How's Your Marriage, Doctor?

Although I've written on the subjectof drinking and doctorsbefore, alcohol overuse, misuse,abuse, and dependence continue to dogmy practice. This article offers a bit of avariation, in terms of a route to care.

Worries from the Family

Last year I received a telephone callfrom the 33-year-old son of Dr. and Mrs.Smythe. His words were, "My sister and Iare really worried about our mom anddad. Since he's retired, the two of themhave become a couple of drunks." At hisrequest, I met with him and his sister formore information. I learned that Dr.Smythe was age 68, having retired fromradiology 3 years previously. Mrs. Smythewas the same age, a former nurse, mother,and homemaker. Her children describedher as an alcoholic for many years,in denial and never open to getting anassessment or being treated. They didn'tknow when she had last seen a physician.

They described their father as codependentand an enabler of their mother'sdrinking. Over the years, he placatedthem when they tried to talk about heruse of alcohol. He drank but minimally,his father having died of cirrhosis—untilthe past couple of years. His speech wasoften slurred when he called, and theyfound empty gin bottles in the trunk ofhis car and a stash of liquor hidden in theworkshop of their summer property.Things had deteriorated to the pointthat the son and daughter didn't wanttheir parents coming over to see thegrandchildren.

Reclaiming Their Lives

I told them to let their parents againknow how worried they were, that theyhad come to see me, and that I would bemore than willing to meet with them andtry to help. The following day, Dr. Smythecalled and said, "My wife and I would bedelighted to come in, anything to appeasethe kids, they and the grandchildrenmean the world to us." The visit was interesting.They were a proud and dignifiedcouple, elegantly dressed, formal, and abit pedantic. Lots of words were spent ontheir rationalizing and minimizing theiruse of alcohol, describing their children as"worry warts," and blaming their kids'spouses as "teetotalers and very judgmental."They presented a united front.

I made the strategic decision to leavethe whole subject and build rapport byasking about other issues. They were veryopen to returning. As they were leaving,Mrs. Smythe said to me, "On the way overto your office, Dr. Myers, we decided tostop drinking completely. If that will pacifyBob and Paula, then why not? No hugesacrifice on our parts."

They did stop, and 11 months laterthey are still not drinking. Our visits havefocused on classic retirement issues for Dr.Smythe (eg, need for structure, returningto avocations, taking up new hobbies, andsharing household responsibilities with hiswife) and their marriage (eg, balancingtime together and time apart, renewingtheir sexuality, budgeting on a fixedincome, planning travel, and makingimprovements on their cabin). I found aninternist for both of them, and they go toa health club together. They are doingvery well and seem happy—and so is theextended family, from what I can tell.

Michael F. Myers, MD, a clinicalprofessor in the Department ofPsychiatry at the University ofBritish Columbia in Vancouver,Canada, is the author of Doctors'Marriages: A Look at the Problemsand Their Solutions (Plenum Pub Corp;1994) and How's Your Marriage?: A Book forMen and Women (American Psychiatric Press;1998). He is the past president of the CanadianPsychiatric Association and welcomes questionsor comments at myers@telus.net.