Basem Attum, MD, MS

AAOS Now

Published 2/1/2018
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Basem Attum, MD, MS

My Substance Use Disorder: Recovery and Redemption

'I got back to my principles'
In rehab, I was isolated: no TVs, no phones, and no computers. Not using drugs was scary to me. I had been convinced it wasn't possible. Although the initial withdrawal symptoms were eased with phenobarbital, I was always tired, had no memory, and was very depressed. I went from meeting to meeting. I learned all the facets of drug addiction. My peers represented all of society: from famous musicians and professionals to laborers. They were of all ages.

My job was to learn about myself. I had to change every part of my life because relapse could lead to death. Eight people who entered treatment with me died of overdoses shortly after they were released from treatment.

I had been in a halfway house with one friend. When we were supposed to meet for a workout and he didn't show, I phoned him several times but he didn't answer. His car was in his home driveway, but I figured he'd gotten a ride to work. Later, another friend called and told me that my workout buddy had been found dead in his room with a needle still in his arm. He was 26 years old.

For the first 6 months in the halfway house I didn't do much. I had so much shame. My family hated me. My girlfriend wanted to kill me. I had lost my orthopaedic surgery residency spot and my medical license. I had basically destroyed every relationship in my life, including my personal and professional connections. I didn't know if I was ever going to be a doctor again. I wondered if I'd be able to feed myself.

About a year later, I began working for an orthopaedic education company and started orthopaedic academic work to start to rebuild my career. It took a while to muster up the courage, but eventually I approached a group of orthopaedic trauma surgeons and told these complete strangers what I had put myself through and the tornado of personal and professional damage that I had recently left behind. After a few conversations, I was given opportunities to work for them.

I got back to my principles—the ones I used to live by and had recently relearned: reliability, dependability, honesty, and consistency. This work proved invaluable. It helped me obtain a medical license. It restored my confidence that I was capable of working in the medical field. I took every opportunity that was presented to me and ran with it in the hope of a better future.

I had no idea that help for struggling physicians was available, nor that protections exist if you seek out help for yourself, and consequences are more severe if you are required to get help after getting in some sort of trouble. I learned that almost every state runs a successful monitoring program to help physicians stay sober—and these programs have a high success rate.

Physicians need to know that these monitoring programs become advocates to employers, licensure boards, credentialing committees, and residency programs for verification that a physician has been successfully treated and is consistently monitored. I used to think that these programs were basically built to inconvenience and punish the physician. Now I know that they are there to ensure that the physician does not slip back into addiction and to advocate for the physician.

Today, I still undergo random drug screens, attend weekly Alcoholics Anonymous meetings and weekly meetings for physicians with substance use disorder. It gives me hope to meet with physicians who have recovered and stayed sober. I learn from them. I am currently a licensed physician, seeing patients, able to prescribe controlled substances, and can provide evidence that I have been clean and sober for more than 4 years. None of this would be possible without the advocacy of the monitoring program.

I have renewed relationships with all my family members. Although I have mended many relationships, I have learned that certain things cannot be undone. I have scarred my family and can only hope that they can heal from the damage I have inflicted. Memories of how desperate and singularly focused on getting drugs I was when I was misusing opioids and Ambien, and how helpless I felt to stop on my own, keep me from relapsing. I follow a program set out by my state's physicians' health program that has kept me clean, and I am confident it will continue to do so.

The fear of losing my career, my girlfriend, or my family could not keep me from drugs—but the fear of going back to being trapped in my own body like I was during active addiction can keep me sober. This experience taught me that I cannot run away from myself. I never want to go back to that place. What I was doing was so dangerous, I'm lucky to be alive.

I'm training in the principles of a sober life: never run from the truth; accountability and responsibility for one's actions are imperative to a healthy, happy life personally and professionally; secrecy is addiction's greatest weapon; and finally, from my father, "It is easier to stay out of trouble than to get out of trouble."

We didn't talk about this in medical school. As physicians, we are trained to take care of others before taking care of ourselves. But if physicians don't take care of themselves, they are no good to anyone.

My hope is that my growing expertise in what it means to take care of myself will make me a skilled and empathetic physician and restore me to my life's work.

Basem Attum, MD, MS, is currently a research coordinator at the Division of Orthopaedic Trauma, Vanderbilt University Medical Center. He can be reached at baattum@gmail.com.

From the Patient Safety Committee
As a medical student and resident, Basem Attum, MD, MS, struggled with an addiction to pain relievers and sleeping pills. In this last installment of his memoir, Dr. Attum relates how he lost his residency spot, beat a very dangerous habit, and ultimately survived to become an advocate for assistance. We hope that his story has provided an opportunity for readers to examine their own tendencies toward addictive behavior—whether to alcohol, drugs, gambling, sex, work, or something else. Those who see similar maladaptive coping strategies in themselves can begin now to make changes. Increasing evidence points to the importance of effective coping strategies such as adaptation and resiliency in creating optimal health, particularly when we reach the limits of current knowledge and technology.

You can find previous installments online: part 1, "The Nightmare Begins,"; part 2, "Out of Control,"; and part 3, "Weathering Withdrawal."

"Dr. Attum's story is not unique. But his courage and humility in sharing it are," said David Ring, MD, PhD, chair of the Patient Safety Committee. "We all owe him a massive debt. Both patients and surgeons should not be shy to ask for help. The AAOS Patient Safety Committee has an online Pain Relief Toolkit with tips on safe pain relief strategies." For more information, visit www.aaos.org/Quality/PainReliefToolkit.