Mel Ashton’s role as an addiction therapist couldn’t prepare
him for the alcohol-related death of his brother. He describes
what happens when the personal meets the professional
16 |
drinkanddrugsnews
| February 2012
Alcohol|
Personal loss
www.drinkanddrugsnews.com
Too close to
h
I
n the early afternoon of 14 July 2003, I took a call on my mobile phone from
my younger sister. It was unusual for her to ring me at work and in the
moments before I answered it, I knew it had to be important. It was. Before I
heard the words I will never forget, I heard her sobbing. My sister simply said,
‘he's gone, Melvyn’. Of course, I instantly knew who she meant. She was
referring to my younger brother, who was then aged 42, no age at all. But
then, Paul (not his real name), had been dependent upon alcohol for all of his adult
life and, while I objectively knew that early mortality, and certainly chronic morbidity,
were likely to be visited upon him sooner rather than later, it took me several
moments to absorb the hard, cruel reality that he had actually died.
In fact, Paul had died in hospital. My sister told me that the cause of death was
two-fold – first, an oesophageal bleed, and second, a serious fit, or as I knew it, an
alcohol seizure.
I remember not knowing what to say. After we ended that call, I sobbed in the
office, where one or two of my colleagues stood motionless as they too absorbed
the reality. They comforted me as best they could in the circumstances. On one
hand, I couldn't quite believe it – not my brother. On the other, why not? It was not
the first time that he had been hospitalised for alcohol-related problems or
detoxified in the three decades that this ‘ambiguous molecule’ – as Griffith
Edwards calls it in his book of the same name – had dominated his life.
I also knew from my professional role, which included teaching addictions at
higher education level, that – according to Alcohol Concern – the number of
alcohol-related deaths in the UK has ‘consistently increased since the early 1990s,
rising from the lowest figure of 4,023 in 1992 to the highest of 9,031 in 2008.
Sobering statistics, perhaps. But they were real people with real families, partners
and friends. Paul had been added to the prevalence data for the year 2003-4.
I left my office shortly afterwards, still in deep shock at the news, and I tried to
leave behind my role as a senior addiction therapist and tutor. The former called for
me to work with harmful and dependent drinkers as a matter of course, and I always
found this a humbling experience, respectful of the size and nature of the problem
and clients’ efforts to rid themselves of it. The latter simply confirmed what I already
knew – that alcohol dependence and its related mortality can happen to anyone. It
did not select its victims according to their social, economic or ethnic status.
However, during the period of coming to terms with our profound loss, I at
times also found it difficult to let go of my professional role and identity and
simply grieve as a son and brother. I vividly recall visiting the hospital mortuary,
where my brother lay, cold, stiff and yet, I hoped, ‘at peace’.
I spent some time alone with him. At one stage, I apologised to him for not being
able to help him as an addictions professional and his kin. I tried to explain why – not
for the first time in his history – especially to my parents and two sisters. At the
same time, I felt a sense of guilt, not so much borne of that difficulty, but of the
personal distance I had sometimes put between me and Paul. In truth, I had not
given him the support that he needed, as a brother. I used the fact that we – me and
my own family – lived over 30 miles away and had busy lives to justify this to myself.
Importantly, I also told myself and others that ‘you can’t social work your own
brother – you’re too close to it’. I still think that, for good reasons.
But, if I’m honest, I also felt a sense of disappointment, even anger, towards Paul,
especially for the worry that his problem had visited upon our now elderly parents.
‘Why,’ they asked with good reason, ‘can't Paul stay off the alcohol?’ A very pertinent
question for all who deal with, or are affected by, this significant problem. I recall the
words of a colleague, a former advisor on alcohol to the chief medical officer, who
commented with absolute sincerity that this was as ‘serious as it gets’.
As I stood and stroked my brother's lifeless forehead, I made him a promise that, at
the time, I was determined to do my best to keep – that I would do all I could, in my
professional role, to prevent others frommeeting the same fate. I have tried to fulfil
this promise since, but not necessarily with a less fateful and final outcome.
At one stage in my bereavement leave, I visited the treatment agency that had
known and worked with Paul. The worker – ironically, a former neighbour of mine –
was not available for me to speak to and for reasons of confidentiality, I was not told
anything more than they had sought to treat him as best they could. Paul was, as I
already knew, drinking in excess of a bottle of vodka per day and his living conditions
caused a lump in my throat. It was not untypical, as I well knew, for dependent
drinkers to find themselves socially isolated and often unable to care for themselves
properly, their lives turned upside down by alcohol. This was also true of Paul.
My eulogy, on the day of the funeral, also reflected upon the battle that he had had
in overcoming his alcohol dependence. Again, there were moments when it occurred to
me if those assembled wondered if I was speaking as his brother or in my professional
capacity. My apparent and unashamed grief hopefully answered this question.
So, how has this all impacted upon me and my professional role? What sense
have I been able to make of it? Clearly, there have been many occasions when his
death and its circumstances have caused me to experience ‘psychological pangs’ of
grief, especially on or close to anniversaries. Moreover, the sense I make of the power
of addiction is of a very complicated phenomenon. Definitions and explanations of
substance dependence have varied over decades, some locating it in a disease model,
others emphasising the role of social learning in its development.
I understand why it makes sense to explain dependence (or in that context,
‘addiction’) as a disease, over which the individual has lost power or control, but
nevertheless, I prefer Orford’s 2001 description in
Addiction
that ‘by long usage, an
activity that was originally pleasurable has become a “necessity”; that a strong
craving is part of the experience; and that despite the many harms that it has
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