Monday, March 9, 2009

Doctor, Heal Thyself: An Addiction Memoir With A Happy Ending

Evelyn Fischel, staff member at Bernardsville Public Library, recently read this compelling nonfiction account of alcoholism and a promising drug treatment "cure." Here is her review:


Olivier Ameisen is a notable French cardiologist who practiced medicine and taught at New York-Presbyterian Hospital and Weill Cornell Medical College. A talented pianist, Ameisen was urged by no less than Arthur Rubenstein to pursue music rather than medicine as his intended career. He was also the first and only student to pass the French baccalaureat without having finished his last two years of high schooling. In addition, President Jacques Chirac awarded him the Legion of Honor for his "contributions to the image of France abroad and to cardiology." But Olivier Ameisen is also an alcoholic whose disease brought him to deepest despair, ruined his practice, and almost killed him.

The End of My Addiction, published in January 2009, chronicles Dr. Olivier Ameisen's desperate attempts to save himself from a hopeless descent toward incapacitation and likely death due to his advanced alcoholism. Having severely injured himself repeatedly in drunken falls, Ameisen found himself admitted to city emergency rooms where he risked having his secret condition discovered by fellow doctors. Personal relationships suffered, and his successful career as a New York cardiologist came to an end when he decided that he could no longer practice. Although he checked himself into numerous rehabs and participated in recovery programs, none of these therapies worked for him.

Some colleagues turned away from him, wondering why he just couldn't stop; a few tagged him as a hopeless case; others gave him encouragement and support. One man in particular, his M.D. thesis advisor Phillipe Coumel, expressed compassionate understanding, saying to him, "As a physician, how can you be embarrassed about having a disease?" This good mentor also motivated Ameisen's scientific curiosity, stating, "I cannot believe that a man of your intelligence cannot find the solution." And Olivier Ameisen did find a solution that worked for him.

The End of My Addiction is a compelling story about the terrible struggles and discrimination facing individuals with an alcohol addiction. It is also a work of medical detection recounting the author's self-experimention with an older medication, baclofen, approved as a fairly harmless muscle relaxant, but found to quell the cravings of cocaine addicts in a University of Pennsylvania study. Ameisen learned about this small study and ran with it, medicating himself with higher and higher doses of the drug until he reached a level where his brain no longer responded to any typical triggers and thus no longer created the cravings which drive addicts deeper into their addictions. Baclofen had completely suppressed the symptoms of his alcoholism, and no serious side effects were experienced. Dr. Ameisen believes this drug deserves a large-scale study, but points out that baclofen is an off-patent product and fears that pharmaceutical companies will not be interested in this kind of study. He has written this book to encourage investment in such a study and has provided chapters on the science behind his experiments.

At the same time The End of My Addiction offers a vivid, but compassionate portrait of what it is like to be an alcoholic today. It was very moving to read about the author's struggles with this disease, and he clearly makes the point that "willpower" is not equivalent to medicine. If people with other diseases were asked to will away their conditions, we would say that was absurd. The author does support the 12 step programs for their helpful behavorial adaptations, and he believes that attention should be given to underlying depression and anxiety when treating patients. Ameisen makes us rethink our assumptions about alcoholism, and he has demonstrated that there may be real hope of a successful medical treatment for this addiction. ~ Evelyn Fischel

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