The End of My Addiction

fluids for hydration, and Valium. I was usually well supplied with Valium, which my physician prescribed for my anxiety, and since I had started bingeing, I had always made sure to have some on hand so that I could detox myself.
    Detoxing from alcohol takes around five days. A day into this regimen, I called my girlfriend, Joan, who proved immensely empathetic and encouraging, even though we were having a rocky time over my inability to make a long-term commitment.
    The next morning, August 19, 1997, I realized I had run out of Valium and could not remember when I had taken the last pill. With Joan’s help, I searched the apartment repeatedly, desperate to find at least a couple of pills, but there were none in the bathroom medicine cabinet, on the nightstand by my bed, in the kitchen drawer, or anywhere else. The doctors I knew and trusted were away, and I could not imagine explaining to another doctor why I needed a prescription on an emergency basis.
    Joan did not understand my concern. “Why do you need Valium so badly?” she asked.
    I explained that withdrawal from alcohol can easily become a medical emergency with delirium tremens (the DTs), seizures, loss of consciousness, hallucinations, major spikes in blood pressure, and even death. The risk of serious, and potentially lethal, medical consequences is much higher in acute withdrawal from alcohol than in withdrawal from any other drug of abuse.
    I also explained that in the days before Valium and similar drugs existed, people were detoxed using diminishing doses of alcohol. If I could get out to a liquor store, I could halt the progression of my symptoms. But my arms and legs felt like they were made of rubber; I was so exhausted that I could not even stand. Terrified of what might happen, I begged Joan, “Please, buy a bottle of vodka and bring it to me.”
    She refused. Looking back, I suppose I could have written Joan a prescription for Valium that she could then give to me. But I was horrified by the thought of doing something that would compromise my ethics.
    I said, “I’m having a medical crisis. Either I drink or risk a negative neurological event, like a seizure.”
    Joan knew that I was a good doctor, but she also knew the depth of my dependence on alcohol. A tall business executive, Joan looked me in the eye and said, “I’m sorry, Olivier, but I can’t bring you liquor.”
    I gave up the fight. “Something is going to happen to me,” I said. “When it does, you must call EMS and have them take me to New York Hospital. I don’t like going to my own hospital in this condition, but they will take good care of me there.”
    “Isn’t there anything else we can do?”
    “You can bring me liquor, or we can wait for the bad things to happen.”
    We waited.
    Half an hour later, I felt a strange sense of agitation mixed with relief. I wondered if this was the “aura” that precedes a seizure. And then I lost consciousness except for a vague impression of medical personnel milling in the lobby of my building or on the street, and a bit later someone pulling a privacy curtain around me in the hospital and whispering, “He’s an attending,” shorthand for attending physician. Then I lost consciousness again.
    When I awoke, I was attached to several IV tubes and a urinary catheter. A young medical student, a bit pompous but sweet, appeared and questioned me about my “malady.” I liked his choice of words so much that instead of asking for an experienced nurse or an intern, I let him draw arterial blood gases. This was a long, very painful process, because I was his first live patient.
    My next visitor was Professor John Schaefer, an outstanding neurologist originally from Australia, whom I knew very well and greatly admired. With matter-of-fact kindness and no hint of moral judgment, he explained that I had suffered multiple seizures, which had been controlled with intravenous Valium. I had been kept heavily sedated for two days and I was continuing to receive Valium intravenously to treat acute withdrawal.
    The seizures were so violent that they produced rhabdomyolysis, a breakdown in muscle tissue that is toxic to the kidneys and is measured by the level of CPKs—creatine phosphokinase isoenzymes—in the blood. The same thing can happen to people who suffer what is known as crush syndrome, from traumatic injuries in a car accident or being trapped in the rubble of an earthquake. Only recently, a colleague told me that on seeing my