Learning how to manage stress is a huge part of being a good doctor. Consultant anaesthetist Dr Rachel Black opens up about her struggles with alcohol and how she overcame them

How did you celebrate passing your finals? Your graduation? Your last birthday? Chances are that alcohol played a significant role. How do you relax at the weekend? Pubs, restaurants, meeting friends? Alcohol probably features here too. What about after a stressful shift? A difficult meeting with your educational supervisor? Do you drink then? Is there anything wrong with that?

Medics are renowned for enjoying a drink or two. From drunken antics at university, to mess parties and conferences, all facilitated by a high income and a stream of new colleagues to have fun with.

Drinking alcohol is fine, in moderation. And therein lies the key word. Moderation. Either you can or you cannot moderate the amount you drink. It took me a while to realise I cannot moderate the amount of alcohol I drink; it took me even longer to accept it. For me one glass of wine on the way home was never enough.

The problem

I tried to restrict my intake, applying new rules after each drunken episode. Only drink with others. Only drink outside the house. Only drink on Fridays and Saturdays. Then Friday became my day off so Thursdays were included. Sundays rounded off the weekend and I deserved it.

As the cycle continued monster hangovers made it difficult to function the following day and I would drag myself through, clinging on, until the time came when I could again relax with another drink. The more I drank each night, the harder it became to cope with normal stressors in daily life: work, family and disappointments without it. The worse I felt, the more I drank, I truly believed alcohol was the solution, not for one moment considering that it could be the problem, or the cause of my discontent. Alcohol had become a problem.

Escalation

I was never drunk at work. I never drove when drunk. I never did anything illegal. I never drank when on call, but I made sure I could the nights before and after. I avoided driving and pursuits that precluded drinking. I was unable to do important things requiring concentration in the evenings; plan the calendar, banking, shopping. I would either forget or do them incorrectly. I never watched the end of a film, I was always asleep. The more I tried to control it, the less I was able to. Eventually I realised that my best intentions were meaningless; after the first drink, I no longer had control.

Choices

If you cannot moderate your alcohol intake you have two options. The first is continue to drink regardless. This way you will eventually lose all that is important to you: your self respect, your friends, your family, your career, your home. Your alcohol intake will progress to keep pace with your rising tolerance, and will invade further into your life causing dependency and bringing destruction.

The second option is to stop drinking altogether. This is the option I chose. After many failed attempts to moderate, I accepted that I had to stop drinking forever. How? It worries me how easily I got into that situation. I drank alcohol normally until I was 30. The next five years were full of pregnancy and breast feeding, but during this time I began to want more wine than was allowed. I returned to work and on paper I had it all: a fulfilling career, enough money, two healthy children, and a supportive husband.

Life was full and busy and I coped by compartmentalising. I was a doctor at work, a mother at home, a friend when socialising. ‘Me time’ had to be found and protected. Me time was wine o’clock and began as soon as the children were in bed and the chores complete. I would sit down with a glass of wine to allow my buzzing brain to relax.

Over time, wine o’clock started earlier, the volume of wine increased and the treat became first a need, then a dependency. I became concerned I was drinking too much and asked my husband’s opinion. “It’s not as if you’re downing a bottle of wine a night, are you?” he once asked.

No, I wasn’t, but by now I was regularly having half a bottle per night (sometimes two-thirds). A colleague then remarked she and her husband would have a bottle of wine each at night; red for her, white for him. This reassured me. This must be normal.

Very soon I too was drinking a bottle of wine most nights, and paying the price during the day; I was tired, irritable, complaining and negative about everything. I began to question the value I contributed to my family and wondered if it would be better for them if I left home and stopped aggravating them.

Depression

I didn’t leave home. I knew deep down I must stop drinking to survive and in doing so resign myself to a life of misery, sobriety and deprivation. I never considered wine as a disease. I believed it was the treatment. I never considered there would be anything to gain from giving up.

Giving up

Giving up was not easy and I had a few false starts. I am still challenged by thoughts of “Wouldn’t it be nice?” but they are just thoughts. I now know, in fact, it would not be nice.

The resulting magnitude of change in my life, my priorities, my thoughts, my likes and dislikes has astounded me. I now have more time, more attention, better concentration. I am a better mother, wife, friend and doctor. I am happier. I no longer seek parties and big nights out as before. I am content.

I am productive in the evenings now they are no longer a blur, and can drive my children to their activities without resentment. I am better able to deal with problems and stressors; my first thought being “Thank goodness I’m not hungover too”.

Moving on

After more than a year of being free from alcohol I can see that drinking excessively almost crept up on me when I wasn’t looking. Friends and colleagues had similar lifestyles and I was not alone or unusual in the amount I drank. It was a gradual change that I didn’t notice until it was dictating my life. Be aware of your drinking patterns.

Be aware of the slippery slope. If you think you drink too much, you probably do and one day may have to choose how you wish to spend the rest of your life.

Dr Black wrote a book about her struggles with alcohol. Her book is called Sober is the New Black.

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