5 minute read
Learning to Love Through Addiction and Loss
Ilearned of my dad’s death after my first organic chemistry class. It was the first day of my sophomore year of college. He died at home suddenly. His autopsy revealed he likely had a heart attack while experiencing an alcohol withdrawal seizure. Despite being intimately familiar with the impacts of addiction, I didn’t know that what he struggled with was a disease. At the time, I felt alone and ashamed because of what was happening to him and our family. It wasn’t until four years later—while sitting among patients at the Betty Ford Center in Rancho Mirage, Calif., as a medical student and summer intern—that I began to learn more about addiction and experience the healing power of connection. When I started studying at the University of Minnesota Medical School, I was still hiding all of my feelings and emotions related to my dad’s disease and death. I now know this is a common reaction to trauma and loss, which contributes to isolation and shame. Many families like mine cope in this way due to the stigma associated with substance use disorders and mental illness. We put our heads down and pretend like nothing happened. As I began my experience at the Betty Ford Center’s Summer Institute for Medical Students, immersed in treatment with patients and their clinicians, I was unsure if or how I would tell anyone about my dad. But as soon as I was asked to participate in a recovery group with a small cohort of patients. I introduced myself as a medical student, paused, and quickly shared—for the first time anywhere—that my dad had died of alcoholism. It was a profound beginning to my personal journey of healing and sparked a newfound purpose that would guide my professional pursuits. Throughout my immersive educational experience, I was flooded with emotions. I felt excitement meeting patients and professionals who openly spoke about their stories of pain, loss, and recovery. And I felt peace beginning to understand that my dad died because he had a disease—a disease like other diseases, worthy of medical care and compassion. The truth that I had felt was validated: my dad did not choose alcohol instead of me, he was compelled to the choice by his illness. He fought as best he could, until he couldn’t anymore, and I am lovable precisely because of my experience as his daughter and not in spite of it, as I had feared. His addiction was a terminal illness, as it had been for his father, and as it is—sadly—for many people across the world. For the first time, I was able to feel proud and connected to my family. This also created the opportunity to boldly connect my identity with my drive to become a physician. Fifteen years after experiencing the Summer Institute for Medical Students, I had the good fortune in 2021 of joining the Hazelden Betty Ford Foundation as a psychiatrist and medical director. Now, I get to help the next generation of doctors and share my passion for creating a society where all those impacted by addiction and mental illness can feel the love and connection I felt. I want all those suffering to feel belonging, pride, and a sense of resilience— especially those who are sickest and at risk of dying. Everyone, regardless of their current state of health, deserves to feel cared for and worthy. I implore those of us in health care to embrace patients experiencing substance use concerns by interacting with love, compassion, and acceptance. This vulnerability and tolerance can be hard. Not only does it require us to consider our own fears and biases, but to acknowledge our lack of familiarity and competence. We did not get enough education on addiction and recovery during our medical training. According to the National Survey on Drug Use and Health, medical students
only receive two to 10 hours of education about addiction even though this disease strikes one in 10 Americans over age 12 (Substance Abuse and Mental Health Services Administration, 2013). Instead, we are exposed most often to kindhearted physician mentors’ expressing frustration and fear while trying to avoid people who have substance use disorders—a reaction that makes sense in context. When we aren’t given the tools to care for people and are asked to do it anyway, it is burdensome and overwhelming. Unfortunately, to overcome this burden, we must act to educate ourselves. I encourage all physicians to learn how to screen for mental health and substance use disorders in your patient population. Practice brief intervention skills and tolerance. Find ways to refer patients to treatment. Accept that addiction is a chronic, relapsing and remitting condition for many — a disease process located in the brain that alters behavior and motivation. Come to understand that difficulties in illness management are the fault of the disease, not the individual. One of the most valuable skills I’ve learned from patients is letting go of my agenda for their lives. I communicate my boundaries and am transparent with my thought process when making a recommendation. Above all, I ask for permission to help, and try to model acceptance, love, and hope. Moving into my new office at Hazelden Betty Ford in Plymouth, Minn., I unpacked my copy of the Alcoholics Anonymous “Big Book” I had received during my medical school experience at the Betty Ford Center 15 years ago. Before placing it on the shelf, I re-read notes from patients I had met that summer. My favorite was written by a mother with grown children. It says: “I will never forget the experience we had together. It was a blessing. I can see now how my illness looks through my daughter’s eyes. This will motivate me in my recovery. Your dad loves you. I will be thinking about you and I know you will be a good doctor.” I’d like to think my father was speaking through her that day. Dad, I love you, too.
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Sara Polley, MD, is the medical director at the Hazelden Betty Ford Foundation’s national substance use and mental health treatment center for adolescents and young adults in Plymouth, Minnesota. Dr. Polley is board-certified in Adult Psychiatry, Child and Adolescent Psychiatry, and Addiction Medicine. She completed her Child and Adolescent Psychiatry fellowship at Boston Children’s Hospital, and was chief fellow during her final year there working with the Pediatric Addiction team on research-based interventions that integrate medical, psychological, spiritual, and social treatments for both individuals and families. Prior to that experience, Dr. Polley completed her Adult Psychiatry training in a joint program between Sheppard Pratt Hospital and the University of Maryland. She is a graduate of the University of Minnesota Medical School.
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