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Ridden With Shame as a 'Gray Area' Drinker

<ѻý class="mpt-content-deck">— Like many doctors, I decided I had to get sober
MedpageToday
A photo of Gabriel Bosslet, MD, MA, with his family.

November 1 marked a year since the last time I had alcohol. Being sober for a year after an adulthood where alcohol played a major role has been an interesting journey.

Alcohol was always an integral part of my adult life. Family events always revolved around alcohol. For me, it was how I unwound. I always had a "work hard, play hard" attitude toward alcohol.

The term "" (which I was introduced to recently thanks to a Twitter DM from ) describes the space between the extremes of rock bottom and every-now-and-again drinking -- this characterizes who I was quite well. I struggled internally with my drinking, but there were few external consequences. I would argue with myself a lot about whether I was going to have a drink. I didn't like myself when I drank. I found myself turning inward when I would drink and avoiding interacting with my family.

The most poignant description of gray area drinking for me is this: In the morning I would tell myself, "no way I am having a drink tonight." But the closer I got to 5 p.m., the more my brain would just change and I would forget my 8 a.m. self. I would somehow justify cracking an IPA as I made dinner or stop at the liquor store on the way home from the hospital, despite not wanting to that morning. If you are a gray area drinker, you can probably relate to this. It is the weirdest thing.

The pandemic exacerbated this for me -- just as the pandemic exacerbated almost everything for everyone. I found myself drinking on more days and earlier in the day (although, for me, never really before 4 p.m. and thankfully, it never interfered with my work or my patients).

With a lot of reflection, I have realized that my brain didn't just like the feel of a nonzero blood alcohol level -- it craved a rising blood alcohol level. This meant that having a single beer or a single glass of wine with dinner almost never happened. There were many days where I didn't drink at all; but if I had one drink, I generally had four or five. The serving size of wine for me became a bottle.

Unlike some people who work toward sobriety, I never really hit rock bottom. But there were a few flashing red lights, telling me my drinking was a problem. One was that I am a runner, and I often run at night after my kids go to bed; but I got to a point where I found myself choosing IPA over a 4-miler. Then, my 7-year-old started pointing out that I smelled like beer when I would read him a book before bed. This absolutely killed me.

Beyond just the negative warning signs urging me toward change, I also drew positive inspiration from others. My mom quit drinking on Sept. 18, 2020. She just decided to quit. This was a major motivator for me. She showed me you could not drink and still continue to be yourself socially. This was something I'd been very worried about -- I thought there was some magic to the "social lubricant" theory. So, I started thinking seriously about stopping but had no idea where to start.

The thing about an addiction of any sort is that the shame associated with it is just stifling. I didn't like to talk about my drinking. My wife would very occasionally bring it up and I would find myself getting super defensive about it -- and then being ashamed by my response upon reflection. It compounded upon itself. So, while I have a wonderful relationship with my wife, talking to her about what I considered to be a shameful part of my identity was a nonstarter.

Eventually, I worked up the courage to reach out to a friend at my institution who had written a about his experience with alcoholism. He invited me to an AA meeting on Zoom. My initial reaction was, "no way -- I am not that bad." But he kept nudging, and eventually, I hopped on a Zoom on Nov. 1, 2021. I didn't say anything; I just listened. And, for the first time, I heard folks talking openly about the same struggles I had no idea how to express. They were the exact same feelings I was experiencing.

After that first time, I started hopping on this AA Zoom meeting a couple of times per week. I will admit there are parts of AA that didn't appeal to me and it is not for everyone, but having a community of folks with whom I could share my shame made all the difference.

I am a better person since I quit drinking. I sleep better. I am more available for my family. I have more productive hours in the day. Do I miss alcohol? Sure, occasionally. My wife and I went to dinner the other night, and while a glass of cabernet with my steak would have been nice, for me the downsides just aren't worth it. Plus, now I don't have the shame. Which is big for me.

I share my story because in medicine, we don't talk about this enough. And that doesn't mean it's not a problem among doctors. I posted a about this a few weeks ago, and based upon the number of direct messages I got afterward, there are a ton of people, including healthcare workers, who live in alcohol's gray area.

Sobriety is not for everyone. I greatly envy those who can have a reasonable relationship with alcohol. And I still greatly relish hanging out with friends at bars and events with alcohol; I love going to breweries, and if I see you in real life I am stoked to go hang and have a non-alcoholic IPA (they have great ones now) or a sparkling water, and chat and dance and laugh and be goofy. I'll just be much less likely now to wake up with a headache.

is an associate professor of clinical medicine in the Department of Pulmonary, Critical Care, Sleep, and Occupational Medicine at Indiana University, and fellowship director for pulmonary and critical care medicine. You can find him on Twitter () or Mastodon ().