Fighting against alcoholism is a tremendous challenge and a thankless job, but Rajesh Patil, a surgeon has been recognised nationally for his fight against the disease. NT Network met with Patil to know more about his efforts and the effects alcohol has on people
Janice Savina Rodrigues |NT NETWORK
Alcoholism has wrecked many lives, torn families apart and often led to people losing all their hard earned money only to become bankrupt in a matter of a few months, if not weeks. There is a stigma attached to alcoholism, and the family of the alcoholic often has to bear the burden of this disease. Yes, alcoholism is a disease; a dreadful disease that tears up people and the very foundation of a marriage sometimes.
Take the case of Joseph (the Alcoholic Anonymous refers to people only on first name basis to adhere to the anonymous clause), who was a real estate businessman, but got caught up in the web of social occasions and ‘meetings’ with other business associates and high flying clients. “There was always a free flow of whiskeys and beers at these meetings. At first it began with a few pegs then it went to a full blown obsession and within a year I was addicted. My hands began shaking and then someone told me that if I drank a glass in the morning I would be better, and thus I began my morning drinking,” he says dolefully. Morning drinking is considered to be a sign of advancing into chronic alcoholism.
The addiction reached such a peak that Joseph began spending all his money on drinking. “I nearly became a beggar, I did not have money to pay my children’s fees and even when I was down to my last five rupees in the bank, I went to close the account and after deductions for the passbooks, I spent the last four rupees at a roadside bar,” says Joseph, who is now sober for the past 32 years.
Reading a case like this, people often feel it will not happen to them, that they will not give in and have the will power to overcome the temptation, but GMC doctor, Rajesh Patil says this is not the case, no one knows when or how you can turn into an alcoholic.
“A huge percentage of patients admitted to GMC either come due to alcohol addiction syndrome or due to various complications of acute alcoholism like pancreatitis and chronic alcoholism like Hemetemesis (vomiting of blood) or cirrohosis of liver. Many have difficult withdrawals. Most of the patients would recover but many would succumb to the illness. Apart from these direct reactions, there are other psychological reactions too, including suicidal thoughts, self assaults like stabbing themselves and abnormal sexual behaviour like inserting foreign objects into their rectum, including sticks and glass bottles,” says Rajesh Patil, a laparoscopic surgeon who was recently felicitated by the President of India for his work in the mitigation of alcoholism in Goa and beyond.
Having worked in the area for over a decade, Patil has witnessed alcohol wreck lives. More than the alcoholic himself, it affected the families and the caregivers including the nurses at the hospital. “My ward sisters would always complain that alcoholics tear bed sheets and mattresses and would be abusive in the ward. I observed that the number of re-admissions was also on the rise, this is the time I realised that alcoholic patients were getting well physically but mentally and psychologically they remained untreated. Due to their abusive nature many of them would not be welcomed in the ward,” he states. Patil thus decided to step in and take on the yoke of fighting the disease.
Alcoholism is a disease of denial; no alcoholic will take advice seriously especially when he or she is healthy. Being a surgeon, Patil is at an advantage when it comes to convincing patients who would seek treatment, but still convincing them is always a challenge, as many patients confessed inability to control alcohol intake.
It was at this point that the doctor realised that mere physical treatment of alcoholism is not enough to control the disease. “I explained the need for counselling alcohol abuse patients at GMC complex and our dean readily agreed. Thus we began the counselling group in Ward 111 nine years ago. We tried to understand how the disease of alcoholism can be treated holistically. These sessions stressed on the education of the spouses of alcoholics and also their children.”
Goa has about 72 Alcoholics Anonymous groups spread across the state. “We invite the members to come to the hospital and conduct meetings with the alcoholic patients. We identify the nearest AA group to the patient’s residence and advise attendance of regular meetings. We also provide telephone numbers of the group and in severe cases suggest a mentor to the patient as and when he gets a desire to drink alcohol. No patient is discharged without counselling in the hospital. We also encourage the spouses to attend meetings of Al-anon.” says Patil.
Al-anon and Ala-teen
Al-anon is an associate group that works with the families and friends of alcoholics, while Ala-teen works with the children of the alcoholics. “There are 26 al-anon groups and 3 Ala-teen groups in Goa,” says Patil.
Al-anon trustee Sarita (only first names are used) shares the Al-anon’s 12 step programme:
Admit we were powerless over alcohol — that our lives had become unmanageable
Believe that there is a higher power that could restore us to sanity
Hand over our will and our lives over to the God of our understanding
Make a fearless moral self inventory
Be humble and admit to ourselves and to other human beings of our wrongs
Be ready to remove all these defects of character
Humbly ask the higher power to remove our shortcomings
Make a list of all persons we have harmed, and be willing to make amends with them all
Make direct amends with people wherever possible
Continue to take a personal inventory and admit when we are wrong
Seek through prayer and meditation to improve the relationship with God as we understand Him, praying only for knowledge of His will for us and the power to carry that out
Accept the spiritual awakening and try to carry this message to other family members
Sarita has seen the vicious grip alcohol can have on the family members of an alcoholic, at first hand. Born into an average Goan family and being sheltered for most of her life, she was attracted to her husband for his adventurous ways. There was no sign of alcoholism at any point.
“After we got married, I moved to Mumbai, I noticed a drastic change in behaviour when he was under the influence of alcohol. Otherwise a kind-hearted person, he would become abusive, critical about everything. The turning point came when I lost my first born to cancer within a year of birth. I came back to Goa, and here at every few metres there was a bar and liquor was cheaper; it thus became uncontrollable. His drinking became worse by the day and eventually he drank all day and night,” she says.
The family’s condition deteriorated over time, with abuse and shame. “I became fearful when he was around. And my son too was ashamed to go to school, some of his classmates had seen his father coming out a bar drunk and they began to tease him relentlessly. There was no respect, no money. Our health deteriorated and we could do nothing about it,” says Sarita.
Even after he joined the AA there was still signs of stress in the family with the irritability and withdrawal symptoms. “It was then that I learnt to deal with him and let him be, I would say ‘the choice is yours’,” says Sarita, and since there was no more bickering, slowly her husband began to see sense in all that was happening.
Now the husband and wife have dedicated their lives to fighting against alcoholism and all that it entails.
The unlikely suspects
Patil has been witness to several cases of alcohol abuse, from school children, women and even within the police force.
“The constables are the worst affected, when the world is celebrating New Year or any other festivals, they are on high vigilance duty, if there is any dignitary visiting the state, they don’t get leave and often have to forego family functions including their children or sibling’s weddings. In this state they often resort to alcoholism,” says Patil.
Women are not left out when it comes to alcohol abuse. Studies have indicated that the percentage of women consuming alcohol has also gone up from 2.1 per cent a decade ago to 4.2 per cent during 2015-16.
“In my experience the number of women alcoholics is on a steady rise. Earlier not many would come to take treatment. Most of the women alcoholics suffer silently. We have an incidence of about 10 to l2 per cent among women alcohol addicts. The impact of alcoholism in women is seen on the entire family, the children suffer the most,” says Patil.
Apart from the social impact, Patil also outlines that alcohol has been one of the major causes in the decline in fertility. “Drinking in women can affect their ovaries and can be a causative factor for PCOD, irregular menstrual cycles. Consumption during pregnancy can lead to foetal alcohol syndrome, a major cause in cleft lips, palates and other developmental issues. In males, alcohol can affect Spermatogenesis, and thus gives rise to defective sperms,” says Patil.
Alcohol abuse is often linked to older people, but there has been a drastic change in the patterns of alcohol consumption leading younger and younger people to gulp down spirits.
Patil says that in Goa, adolescents as young as 12 and 13 venture into alcohol abuse. “Children are exposed to alcoholism at a very young age. The age of initiation is often 12 years as compared to a decade ago which was 20 years. Various myths about the beneficial effects about alcohol sometimes are the causative factors. Most of the children find role models in the house itself. We do get patients as young as 20 year olds with cirrhosis of liver. And it takes about 6 to 7 years of persistent drinking to develop cirrhosis of liver,” he asserts.
Speak to a few youngsters and they are bound to infer that alcohol relives stress and it gives them a ‘feeling of fun and enjoyment’. But ask Patil if this has any truth, and the answer is in the negative. “Not at all! I don’t believe that alcohol can really alleviate stress. No doubt it acutely decreases a sleep onset latency (which helps people to fall asleep) but at the same time it can fragment sleep and cause alteration between sleep stages and deficiency in deep sleep. The overall effect is repeated awakenings and restless sleep with bad dreams,” he says.
Need for stricter laws?
The first thing that people often do while crossing over into the state is to buy alcohol; thus the ban on the highway liquor shops across the country and the ban of drinking in public areas have definitely shown positive effects, however small the impact may be. “The laws prohibiting alcohol use are good, but implementation is the key,” says Patil.
The ban on highway liquor shops had a positive impact, according to the doctor. “25 per cent of the drinkers will find alcohol regardless of a ban; but 50 per cent of people may not buy alcohol if they don’t see it. This in the long run could lead to a decrease in high velocity vehicular accidents on the highway as far as drunken driving in concerned,” says Patil.
As far as the rules are concerned, Patil is of the opinion that there are equal numbers of registered and unregistered bars in Goa, and the bans only affect the registered ones, leaving the unregistered ones to operate without hindrance.
“I would give one suggestion to further the government’s move of taking the licences if found under the influence of alcohol – the licences should only be returned to the person after he or she has attended five to ten counselling sessions in the Goa Medical College. This is the system followed in some foreign countries,” says Patil.
With the award, Patil has now got a boost to work harder in the fight against alcoholism. The message that he wants to give is that: “One, stop before you start. And two, take help before the drink and not after it,” he concludes.