As doctors, we are trained to observe people, and to see when things are not going so well for them. We are intelligent, caring and sensitive, and by and large we go into medicine because we care deeply about people and want to help them. So why do we turn a blind eye when it comes to problems with alcohol, in ourselves and in our colleagues?
Alcohol is a beloved drink of many doctors. We love our wine, are often connoisseurs of it, and some of us even grow grapes and make wine as a hobby. We have been told for many years now that a glass or two of red wine is good for our heart, and there have been studies to back this up.
But recent meta-analyses(1,2,3) have shown that these studies were flawed and biased and that alcohol is not good for any part of us. In fact, studies in recent years have shown what our bodies have always known … that there is no safe level of alcohol consumption. The American Society of Clinical Oncologists(4) came out and stated this fact in 2017, a fact that the Cancer Council Australia(5) stated some years ago in 2011.
The physical harms of alcohol are well known, although often conveniently ignored. And we underestimate the social and interpersonal damage alcohol does in our homes, and in our communities. Being raised in a household where there is alcohol abuse can profoundly impact children, with long-lasting effects on their mental, emotional and physical health.
Alcohol and doctors
The culture of medicine has supported our own use of alcohol to relieve our tension and stress, to reward ourselves at the end of a hard day’s work and help us to wind down and take the edge off the day. Even though the studies that show the incontrovertible harm of alcohol have been out for a few years, they have largely been ignored, and we continue to drink and advise our patients to do the same, or at the very least, we don’t counsel them not to drink.
Alcohol is a touchy subject to talk about, a no-go zone for many. We are willing to do whatever it takes during the day, as long as we can have a drink at night. We are willing to follow the latest guidelines on food, exercise, to base our practice on the best available evidence when it comes to anything else, but not when it comes to alcohol.
What does alcohol do for us, that we are so attached to drinking it, and willing to override the truth that we know and feel in our bodies, as well as the available scientific evidence?
The social sanctioning of alcohol use, reinforced by doctors telling people that they can drink in moderation and using science to back this up, has done us untold harm, as individuals and as a society, and it is now up to us to redress this imbalance by being honest about the harmful effects of alcohol, in any amount and any form.
But the first step in that process is the willingness to be absolutely honest with ourselves.
Being willing to observe ourselves just as we are and to deepen our understanding of why we do what we do, brings us greater awareness of our motivations and actions, and calls us to greater responsibility in the way we live, which can support us to make true and lasting changes in our lives.
Alcohol is an acquired taste
We are fond of saying that we like a drink, or even that we love a drink, but what do we mean by that? If you give a child a glass of red wine or whisky, they will not like it; it is definitely an acquired taste! “Acquiring a taste” for alcohol means teaching ourselves to get used to something that is by nature distasteful, as it is made of fermented fruit or grains, so it is naturally ‘off’ and the body reacts to it. Why do we even try it more than once? And why, when we go there and then feel the after-effects the next day, do we choose to go there again?
Alcohol is such an integral part of our culture. I know that when I was growing up, I was given a glass of wine with dinner from a very early age by my parents, who were also doctors, to teach me how to drink. It is a social lubricant and a socially acceptable way of dealing with stress, a legal drug that does not hurt us or other people … or so we have been led to believe … but can we still say that is true?
Drinking ‘just’ a glass or two of good red at night may take the edge off our stress and tension, but it also takes the edge off us. It numbs us, slows us down, helps us to check out, to switch off, makes us less available to our loved ones at home, and prevents us from dealing with the unresolved problems that are causing our tension in the first place.
For some, these factors build up in the body, leading to more and more tension, and then we need to drink more to deal with that. This can set us up in a vicious cycle of discomfort and relief, of hard work and reward, that we can find harder and harder to break free of, and before we know it, our drinking may be not just a simple pleasure, but a compelling need.
I am not saying that everyone who enjoys a glass or two of wine at night is going to end up with a serious drinking problem, but that certainly happened to me and I know that I am not alone in this.
What does alcohol really do?
Have you ever watched someone change as they drink? Have you ever felt they are not quite themselves? Have you ever felt those changes in yourself? Have you ever said or done things drunk that you would never do sober? Have you ever said that you will never drink again and then drunk later that day, or the next week? What’s really going on when we drink?
Quantum mechanics has shown us that we are not just the solid matter we have been trained to see, but largely (99.99%) space, and that even the tiny amount of matter we are made of is moving in and out of other universes. Albert Einstein’s equation E=mc2 showed us that everything in life is energy. Consider then the possibility that when we drink, we are being altered, changed, affected in some way energetically – that other energies can influence us and cause us to do things we wouldn’t otherwise do. Of course, we are still responsible for allowing this by drinking in the first place, but it helps us to understand why our behaviour can change so much when we drink, why we make decisions and do things we normally wouldn’t do, because it’s an energetically altered version of us making them. Once we start understanding life in these energetic terms, there is no mystery. Everything makes sense. We override our common sense and the knowing of our bodies that alcohol is harmful, not because we want to hurt ourselves or other people, but because we are being influenced and affected energetically.
We override the knowing that alcohol is a poison, and a Class 1 carcinogen, because we love the fact that alcohol is an A-grade numbing agent and it helps us to ignore, override, and even deny the tension, stress and ill-feelings we carry about ourselves … the only problem is that whilst it might seem to bring some sort of temporary respite or relief, it never actually solves the issue or underlying tension and ill-feelings that precipitated the desire to drink in the first place and which we then just tend to compound further with drinking alcohol.
Why do we turn a blind eye?
We find it very difficult to admit, to ourselves or to anyone else, that we are struggling, and we have trouble talking to our friends and colleagues about personal problems, let alone seeking professional help.
But doctors have higher rates of anxiety, depression, substance abuse, and suicide than the ‘normal’ population, especially young female doctors, and as a profession we are struggling to cope with the increasing burden of illness and disease, in our patients and in ourselves.
Yet we don’t feel safe to say that we are struggling, or to ask for help, for fear that we will be seen as ‘not up to the job’, or not ‘having what it takes’. And we don’t feel able to genuinely ask another person how they are, for fear of not knowing what to say or do if they admit they are in trouble.
We need to remove the stigma around mental illness, stress and substance abuse, as well as the punitive mandatory reporting laws and currently terrible treatment at the hands of AHPRA to have any hope of dealing with this problem. To effect such systemic change will take time, but on a personal, practical level, what can we do?
What can we do instead of drinking alcohol?
Let’s say we are finding ourselves on that slippery slope of not just wanting but needing to drink … what can we do instead?
There is no one-size-fits-all solution to this problem, and we each have to find our own way to live, but there are some simple steps we can take that can help us get back on track.
The first is to be absolutely honest with ourselves, about how we are feeling and why we are drinking.
Are we feeling good about ourselves, or not? We are sensitive beings who have been affected by life and people, and often deeply hurt. We can end up believing we are not good enough, not lovable etc., and it is not a weakness to admit to and feel this, but a strength that takes courage and a willingness to heal. I know that until I stopped drinking I was firmly in denial of the issues that lay beneath my desire to drink.
And why are we drinking? Are we doing it to numb ourselves? Are we doing it to be sociable and fit in? Are we doing it for relief from tension and stress? Is it a pleasure we can take or leave, or is it getting to the point where we cannot get through the day without it and we look forward to it all day?
True answers lie not just in finding other ways to relieve ourselves at the end of the day, but also learning to deal with the feelings we are seeking relief from, and with stress and tension as it arises, so that it doesn’t have to build to the point where we feel we have no other way to deal with it but to have a drink.
We are rewarded for what we do
When we are young, we are appreciated and loved just for who we are, with no need for us to do anything. From the moment we first smile, take our first step and interact with the world that starts to change, and we learn to be recognised and rewarded for what we do. This constant seeking outside of ourselves for approval, leaving behind the loveliness of just being us, creates a sense of separation and a feeling of emptiness in us that we can never fill from the outside, no matter how hard we try.
Learning to re-connect with ourselves, with the lovely warm feeling we had inside us when we were young, with the simple pleasures of life, can be a great start to learning to deal with the tension of being in life. Doing this can be as simple as taking a few moments to breathe in a way that develops that re-connection, and the Gentle Breath Meditation has certainly been life-changing for me. Once we feel the delicious truth of who we are, and the sweetness that lives inside us, we will want to care for ourselves more deeply and will feel far less need to look for that sweetness outside of us, especially in its fermented forms. Drinking alcohol is a poor substitute for enjoying the sweetness of life, people, nature, and the beauty that lives inside us.
Once we reconnect to the loveliness inside us, the world reflects that beauty to us, and stopping to smell the roses, enjoying nature in its many glorious forms, walking and other gentle rhythmic exercises that bring you back into your body and allow you to enjoy it, connecting with and spending time with people you love, taking a break, are all simple things we can do to relieve stress and tension and increase our enjoyment of life.
Learning to appreciate ourselves for who we are
And last but by no means least, learning to appreciate ourselves, just as we are, for who we are, irrespective of what we do, is a vital step for us as doctors. We are so used to being appreciated for our great work, and have learned to look for this appreciation outside of ourselves from an early age, but as perfectionists we are always doomed to fail, sooner or later, unless we learn to appreciate ourselves as the great people we truly are, no matter what we do.
This appreciation deepens our love and care for ourselves. And the more we care for ourselves, the more we are able to care for others. This restores our sense of purpose in life, and renews our commitment to the great work we do, allowing us to complete each task as it comes up without feeling overwhelmed by the enormity of all that there is to do. And it is so important that we balance all this work with genuine rest, not the numbing sugar-hit of alcohol, but a repose that allows us to deeply appreciate and honour all that we are and bring.
There is nothing we can experience, be it good or bad, that alcohol will make better. If anything, it will only add to our problems and complicate them or at best, put them off for another day. If we have a problem, drinking alcohol will not make it go away. If we can deal with it ourselves, great. And if we can’t, then we need help. That is what we are all here for … to support each other, to see things from different angles, to shine a light on a problem so that it no longer seems insurmountable.
We are not designed to live life alone, and we need to be collegiate with each other, to support each other, look out for each other, and to be willing to have the awkward and difficult conversations that may just save someone’s life and start them back on the path to recovery of their health and wellbeing and the truth of who they are.
References:
- Alcohol Consumption and Mortality From Coronary Heart Disease: An Updated Meta-Analysis of Cohort Studies. https://www.ncbi.nlm.nih.gov/pubmed/28499102
- Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data http://www.bmj.com/content/349/bmj.g4164
- Chronic heavy drinking and ischaemic heart disease: a systematic review and meta-analysis http://openheart.bmj.com/content/1/1/e000135
- There’s no safe level of drinking when it comes to cancer risk, oncologists warn https://www.advisory.com/daily-briefing/2017/11/09/alcohol-cancer
- Alcohol and cancer: a position statement from Cancer Council Australia https://www.mja.com.au/journal/2011/194/9/alcohol-and-cancer-position-statement-cancer-council-australia
Anne Malatt on Life 