The End of My Addiction

ward, we had discussed the fact that our romantic relationship did not have a future, a conversation I only had the courage for after several drinks. Through one of her relatives, she helped me find an apartment to sublet on the Upper West Side.
    A year after closing my practice informally, I was still paying rent and a portion of employee compensation and benefits for my medical office space, as well as continuing to carry the lease on a Hewlett-Packard echocardiography machine and very expensive malpractice insurance. That was in addition to my normal living expenses and the huge rehab bill I was running up on my credit card.
    Spending so much money on an inactive practice made no sense, but it let me hold onto a portion of my identity as a physician. I wasn’t yet ready to lose that. I couldn’t yet see that I would remain a physician after the last tangible tie to practicing medicine was gone.
    A member of the Marworth staff researched my insurance coverage and told me that although my regular health insurance would not cover any more rehab, my disability insurance probably would. It had never occurred to me that addiction would count as a disability, and I thought back to the insurance salesman’s relentless hard sell when I was setting up my private practice. I needed to buy my own health insurance for the first time, after previously being covered under France’s universal health care system and Cornell University Medical College’s employee benefits.
    I bought comprehensive medical insurance, but I told the salesman, “I don’t need disability insurance. I don’t have any health problems.”
    He wouldn’t take no for an answer and kept coming back to the office to make a fresh pitch. “You’re a cardiologist, but you could have a heart attack yourself, Doc,” he said. “You could get cancer. You could get hit by a cab right out there on York Avenue.”
    Finally I bought the insurance, thinking I was throwing away $350 a month on the premium, just to get the guy out of my hair. Not once in any of his sales pitches did he mention addiction as a covered disability. When I became ill I never thought of asking, because I assumed that addiction was not considered a real disease like cancer, and some of the physicians at Marworth bitterly lamented the fact that their disability insurance did not cover addiction. Thanks to my having put all my expenses on automatic bill payment the year before, however, my premiums were fully paid and up-to-date.
    After I finally left Marworth on September 16, I got in touch with my insurance company. It took some debating, but the company finally agreed that the disability insurance covered my alcoholism. I was reimbursed for my costs at Marworth and High Watch Farm—and for a time I received money for living expenses, a fraction of what my final salary at Cornell University Medical College had been.
    With the disability insurance payments I had a little breathing space financially. In addition, I had Marworth’s seal of approval. The Harvard of rehab assured me that after two months of study I had earned graduation and was ready to reenter the world.
     
    Just before I left Marworth, the psychologist gave me great news: my liver enzyme level had normalized. The specter of severe liver disease had preoccupied me throughout my stay. Then my counselor told me to call my case manager at CPH so that she could explain the monitoring system.
    “Okay,” the case manager said, “a psychiatrist affiliated with CPH is going to page you once in a while, so you have to carry a beeper. At first you’ll meet him at his office on the Upper West Side. And then he’ll page you around twice a week at random. There will be no set schedule. When he pages you, you have to go downtown and give a urine specimen within a couple of hours. That could be any day of the week.”
    I said, “Urine? For alcohol? Urine specimens are stupid for alcohol.” If you drink, your urine will be clear in a few hours because of how the body metabolizes alcohol.
    “Yes, but we have to check for cocaine, heroin, methamphetamine, prescription painkillers, cannabis, benzos, and other commonly abused drugs. Those can be detected in the urine for days or even weeks after you stop using them.”
    “I’ve never seen a line of cocaine in my life. I’ve never taken an illicit drug.”
    “We still have to check.”
    “But you tell me CPH is a program of honesty like AA. AA says if you’re dishonest, your