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Doctors' Horror Stories of Drug Addiction

John Pekkanen--a noted medical journalist, book author and prize-winning magazine writer and editor--asked physicians to talk freely, frankly and anonymously about their work and lives for his new book, "MD: Doctors Talk About Themselves." He found that physicians--who often witness the terrible effects of substance abuse--have their own problems dealing with drugs and alcohol. This is the last of three parts.

December 06, 1988|JOHN PEKKANEN

I went into an anesthesiology residency and began my love affair with Fentanyl, a narcotic-anesthetic that we use all the time. I saw how great it made patients feel. I tried it intravenously. With Fentanyl, if you use it once, you are hooked. It removed every trace of anxiety and tension I had felt. But I never became so high that I felt detached; I felt efficient and in control. My mistake was in thinking I would always feel this way.

Getting Fentanyl was ridiculously easy. All I had to do was open a cabinet and take as much as I wanted. I'd use a tourniquet and syringe to inject myself.

I got away with this for months and all the time I was using more and more. When my addiction reached its height, I needed to shoot up every two hours. So if an open-heart case took four or five hours, I'd have to leave in the middle of the operation, go to the men's room in the OR suite, get my fix, and then go back to the operating room and continue surgery. I was so quick, I could inject myself faster than most people actually go to the bathroom.

I had the "M. Deity syndrome." You know--I'm smart, I'm in control of this. And, being an anesthesiologist, I told myself I would know when to stop to prevent any disasters.

Experienced Withdrawal

During one 20-hour neurosurgical operation, my relief came every two hours or so, and I went off for my Fentanyl fix. But later that night, my relief didn't show up for hours. I became edgy and distracted because I was experiencing withdrawal.

I was so distracted, I injected a blood product into the wrong port of a catheter. It caused a blood clot that went to the patient's lung, and the patient arrested. We gave him every drug imaginable--Adrenalin, calcium, bicarbonate--and we shocked him with the defibrillator pads a half-dozen times before his normal heart rhythm was restored. Luckily, he suffered no ill effects from the arrest.

People arrest during surgery for no apparent reason sometimes, so no one realized that my mistake had caused the arrest. At that time I was so deeply into my addiction that I even denied it to myself. Can you imagine? I had almost killed a patient, yet I convinced myself that I wasn't responsible.

Part of my recovery has been to admit my responsibility, which has been difficult, and to realize that I can no longer be an anesthesiologist. I have heard that about 85% of anesthesiologists and anesthesiology residents experiment with some of the drugs they give, especially Fentanyl, and I believe it. It's too tempting.

During my chief residency, I started to snort cocaine. I had a friend who sold it, so it was always easy to get. I had about 40 residents under me, and eight or 10 of us snorted cocaine together regularly, sometimes at the hospital. We'd go into the physicians' lounge late at night and have a little cocaine party while we were on call. I'm a hyper Type-A personality anyhow. Cocaine very quickly made me paranoid, but I still had a compulsion to use it.

After my residency, I was given a cardiology fellowship, an honor that can really help your medical career. But I resigned from it within a year because I had to be on call every third night for it and that meant I couldn't get high with alcohol or cocaine those nights.

I took a job in charge of an intensive care unit and a coronary care unit. I made $80,000 a year for a 50-hour week. I could make up the schedules, so I could have weekends off and work four days a week.

Blackouts Began

I started having severe blackouts during this period. They would scare me. I'd wake up in my apartment and couldn't remember how I got there or where my car was. It was only by the grace of God that I didn't kill anyone or myself when I drove home from bars. I never even got stopped by a cop.

I got into heroin next. I could get it pretty easily, but if I ran out, I would order a double dose of narcotics for a patient and give the patient half and myself half. I even had nurses I was dating get me prescriptions for Percocet, a narcotic. They would say it was for their grandmother and give it to me. No one ever confronted me about my drug or alcohol problem. You just don't go up to a doctor and accuse him of being a drug addict.

Each morning I'd carry about two dozen $20 bags into the hospital and take them into the bathroom or the on-call room. Here I was now making $100,000 a year, but I had to borrow money to get a flat tire fixed because I was spending $300 a day on heroin.

When I couldn't get high from heroin anymore, I took Quaaludes. I blacked out at the hospital once. At about the same time a nurse I knew told me she was worried about my behavior changes. My speech became slurred at times. I was really falling apart.

'People Are Concerned'

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