Tag: alcoolism


un articol despre consumul de substante si impactul asupra functionarii cuplului in numarul din luna aceasta al Psychologies (titlul cu extra doza de dramatism nu-mi apartine!)

On the topic of alcohol culture in Romania* 

I have written a few words in preparation for this meeting and, with your permission, I would like to read them to you and then I invite you to respond and bring in your own experiences. As you can see, this is going to be an old fashioned presentation, with someone who speaks simple words and someone who listens and allows their mind to travel freely through the mind of the speaker and their own. The adding of technical so-called improvements has the effect of distracting the listener and give speech the uniformity of corporate communication. We are not corporations. We speak if we find an interested listener and then, in our turn, we listen when the listener has something to respond and we have dialogue. So, as they say, lend me your ear!

As I was considering the meaning of my presentation’s proposed title, “alcohol culture”, and not wanting to appeal to google for an easy fix, a definition or some handsome quote, I first looked around. I was in Krakow, Poland at the time and one of the things that I found interesting was the presence of 24 hour shops dedicated to selling alcohol in all strengths and sizes. ALKOHOLE 24H would be written in bright, glowing neon letters on almost every major street. I said to myself this is surely a very visible manifestation of alcohol culture in a society. So how about Romania, what do we have in this respect? As hard as I tried to find something that would be representative, maybe even symbolic for our relationship to alcohol (so maybe this could be a tentative definition for now – alcohol culture is the relationship that people in a society have with alcohol, alcohol use and alcohol users as well as with the negative consequences of alcohol use and abuse) I could not find anything. From the young people getting smashed with their friends in a club, to the urban man and his booze at the end of the day, relaxing him into a sort of a stupor that allows the mind to come down from the excitement and the stress of a day’s work, the blue collar worker meeting with friends for beer, sometimes during work hours when the friends are the coworkers, to the middle aged mother and wife drinking by herself, now not so much a mother because the children have gone and with them the major purpose of her life and the husband had been absent for years, the rural folks for whom the day starts with a shot of palinca and ends with one too, many others in-between, all proudly home made out of the best ecological fruits, ‘no additives’ they proudly boast to the visitor as if it’s some sort of a medicinal remedy – nothing seems to be quite able to capture some sort of specificity of my people’s relationship with alcohol. The neurologists say that alcohol does not have a specific target in the brain, that it rather permeates the whole brain, making the neurons’ membranes more fluid, more permeable. In the same way, alcohol permeates all walks of Romanian life.
So, at this time, empty-handed and out of ideas, I stopped looking out and started looking in. What was MY relationship with alcohol? What kind of history do I have? One’s experience can hardly be considered evidence for something larger, but when one doesn’t know, it feels good to return to something that is known, namely the lived, personal history. And while contemplating these issues, one thing came out to the fore with a force that surprised me with the intensity of a small revelation. It was about the first years of my life as a child in a family with two children in communist Romania in the 80’s. I was the eldest. And, for the first few years, I was completely in love with my father. He took me to the zoo, we would go out and eat steak together. When I was left in the care of my maternal grandparents who lived several hundred kilometers away, in a small village in the middle of the great Romanian planes of the South (a sort of Kansas, if you will), he would arrive in the morning unexpectedly and, to my delighted surprise, wake me up from my slumber with his spiky beard and his strong smell of tobacco. One of the first stories that include me (told by those present then, I have no memory of it myself) is about how there was a flood near my grandparents’ house and the bridge became impracticable, so my father had to get on a tractor to be able to make it to the outside world where a job awaited him. And I, a child of maybe 3 years old, running behind and crying, to the amused delight of the adult audience, “daddy runs away from me in a tractor!” At 4 or 5, I would wake up very early in the morning (despite the possibility of getting a later rise allowed by my mother’s working schedule that started later in the day), just to be able to hold his hand on our way, me to the kindergarten, him to his work that started at 7 am, in a communist factory now long closed, demolished and the land sold to corrupt politicians and their proxies. It would be cold, winter time, very dark, I could feel his big hand holding mine and I would sing from the top of my lungs “the night is made of silk” – “noaptea-i de matase”, a popular tune at the time, heard on one of the few TV programs of which we only had a couple of hours every week. I don’t think I ever felt so free and uninhibited as I did in those mornings. Then, when visiting his parents, he would amaze me with unimaginable superpowers, such as the possibility to step barefooted on a thistle so big and so thorny that I would be scared to even look at.
And then, all this stopped. He continued to be around for awhile, helping me with homework in school sometimes, but something started slowly growing and that something finished our relationship – my father started coming home drunk. There would be fights with my mother about the drinking and the money. He would get upset and raise his voice. Mother would raise her voice as well, then she would start crying, I felt sorry for her and started hating him for making her cry and making me miserable. I began to be able to identify the signs of alcohol intoxication – the red eyes, not quite sure in their tracking movements, a slight awkwardness in walking, a change in the tone of voice, not so self assured anymore and a tendency to let it all pass that was not goodness of the heart, but rather a wish to not be bothered. Surely, this is not the picture of the violent, alcoholic father, but violence has many ways of manifesting itself. I think I have lost my father to alcohol in a discretely violent way. Life was very hard in Romania, in the 80’s. Especially so for a man with family and children. The industry had started its collapse (it was the beginning of the end for the communist system) and oftentimes my father’s payment was cut short. We went through terrible shortages of food, electricity, even running water. I remember my father having to wake up at 3 in the morning, to be able to catch a winning place at the line for milk. More importantly, I think, there was a lack of hope – at a time when the world was preparing for the opening that was to come in 1989, Romania seemed to plunge deeper into darkness, a North-Korea of Eastern Europe.
And if you’re wondering, as they say in the books when they describe the natural evolution of alcohol abuse, spontaneous recovery is possible and that is what happened in his case, but only after several years of misery and lost time when I, a medical student by then, would be too busy, sometimes with my own alcohol abuse, to notice that he has changed. Then I moved to a different city and almost to a different world than his, a world with computers and internet and travels abroad that he cannot understand or relate to. Many of my patients have had similar histories of losing a parent, more often the father, to alcohol. Good men, loving fathers, devoted to their families, men who worked hard to build a career, to make their parents proud.

And so, with this inner exploration coming to an end, what do I have to say on the topic of Romanian alcohol culture? To me it has to do with family life and the disruption of relationships in the family. Romanian life, at least until the end of the communist period was very much a traditional, family-centered life. This was and it continues to be especially true in rural areas (both of my parents belong to a generation that was uprooted at an early age from their rural life and family and moved to the city, to work in the developing socialist society, at the beginning of the 50’s and 60’s). There continues to be a lot of disruption to life in the family – parents emigrating and leaving their children behind in the care of an aging grandparent incapable of being a substitute for the missing parents, confusion over values in life and that same feeling of hopelessness that never really left us. Sure, we have large amounts of television. Most goods are available, but not necessarily affordable. The ruthless rule of the almighty party system has been broken into smaller, but not necessarily kinder private or corporate masters. We are still the poorest nation in Europe. We are still struggling just to survive. And alcohol is here to help us ease the pain and forget for awhile the despair, the disappointment and the anger of the generations past and generations present.

I do not intend to suggest that this is more than a starting point, one of many, in a conversation about alcohol culture in my country. But it is important to consider that, beyond the globalization trends among the urban middle class, drinking in the same way their Western generational peers are drinking, there exists a background of drinking as remedy (‘no additives’, remember..!?) or drinking as therapy, maybe in the same way the North American Indians were drinking after their society collapsed and the white man moved in. Or the way the natives of South America chew coca leaves. It would surely explain why we seem to not be able to look at our relationship with alcohol from a critical point of view (Romania is probably the only country in Europe that does not have a government body set up to handle alcohol issues at a national level, especially from a health perspective). Or, in the words of Mrs. Zizi, my cleaning lady, a woman without a home of her own, without a job or a pension, without health insurance, who works just to make ends meet, a woman such as many women and men in the Romanian population, when I confront her about her smoking and heart problems, she says “please, doctor, why do you want to take away the only pleasure that I have left in this life?”. And I know it is not only the denial of the addicted, the resistance to change or the ambivalence manifested through exaggerations, for her and for many like her it is also the truth.

Thank you!

* presented in English at the ‘Empowerment’ Workshop, part of the ‘Power to Resist’ international project on alcohol abuse in Denmark, Sweden, UK, Spain and Romania, organised in Bucharest by ALIAT NGO on October 20th.

tot e ceva

in timpul celor 5 ani cat m-am pregatit sa devin psihiatru, au fost 3 luni in care ma duceam zilnic la o sectie a spitalului colentina, pentru stagiul de medicina interna. fusesem dat in grija unei doctorite, o femeie de vreo patruzeci de ani (poate mai mult, poate mai putin cu cinci ani, nu am fost niciodata bun la a ghici varsta corpurilor oamenilor). mi-a spus pe un ton ferm ca trebuie sa vin, de luni pana vineri, de la 8 la 13. in fiecare dimineata, acelasi ritual se intampla fara abatere in salonul de 8 sau 10 paturi, fiecare pat ocupat de un pacient cu ciroza hepatica. (poate ca mai era si cate un barbat cu alta suferinta din zona burtii, dar era clar ca specialitatea salonului – sau a doctoritei? – era ciroza). cirozele sau ciroticii sau acei barbati trecuti bine de prima tinerete (in timpul careia bausera zdravan) se internau cand boala lor de ficat se decompensa, adica burta le era plina cu apa, iar venele din gat si din fund galgaiau, aproape plesnind de sangele gros. uneori mai si plesneau si pacientii mureau. insa cat am fost eu pe acolo nu am fost martor la niciun deces. am fost in schimb martor la acest ritual de dimineata. doamna doctor intra in salon la prima ora. in salon mai erau o masa in mijloc, doua scaune si mirosul corpurilor de barbati batrani si bolnavi, tragand sa moara. pe scaun te asezai numai daca scriai. doamna doctor intreba asistenta de una, de alta, facea foile de observatie sa fosneasca in asteptarea VIZITEI, se uita la ceas, se uita la mine si apoi porneam, ea inainte, eu in urma ei. primul pat. verifica temperatura, analizele, apoi incepea examenul fizic – intai palpa burta cu mainile, apoi tensiunea arteriala, apoi inspecta stelutele vasculare pe piele, mi le arata si mie, in final ii cerea omului sa se aseze pe o parte, sa-si traga in jos pantalonii de pijama, in timp ce isi punea alifie pe degetul infasurat in plastic, apoi tuseul rectal. scotea degetul, se uita atenta dupa urme de sange, apoi spunea “gata”. uneori spunea “ne vedem mai tarziu”. trecea la urmatorul pat unde procedura se repeta identic. de opt sau de zece ori. cand termina, ne intorceam cu acul si galeata la pacientii carora li se spusese “ne vedem mai tarziu” si doamna doctor le dadea cep – perfora cu un ac burta omului, lasa sa se scurga lichidul (nu mai mult de 1 litru, ca sa nu se intample alte necazuri). intr-o zi, aplecata peste abdomenul unui nefericit, s-a intors catre mine, acul la cativa centimetri distanta de piele, si-mi spune parca imbietor “daca te tii de treaba si iti dai silinta, intr-o zi o sa te las si pe tine sa faci asta!” ma gandesc uneori ca daca vreunul dintre pacientii cu alcoolism pe care i-am tratat au evitat in felul asta o vizita in salonul doamnei doctor, tot e ceva.