The End of My Addiction

Ste.-Anne and one of France’s most eminent specialists on alcoholism, whom I had been consulting for several months. “Should I go into a rehab clinic?” I asked.
    Descombey said, “That doesn’t really seem to be the answer for you, does it?”
    “No, but what else can I do? I think maybe I should live in rehab.”
    “That is not feasible,” Descombey said. “But the way you recover from your binges is extraordinary. You’re back on your feet within twenty-four to forty-eight hours, and then only a few days later you just fall again into alcohol. Your cycle is getting shorter and shorter. I am afraid you will not live.”

    In my cardiology practice, I often found that a male patient’s wife or girlfriend was a useful source of information on which to base a diagnosis. The women noticed behaviors and recalled experiences that the men were too embarrassed to mention or had repressed.
    During my alcoholism, I told every physician and therapist I saw that my fundamental problem was anxiety, which expressed itself in chronic muscular tension, and which, intensifying to a panic state, triggered the overwhelming need to drink for relief. None of the doctors who treated me for addiction took this seriously.
    But my old girlfriend Joan remembered it well, perhaps because she heard me talk about it many more times than any physician did. One day in November 2000, while riding on the subway, she picked up an abandoned copy of The New York Times . There she read an article about a University of Pennsylvania researcher who was studying the effect of a muscle relaxant called baclofen on a drug addict’s craving for cocaine. She tore the article out of the paper and mailed it to me in Paris.
    When it arrived, I was in the middle of a huge binge. I glanced at it and tossed it aside. A few days later I vaguely recalled it and went looking for it, but I couldn’t find it. I assume I spilled liquor on it, and the cleaning lady threw it away.
     
    My life continued as before. My drinking meant I could not avoid hospitals altogether, but whenever possible I detoxed myself on my own as I usually did in New York. However, in December I went for detox into a hospital where I had done some of my medical studies, and where an old friend from those days, Élodie, was now the head nurse. And then in June 2001 I had another bad fall.
    I may have fallen on the street or at home. I don’t know which, because it happened in a blackout, but if it was on the street, I managed to get home and go to bed. Despite the alcohol in my bloodstream, I woke up with pain in the left side of my chest. The pain became acute, and then extreme, but I thought it would pass. By now I had become used to waking up with bruises and aches from falls during binges, and anesthetizing the pain by drinking more alcohol. I tried the same tactic for the chest pain.
    Two days later, in even more intense pain, I called my friend Élodie at her hospital. Élodie spoke to the head of the department of medicine, also a friend from medical training, and he made a special one-time arrangement for EMS to take me there, in Paris’s suburbs, rather than to a closer hospital in the city.
    I arrived unconscious. When I woke at 5:30 the next morning, the nurse on the floor told me that they had considered putting me in intensive care and intubating me to make sure I got enough oxygen in my lungs. But they decided I could breathe on my own and put me in a regular room. The nurse also told me that I had three fractured ribs. These had perforated the pleura, the envelope around the lungs, giving me pneumothorax, air around the lungs, a condition that can collapse one or both lungs. There was also blood in the chest cavity, a serious complication known as a hemopneumothorax.
    In medical school they teach students that fractured ribs are among the most painful of all injuries. As an intern I saw the distress of patients with even one broken rib. The only way to reduce the pain even for a few seconds, without medication, is to hold your breath. Moreover, I began hiccupping, which made the pain atrocious. I tried holding my breath and drinking water to stop the hiccups, but neither tactic helped.
    I asked the nurse if I could have metoclopramide to control the hiccups and something for pain. She said, “There is nothing on your chart. Can you hold out with some Tylenol until the doctor makes rounds later this morning?”
    I asked her to call the intern on duty, but she did not