Sylvester C. Sviokla, MD, ABAM

medicine bottle

I was filthy and smelled horrible. I caught wind of myself occasionally and was repulsed. I was destitute and ashamed. I was living on an apartment building roof top in Manhattan Beach, California. I only climbed down to obtain/steal some more vodka. I was drinking about a quart and a half a day. Although the days were warm that early winter, the nights were cold. And I had reached the point where all that vodka only knocked me out for a short hour or less per day. When I awakened from that brief restless escape, I was shivering and obsessed with the thought that I would not pass out again for another whole day. I was hopeless and desperate.

It was only a little over a year earlier that I owned a beautiful home in La Jolla, California and was running a very successful emergency department in the city of San Diego. I was ostensibly on top of the world- albeit a world that was rapidly crumbling. I had begun writing Vicodin extra strength prescriptions for myself in other people’s names and had reached a point where I needed 150 of those monsters a day to keep me out of withdrawal. It had taken me about a year to reach that amount and I knew I was living on borrowed time. My brain had developed tolerance to the hydrocodone, as my liver had to the acetaminophen. Although getting caught would instantly ruin my life, I just didn’t care. The thought of the impending withdrawal when I did get caught had to be pushed off as far into the future as possible. When that day arrived, it was worse than I had imagined. The Medical Board of California was at the door of my house as I was arriving home from work one afternoon. I drove on by and checked myself into a hotel to hide, but that didn’t work! They summarily revoked my medical license which meant that I lost my job, my identity and my only source of income all in one fell swoop. The details of the complete destruction of my life as I knew it provide fodder for another story at another time. Trust me; the fall was devastating in its extent.

The acute withdrawal period from the opioids lasted for a couple of weeks. My legs, my bowels and my brain never stopped moving. Dysphoria means that one feels “bad” and I was dysphoric. They need to invent a new word because that doesn’t do “bad” justice. In spite of the continuing fatigue which is characteristic in the post-acute withdrawal period, I managed to stay drug and alcohol free for about eight more weeks as my world was crashing down around me. I was in continuous mental anguish and decided that good old legal alcohol might provide me some relatively harmless relief. Wrong on all counts! I soon had to move north to the LA area after losing my home in La Jolla. My wife went to work for the first time in 30 years so she could afford to rent an apartment. I was a defrocked doctor and even my two Harvard degrees did not render me employable. It was on the roof of the very apartment house in which she rented that I chose to live in secret so that I could continue to drink. Every once in a while, I would wander into an AA meeting on my way back from one of my vodka runs. I was drunk but quiet. I sat in the back and kept hearing stories that made me think that I was just like those alcoholics. What I couldn’t figure out was how I was different. I climbed back to my tar paper and gravel covered lair, sat with my back against my favorite chimney or air vent and tried to figure it out. How should I stop? When should I stop? I needed to think about it some more. I would often wander over to the edge of the roof and wonder whether a head first dive to the concrete below would end it all. I was pretty sure it wouldn’t since the building was only a little over two stories high. Why couldn’t I figure this thing out? Why couldn’t I just die? It had just passed midnight and it was the first of December 2000. I was staring at half a bottle of Popov vodka, straining hard to compare myself to those successful members of AA I had envied. And then it hit me. I wasn’t like those alcoholics, I was one of them. The obsession left me that night at that instant. What those sober members had in common was that they had stopped drinking. They didn’t think about it, they didn’t talk about it; they didn’t plan it- they simply stopped. I could stop now, because they all had. It was like looking at an Escher print in which I suddenly saw that it really depicts white birds on a black background and not the other way around. I had no more information about the print; I just had a change in perception. I haven’t touched a drug or drink since.

The instantly acquired joy of that night was the knowledge that I could do it. I was going to make it after all. Although it took nearly five years to regain my license, I made progress, no matter how small, every day. I studied my disease and became board certified in addiction medicine. I treat addicts daily and love my work. I have regained the respect of my wife and four children. I wrote a book about my experience “From Harvard to Hell…and Back” and a publisher actually picked it up. I speak to young doctors every year at Rhode Island Hospital about the increased risk of addiction. I was asked to speak about my experience to England’s largest charity addiction group’s annual conference (Addaction) in Manchester UK. I had the honor of addressing the department of cardiac anesthesia at the Massachusetts General Hospital about my story a year after they had helped me through open heart surgery. The list goes on and on. But the greatest joy I know today is that my family believes in me and not one of my eight beautiful gifted grandchildren has ever seen me impaired. More than that, they trust me and seek me out.

Dr Sviokla graduated from Harvard College and Harvard Medical School. After his surgical career was interrupted by a hand injury, he successfully ran Emergency Departments on both coasts before succumbing to his opioid and alcohol addiction and losing his medical license for 5 years. He is now Sober for nearly sixteen years, is board certified in Addiction Medicine and practices in Rhode Island. He is medical director of Phoenix House RI and the author of “From Harvard to Hell…and Back”.