Editorial Comment  1/21/2020: Dreams Realized, Dreams Slain

Some days ago, I was witness to an extraordinary event.  That’s not quite right; I was an invited participant, in consequence of the way the event was handled.  Two friends married, for whom such a marriage would have resulted in imprisonment, or just as likely, the deaths of either or both spouses, just within this past century.  Wonderfully choreographed, with many hundreds of family and friends attending from homes thousands of miles afar, the marriage was between two exceptionally caring healthcare professionals who had been imaginatively, patiently planning toward this point for over eight years.  Their guests included a disproportionate number from our field; it was a happy, even hilarious event, the more for being a setting where abstinence felt comfortable and no conversations were taboo.  I asked one dinner companion if she thought such a wedding, between two gay partners as it happens, would have been tolerated in any part of this country, 50 years ago.  I marveled at society’s capacity for change, at the same time that I silently suspected that I was deluding myself.

Then, by contrast I read painfully through a NYT Opinion piece on the fates of the authors’ contemporaries, children together growing up in a small town in Oregon, Yamhill – “Who Killed the Knapp Family?” More an excruciating family biography than simply an opinion, authors Kristof and WuDunn provide it as an example of a two-generation-long tragedy.  The chronicle was, in the end, about the death of dreams and the victory of addiction over ambitions and values.  And that’s why I thought you might want to read it.   Because just as everyone deserves good friends and joy-filled weddings, ample food and fulfilling education, these conditions are contingent. They do not flourish or even survive in the Yamhills of America.

The NYT article is about much more than the soul-destroying nature of addiction, but it is certainly about at least that.  It further inventories the influences and deficits that not merely abet addiction in a small community; but which make it, for many, the only choice.  Such inventories are useful, they can form a task list for systemic change.

- Editor-in-Chief: Dr. William Haning, MD, DFAPA, DFASAM