The Only Life I Could Save

by Katherine Ketcham

  “I had to put my own name in my own newspaper as a drunk driver,” Bill remembers with a self-deprecating smile and a sad shake of his head. “That brought some interesting letters to the editor.”

  In one of the worst episodes “in those dark days,” Bill drove up to Spokane, Washington, for a job interview. “I interviewed for a lot of jobs back then,” he said with a sad, sideways smile. “I figured if I could only find the right job, I wouldn’t drink so much.” After his interview, he decided to celebrate at a fancy restaurant.

  “Guess what?” he says, eyebrows raised, his smile somewhat subdued. “I lucked out and arrived at the beginning of the happy hour. The house specialty was martinis served in one of those wine goblets they call tulip glasses.” He chuckles but without his usual mirth. “More like a goldfish bowl than anything else. I had three ‘bowls’ of martinis (because the price was so good, I told myself), and then I had a full bottle of wine and an unremembered amount of after-dinner brandy.”

  I think my eyes must be huge because Bill laughs. “Alcoholics can really put it away,” he says. “But what may seem like a blessing is actually a curse.”

  After the brandy, he remembered only two things—looking at the speedometer, which read one hundred miles per hour, and stopping for gas in George, Washington. From George to Walla Walla, a distance of one hundred miles, Bill drove in a blackout.

  Two months later, Bill was offered the job at the P-I. He asked for a month off and voluntarily entered Alcenas, a twenty-eight-day alcoholism treatment program in Kirkland, Washington. Three days after completing treatment, Bill started his new job and his new life.

  I will never know why Bill told me his stories, except that maybe it was one of those “God things.” I’m not a religious person. I don’t believe there is a mythical figure sitting up in the clouds dispensing favors and hobnobbing with angels. But I do believe there is a force in this world that throws color, light, and goodness all around, a hidden power that is greater, stronger, more enduring than the dark energies of ignorance and prejudice. I am willing to call it “God” for want of a better word. Whatever this force is, however it happens to work its large and small miracles in the world, I do not doubt it is there, fighting the good fight, pushing us along when we hesitate, lending us grit and gumption when we are most in need, and helping us put up with our imperfections and the flaws and limitations of others.

  God thing or not, some bizarre quirk of happenstance places me in that office with Bill Asbury, who gives me his stories, trusting (I believe) that they might spark something inside me. Somewhere along the way, my life switches tracks, and whatever I had planned or hoped for in terms of a career or a future was suddenly not mine to design or control. Bill’s stories grab hold of me and don’t let go. Something had happened. Some “thing” had come into Bill’s life—it shook him empty of reason, right thinking, and good living and came perilously close to destroying him and all that he loved. Then some “God thing” did battle with this “some thing” and brought him back to the life he was meant to live, the person he was meant to be.

  What happened? The question haunts me. Once planted, Bill’s stories take root and grow to the point at which alcoholism is just about all I can think of. If my goal is to be a writer, then wow, here is a subject worth writing about. Now I’m the one walking into Bill’s office (not quite comfortable enough to put my feet up on his desk), asking him questions; trying to figure out what he means when he says alcoholism is a disease, what causes it, why some people get it and others are spared, and how it can so totally change your personality, dreams, goals, and desires that everything you love becomes less important than the drug.

  One day (and looking back, I wonder if this was Bill’s plan all along), Bill suggests that I read a monograph by James R. Milam, PhD, the person who founded the treatment center where Bill got sober. He hands me a bright, yellow-covered booklet titled The Emergent Comprehensive Concept of Alcoholism. I devour every word, although I understand about half of them. It’s the most incomprehensible document I have ever read.

  “Milam is brilliant,” Bill laughs, “but he can’t write for beans. His head is up in the clouds. He needs someone to bring his ideas down to earth so normal people like you and me can understand them. Why don’t you write an article about him?”

  What a gift—a writing project! I jump headfirst into the research, attending Milam’s lectures and interviewing him at Alcenas, filling entire notebooks with scribbled thoughts and verbatim quotes that I type up on my ten-year-old Smith-Corona (my high school graduation present from my parents). Milam slightly terrifies me. I’m five feet, three inches tall, and he’s well over six feet, with a craggy face that looks as if it were carved out of granite (thus his great difficulty forming a smile) and a deep, resonant voice. After we spend several dozen hours together, he seems to warm up to me, but he never hesitates to tell me when I ask a stupid question (“You just don’t get it,” he thunders, more times than I can count) and constantly reminds me that I have a lot of work to do if I’m going to accurately communicate his concepts to the world. I don’t have any set ideas and nothing really to prove, so I don’t argue with him, but I can’t pretend his comments don’t sting. He’s a tough one, but I console myself with the knowledge that he’s got a point—I do have a lot to learn.

  I write an article titled “Alcoholism: A Disease Not a Disgrace,” followed by another article and then another, all three published in a Seattle magazine. Milam likes them enough to pull them together into a pamphlet that he hands out to patients and their families at his treatment center.

  “Why don’t you write a book with Milam?” Bill asks me one day.

  “A book?” I’m not at all sure he’s serious.

  “Sure, why not? You’re young; you’ve got the energy; Milam knows you and maybe even likes you, which is saying something,” Bill chuckles heartily. “And people need this information in digestible form. Go for it!”

  The idea excites and petrifies me. Who am I to think I could write a book? But, I argue with myself, this isn’t about me—it’s about the importance of communicating Jim Milam’s brilliant concept of alcoholism to a larger audience. If I can break through the scholarly verbiage and impenetrable layers of his monograph to reveal the simple theory behind it all—that alcoholics become addicted to alcohol because their bodies are physiologically incapable of processing alcohol normally—then maybe, who knows, maybe such a book will offer help and hope to alcoholics like Bill, my sister’s husband who is definitely showing signs of out-of-control drinking; my friend Elizabeth’s elegant, binge-drinking mother; my favorite uncle; and all those other millions of struggling people.

  I talk to Pat, my fiancé, about the book idea, expressing my doubts that I can “go the distance,” as one writer friend describes the process of writing a book. “I have no doubt at all you can do it,” Pat says. “You’ve got the passion and the drive.”

  I raise my eyebrows at him. “Oh, yeah,” he laughs, putting his arms around me, “and the talent.”

  I write two letters: one to Little, Brown and Company in Boston and the second to tiny Madrona Press in Seattle. My letter is heartfelt, promising to change the world for alcoholics and their families. Little, Brown sends a nice letter back, letting me know that they have another similar book in the pipeline, but Dan Levant, Madrona’s publisher, calls and asks me to lunch. We dine on Chinese food that he orders for both of us at a little hole-in-the-wall restaurant in Seattle’s Chinatown. I offer to help pay the bill, but Dan just laughs.

  “I don’t know why I always make deals over kung pao chicken,” he chuckles, “but I’d like to offer you and Dr. Milam a contract and a $3,000 advance.” A contract! An advance! I can’t control myself—I throw my arms around his neck and give him a big kiss on the cheek. Then I invite him to my wedding.

  Pat is working on his master’s degree in Bellingham, two hours from Seattle, spending his days searching in rock specimens for 300-million-year-o
ld microscopic fossils called foraminifera, and I’m hunkered down in the University of Washington library with thick texts explaining the biochemical and neurophysiological mechanisms of alcohol addiction. I’ve never been particularly interested in biochemistry or neurophysiology, but I’m enthralled by descriptions of the microsomal ethanol oxidizing system, alcohol dehydrogenase, acetaldehyde, tetrahydroisoquinolines, and mitochondrial disfigurations. I’m hooked; I can’t get enough of this stuff. I take all my notes by hand and later transcribe them on my electric, noncorrecting typewriter. Wite-Out correction fluid is my best friend.

  Under the Influence: A Guide to the Myths and Realities of Alcoholism sells 50,000 copies in hardcover before Bantam Books buys the paperback edition for $17,000. I’m floating on air. Madrona buys my second book, which focuses on the benefits of nutritional therapy for alcoholics, titled Eating Right to Live Sober and coauthored by Ann Mueller, MD, medical director at Alcenas. Pat earns his PhD while I’m writing that book, and we have our first child, Robyn. Two years later, we have a second child, Alison, and Dr. Mueller and I write a book titled Recovering: How to Get and Stay Sober.

  When Pat is offered a tenure-track job teaching geology at Whitman College, we move to Walla Walla and buy a small Cape Cod home for $55,000 (my father loans us the down payment). Two years later, Ben is born, and I start work on a book with intervention specialist Ginny Gustafson titled Living on the Edge: A Guide to Intervention for Families with Drug and Alcohol Problems.

  Books and kids. Life is good. I’m head over heels in love with my husband, our children are healthy and tons of fun, we have a close group of friends, and Walla Walla is a peaceful, friendly place to live. I couldn’t be happier. Over the years, I write books and more books—a book on the fallibility of eyewitness testimony with world-famous memory researcher Elizabeth Loftus; followed by a book with Ernest Kurtz titled The Spirituality of Imperfection: Storytelling and the Search for Meaning; another book, The Myth of Repressed Memory with Beth Loftus; and two books on traditional Chinese medicine with acupuncturist and herbalist Jason Elias.

  I’m moving away from addiction, and it feels good. After writing hundreds of thousands of words on the subject, it seems as if nothing has changed. I was so hopeful way back when, and now, when I hear people arguing about whether addiction is a physiological disease or merely a symptom of psychological or emotional problems, I want to scream, “Read the damn research!” Decades of scientific study by distinguished experts—biochemists, neurophysiologists, geneticists, pharmacologists, psychologists, and on and on it goes—provide the basic facts we need to understand addiction. We know what the disease is, and we know how to treat it.

  The knowledge is in our hands, but it seems we keep shoving it into the background as new theories come rolling in. Anyone with a website or a PhD can promote a theory about drug addiction without paying much attention to the long-established facts. Medical students receive little or no training in addiction, and yet most of the people sitting in doctors’ offices are, in one way or another, affected by the disease. Alcoholics are referred to psychologists and psychiatrists, who all too often have no training in addiction and who therefore mistakenly assume the causes of excessive drinking or drug use are emotional or psychological, which they treat with talk therapy or drugs. Would we send someone with a newly diagnosed cancer (also a chronic, progressive disease) to a psychologist to uncover the reasons behind the spreading malignancy? Treatment for addiction is haphazard, often substandard, and insurance often doesn’t cover it. If they’re lucky, addicted individuals are offered three or four weeks of inpatient care, after which they are released to fend for themselves with little or no follow-up. Would a heart attack patient be released from the hospital with no follow-up appointments or plans for ongoing continuing care?

  It drives me crazy. I had high hopes once upon a time that the world would be a kinder, more generous and forgiving place for addicted people, but now I just feel frustrated and sad. I’m tired and worn out. I want to write books on happier subjects. Maybe I should stop writing altogether. I don’t know. With the kids in high school and middle school, I wonder if it’s time to cut back on work or even switch careers. Secretarial work sounds appealing—I’m a really fast typist and have years of experience. Why not? So, I get a part-time office job at Whitman College and have fun being out in the world again, talking to someone other than myself.

  One weekend morning, I pick up the phone to hear Bill’s cheerful booming voice. “Well, hello, Kathy!” We share news of our families, and then he drops the bomb.

  “It’s time for another book on alcoholism,” he says. “The field has gone to hell. Managed-care companies are refusing to pay for inpatient treatment or are cutting way back on the days they will cover, outpatient treatment is all over the map in terms of quality, and recovery support services are virtually nonexistent. The stigma of addiction as a psychological ‘illness’ that happens to weak-willed people persists and is becoming more pervasive. People are dying because they can’t get into treatment or because they don’t want to admit they have this disease. The world has gotten much, much worse for alcoholics. You need to write another book.”

  I don’t want to. I don’t say it, but I sure think it. I figure I’ll stall for a little while, listen to Bill, tell him I’ll think about it. Then I’ll come up with an excuse—wanting to be with my children during their last years at home, another book in the works—something, I’ll think of something. I’m tired of alcoholism and addiction, exhausted by the heartbreaking stories and the darkness and doom surrounding it. Bill is right—people just do not get it. How the heck are we going to convince them that this is a real disease and it’s all around us? Maybe it is even in your family, so watch out! Who wants to read that sort of book? Why shout into a wind tunnel? Really, no, thank you.

  But Bill won’t let go. He calls again. And again. I suggest that he write the book; he could even coauthor it with Jim Milam. He says he’ll think about it, but a few weeks later, he writes me a letter full of writer’s angst. “I am discovering that writing books—or even contemplating same—is an act of will and great courage,” he writes in his surprisingly legible longhand script. In the end, I can’t say no to William F. Asbury, my great friend and former boss, the person who so willingly and candidly offered his stories, who opened the door to a world I never knew existed, and who gave me all the advice and encouragement I needed to start my career.

  The book, which we title Beyond the Influence, takes almost two years to write, and it’s long, more than four hundred pages in manuscript form. Seven or eight months later, the publisher’s page proofs arrive. I read through the pages, looking for any egregious errors that might need correcting, and experience a sense of relief, even triumph, when I finally get to the last chapter titled “Walking the Walk.” It’s a really short chapter, just five pages of the 297-page book. Phew! Almost done.

  I read those five pages. Then I read them again. And that’s when another “God thing” comes crashing into my life. I swear, if there is a God in the heavens, He or She or It took one look at this just-turned-fifty-year-old woman and said, “She needs to know whereof she speaks!” BAM! The lightning bolt crashes down, opening up the earth beneath me.

  We have an obligation, as human beings, to do what we can to ease the suffering of others. This is not superficial charity or the work of do-gooders—this is our responsibility as individuals who are part of a larger community. When a fellow human being is in pain, we are called upon to do what we can to alleviate the suffering. When people are powerless to help themselves, we are asked to do what we can to assist. When we are presented with an opportunity to change what does not work and in the process save even one life, it is our duty to seize the moment with all the passion that we can muster. . . .

  Looking with compassion at the panhandlers on our streets, the drunks passed out in our city parks, and the broken, bloodied bodies in our emergency rooms, we will renew our commitment to he
lping those who cannot help themselves. We will ask what we can do to make the world a less hospitable environment for the drug alcohol and a more humane place for people who are addicted to alcohol. We will begin to walk the walk and not just talk the talk.

  Now is the time.

  Now is our chance.

  Having written those words, believing in them with all my heart, what choice did I have? Once again, a door opens, and I walk through it.

  2

  walking the walk

  1998–1999

  I press the silver button on the wall and wait for the buzzer, signaling that the metal door is now unlocked. Pushing my hip and shoulder against the massive door (I bet it weighs a thousand pounds off its hinges), I walk a few steps, and it closes hard behind me. I press another button and, when the buzzer sounds, open the second heavy door.

  Beige concrete walls frame a narrow hallway, at the end of which is a small table, two plastic chairs, and a pair of handcuffs soldered into the wall. A girl, no older than fifteen, sits cross-legged on the floor, one hand cuffed to the wall. When youth in detention are handcuffed to the wall, they’re considered a danger to self and others; the handcuffs are not for punishment but protection.

  “Who the fuck are you?” she says, looking up at me, her eyes narrowed in suspicion. My guess is she’s coming down off meth, a nasty withdrawal process that often causes irritability, paranoia, violent outbursts, and intense drug craving, along with severe anxiety and depression.