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Bob-American Weekly, March 11, 1951 |
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I'm a Nurse in an Alcoholic Ward
by
Anonymous
The
author--a onetime alcoholic--has nursed 5000 drunks
through the fading hours of their most spectacular sprees.
Here is what she has faced in salvaging doctors, lawyers,
ministers, priests, housewives and stenographers
from drink and the devil
A
redheaded woman in a mess is really a mess, and five years
ago I was just that. Like well over 100,000 others, I found
my way to sobriety through Alcoholics Anonymous. AA says
that if you want to stay sober you have to help somebody
else get sober. Since
I was a nurse, it seemed logical that the best way to meet
this requirement would be to find a job in an alcoholic
ward.
That’s
how it happens that during the past five years I’ve
nursed more than 5000 alcoholics through the fading hours
of their most spectacular sprees, in the AA ward of Knickerbocker
Hospital in New York City. Helping other alcoholics to get
well has become my life work.
Friends
look at me with frank disbelief when I tell them I love
my work because I meet so many nice people. That statement,
applied to men and women who have indulged in every folly,
benign and malignant, may be a little hard to swallow, but
I really mean it. In five years only one patient has ever
taken a swing at me, and it was a woman patient, at that.
Being female myself, and redheaded besides, I promptly socked
her back. After that she was very co-operative.
The
only other violence was of my own instigation. A fresh,
peppery little man—he came about up to my shoulders--kept
pestering me for a drink, and drinks are not served in alcoholic
wards. To stall, I told him he would first have to take
his pill, which I knew would put him to sleep. “No
drink, no pill,” he said, and I retorted, “No
pill, no drink.” This kept up until my patience was
gone. I turned the little fellow over, paddled his bottom
and said, “Now, will you take the pill?” He
took it nicely, and from then on we were good friends.
One
thing has begun to be a little irritating, but only because
of its monotony. About every third male patient, when he
first comes in, takes a bleary gander at the white uniform
and the red hair and croaks out a sally that’s supposed
to brighten everybody up--“H’r’r’m’m’m,
do you go with the room?" They usually apologize the
next day.
Yes,
most alcoholics are nice. In no other branch of nursing
within my experience are such respect, consideration and
gratitude accorded the nurse by the patients. Even the most
berserk were likable before they ran afoul of firewater,
and can be likable again. The recovered alcoholics I have
known have been quicker to help and readier to forgive,
possessed of a livelier understanding and faster wit, than
the general run of people. After recovering, that is. Drunk,
they can be pretty dreary.
The
origin of our ward is closely connected with the origin
of AA itself. AA was founded in 1935. By 1939 it was evident
that, though the movement was reaching a pitifully small
percentage of the alcoholics who needed help, it was nevertheless
achieving greater success than anything else ever had. Sufferers
flocked to AA by the hundreds, many of them needing immediate
medical treatment. The AA program of rehabilitation is based
on understanding, friendliness, honesty and faith--all things
requiring maximum application of the mental and moral faculties.
Many desperate drunks who wanted AA could never stay sober
long enough to do the necessary clear thinking.
At
this point a great team--the AA founders.“ Bill,”
a New York broker, and “Doctor Bob,” an Akron
physician--stepped forward with an idea. Why not a place
where sick alcoholics could be sobered up under expert care
and at the same time gain a foothold in AA? Private-hospital
officials, conditioned to believe that drunks could mean
only pandemonium, were chary. Then, in 1939, such a ward,
of eight beds, was established at St. Thomas Hospital, in
Akron. In 1945, Knickerbocker, a private general hospital
with 200 beds and a forward-looking management, agreed to
open its doors, and thus the first AA ward in the East was
born. The third floor of one wing, with a capacity of nineteen
beds, was given over to the experiment.
The
ward’s success surpassed its backers’ hopes.
AA volunteers are on round-the-clock duty, ready to discuss
the temptations and techniques
of the life of sobriety. Half our patients, we estimate,
go out from Knickerbocker into immediately successful AA
lives, and two thirds eventually find their way to recovery.
St. John’s Hospital, in Brooklyn, and St. Michael’s,
in Newark, have opened wards after the St. Thomas-Knickerbocker
pattern, and other hospitals have the plan under consideration.
I’ll never forget my first day on duty. I spotted
a wistful-looking little man with a red face and blue eyes
waiting outside the ward. He was alone, and I knew that
no patient could be admitted to this particular ward unless
accompanied by a member of AA. Eager to demonstrate my efficiency,
I said brightly, “Don’t worry, we’ll take
care of you. Where’s your sponsor?”
I
took his bag and was about to remove his hat when he turned
kindly old eyes up at me and said, quietly, “Relax,
young lady; I’m Doctor Silkworth.”
At
that moment I wanted to sink through the three floors to
the basement and on down into bedrock. Dr. W. D. Silkworth
was widely known as one of AA’s first medical advisers.
Besides, he was the doctor in charge of the ward! Since
then I’ve learned to tell the difference between doctor
and patient, and possibly a few other things. You can’t
work with a man like Doctor Silkworth--as I did until last
year--when, at the age of seventy-eight, he died--without
learning something.
The
traffic in our ward is evidence that alcoholism is no respecter
of prestige. Two eminent men appeared for treatment just
a few weeks after their pictures had appeared in advertisements
as endorsers of special brands of strong waters. Ministers
and priests are frequently our guests, as are doctors, lawyers,
engineers, pilots, editors, housewives and stenographers.
Contrary
to a popular notion, the alcoholic is not just the man in
the gutter. The scion of a Social Register family once inherited
a sizable fortune while recuperating in one of our beds.
We’ve had a prominent judge, a famous senator and
a member of Parliament. Practically every race and nationality
has been presented, and the patients’ occupations
have spanned the alphabet from auctioneer to zither player.
Our sample indicates that Irish stock is the most susceptible
to alcoholism, Jewish the least, and that no ethnic group
is immune.
Influx
by occupations seems to be related to the calendar. Around
mid-December we get a lot of housewives in the women’s
ward. Early in January the policemen begin coming in, and
a little later that month the musicians. In February there’s
a concentration of publishing people--illustrators, writers,
editors, advertising men. March is the month for business
executives, great and small, and April brings a parade of
salesmen. The rest of the year it’s an odd assortment
of bankers and peddlers, sailors and tailors, stenographers,
bookkeepers and storekeepers, with an age range from nineteen
to eighty-one.
As
for the seasonal tides within occupations, one must remember
that a person is not an alcoholic just part of the time.
If he’s an alcoholic at all, he’s one all the
time. He needs only an occasion involving extra liquor and
extra tension to set him off. These situations seem to arise
at different times of the year in different occupations.
Take
the housewives. Around the middle of December the kids are
home for Christmas vacation. The weather is bad and they
can’t be out of doors all the time, so they’re
underfoot and quarreling. There’s the endless business
of Christmas shopping--what to get Uncle Fred, and did old
Aunt Minnie give us anything last year, and how much to
spend? This last factor must be weighed against the family
budget and the husband’s disposition. On top of all
that, the routine work must go on, but it’s the season
to be convivial. What is more helpful to the spirit of joy
than a little nip, particularly since people are freer with
their liquor at this time of year? Then there are lots of
parties. And there’s the haunting feeling, to a person
having even a sketchy religious background, that Christmas
was supposed to mean something quite different from all
this. A woman who’d been walking the alcoholic tightrope
up to then might easily fall off and land in Knickerbocker,
with me.
Cops
have a similar situation. During the holidays they have
more traffic, more shoppers, more
thefts, bigger crowds--in short, more police work of every
kind. Bartenders are known to be solicitous of the men in
blue. When holiday business is good and weather bad, there’s
no lack of little nips to warm ye. Christmas and New Year’s
tips to the officer on the beat are traditional, and they
frequently come in the shape of a bottle.
The
alcoholic cop may be able to stay in harness through New
Year’s Eve somehow, but he’s likely to be ready
for expert care very early in the year’s first month.
The same goes for the orchestra lads. The holidays are the
time when they play their biggest jobs, get their biggest
tips and
the most free liquor.
Why
the publishing crowd comes in during February, I don’t
exactly know. My hunch is that the so-called “creative”
folk may be a little more sensitive to weather than the
rest of us, and those February doldrums in these latitudes
would get almost anybody down. One February we had quite
a delegation from the editorial staff of a famous, and somewhat
snippy, national magazine. I guess those creative imaginations
got going on how nice it would be in the tropics, and local
reality seemed just too grim. But as I say, you have to
be an alcoholic first, before the weather can do much about
it one way or the other.
In
many industries, orders are placed for the whole year in
one of the early spring months. These are tense times for
executives and salesmen. If it turns out to be a big year,
they’re exuberant; if it is a bad year, they’re
gloomy; and both states of mind are sure to bring action
from the alcoholics.
On
entry, our patients are a beaten and penitent lot. They’ve
been picked up by AA’s wherever they happened to be
when they called for help. They come from precinct lockups
and flophouses, Bowery dives and penthouse suites, suburban
estates, country clubs and furnished rooms. Nobody is ever
brought to our ward against his will. Indeed, they’re
given to understand by their sponsors that they’re
lucky to get in. We have no repeaters—patients are
admitted once, and only once. Sponsors deliver them, their
suitcases and eighty-five dollars in cash in advance, then
leave. Now begins the five-day course.
Once
signed in, the patient’s first two days are the most
worrisome. It is in this period that deep depressions due
to remorse are most likely
to occur. The ward came near being discontinued during its
first month, when a depressed patient found his way to an
unbarred window and jumped three floors to his death. AA
supporters quickly passed the hat, raising $1000 for strong
steel screens. We’ve never had another attempted suicide.
No patient is admitted who shows signs of oncoming delirium
tremens or convulsions--these are sent to a municipal hospital
equipped to handle disturbed patients--but sometimes the
doctors guess wrong. Last year, among 1000 patients, we
were caught with two cases of convulsions and a dozen of
DT’s.
Delirium
tremens must be sheer hell. Its onset is marked by acute
nervousness. First come the auditory hallucinations; then,
usually the visual. The patient hears his name being called,
or a violent argument in progress, or non-existent loud
music. Then he begins to see things. I’ve had patients
ask me in all seriousness to watch where I stepped so I
wouldn’t squash the strawberries. One demanded to
know how the geese got into his room. These visions are
sometimes, but not always, frightening. The strawberry and
goose people were quite calm about what they saw. Heaven
knows what fiends and horrors they’re seeing when
they scream. The worst case I ever saw
was a man who was convinced he was being run down by a train.
Most patients, during DT’s, have moments when they
know that what they’re seeing is not real--and times
when they’re completely convinced of its reality.
No
one condemns the alcoholic as he, when the remorse is on,
condemns himself. We give them vitamins to re-establish
nutritional balance, fruit juices to combat dehydration,
and bromides and belladonna for jagged nerves. By the third
day they’re beginning to take an interest in the world
again, and that’s where Duffy’s Tavern gets
in its wonderful work. (Duffy’s Tavern is a kind of
clubroom in the men’s division, where patients meet
and talk.)
The
five days are planned as a chain of healing that will lead
back into a life of sober usefulness. The first couple of
days there’s nothing much to do but medicate and feed
them and maintain an attitude of good-natured understanding.
This in itself, for people who are accustomed to contempt,
hostility and despair when they’re “on one,”
is an important part of the treatment.
I
have a couple of devices of my own for maintaining morale.
Every patient gets a nickname. “Cuddles,” “Peaches,”
“Saint Anthony, " “Pontius Pilate,”
“Napoleon,” “Pinhead” and “Windy”
are my favorites, and I use them over and over. We also
make a good sport of treatment with the B-complex needle.
This is inserted in the part of the anatomy scientifically
known as the gluteus maximus. When I come into Duffy’s
with the needles, calling, “All right, boys, bottoms
up!” I can always count on an assortment of grunts,
groans, grouses--and laughs.
On
the third day, patients are encouraged to move around. In
the women’s ward, there’s visiting from room
to room and talks with AA’s from the outside; and,
for the men, socializing in Duffy’s Tavern. The patient
begins to realize he’s not alone in his plight. If
others can endure it, he guesses that he can too. The fog
begins to clear, and memory, at least partly, returns.
One
time a husky tugboat captain who’d been staring gloomily
out the window of Duffy's suddenly snapped his fingers and
exclaimed, “Nyack!” "What do you mean,
‘Nyack!’?” asked a mounted policemen.
“That’s
where I left my tugboat, ten days ago!”
the skipper replied.
“Hey,
I just remembered,” said the cop.
“You
know where I left my horse? Van Cortlandt Park.”
People
sometimes wonder how we AA’s can extract so much comedy
from our own tragedies. Alcoholism is tragically foolish
and, believe me, there’s very little comedy when the
drinker first realizes the full consequences of his drinking.
After
the calamity is honestly faced up to, though, and a new
life has begun, we figure there’s no use brooding
over it.
One
of our patients, a New York politician, took a route to
Knickerbocker which is typical of some of the more flamboyant
toots. He’d been drinking for several weeks and had
obviously had more than enough when he stepped into a bar
where he was well known and ordered a drink.
“O.K.,”
said the bartender, noting his condition, “but first
you better go out and get a ham sandwich and a cup of black
coffee.”
The
politician discussed this step with another drinker. Concluding
that it was sound, they set out for a nearby diner. On the
way, they got to talking about the races in Florida.
“Let’s
go,” said the politician.
“O.K.,”
said the friend. They took a cab to
La
Guardia Airport and in a short time were in Miami. The politician,
besides being a follower of the races, had a wide acquaintance
in the New York and Miami police departments. A policeman
recognized him as soon as he stepped off the plane--his
heavy overcoat and derby were easily spotted in the Florida
sun.
“Look,
chief, you’re drunk,” said the cop.
“You’d
better go home.”
“I
guess I am a little, at that”’ said the amiable
politico, and stepped aboard the next northbound plane.
Back in New York the same bartender was on duty at the same
bar.
“Where’d
you go for that sandwich?” he
said,
spoofing. “Florida?”
“Yeah,”
the politician said, and in a couple of hours the bartender
was drunk’ too, loudly asserting that it could not
be. Meanwhile the AA alarm had been sent out for the ward
boss, and a pair of AA’s who’d been scouting
New York for him closed in.
The
silliest story I ever heard in Duffy’s was about a
party I nicknamed Old Number Seven. His wife, to bring him
off a prolonged binge, had removed all his clothing except
his underwear, while he slept and had locked his closet
door. When he awoke he was faced with the problem of how
to get out and get a drink. He found a pair of tennis sneakers,
ripped a square of cloth from the sheet, painted a big figure
“7” on it, pinned it on his back and stepped
out onto the avenue as a cross-country runner,
headed for his favorite saloon.
AA
volunteers, many of them graduates of the ward themselves,
drop in at Duffy’s and swap yam for yam. In this way
many patients realize for the first time what alcohol has
been doing to their lives and glimpse a way out. One man
convinced his wife that the best plan for their security
in old age was to sell their home and invest the proceeds
in “a sound business”—a bar and grill.
He quit the office job he’d held for thirty years
and went into the liquor business. He drank up the establishment--capital,
surplus and profits--in a year. Facing up to what he’d
done, he resolved, in Duffy’s, to start clean. Now
he’s one of our most effective volunteers. He hasn’t
got his home back yet, but he’s back at his old job,
pays the rent provides meals and stays sober.
One
wealthy suburban housewife, mother of six school-age children,
was the worst brat of the lot. Everything was “simply
too much” for her. The children were too noisy and
demanding, her husband too busy and preoccupied, household
routine too dull, the cares of community living too numerous—she
had to get drunk, for solace. Our ward, followed through
by AA brought a change. Now she not only has ample time
for her home, her husband and her children but is also a
skillful AA worker, president of her PTA and a truly wonderful
person.
The
fifth and final day of our treatment brings its own special
hazards. The patient’s head is clear, his strength
has returned and he has found new and understanding friends.
Now he must face the world outside, the mess he has himself
created. He slept poorly the night before. This uneasiness
is so common that we even have a fancy name for it--“predischarge
tension” Discharge day is the despair of many alcoholic
wards. To many patients, the shambles outside seems beyond
solution--they streak to the nearest bar, the deadly cycle
begins all over again, and much good work is undone.
Our
ward takes certain precautions. Nobody can be discharged
unless he has been signed out, in person, by his sponsor
and has been safely conducted to his home. He’s encouraged
to attend the weekly meetings of his local AA group. There
he learns that other men and women of his community--some
of whom he knows and respects--have somehow found the courage
to deal with situations at least as disastrous as his own.
He digs in. In almost exactly half the cases, he’s
back in a few months as an AA volunteer, ready to help others
back along the path to sobriety.
Of
course, we have our casualties. Every now and then I hear
of somebody who once spent five days with us and who is
now dead, either of convulsions in some other hospital or
a suicide somewhere. These are the sudden ones; the slowly
dying are just as pathetic. There’s a nice old gentleman
who lives in a big house by the seashore, alone except for
a butler and maid. He doesn’t need AA, he says. Every
time he gets tanked he calls me up and begs me to marry
him. In this condition there’s no use trying to talk
any sense into his head, so all I can do is kid him along.
It’s kind of hard, though, when I know for a certainty
that one of the lonesome little drinking bouts of his is
going, pretty soon, to be his last.
The
reasons for failure are among the many mysteries connected
with this baffling disease that researchers are still trying
to unravel. Some people seem incapable, drunk or sober,
of the clear thinking necessary to grasp and apply the AA
program of living. There are physiological, neurological,
racial and cultural influences that are only beginning to
be understood.
But
one of the greatest hazards, in my opinion, is pride. Many
thousands with otherwise sound minds are enduring alcoholic
torture rather than humble themselves to share the companionship
of the genial ex-tanks of high and low estate who make up
their local AA groups. They, and those who care for them,
pay a terrible price for such pride. I know a “self-made”
business executive who came home drunk one night and was
exasperated when he found his wife and daughter asleep.
“Just to get a rise out of them,” he fired a
bullet into the wall, lay down and played dead. He says
he’s not an alcoholic!
My
own story? Humdrum enough. I was born in New York City,
attended Catholic grade and high schools until I was eighteen,
then spent three years in nurse’s training at St.
Mary’s Hospital, in Passaic, New Jersey. I was a happy-go-lucky
kid, and the glamour of the nurse’s cap wore off when
I discovered the discipline and effort it took to win one.
When I met a big, hearty and, at that time, thoroughly enchanting
Swiss, I gave up nurse’s training and took an office
job in New York to be near him. We fought hilariously for
seven years and then were married. Sometime during that
period I found time to finish my nurse’s training,
but I never worked at it.
My
husband was a man who worked hard, played hard and drank
hard, though he was not an alcoholic. At the time unaware
of any distinction between the mere heavy drinker and the
alcoholic, I drank with him. His recreational passions were
hunting and fishing. I went along on his sporting trips,
enjoying them thoroughly--up to a point. That point was
when I’d got liquored up and was feeling sorry for
myself. I was “neglected,” and I began to make
spiteful remarks. My patients tell me I have a ready tongue
even when sober, and in those days I must have been something.
Our quarrels, once more or less good-humored, grew increasingly
bitter. My drinking, I now realize, was showing definite
alcoholic symptoms.
I
was bored most of the time, and drinking seemed a handy
antidote. We had had no children. I lacked the initiative
to practice nursing, and time hung on my hands. A couple
of the girls would drop in at our apartment during the morning.
We’d talk for a while, then have a drink. I’d
nibble at the bottle during the day and would be pretty
well along by the time my husband came home. A few drinks
with him and a party that night and I’d either be
blind, stupid, quarrelsome drunk or passed out.
How
many times I’ve heard those admonitions that haunt
every alcoholic: “Why don’t you just have a
few and enjoy them? Why don’t you drink as we do?”
Why couldn’t I stop, once I started? I didn’t
know. Exactly how my husband and I stuck it out for eleven
years I’ll never understand. The blowoff came in 1945.
He told me he was through and packed me off to Reno.
It
was a devastating blow to my pride. I thought I’d
been the one who was putting up with him. I learned, suddenly,
that he’d been tolerating me. During the next two
years I worked in a Reno department store, toured in Hawaii
and visited San Francisco. I returned to my own family in
New York in 1947, completely licked. I now found that I
couldn’t drink at all without getting drunk. Therefore,
I had to be careful. My life was made up of stretches of
sobriety punctuated, at ever-closer intervals, by short,
despairing binges. When my brother-in-law told my about
AA, I was ready.
My
first AA meeting was, in many ways, a disappointment. There
was a strictly “low-bottom” panel that night,
that is to say, the speakers were not Harvard and Wellesley
graduates--“bottom,” in AA parlance, means the
lowest state of alcoholic squalor a person will accept.
Their drinking had carried them so much farther along Hobo
Highway than mine that we seemed to have little in common.
It left me with a conviction, though, that these people
had the answer. The Twelve Steps of AA won me immediately--admit
our frailty, seek God’s guidance, repent our misdeeds,
make amends, take a moral inventory, help others. Here was
religion actually lived. Many are successful in AA without
believing in God. To me, the highest power has always been
the same God I used to know in church. Here I also learned,
“once an alcoholic, always an alcoholic,” which
explains why, even after five sober years, I say that I
am, present tense, an alcoholic. We stay sober one day at
a time, never forgetting that we are alcoholics and therefore
cannot take the first drink.
After
a month of daily increasing happiness I was struck with
an overwhelming sense of gratitude. I was grateful to that
lonely handful of men who formulated the AA principles of
recovery and set them down; grateful to the thousands of
alcoholics who, in the face of every conceivable difficulty
and temptation, had picked up these tenets and doggedly
clung to them, fighting to hang on to their sobriety so
it could be passed on to me. I felt I must do something
in return.
When
I learned about the AA ward at ‘Knickerbocker I knew
what that something would have to be. I was a trained nurse.
During all the years I had frittered away, that training
had seemed meaningless. Now it made sense--I was meant to
work in that ward. I bombarded the supervising nurse with
telephone calls by day, and prayers to God at night, and
three months later I got the job.
These
five years have brought deep satisfactions. I can’t
convey how much it means to me to see the transformations
in people. They come to us physical, mental and moral wrecks.
They leave encouraged but still uncertain. Then, months
later, they come back--bright-eyed, rosy-cheeked, eager
to help; job back, family back, going concerns again, ready
to pass on, with dividends, what’s been given to them.
To
know that I had some small part in this rebirth is a blessing
far beyond what I deserve. The failures, the lost ones?
Well, they’re sad, of course. However, we must accentuate
the positive. But for the grace of God, all of us might
have been lost.
(Source:
Saturday Evening Post, October 18, 1952)
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