When Doctors Can Hear, but Can’t Help

article-1286369-07BA6D6D000005DC-830_468x347Last week, I read a troubling article that fell under the column title “Hard Cases” in the New York Times. Read on and you’ll understand why.

The author, New York Times writer Abigail Zuger, M.D., wrote about a patient’s wife who called her to express concern about her husband drinking. Dr. Zuger was surprised to learn about her patient Tom’s drinking, and yet without Tom’s admission of a problem, there was nothing Dr. Zuger could do or say.

Dr. Zuger goes on to write about the difficulties doctors have detecting drinking problems that are not extreme, and that many patients try to save face. “A new analysis from the Centers for Disease Control and Prevention estimates that of the 38 million problem drinkers in the country, only one in six have come clean to a  health professional,” she writes.

The phone call from Tom’s wife made the situation clear to Dr. Zuger, yet she was forced to reply, “I’m so sorry. I can’t talk to you about that.”

There are moral and ethical standards whereby an adult patient’s health issues are his business alone. And of course, there is the law and the HIPAA (Health Insurance Portability and Accountability Act) which govern patient privacy.

Dr. Zuger did tell her patient, Tom, that his wife called, but didn’t say what she’d called about. She asked Tom if it would be okay for his wife to come to his next appointment, to which he replied, “Absolutely not.”

The story ended there. The doctor never met Tom’s wife or spoke with her again. But she listened and never forgot.

To read Dr. Zuger’s article, “What Patients Don’t Tell Their Doctors,” click here.

 

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A Month With No Drink–Two Years and Counting

images-3Two days, ago, I completed my now annual no-alcohol September. It obviously was not as novel an endeavor as last year’s (my first go at it), which I wrote about in a post linked here and have also pasted below. But going a month without drinking still posed its challenges and continues to be an experiment–a sort of test of my energy, my self-control, my mindfulness, and my emotional state.

September has always been an exciting month for me. While it marks the end of summer–a season that is hard not to love–I have a soft spot for autumn. For me, September is a time of renewal, and harkens back to my love of fresh, clean notebooks and brand spanking new sharpened pencils at the start of each new school year. So it seems right that September is an opportunity to cleanse my system of the tasty glasses of wine and chilled pints of beer I so enjoy consuming during the year’s remaining 11 months.

September is also a month filled with Jewish holidays–some happy, some not. As we both celebrate and repent with friends and family, flanked over crowded tables of food and drink, it seemed easy to focus on the spirit of togetherness rather than the gentle buzz that often fuels my conversation at a slightly faster (read: less inhibited) speed.

I will admit that the earlier part of the month was the toughest. The house was abuzz with two kids back to school, frenetic afternoons and no more leisurely summer dinners. A glass of wine would have been just the antidote, slowing things down a bit in order to wallow in the remnants of warm nights and after-dinner walks to the park with our dogs.

Without booze, however, my focus was clear and I was able to linger in the moment, mental energy intact. As the days of September continued, I began to think of one upcoming day in particular–my son’s bar mitzvah which was taking place on September 22nd. After months of planning every detail, including the selection of wines that I did not taste but instead lined up one evening for my husband and a couple of friends to compare and contrast–I wondered how it would feel to fill my glass with seltzer rather than alcohol.

“You know, you can have a bye on the 21st,” my husband told me. “It’s your son’s bar mitzvah.”

“I know,” I answered, unwilling to commit one way or the other.

The bar mitzvah day approached, and I started to take my mental temperature–would it be easier to give a speech with some wine in my system? Yes. Would it take less effort to navigate the room, schmoozing with relatives I rarely see? Yes. Did I need a liquid boost to bring me to the center of a rousing hora? No.

So I let the decision hang in the air, waiting to see how I felt on that day. It arrived, and after a beautiful service in the synagogue, our crowd of family and friends moved into the sukkah for cocktails. The sunlight was streaming through the leaves and branches that covered the bamboo ceiling of this temporary structure, and I felt overcome with the emotion of the day. I wasn’t nervous. I wasn’t stressed. I was happy and calm and reveling in the moment. I walked over to the bar and ordered a glass of white wine and enjoyed every sip.

After that day, I continued my month alcohol-free. And now, I’m kind of glad it’s October.

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A Month With No Drink–Six Days To Go

 

calendar-crossed-outJust over three years ago, I wrote a post on Drinking Diaries, announcing that my husband and I were going to be alcohol-free on Mondays. It sounds like no big deal–and it wasn’t–but it was the first time we had made a conscious decision to keep wine off the dinner table. We’re not big drinkers, but it wasn’t strange for us to have a glass of wine with dinner nearly every night. Three years later, we’ve stuck to our alcohol-free Mondays, and often opt for seltzer or iced tea on other days too.

In my continued effort to explore the role drinking plays in my life–and in celebration of our new Drinking Diaries anthology–I decided to go alcohol-free for the month of September. I’d been looking for an excuse to try abstaining for a month, ever since I interviewed Carrie Wilkens, PhD, cofounder and clinical director of the Center for Motivation and Change in New York City, for an article I wrote called “The Art of Mindful Drinking,” During our interview, I remember Dr. Wilkens saying that one of the first things she suggests patients do is to take time off of drinking. And so, I did.

Here’s what I learned:

  • It wasn’t as hard as I thought it would be.
  • I missed drinking most on Friday nights, a sacred evening for our family when we have a longer-than-normal dinner and always stay home.
  • I strangely enjoyed the challenge of saying “no,” particularly during occasions when I would normally have had a glass of wine or two, such as during our book party and at a gourmet dinner out with my husband.
  • All this time, I thought it was wine that was making me tired. But it turns out I still doze off in front of the TV–even without any alcohol in my system.
  • Last weekend, I had to tell a waiter several times that I wasn’t drinking, as he refreshed the glasses at our table from a giant pitcher of red sangria. It made me empathize with other abstainers.
  • I’d expected to feel more clear-headed and energetic without the alcohol, but I basically feel the same. Perhaps the amount I normally drink isn’t enough to make me feel fuzzy and lethargic?
  • I miss drinking when I’m eating a good dinner. There is no doubt that for me, wine not only takes the edge off, but also enhances flavors, adding to my enjoyment of food.
During that same interview with Dr. Wilkens, she explained that “It’s not unreasonable to have alcohol as a part of your life, as long as you are able to assess whether or not you are relying on it too much.” The key, she added, is imageslearning to consume consciously enough to know how you’re being affected.

Consciously is the key word here. And taking the month off of drinking has made me more aware than ever of when and how much I’m consuming. Another positive factor came from a parenting perspective–it felt beneficial showing my kids that I wasn’t drinking, allowing them to see that I am mindful of my alcohol consumption.

A month without drinking has me feeling refreshed and triumphant, and I’ll probably do this again at some point in the future. I’d be lying, though, if I said I’m not looking forward to the end of the month. I can already “taste” the tannins of a full-bodied cabernet in my mind. But first, I still have six more days to go.

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Wine and Serenity on Superbowl Sunday?

cgon175l-1I don’t know about you, but my Sundays (and some Saturdays) since September have been filled with football. I have a husband and a son who are fairly smitten with watching overgrown boys run around a field in any type of weather throwing and chasing a ball, and then falling upon one another to retrieve what seems to be as valuable as the Hope diamond, ignoring that they are potentially crushing someone else’s–or their own–skull.

It is commonplace on these long weekend afternoons for my two boys to sit on our family room couch, snacking on thick, extra dark pretzels (paying no attention to the crumbs and salt bits that fall in between the couch cushions), tossing a football and tackling one another or our dog during commercials–and drinking. If my twelve-year-old is feeling really hyped up for the event, he’ll ask if he can have a soda–usually saved only for special occasions in our house–while my husband opts for a cold Saranac Black & Tan, his beer of choice on these special game days.

When game time begins and all players–and viewers–prepare for the coin toss (or on some days the pre-game show needs to be screened first), that’s my clue to take to the living room. I’ll usually curl up on the couch, with either a cup of tea or a glass of wine close by–book, newspaper, and laptop at the ready for at least four hours of quiet time (save for the occasional shrieks coming from the next room).

Once in a while, my husband will gently request (“quick! come fast! hurry up!”) that I come and join them to watch a replay of some player running 40 or 50 yards down the field and then doing some kind of tribal dance in the end zone (that’s actually my favorite part). I oblige for the sake of my son–wouldn’t want him to think that his mom isn’t a woman with varied interests.

And then, I retreat to my corner in the next room. Happy. My husband chugs his beer and my son his soda, and both scream at the TV. I sip my wine (or tea), cozily engaging in my reading and/or writing. So, in truth, it turns out that football days are not so bad. This coming Sunday is the almighty Super Bowl. There will probably be a lot of noise coming from our house as of 6:30 pm EST when the Baltimore Ravens and San Francisco 49ers take to the field (full disclosure: I had to ask a friend who was playing). I may hide out at a neighbor’s house. Or maybe, just maybe, I’ll put down my book, opt for a beer, and relocate to sit with the boys, pretending that I actually care.

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An interview about drinking & traveling

caipirinhaWhen I’m not writing about drinking, I’m often writing about traveling. The daughter of two Europeans, I was taken along with my brother wherever our parents went–from France and Jamaica to Israel and Venezuela. I didn’t realize how lucky I was at the time, and as a result of all those journeys, I was bit by the travel bug at an early age. Experiencing different and foreign places, seeking adventures and exploring cultures are what I like to write about most.

At a recent adventure travel conference, I had the pleausre of spending time with a talented travel journalist and blogger, Ellen Barone, who invited me to do a Q+A for her blog about two of my favorite pastimes: drinking and traveling.

Of all the countries you’ve traveled to, who  are the heaviest drinkers and who are the lightest? 

The Brazilians love to party. I’m not sure if it has to do with the consumption of those potent, simultaneously sweet and tart Caipirinhas—touted everywhere as the Brazilian national cocktail—but after a couple, I had no trouble dancing the samba late into the night. The lightest would probably be in Israel. Israelis are not exactly known for their drinking prowess.

What’s your favorite country to drink in? 

While France first comes to mind, I’d have to say that Italy offers me a more diverse selection of drinks I like. An evening that begins with a glass of Prosecco, a Campari and soda, or a Negroni is bound to be a good one. I enjoy Italian wine, and then of course, what is better than a true Italian-made cappuccino?

If you’re a non-drinker, where’s the worst place to visit?

That’s a tough one. I can’t think of a place that I’ve been to where alcohol is not rooted in the culture—from Ouzo in Greece to Arak in Jordan. By the same token, many countries serve delicious, alcohol-free drinks with locally grown fruits. It’s easy to get hooked on passion-fruit smoothies in chicha moradaThailand and on Chicha Morada (made with purple corn, fruit, cinnamon and cloves) in Peru.

Is there a travel story in your book, Drinking Diaries?

There is a wonderful essay in our book, “Veni, Vidi, Bibi (I Came, I Saw, I Drank”), which is essentially the writer’s quest to find information about an Italian peasant woman whose image adorns the bottle of a liquor called Amaro Lucano and who may be the author’s ancestor. The writer, Helene Stapinski, travels back to her family’s southern Italian town of Pisticci, to get answers. The way she describes her encounters with the locals—all of whom attempt to serve her Amaro Lucano—is very colorful.

To read the complete interview on Travel Updates by Ellen Barone, please click here.

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A Thanksgiving Transition

by Caren Osten Gerszberg

Thanksgiving is my favorite holiday. It’s everything cozy—autumn’s chunky sweaters, deep red wine and warm cider, hearty food, a roaring fire and most of all, close family and friends—jammed into one wonderful day.

I cook for days, mostly alone, and with little stress develop a fairly traditional menu, including an array of dishes that I know most at our table—foreign, health-conscious and kids included—will enjoy. With abandon, I sauté and carmelize, roast and bake and love practically every minute of it. Just like my mother once did.

This year, however, Thanksgiving will be different–a sort of unfortunate transition–as it’ll be the first one without either of my parents present. My father passed away six years ago, and my mother, who is still alive, is not invited. It’s not to say that I don’t want her here, because I do. But I’m choosing not to have her join because her acute anxiety, depression, and alcohol problem have reached such an intense level that I don’t feel like subjecting myself, my family and our friends to her behavior. It may sound cold, but truthfully, I am full of sadness about it and not sure if it’ll feel like a relief or a gaping hole come next Thursday.

This year, I will celebrate a version of Thanksgiving with my mother—one day early. My husband, kids and I will go to the assisted living community where she lives and celebrate with her on Wednesday. I’m not sure that she’ll notice or care that she’s not with us on the actual day. But all I’ll have to do is remember the difficulty of a previous thanksgiving to remind myself that I’m doing the right thing.

This is how it went previously.

Thanksgiving arrived, and although I wondered if my 24-pound turkey, which I’d named Matilda, would ever actually be done (she took about 6 hours), my hopes were high for a lovely day. My husband and kids played basketball out front in our driveway, and my dog trailed me, sensing when I was going to use the turkey baster and hoping she’d get to lick a drip of anything meat-related. Following an urge to blast some loud music, I decided to be a bit zen and put on Mozart instead of Dave Matthews. The day was going without a hitch.

And then, my mother arrived. At 77, she looked good physically, and I was glad to see her. But the predictable was only moments away.

“Can I please have a glass of wine?” she asked.

“You can have one glass, with dinner, so just wait until then,” I answered.

My mother, a French native who has always loved wine, grew to love it too much about ten years ago, and her love morphed into an addiction which continues to plague me at every event—both big and small, mundane and celebratory.

Moments later, a friend chased me through the kitchen, clutching a glass and obviously uncomfortable as my mother followed closely behind her.

“Here, Caren,” she said. “This belongs to your cousin but your mother was drinking it when he got up to go to the bathroom. I thought you may want to know.”

I looked at my mother-turned-child, and like the stern authority I needed to be—lest she get drunk, slur her words, and become an embarrassment to her grandchildren—I told her: “NO! You can have some wine with dinner and you need to wait.”

We sat down at the table. She kicked back a glass of Sauvignon Blanc, and without hesitation, asked for more. Her request for more wine was relentless and continued throughout the meal. And dessert. While we talked Thanksgiving trivia and my son told some turkey jokes, friends began passing the bottles to the other end of the table, trying to make the temptation a little less for my mom. She followed me into the kitchen, asking again and again, until finally, I picked up the phone.

“I need a taxi. How long will it take?” I inquired, trying to breathe deeply and keep calm.

Ten minutes later, I ushered her into a taxi. She complained that she didn’t want to leave, but I stood firm. I was just trying to cut my losses before it got worse for both of us.

Once she was gone, I could finally relax, but not without feeling brokenhearted. I wanted my mother to be here, to share in a beautiful family tradition that we’d always shared–despite her not being born in this country. For years, she had seamlessly hosted a house full of people, where being grateful went along with a table laden with scrumptious food.

But she’s not the adoring mother I knew. I miss that mother. But I still love Thanksgiving.

Caren Osten Gerszberg, a freelance journalist, is co-editor of Drinking Diaries: Women Serve Their Stories Straight Up, just named one of the “Best Bathroom Books 2012 by The New York Times.

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