The End of My Addiction

changed some names and identifying details.
    This book is not a self-help manual, and it is in no way meant to be a guide to self-treatment. Addiction is a serious illness, and anyone suffering from it should seek qualified medical advice and care. Likewise, baclofen, a prescription drug, should be taken only as prescribed and closely supervised by a licensed physician.
    —Olivier Ameisen

1. Moment of Truth
    I CAME TO MY SENSES and took stock of where I was: in a cab, with blood streaming down my face and spattering my trench coat. I looked out the window and in the glow of the streetlights saw the cab was on Lexington Avenue in Manhattan, waiting for the light to change at 76th Street. The church on the corner reminded me it was Sunday, and I looked at my watch. It was almost midnight. The few people on the street were buttoned up against the late winter chill, but it was warm in the cab.
    My apartment was not too far away, on East 63rd Street between York and First Avenues, but I needed medical attention. I asked the driver to take me to the emergency room at New York Hospital, at 68th Street and York Avenue. He seemed oblivious to my condition, and I wondered what had happened. Had the cab braked suddenly so that I hit my head, or had I been injured in some other way before I hailed it? I knew I’d been drinking, but not where or how much.
    As the cab pulled up in front of the hospital emergency room entrance, a memory of the evening began to come together. Around 8:30 p.m. I had visited my friend Jeff Steiner, the CEO of Fairchild Corporation, to ask his advice on running my cardiology practice, which I’d started two and a half years before. I’d been introduced to Jeff in the late 1980s by a mutual friend, another physician.
    Although I’d intended not to drink that evening, I felt insulted when Jeff’s butler offered me a choice of teas. “Why doesn’t he offer me an alcoholic drink as well at this hour?” I thought. “Is this a judgmental message?”
    I asked for and drank a glass of Scotch, then made a show of declining a refill. Much later I learned that Jeff was not aware that I had been drinking heavily. He’d known me only to have a few drinks at large parties, here and there, over the years. But my mounting concerns about my practice finances had changed that.
    The standard expectation is that it will take a new medical practice two years to break even. Mine broke even in four months. And almost three years later, in March 1997, there it remained—hovering a little over the break-even point.
    Staggering into the emergency room, I thought, “They will see I’m drunk. That’s not so good. But at least I know the place is well run and will fix me up right.” I had been associated with New York Hospital and its partner institution, Cornell University Medical College, * ever since I arrived from France in the fall of 1983 to do research and clinical fellowships in cardiology. Thirteen and a half years later, I was a clinical associate professor of medicine at Cornell and an associate attending physician at New York Hospital, in addition to running my private practice.
    Inside the emergency room, I passed out again. When I came to, one of my ex-students, Matt, now a resident, was standing over me preparing to stitch the wound in my forehead. So as not to be left with a scar, I asked him to use Steri-Strips instead. He did and then left me to lie quietly for a few hours so I could sober up enough to walk home safely. He was plainly even more embarrassed to treat me in my drunken state than I was to need treatment. I cringed at the thought of my appearance in the ER being discussed around the hospital, then pushed the thought out of my mind. Matt was not the kind of person to talk about it; that was some comfort.
    Lying there, I ran the video of the evening in my mind. “Run the video of what happens when you drink” was something I’d been hearing in Alcoholics Anonymous, where I was still very much a newcomer.
    My conversation with Jeff Steiner had been frustrating for us both. Although he was eager to help, there was a mismatch between his expertise and my problems. What I really needed was a small business adviser, not a big corporate dealmaker.
    As I left Jeff’s apartment, my mind whirled with conflicting thoughts. My cost-blind practice style might function better in France’s universal health care system than in the United States, I thought, and I wondered if I should relocate back