by Vera T.
I am looking down, watching the tears drip onto my shoes and slide onto the floor. I can’t look up at their faces, not yet. I am sitting in a circle of other doctors, dentists, and nurses who are all in recovery. We are professionals who have one thing in common: an addiction that has gotten in the way of our work.
Some of us, like me, called the help-line that is embedded in each of our trade journals. Others of us were mandated to come to this particular meeting in order to retain our license to work. There are a few members who have been here for more than five years. The elderly man sitting across from me is a psychiatrist who has been coming to this meeting weekly for 16 years. He doesn’t go to 12-step meetings, as he prefers the security he gets here of not running into his patients.
I don’t understand why I am crying. I have already been to a number of 12-step meetings, and have finally been able to say, “Hi, I am an alcoholic.” But right now, I can’t even look up into their faces – these people, who are health care professionals, like me. I come from a work culture that values self-sacrifice and will power. After all, we have had to endure the long nights of call, with no sleep or food or even bathrooms breaks for hours at a stretch. Somewhere along the line, each of us cracked under the pressure.
Eventually when I sneak a peak up, I see that almost no one is looking at me. Most are staring ahead, seemingly absorbed in their own thoughts or just staring out the window. It feels like I am standing in an elevator, not making eye contact while listening to someone speak about something quite private, intensely personal. Well, at least it isn’t me talking, I think, as I try to settle my emotions which keep wanting to flare every time I think of the reason I am sitting here. I wonder about how my ‘cloak of competence,’ my professional veneer, has turned to become this burdensome cloak of shame.
Two months later, I am sitting in a session with a patient. She is laughing at herself, elaborating on a story of how she fell down drunk and had to be carted off to the ER. The nurses were huffy, she giggled, when she vomited in the bathroom. The doctor was impatient with her teary and elongated explanation of the accident. The other patients in the emergency room did not want to listen to her either. She chortles at her recollections, and then shrugs at me saying, “I know I was being stupid. Well … you wouldn’t understand.”
My smile freezes on my face. I feel inwardly offended. Of course I understand both the idiocy of that moment, and the jollity of the memory. Of course I do. I understand every single time a patient sighs at me, “Why do I do this again and again? I promised everyone I would stop, I really thought I would stop.” I get the frustration and the helplessness behind it. It is an empathic understanding that I thought she and I shared, but am I wrong? Does she really think I do not understand?
Then it hits me why she thinks this. What does she know about me? It is a peculiar relationship we have, in some ways so ‘intimate;’ I know her thoughts that she might not even tell her family or friends, and yet, she does not know anything about me.
I wonder if I should self-disclose.
After being in ‘official’ recovery for some months, it occurred to me that I was not being honest with my patients. I wasn’t expected to be. In fact I am mandated by my professional ethics to be friendly but private. I am supposed to engage in a one-sided communication: “You tell me your secrets and I will tell you my advice about you, but I share nothing personal about myself.” Giving information to my patients could be imposing a personal dimension that could complicate our utilitarian relationship. It could erode my credibility and my authoritative power. I am to keep strict professional boundaries and ensure that both of us always know that we are NOT friends.
This approach has worked for years. I have reasoned that patients do not want to hear my troubles, past or present, when they are there to offload theirs. I have often felt lonely, since these were people that I most identified with, more so than my professional colleagues or my non-addict friends. In retrospect, I think it has allowed me to hide, live vicariously in the relapses and recoveries of others without having to look at mine. As long as we were talking about YOUR addiction, we were not talking about mine.
I deliberately chose a home group away from where I would see patients. I got better at saying I was an alcoholic in meetings where no one knew me, but when I wore my professional hat, I felt this thick shame like a powerful snake about to envelop and squash me with its coils. When I saw a colleague in a meeting, I felt stupid, embarrassed. What was wrong with me that I was in this situation? How dare I work in the addiction field!
This attitude has changed as I have inevitably run into patients at 12-step meetings. “Heh, doing research?” some would ask. Others seemed really excited to see me and others just nodded from across the room. Some even said that they felt they could trust me more and take my advice more seriously. Self-disclosure seemed welcomed or at the very least, neutral. The problem seemed to be mine.
I once admitted my discomfort to another doctor in recovery. He shook his head vehemently. “It’s good to tell the truth. Patients really do appreciate the honesty.” I admit I feel the very same way with my addictions doctor, who has her own story of addiction and recovery. Even though we have disagreed on many issues, I always respect her opinions, while easily dismissing other colleagues who did not ‘get it.’
Standing up as a professional in recovery still takes all of the courage that I can muster. I admit, if I can leave it out of the conversation that I have with someone out of the rooms, like at work, I still do. If the situation feels safe for both of us, sometimes I do venture out and see what happens.
Of course, there is the issue of providing safe boundaries. Migrating from those must be done with great caution and consideration for the other person’s situation. Sometimes self-disclosure drops like a stone, but other times it opens up a window of credibility I have never experienced before. I wonder now, would my patient have wanted to hear that I had a similar story of foolish behaviour in a public place like the ER?
Mostly I love the anonymity of the rooms, where I can leave my white coat behind. I don’t like to be reminded of my job, as when someone comes up and complains to me about their doctor or asks what medication they should take for an ailment. I love my job, but not when I am a ‘drunk like everybody else in the room.’ It is hard to be both at the same time.