Treating the Impaired Physician or How Old Doc Meadows Got Sober

Updated: Jan 12, 2021

Video version available here.

Today, I’d like to talk about the treatment of the impaired physician, the doctor whose life is spinning wildly out of control, and whose medical career is on the line.

I’m talking about…

The old country doctor whose drinking has gotten terribly out of hand,

The young anesthesiologist dying of a fentanyl overdose locked in a bathroom stall,

The burned-out ER doc who discovered that crack cocaine gave him super powers,

The Little Old Lady Family Practitioner who injected herself with Demerol every 4 hours for her arthritis, medically necessary, don’t you know?

And the orthopedic surgeon who carried vodka miniatures hidden in his socks, to get him through the day.

Addiction occurs among physicians at the same rate as in the general population, about 10%. Unlike the general population, however, an intensive rehabilitation program, geared specifically for doctors, vastly improves their chances of long-term sobriety. Over 70% of these physicians will be clean and sober—and practicing medicine—five years later.

The question becomes, how was this accomplished, and can these principles be applied to anyone suffering from the disease of addiction? And, who were these doctors, what did they learn, and how did it change them?

“We’re all just bozos on this bus.” As a group, we were diverse: every specialty, every religion, every part of the country. We were frightened, for addiction had taken over our very lives. But try as we might, we couldn’t quit. In rehab, we had to accept the fact that we were all the same. Our disease was very democratic that way. No longer were we allowed to drive the bus, but they wouldn’t even let us navigate. Just sit in the back, they said, and try to pay attention.

“I don’t need anyone’s help.” As practicing physicians, we denied our problem to everyone, including ourselves. We isolated ourselves from our friends, our family, and our colleagues. Unfortunately, we found that we couldn’t do it alone.

All we could think about, was when we going to get high again. We were terrified that our using would be discovered. But if you had asked us, we could only say, “I’m fine. No problem here. Thanks for asking.”

“Rules were made for people who can’t think for themselves.” In many ways, the practice of medicine enables addiction: black and white thinking, tunnel vision, overthinking, an ego the size of Cleveland.

We were sure we knew the answer to every question and of course, we were always right. We wore the white cloak of invincibility walking up and down the hospital halls, and we carried arrogance around in our little black bags.

“One day at a time.” The slide into full-blown addiction was slow; a drink with dinner became a dozen or more. Party favors and pain pills, legally prescribed, became the order of the day.

Just as insidious was the decay of our mental function. Our get-highs were all neuro-toxins, killing or sickening the neurons in our brain

By the time we hit detox, we all suffered from depression. We were trapped in the thought patterns that carried us into addiction. And we held onto those old ideas with a terrible fierceness.

Our little white lies became outright dishonesty. Our slipping ethics became full-blown moral bankruptcy. We thought nothing of compromising our principles when they interfered with our using.

We found we could not think our way out of addiction nor into sobriety. Only prolonged enforced abstinence worked, until with time, our thinking gradually returned to normal, which, in most cases, took at least 3 or 4 months. Which is why 28 days is not nearly long enough.

“Hey! Who’s the doctor here.” We had to accept the fact that we weren’t the doctor anymore. NOW, we were the patient. It took most of us a month just to wrap our heads around this idea.

“The bottle was but a symptom.” Our problem wasn’t just chemical dependency. Our thoughts, our reasoning, our habits, our very character, had become warped. To untangle the knots of our disease required a wholesale rearrangement of who we were. Our minds, our goals, our priorities, our relationships, and more.

“You don’t have to change much, just everything.” We began the process of self-discovery, making peace with the past, removing the resentments and character defects which had hobbled us. We examined the mental patterns that got us so deeply into trouble. With much effort and a lot of help, we started dumping old ways for new ones.

The principles we needed turned out to be quite spiritual in nature. Sadly, they sounded much like the words of wisdom we learned at our mother’s knee.

“There is a God, and it sure ain’t you!” We had long ago abandoned the religion of our fathers. Medicine had taken its place. She was a harsh mistress, but we loved her. She gave us respect, position, and power. Oh, and don’t forget the money, the wonderful money!

But as our addiction took control of our lives, we worshiped at the altar of John Barleycorn and Lady Cocaine. We surrendered our will and our lives to them and did their bidding. They had become our Higher Power and they would have no other gods before them.

But now, they told us, we had to find a Higher Power we could relate to. A source of strength when the terrible craving returned, for it surely would.

Amazingly, for those of us who had styled ourselves as agnostics, when we reached out, we found something. Prayer became a part of our world, and much to our great intellectual surprise, it actually worked for us.

“I am not the thoughts in my head.” We discovered we could control our thinking. We were no longer at the mercy of our resentments or our emotions. We learned how to shed negativity in all its forms. We learned that we could decide which thoughts we wanted to keep, and which we could reject. This new thinking encouraged us to try new patterns of behavior.

We gave up self-seeking and began to care for our fellow man. We learned the dangers of our ego and self-will, when they were given free rein. The idea that we were the most important person in the world had to go.

The altruism that brought us to medicine in the first place, and which had died so gloriously in the days of our using, was rekindled.

“My job, my job, my job.” No longer was our medical career our number one priority. My new priorities were: my Higher Power; my recovery from addiction; and my family, in that order. And I’m glad to say that helping others was now back on the list.

When we listened to our deepest inner self, all manner of virtues came tumbling out, honesty chief among them. We liked the way it made us feel. As Thomas Jefferson said, Honesty is the first page in the book of wisdom.

“We ceased fighting anything and everything.” Overcoming our addiction changed us. Life was good, and getting better every day. We were at peace with ourselves, our world, and with life itself.

But like any other chronic disease, daily treatment is required. Constant vigilance of our thinking is necessary if we are to maintain our sobriety and our new-found serenity.

These principles used in the treatment of addiction to drugs and alcohol are not new, but they have been applied here with an enlightened intensity, so yes, they can be used on anyone who is ready to change.