Alcoholic Stigma in the Doctor's Office

By Amy Dresner

(Originally posted on THE FIX on 07/24/15)

I went to see my Russian Medi-Cal disability psychiatrist and learned the stigma against alcoholism was still alive and well.

If you weren’t sure that the stigma against alcoholism was still alive and well, I’m here to tell you it is. 

I went to see my Russian Medi-Cal disability psychiatrist. Yes, the same one who called me “unstable” after reading my chart for two minutes and was more concerned with my financial and marital situation than she was with my psychiatric history. I brought my Russian-speaking bestie, hoping that her ability to wax poetic in their native tongue might buy me some bonus points as my vague resemblance to an '80s Soviet Union prostitute wasn’t cutting it.

The office was manned by miserable, rude, doughy middle-aged women wearing too much make up. I looked at the local Ruskie papers that might as well have been hieroglyphics to me. An extremely depressed black guy in a hoodie, clutching his shoes to his chest sat down next to me. I smiled stiffly. 

My name was called and my friend and I went into Mrs. Putin’s office. 

“Which one of you is Amy?” she asked.

“I am, “ I said.

“Well, how would I know? You haven’t been in since last June.”

This is going to go well, I thought. I shot a sideways glance to my friend and she began to speak to the good doctor in Russian. The following is all translated:

“I’m here because you weren’t very nice to my friend the last time.”

“I won’t be nice to her this time. She is here for more drugs.”

“She’s here for Prozac,” my friend said calmly.

“I know exactly who she is and what she’s been up to, drinking and all that.”

“You have no idea who she is,“ my friend said.

“I don’t need more alcoholics in my office.”

“Let’s go," my friend said to me. "She isn’t going to be nice to you or helpful. She doesn’t need more alcoholic patients.”

My mouth dropped open and before I could explain again that I was two years sober and had just left a meeting as the goddamn motherfucking secretary, all that came out of my mouth was a soft, almost whispered, “You fucking cunt.”

My friend, also in recovery, went off on her in Russian. She took off her sunglasses and with her piercing blue eyes calmly said that doctors should work not just with their heads but also their hearts and that she was a heartless monster. The doctor looked at her in quiet shame. I was already out the door and in the parking lot, chain-smoking and pacing furiously.

I was PMSing so I was particularly agitated this day. I was sporting tits that rivaled Pamela Anderson’s and acne like a 16-year-old that worked over a fryer. Coming up against this type of discrimination from a doctor no less, ignited a rage in me that I was scared I might not be able to contain.

I was so angry I was almost crying. It had been years since I’d been accused of using when I was clean. My parents have always been extremely supportive of my recovery. They weren’t happy about my addiction and multiple relapses but I never felt like they were judging me, more that they were concerned and unsure of how to help me anymore.

Later, when I called my sponsor to complain, I got my ass handed to me for my lack of restraint of pen and tongue.

“You might be the only version of the Big Book she ever comes across. I don’t think calling her a ‘fucking cunt’ is going to change her mind or her behavior.”

Boom. You could hear the cloak of shame fall over me. 

“And maybe, just maybe, this was a blessing because she would not be able to give you the kind of care you would need or want.”

Double punch to the gut. I dropped.

But don’t doctors have to take the Hippocratic Oath of treating the ill to the best of their standards? It’s not like I went in there, bloody and shitfaced, demanding a bunch of Class 2 drugs. I get that she’s Russian and alcoholics are more prevalent in that community than borscht and more violent than Charles Manson on angel dust, but still. Even though they have begun teaching about addiction/alcoholism as a “disease” in medical schools, the social stigma still exists as it being some sort of moral weakness or sign of degeneracy with recovery being the exception and not the rule. 

In the program, there can be a weird type of reverse pride ... a competition of who drank, shot, snorted the most, who had the lowest bottom and rose like a phoenix from the ashes. There is a perverse type of hubris that comes from being the most bad ass, thumbing your nose at the Grim Reaper, or the law and still coming out alive. I, myself, am guilty of this but I think for many of us, it is a way to handle and reframe the shame. If we can’t revel and laugh at the degradation, how can we get past it? But holy fuck, was I reminded this day in the doctor’s office of how the public still sees alcoholics. As a single chick who’s dipped her flat foot in the waters of online dating (read: Tinder), I was sensitive to the fact that being a former drug addict would not, for most people, be an asset. It’s like telling somebody you have herpes (which I don’t by the way). It could most definitely be a deal breaker. 

A recovering crackhead lawyer had this story to share: 

"Once a partner in my law firm (years ago), before he knew anything about me, said, 'Isn't drug addiction gross?' Of course, I had to say, 'Oh yeah, it's disgusting.' He was my boss. But knowing that I was an addict (who preferred one of the "grossest" drugs ever) and that I have a brother who is homeless, and schizophrenic, and utterly off-the-map crazy from years of shooting meth, the comment made me feel like a pile of shit. And I carried that feeling with me for all of the years that I worked at that firm. Knowing that I was gross. That my family was gross. That I was a sub-human creature. It has bothered me and stuck with me ever since … Because in my darkness, where I want to die, where I swallow handfuls of pills just so I can sleep, even though I know the combination may well kill me, I know that they are right. Thankfully, I live most of the time feeling the light and being able to stave off that darkness. And I walk down hallways and sidewalks feeling not like a gross drug addict, but as someone who has managed, for now, in this moment, to recover from a terrible fatal illness." 

A comic confided this to me:

“I basically felt like I had to cut the past out of my life. (I never did AA, so no amends.) Certain friends, etc., honestly brought me shame and discomfort to be around. Worrying about mistakes you made and people judging, looking down, or not trusting you ... Even if they didn't say anything or think it ... I was assuming they were. I am a much kinder, better person now. But in their eyes, they only saw the 'old me' or at least I assumed they did.”

Both wished to remain anonymous for this piece.

I realized I haven’t experienced much outright “prejudice.” Writing for a recovery mag, being a voice of addiction for Huff Post Live, being “out” with my alcoholism/drug abuse/sex addiction, being surrounded by program people … I suddenly realized that I had been living in a bubble wherein I was out of touch with what much of the “real world” still thought about alcoholics and addicts and why anonymity is still crucial for some people.  

I was referred to another psychiatrist, also Russian, and when I explained the prior situation, she asked, “Why you didn’t get along?”  

“She didn’t want any more alcoholic patients,” I explained.   

“How long are you sober?” she inquired.  

“Over two years,” I said.

“Yes, well I’m not taking anymore patients right now, I’m sorry.”

Uh huh. And the hunt for a doctor with a heart goes on…