(I apologize to anyone who may have heard me relate this story in the past, at a Western Doctors in Recovery meeting):

From 1988 to 1992, I was the medical director of the alcoholism and drug addiction rehabilitation unit at a facility we’ll call Very Large Army Hospital (VLAH). Coincidentally, “Fred”, a high school classmate, an Army officer and a pediatric oncologist, was also stationed at VLAH. We were at opposite ends of the hospital.

My job was to get a mixture of willing and unwilling, mostly active duty soldiers, sailors, airmen, and Marines, with a smattering of Coasties, to get well from their substance use disorders. They had a distressing tendency to fall drunk. In looking back over the statistics from that time, which the Army was fairly good about keeping, we had a five-year recovery rate of over 30%, somewhat over the average when you consider that relapse commonly meant discharge from service.

With great regularity, these young guys (mostly) would do stupid stuff. And I would grow furious, and go tramp off to Fred’s office on the exact opposite side, the antipode, of the hospital, which was slightly uphill from my own. I would purge myself while in his office, ventilating: about the inconstancy of my patient population, about their perfidy, about their unwillingness to accept appropriate therapeutic recommendations, about all of the injustices of the medical world. I would rant and rage. Fred, who in some respects resembled a sympathetic Bassett hound, with a lugubrious mien, would sit quietly and nod episodically.

On one occasion, I did all of this. And Fred, to my surprise, smiled. He had a lovely smile. After he had heard me out he asked, “Could I tell you about one of my patients?”  “Sure,” I responded, thinking that it was my turn to be the receptacle of complaints. And he proceeded to instruct me about a six-year-old boy, with an acute leukemia, for whom he had successfully, with many months of effort and the combined energies of an entire team, managed to secure a partial remission. He was ecstatic in reporting this to me. I hesitantly asked, “Fred, could I ask, how long is the kid likely to survive?” Still ecstatic, his voice lifting, he replied, “Oh, 3, maybe even 6 months!”

• I uncharitably thought to myself, what a lot of work.
• …And then it hit me, on the trek back to my office, amidst my unrepentant drunks, that Fred didn’t painfully buy a little kid six months just so a little kid could have six months more in the world.  He bought the little kid six months so that the parents could have six months more of their son.
• My error in perception centered on who was the patient.  Fred was attempting to re-frame my role. 
• Sometimes my treatment of our patients is incidental to the treatment of their families.
• Fred himself died not many months later, the outcome of an illness that had stalked him for many years.

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