break it (which is rare), I regret it.

Alcohol is a depressant. So when I am depressed, I don't drink. It makes everything seem a lot worse. I've quit drinking during a few depressing of my life, especially after particularly bad ends to relationships. Alcohol is like kind of like sugar (which of course is a component of alcohol) -- the drinker gets a brief high, and then rides a long descent into depression. More alcohol will help, but only briefly and the downhill slide gets worse.

My brother is a recovering addict.. he's been sober for 8 years plus and is now a licensed substance abuse counselor. It took him quite a bit of "field research" before he finally quit drinking and drugging. And he made quite a mess along the way.

But there IS hope. He finally started living the 12 step program advocated by AA and NA and he's a healthy, happy, functioning, positive contributor to society.

---And I LOVE Vernor's too. Popular in Ohio as well as Detroit, and now available in No.Va.
 

My wife is a drinker. I have took all the alcohol out of the house over a year ago after I started finding empty wine bottles I had never purchased and other evidence of secret drinking.

She's made a fool of herself in public, she's passed out in front of our children and is destroying herself. She does not even admit to a problem and throws it back at me if I try to raise the issue.

We have troubles and her drinking just makes it much worse. I have asked her to stop, demanded that she stop, asked her friends to get her to stop and nothing has worked so far.

Please pray for us. IPlawguy, how did your brother get convinced to stop drinking?
 

I was wondering the same thing, IPLG-- what finally worked?

(Your brother indeed is now a very positive influence on a lot of people)
 

My sister got drunk and hung herself in a closet with a telephone cord.

My other sister still blames herself.
 

My parents were both heavy drinkers. My father broke my brothers arm, no one could tell anyone about it. My mother got out of bed at 11 am, but no one was allowed to talk about it. My father lost a lot of his work, and no one could talk about it.

It's the secrets that are so hard for the kids. I still hate that so much. I see my parents once a year, and often that seems like too much.
 

My family is of Irish and German extraction. There was never much hope.

I can say that among the various high-functioners of my family, drinking was rarely, if ever, done around children, and drunkenness was never public. Like all good Southern families, we kept our drinking hidden in shame where the baby Jesus intended. I did not know about some of the alcoholism in my family until well into my teens.
 

Drinking has always been a part of my life. I was 14 the first time I had a drink. My mother gave it to me, and told me it would "calm me down." The first time I was really drunk was at my mother's baby shower, when they decided to let a 16 year old (me) bartend. When I was 20, we went to a wedding, and my stepdad bought me so many drinks we had to stop on the way home so I could throw up off a bridge.

My Uncle starts every day with a beer. He'll shake if he doesn't. Sometimes he tries to hide it by putting it in a Dunkin Donuts mug, but coffee doesn't come in a silver can, and it doesn't smell like beer, so no one is buying it.

I worry about what I do when I'm drunk. I don't usually remember. I know that I have thrown up, burst into tears, and even passed out in front of close family and friends. In a family full of (functioning) alcoholics, it's not good to be labelled the drunk. I'm trying to control it.

As much as I worry about that, I worry more about my cousin. She's a sorority girl, and a VERY heavy drinker. Her drinking is not something most people can relate to. She takes the bag out of boxed wine and puts it in her purse. One time, she told me she woke up unaware of what she did the night before, and ended up taking a Plan B pill with boxed wine.
 

Prof. Osler:

Great topic indeed--and nice to reconnect with you many years later. I might have been standing nearby when IPLG made that comment to you!

Rather than add to the stories recounted here, I would just like to say that my professional career (primarily in addiction counseling for the past 25 years now), while sometimes frustrating, has been tremendously rewarding because people can and do recover. The hope that exists among recovering people, in groups like Alcoholics Anonmyous, is palpable, real, and inspirational. I "feel the pain" from the other posters, but encourage them not to give up, to keep trying, to consider Al-Anon or ACOA groups, to consider an intervention, but above all to keep at it.

If we think of alcoholism/ addiction as a chronic disease process (my belief), then we may better recognize that sometimes multiple and ongoing treatment is needed (think of diabetes, asthma, heart disease, hypertension, etc.).

Peace, Kevin
 

Interesting post. I never knew that about teachers. I'll have to start watching my colleagues more carefully. ;-)

The night my long-ago-ex-husband broke down the bathroom door in a drunken rage to get to where I had tried to escape with our infant daughter, I realized--with an all-too-bright flash of illumination--that I had married my mother.

Alcoholic rages and all.

As far as I know, my mother didn't start drinking until I was a kid, just socially, after dinner, with friends. By the time I was teen, she was drunk most of the time--I might walk into the kitchen before school to find her chugging vodka straight from the bottle. She hit on my friends, stumbled and fell in restaurants, and once yelled (repeatedly), "We're all going to die!" so loudly on an airplane that the crew took her to the back to try to sober her up--and quit scaring the other passengers. One night, when I was 18, my mother was so drunk that I honestly thought she was going to die. My dad was in Vietnam, our family lived in another state, my older sister lived on her own ... I didn't know what to do.

I think the worst part is how normalized it all became. So normalized that I married a man pretty much just like her. The misery felt so comfortable, you know.

Fortunately, I had the good sense to realize, when my child was just an infant, that it wasn't normal. We got out.

My mother, who died many years ago, never quit drinking. I almost never have a drink.
 

When does "social drinking" become "abuse," I wonder?
 

I inclination not agree on it. I think precise post. Expressly the designation attracted me to read the intact story.
 

Since we seem to have some addiction specialists reading this particular entry, I'd like to pose a question: in your experience and training, do you identify the key problem as being the alcohol itself, or the addictive personality that leads to alcohol abuse?

I ask because I know several people that have been addicted to alcohol in their lives, and when they finally quit they seemed to substitute another vice (gambling, cigarettes, etc.) for the alcohol. What are your opinions?

(p.s. I recognize that each individual case is unique and that it's not as simple as distilling it down into such simplistic concepts, but I'd like your general thoughts.
 

Thank you for this post, professor, it is an excellent use of your voice to raise awareness for what I think is a disease that has been deemed passé by our society. The posts above reveal the reality behind this addiction, the pain and the ugliness. There have been a number of alcoholics in my life, and there is one in my life currently (that I know of). Life with an alcoholic is both predictable and completely unknown. You can predict the patterns of abuse, gleeful productivity and joy, violence, sadness, regret, repentance, abstinence, and abuse...like a sad, scratched record. But you cannot predict the phone calls in the middle of the night, the hospital visits, wondering just how bad it will be this time, wondering when it will be the last time. How bad they look, poisoning themselves, how much you miss them because 99% of the time they are just not there. The anger.

The only cure is abstinence, and it is imperfect. That is no excuse not to try. As with most things, I use a swimming analogy to understand. An addict is like a drowing person. You may or may not be able to help save them, no matter how strong a swimmer you are. If they absolutely do not want help, you only risk your own life in trying.

There must arise in that person a desire, for more, more normality, more health, or maybe for just less harm. All I know to do for a drowing person is be there, ready to assist, and keep fighting for that to happen, while keeping myself afloat and clear of harm. The risk to this is that ultimately you will most likely watch the person you love die.
 

This comment has been removed by the author.
 

This comment has been removed by the author.
 

Hi Mark, good article. I figured out about the time I was 8 that something was wrong with my dad, and it didn't take much longer to find out it was alcohol. Watching his face fall in his dinner every night, having to do yard work in the dark, listening to him vomit daily, and carrying his drunk butt upstairs are what compile my childhood memories. What everyone else saw was a high functioning business man living his dream. No one seemed to notice it was a nightmare.

It's no wonder that my career path went towards mental health and substance abuse. I know I have been blessed to help many people and families turn their lives around.
 

Ginger, IPLG, Kevin, JBlack, and everyone else-- thank you so much. I keep rereading these comments and feeling my guts tighten as the base truth of them hits home. Ginger, your post especially speaks to me, since I find myself in that position. I was struck by your wisdom as a student, and am even more struck by it now.
 

Before coming to law school, my boss gave me some advice through a story told to him.

A law school student was fortunate enough to be picked up for the summer as a clerk at a major firm. During the summer there were many social events that clerks were expected to be at. This is where alcohol abuse showed it's ugly face.

While there, the young clerk was drinking red wine heavily, mingling in one of the main rooms of a senior partner's house. Underneath the clerk's feet was beautiful white carpet. The clerk became sick, vomited on the carpet, and sat down heavily in one of the chairs in the room. Sadly, the true tragedy was not the now red stained carpet. The chair that the clerk sat down so heavily in was occupied by the small dog that belong to the wife of the senior partner; he had killed it.

My bosses advice: don't be that guy.
 

I have been that guy. It was the worst year of my life, and I did not realize it at the time.

This whole post is such a shock, even though I know it is all true. We so much want it not to be true.
 

My father was an alcoholic, and my brother and my husband are both alcoholics. I've seen alcohol destroy many lives. I openly discuss it with my children in hopes that they see it as a disease and that they could be genetically disposed to this terrible disease. Knowing that it’s a disease does not make dealing with a drunk any easier. I can relate to so many of the posts here. The terrible memories it stirs up. It's tearing my family apart and I pray that he stops drinking daily. He doesn’t remember what any of us talk to him about, and it hurts the kids the most. It hurts everyone.
 

There was a time when a Baylor professor admitting to drinking at all would be a scandal. They did it, they just did not admit to it.
 

My brother had to change his life in many ways, including making a permanent move away from Northern Virginia and the friends and habits that abetted his drinking and drugging.

The first step was a 28 day stay at a treatment center in Minnesota. That gave him the base to work from. After returning to the D.C. area and doing "field research" that proved he had an addiction, he next ended up in a halfway house back in the Twin Cities. He recently told me that one of the counselors there first reached him by asking questions about his life and letting my brother figure it out on his own. Good looking, college-educated, athletic, articulate and bright young men aren't generally found living in halfway houses working parttime jobs just to survive... and the truth started to dawn on him.

Through active participation in AA and NA and the 12 step program, my brother developed the network of support that helped him stay on a recovery path. And once he got on that path, he started to help other people.. which gives him the feeling of "being needed" and "being appreciated" that drugs and alcohol used to provide.

Yes, I agree that addictive personalities become addicted to other things... many AA members seem to become addicted to going to meetings. And hanging out with other people in recovery.

Not a bad alternative to their old lifestyle!

It takes a lot of support from a lot of people who believe and who will tell the truth. Its very hard for one person to do this on their own.

There are people in recovery in all walks of life that can and will support.

AA is a program of attraction, not promotion. And unfortunately, many people need to hit some sort of bottom before they will be attracted. I think all you can do if you see someone with issues is to let them know you believe and that you care and to let them know you will support them when its time for them to get on that path.
 

I had a boyfriend my first quarter of law school who was still in undergrad. He was in a fraternity, the only apparent purpose of which was to facilitate binge drinking. He didn't drink when he joined the fraternity, and after the first night he didn't remember anything of, he told me he was horrified at himself. He told me he was going to stop, but the drinking only escalated, to the point where not remembering his entire weekend became the norm. I was growing increasingly uncomfortable with this and suggested that he stop or slow down. He replied that he only drank with his fraternity. (This was supposed to make it better.) I suggested that he spend less time with his fraternity, if he was tired of throwing up all Monday. His response to this was to break up with me, to spend more time with them.

But we had all of the same friends, so I made the seriously misguided attempt to remain friends with him, to the point that I had a party and invited him. Other friends of mine brought alcohol (although I had asked them not to), although I was not drinking. My other friends became tipsy, but not drunk--my ex got totally smashed, to the point where he couldn't find the walls and my other friends were telling him to stop, but they wouldn't cut him off. I finally decided we had had enough, and I went to cut him off and make him at least have some water. We argued at the refrigerator--he kept opening it to get more alcohol, I kept closing it to hand him a bottle of water. He got angry and slammed the door into my hand as hard as he could.

In the interest of full disclosure, he was so drunk that it didn't really hurt much, but it was not for lack of trying on his part.

He then went over to the couch and asked my best friend if they could make out.

When confronted about this later, he variously sad that he "didn't mean to hit" me, that he didn't hit me, and that he didn't remember anything about the night. He refused to apologize. It was at that point, sadly late in the game, that I decided I was done.
 

This is the first place I am ever admitting this. I am a lawyer, and I am one of your former students. I have a drinking problem. I know that my problem is habit and not physical addiction, which is fortunate for me. I know this because I've abstained and had no physical side effects. Still, I plan my evenings around my drinking.

My drinking has a number of bad effects. For one thing, I am an athlete, and despite all of my exercise, I cannot lose weight because of the amount of alcohol I drink. It also triggers very impulsive behavior that has resulted in a number of embarrassing mornings after. But the absolute worse is that I have noticed lately that my memory isn't as sharp as it used to be, which is particularly scary to me.

My problem really seems to have begun when I began drinking liquor. I can drink beer and wine and be fine because I can't consume enough of it in an evening. But liquor is really, really bad.

I also know I have a problem because when I watch certain TV shows like Big Love, where the characters totally abstain, I marvel at how they can get through a lot of difficult life events without a drink.

Unfortunately, a lot of us who are ambitious must bear this burden privately because we have become such a feeding frenzy culture. I have no faith in any institution, including Alcoholics Anonymous. In the end, the Drudge Reports of the world always have someone who will betray their obligation of silence to embarrass another person.

That is all. This is a wonderful topic.
 

Professor Osler,
Thank you for your post. As a current law student, a Christian, and the daughter of a fall-down alcoholic, I wrestle with the consequences of drinking. While not a teetotaler, I often feel as though any amount of alcohol consumption can send someone off into the abyss of addiction, especially if there is much predisposition to abuse.

My mom has been an alcoholic since before I was born. She drank while carrying all 4 of her children, landed several DWI convictions, and managed to "graduate" from a handful of rehab facilities. Yet somehow, on most evenings, she finishes a fifth of vodka, passes out, and does it again the next day. Her drinking led her to abandon my family and move across the country where she still lives today. It was originally for her to go to rehab after my dad finally divorced her, but she found a job and stayed there. She left 4 children under the age of 14 to my dad to raise alone. Her alcohol addiction robbed me of a mom.
 

Like the Prof. my gut has tightened as I read all of these individual accounts. I live with a binge drinker. He drinks too much too often. He does not over indulge when we go out. I realize this is tied to his moods and also he is genetically prediposed as his father was an alcoholic. He does not get fall down drunk and not remember or get sick. He does not drive drunk and he does not go out to purchase more alcohol if he runs out. He is not abusive. He simply drinks more than a person should drink on any given day. If I call him on it - he will et all guilty and stop drinking for several weeks and then will slowly start up again.

When I mentioned this to his brother a few weeks ago, his brother was surprised.
 

Though I've never been drunk in your class, the stress and expectations of law school made the escape at the bottom of the 12 pack so tempting. You might be surprised how well you can perform on the spot during Practice Court while either hungover or drunk. Hasn't been a day in 8 months I haven't been one or the other, that is drunk as the professor-observer details my faults or hungover from the frustrations of not meeting my own high expectations, feeling worthless, and having to endure the program out of a misplaced sense of pride.

Give me time and I will find my own salvation, my own ability to cope.

What scares me the most: I'm not the only one at our school, not the only one in the class who is a drunk. And I feel betrayed, because as much as Baylor 'cares' and as much stress as they put us through, we find them judging us as failures if we give into temptations. Or worse, failing to provide any source of help.

I found my own help. Found my own way and my own support network; outside of Baylor, no thanks to Baylor. Gonna keep escaping til the stress and pressure cease. Maybe at the bottom of a bottle, maybe at the bottom of that 12 pack, but probably not at the bottom of the law
 

I am a recovering alcoholic (haven't had a drink for over 25 years) the daughter of an alcoholic (or two) and mother of an alcoholic (or two). Someone sent me over here to read your post today. It would take volumes to describe the decimation that alcoholism has caused in my life and those of my loved ones.

But I find the concept of a normal drinker worrying about somehow becoming an alcoholic an odd one. It is usually something that happens with the first drink. Most of us never drink like normal people. We can't even conceive of why a person would WANT to have 2 drinks - why bother?
 

Men in my family live well into their 80's and even 90's. My Dad drank. He is dead. He was 61.
 

At an early age, I nearly self-destructed on alcohol. Maybe a better way to put it is that I was, for some unknown reason, trying to destroy myself, and alcohol aided and abetted. If you knew me now, unless I shared that, you probably would not be able to guess it.

Two of my party buddies from that time period are not so lucky. One was a brilliant writer who went away to an Ivy League school. This was a big accomplishment where I'm from. At some point, the road forked and he stayed on the sauce. I still love him dearly and count him among my greatest friends but he is a shell of who he was. Alcohol has taken his mind... and it was a brilliant mind. He has spent the last 5 years rambling around the world and cooking in various kitchens. I'm not denegrating that -- but this guy should be teaching at Yale... not cooking.

Another friend, whom I nearly died in a car accident with, is now the manager of a chicken express. He was also very smart and a talented collegiate athelete. Alcohol took that. He's in and out of jail. He's now famous in our hometown for fist fighting his dad (and mom) in the front lawn of his parents' house. Apparently they tried to send him to treatment. One of our other friends, who is now a police officer, arrested him that night.

When I look at our three lives, I often wonder how I escaped. We all started as good kids. I may have even been the worst of the three. I used to have a distinct vision that I would die at 22, and I lived my life with that belief. I'm now nearly 30. I still drink, but everytime I do, I feel like I'm handling a loaded gun. I think of my friends who are effectively dead at the hand of that gun. If they are not dead, their former-selves are dead. When I drink, I think "How did I escape this?" That usually slows me down. I'm on my 8th bonus year, if you count from 22. That slows me down even more.
 

I think the next step, from seeing what harm drinking causes, is getting help. And realizing that having a drinking problem does not make someone a "bad" person, but represents a cross they've had to bear that they need a lot of help with.

And that there is an element of randomness to the tendency to addiction: my sister went through AA and NA almost twenty years ago, and is still sober. She's the strongest person I know. We had no idea she had drinking or drug problems until her best friend called to say she was in a treatment facility. What is it that made her drink to excess and my other sister and me not? I drink wine, and perhaps should drink less, but it has not affected my life the way it did my sister's. I seem to have a built-in threshhold that I can't exceed, and she doesn't. I have no idea why. Maybe nobody knows why.

Those affected by alcoholism have a horrible, unfortunate affliction, just as anyone with a serious mental illness has (and I have seen mental illness firsthand in my family, too). There but for the grace of God go I--but hopefully with these posts, that person will know that she or he is cared for and will reach for help. And hopefully as she or he is getting help, others will still be there for support.
 

What do you do, though, for someone like the woman at the dinner party, who probably does not think she has a problem at all?
 

I wonder if anyone read this and recognized themselves as the dinner guest. That woman is probably very angry at Osler, but shouldn't be. Still, I would not want to be standing between the two of them.
 

I remember sitting with my dad on our porch as a child. He would chain smoke and drink and drink. He would listen to my stories from school, my accomplishments and travails. But he was drunk and in his own warm haze.

I am fortunate that I did not grow up with an abusive alcoholic father, but an alcoholic nonetheless. It is only as I have grown older that I have realized the extent of his alcoholism and what it has cost him. Perhaps more importantly I now understand the reasons. It was his escape, his comfort, a convenient way to dodge what haunted him. But it will kill him.

And perhaps that is the common thread for so many alcoholics. Drinking is a way to blink out the struggles in life. It's a destructive salve that turns the pain off, even for a little bit. Its collateral effects are profound.

It is not just alcohol. It is pills, it is drugs, it is anything done to excess that provides mental relief.

This speaks to a larger problem - mental health, which a poster above has pointed out. It is an issue that is shunned and ignored, but all of these posts have shown that it is something that so many people can relate to and understand.

Speaking as a law student, I can attest to using alcohol as a convenient way to 'turn it off'. But I have seen where that road leads, yet I can see myself taking steps down that path. This frightens me. Mental health access and education are important things our society - and our law school - needs to reevaluate.
 

I think for the woman at the dinner party, someone puts her in the car and takes her to a detox center. I know there are laws about who can do that . . . and ultimately she probably has to sign herself in. But somebody should just take here there. Or to a doctor, or substance-abuse counselor. Make her go in the door, push her through the door, whatever.

I know it's not easy and it will not work for everyone, but family and friends have to try. Maybe there is a friend she would trust in her sober moments.
 

Swissgirl - good intentioned idea but my limited understanding of alcoholism is that the person must admit it (hit rock bottom before they will even make a good hearted attempt.

As obvious as the problem is to all around - it is not obvious to the person with the problem. really good intentioned friends and family need to have thick skin to attempt interventions.
 

One of my cousins drank himself to death... at age 33... after his wife left him because of his drinking... and his business failed. It happened the summer I was studying for the bar exam. I realized that while I was very stressed, I wasn't so stressed as to "kill" myself. My cousin's father - my uncle - also abused alcohol his whole life, and was the class clown, and broke his foot and I think went to jail. He and my aunt divorced too because of it. Like father, like son. When my cousin died, his father knew he was on a destructive path and tried to get him to go to rehab. My cousin didn't want any help. What a waste. My mother and father both drink to excess. It was embarrassing in high school - and still is. Several brothers have beers in hand all weekend. Yet, they are all very successful. I gave it up for a long time, but got quite depressed with the impact of this economy on friends and decided to "enjoy" drinking again. At my age, I know better... but I've still over indulged lately. It reminds me of my college drinking days - and that's probably not such a good thing! I once asked a friend if he thought alcohol should be made illegal, after he mentioned how his father emotionally abused his mother when he drank. Banning alcohol certainly didn't work during prohibition. But would it make people think twice about the regular use/abuse of it - and the impact it has on families - and make it less socially acceptable? Considering NJ just legalized medical marijuana, and FDA is regulating tobacco, this is the wrong trend! But still interesting to consider.
 

In second grade for Show and Tell I taught the class how to make a Manhattan. I was a seven year old bartender for my mother.

Alcoholism is miserable. You just have to get away from them and hope they change Intervention does not work, I do not think. They have to hit pure rock bottom before they change.
 

I am a current law student at BLS. Over the past year and a half I have drank at least once or twice a week on a fairly consistent basis. I am constantly reading about the current state of the economy, especially for new lawyers, and worrying. The few hours a week when I'm drunk is some of the only time I don't stress about being able to find work or pay off my debt in another year and a half.

Law school has been nothing but a series of disappointments to this point. I just picture myself in two years having to explain to my family and friends, who have such high expectations of me, how I can't find work. I know that no matter how much I explain that it's the economy or the saturated legal market that deep down they will nod while thinking, "He just couldn't cut it." Drinking makes these thoughts go away - if only for a while.
 

I, too, had an alcoholic father, but he went to AA and quit before it ruined him. He also quit smoking by throwing the pack out a window and never having another. My grandfather quit smoking the same way.

I have the same tendencies, but I have the guts to admit it to myself and quit! No AA, no 12 step, no hit bottom - just plain common sense and will. I quit Meth cold, and alcohol cold, when I realized that I had a problem. Anyone can do it - I know too many who are AA junkies, telling the same old tired stories, no friends not in recovery - very sad people. Still addicted, just to meetings.

Get a life, quit, and stop feeling sorry for yourself! You can stay clean and sober for years as I have without doing the 'poor me, I'm an addict' dance.