HOSPITAL PROGRESS, Vol. 30: 48-50, February, 1949
It's Time to Develop AN OPEN-DOOR POLICY FOR ALCOHOLICS
By Rev. J. Stanley Ormsby, Ph.D., S.T.L.
The attitude of hospitals, in general, towards alcoholism is hands off. They regard alcoholism as a moral aberration and feel sympathy for alcoholics is wasted. Besides, they claim, hospital beds are too scarce, and they are not going to fill the few they have with drunks who will not try to help themselves. Further, they assert that alcoholics cause a behavior problem, and the scarcity of nurses makes this one more headache to avoid. And so they don't want alcoholics. This mode of thought shows they do not regard alcoholism as a disease, and they let the problem go for solution to some other field of therapy. Are they correct in his procedure?
We feel that they are not. But I'm quick to admit that their decision is based on misinformation, misunderstanding, and a distorted public opinion of what alcoholism is and what alcoholics are. The Catholic hospital should take the initiative in focusing the light of truth on the moral and physical causes of the disease of alcoholism and exert the charity of Christ in the treatment of the victim of alcoholism.
Are Alcoholics Hospital Cases?
Some may say alcoholism is not in our field. We should remind them that the hospital is dedicated to minister to the body of suffering humanity directly and to the needs of its soul indirectly. A Catholic hospital is not Catholic if it does not take into consideration the whole man created to the image of God. A Catholic hospital must supply psychosomatic medicine in the best sense of that term. Again, it might be argued that the alcoholic is a problem for the clergyman or psychiatrist. But what can a clergyman or a psychiatrist do to help a person suffering from dietary deficiency and the host of physical ills which attend alcoholic poisoning?
Hospital care is basic if we are going to do anything for the rehabilitation of the alcoholic. As it is today, the acutely poisoned alcoholic is thrown into jail or the psychopathic ward of a city hospital. By this method, he is stamped as a criminal or a lunatic. One taking poison intentionally is readily admitted to a hospital, and all possible care is given to him. The intentions of the alcoholic and the suicide-minded are not the same, but both are poisoned; hospital and medical care is just as necessary to the alcoholic. We cannot reach the intellect and will of a hungry or sick man. We must first treat him physically and then spiritually. This was Christ's practice when He fed the multitudes and taught them - He cured their bodies and then healed their souls. In the case of the alcoholic, hospitals must cure physically before religion can cure spiritually.
In religion we say the pews should not lead the pulpit: in hospital practice we must not let the layman's distorted conception dictate policy toward the alcoholic. The public regards the alcoholic as a moral leper, a backslider who deserves punishment. Hospitals, by refusing aid to alcoholics, have punished them more than is ever realized.
I know that some charitable hospitals take alcoholics for treatment but record them as gastritis patients. This is hypocrisy; if the profession could honestly diagnose the disease of alcoholism, the public and the victim would have a clear picture of the disease and its consequences. Educational campaigns have caused the public to change its opinion about tubercular and diabetic patients, and a much more enlightened attitude prevails about venereal disease, with the result that patients, by and large, are no longer ashamed to come for treatment. Why couldn't the public be educated similarly about alcoholism?
Alcoholism is a public health problem, and health is the hospitals1 business. Broken homes, destitute families supported by public funds, absenteeism costing millions in industrial loss, accidents and crime are but a few of the results suffered by all, because alcoholism is not publicly termed a disease and treated as any other affliction. We have stigmatized the alcoholic, so he will not admit he drinks, nor will his family seek aid for him. Wretched publicity or death often ends the record.
Example at One Hospital
I do not know how many hospitals there are which treat the alcoholic, but one which comes to my mind is the Knickerbocker Hospital in New York City. Under skillful and sympathetic direction, this hospital has done a great work for the alcoholic. And the members of the staff have been surprised to find that the problems they expected in the care of alcoholics never materialized. They have such a long waiting list that the same person cannot be admitted twice. This is not because they have no confidence in one who has had a relapse, but they wish to give at least one chance to each of those who apply.
A patient cannot be admitted to the hospital except with an Alcoholics Anonymous member as a sponsor. The physicians say that there is no more difficulty in taking care of an acute alcoholic than there is in taking care of any post-operative patient. Within a short period, the alcoholic recovers from the worst effects of his drinking bout: then he is given the proteins and vitamins which were neglected in his alcoholic diet. He is supplied with all the food he cares to eat, and as soon as he is ambulatory, he goes into the large meeting room which is called "Duffy's Tavern." And so well do the patients get along that the physicians and nurses enjoy associating with them in that room. Tables are piled high with food, and Alcoholics Anonymous literature is spread around. There is nothing to read except this.
Members of Alcoholics Anonymous meet and talk with the patients, gain their confidence, and prove the possibility of rehabilitation. No patient can leave until the Alcoholics Anonymous sponsor takes him from the hospital. The sponsor follows up his charge and takes him to weekly meetings where the Alcoholics Anonymous program counteracts the alcoholics obsession. He is greatly helped because he is associating with those who have mastered identical difficulties. Eventually he is trained to help other alcoholics, and by taking care of others, he preserves himself from a relapse.
A hospital needs no extra or special equipment to handle alcoholics. A psychiatrist must be employed to discover whether a neurosis causes the alcoholics drinking or drinking causes the neurosis. If a neurosis causes the drinking, he must get rid of the neurosis. In this case Alcoholics Anonymous cannot help him to recover. If his neurosis is the result of drinking, then he can be entrusted to Alcoholics Anonymous members, and they can effect the balance of the cure. Alcoholics Anonymous members have often been more successful in determining this distinction than the psychiatrist. Alcoholics Anonymous members are the best lay therapists in serving the victim who has a neurosis because of his drinking.
How many alcoholics are there? We do not have accurate figures, but we know of 750,000 alcoholics who have become known when they were taken to courts, jails, or mental institutions. Despite the difficulty of obtaining correct data, we do know 12,000 people die each year with alcoholism as the primary or secondary cause of death. God alone knows how many lives have been wasted and souls lost because most hospitals will not accept alcoholics and most physicians will not treat them.
In Alcoholics Anonymous today there are 25,000 members rehabilitated through Alcoholics Anonymous program combined with some manner of hospital care. These 25,000 are well and happy again, united with their families, and living normal and productive lives - assets to themselves, their families, their communities - and especially helpful to other victims of alcoholism who learn from them that life has a brighter side. There are 500,000 cases of tuberculosis, and we have $130,000,000 to spend on curing them and educating the public not to conceal the disease. There are 750,000 known alcoholics, and we have scarcely $500,000 to spend on their cure and the education of the public. Obviously, the need for recognizing and treating the disease of alcoholism is much greater than we suspected.
A.A. And The Hospital
Let us consider the role of A.A. in relation to the hospital. Alcoholics Anonymous is a group of men and women who have recovered from alcoholism and who have dedicated themselves to do all in their power to effect the cure in others. They are convinced that alcoholism is a disease, that the alcoholic can be cured and is worth curing. They regard the whole problem as a public responsibility and feel they can help the victims and the community at large, which pays such a heavy toll (more than a billion dollars a year) because of alcoholism. The educational work of Alcoholics Anonymous is carried out through the large amounts of literature which it distributes throughout the country, and through the examples of the great number of seemingly hopeless individuals whom they have rehabilitated.
The members realize that hospital, physician, psychiatrist, employer, social worker, and Alcoholics Anonymous must work together. They know one alone cannot effect the cure. The teaching of Alcoholics Anonymous might be summarized in the 12 Steps which are gradually undertaken by the new member in such a manner that he will slowly become master of himself. THe steps are:
1. We admitted we were powerless over alcohol - that our lives had become unmanageable. 2. Came to believe that a Power greater than ourselves could restore us to sanity. 3. We made a decision to turn our will and our lives over to the care of God as we understood Him. 4. We made a searching and fearless moral inventory of ourselves. 5. We admitted to God, to ourselves, and to another human being the . exact nature of our wrongs. 6. We were entirely ready to have God remove all these defects of character. 7. We humbly asked Him to remove our shortcomings. 8. We made a list of all persons we had harmed and became willing to make amends to them all. 9. Made direct amends to such people wherever possible, except when to do so would injure them or others. 10. We continued to take personal inventory and when we were wrong promptly admitted it. 11. We sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry it out. 12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.
These steps cannot be given to an individual until he is cared for physically by the hospital, by the physician, by the psychiatrist, and by the close and brotherly working of other members. In the few hospitals which treat alcoholism, it is admitted that much of the success is attributable to co-operation with Alcoholics Anonymous.
Who is an alcoholic? Everyone who drinks is not an alcoholic - even one who drinks excessively is not necessarily an alcoholic. There are certain symptoms which mark the alcoholic:
Who Are Alcoholics?
1. The desire for liquor the morning after over-indulgence; only a confirmed or potential victim of alcoholism can tolerate the taste of liquor after such an experience. 2. Desire for a drink at definite periods throughout the day. 3. The desire to be alone while drinking. 4. Drinking to conquer a sense of inferiority, to impress others, or to display an air of nonchalance. 5. Moodiness, jealousy, irritability, and nervousness as a result of drinking. 6. An allergic reaction to alcohol.
The alcoholic is often proud and sensitive, has a high degree intelligence and a highly sensitive nervous system. He is frequently a capable person; consequently, pride can wall off his drinking from its cure. Here is the greatest work of Alcoholics Anonymous - seeking out and serving the individual alcoholic before his condition reaches its lowest level. The alcoholic knows he doesn't want to get drunk; he doesn't want to cause trouble to himself and to his family; but he doesn't like to admit he is no longer able to control his drinking. The alcoholic must admit that he has a serious problem that he cannot handle by himself. He must seek the help of almighty God, the Power above himself; here prayer comes into the program. In a most practical way the alcoholic is taught to pray; considering this attainment, a man may even consider himself fortunate to have been an alcoholic, if he has learned the secret of his own weakness and the power of God's help.
In the Alcoholics Anonymous the victim has the companionship of other alcoholics who appreciate his trial, know his difficulties because of their own experiences, and do not tempt him with more drinking. They understand what the alcoholic is up against, and in each they see themselves, realizing, "there but for the grace of God go I." They know their own success is measured by their assistance and service to others.
In working with Alcoholics Anonymous members, I have found great humility, excellent natural ability, and practical Christian charity. They seem to have a deeper understanding of spiritual values than many other lay people. Love for one's neighbor, willingness to go all out to save one life is manifest. Few hospitals would not co-operate diligently with such a group of men whose free time is dedicated to the service of others.
In service to alcoholics, Catholic hospitals have unlimited possibilities. United as the Catholic hospitals are with the Church, they have the means to cure body and soul. Because of their unified authority, they could, with one stroke of the pen, open their doors to victims of acute alcoholism. They would have at their disposal the experience and assistance of every member of Alcoholics Anonymous. Catholic hospitals can lead the way to a new appreciation of the dignity of man created in the image of God.