I do not remember when or where I first heard the saying that “Many a bad deed is blamed on good liquor,” but the notion that intoxicants are often the explanation for evil acts rings true.  It may have been my Polish grandfather, who famously consumed at least a fifth of very bad whiskey daily without ever appearing drunk. He would have pointed out that he never drank good liquor and never committed any indictable crimes. He would have pointed this out if he spoke any English.  In fact, he spoke very little, and I am not sure what language he spoke when obliged to communicate. When I was 4 years old and he was in his 80s, he urged me to take a sip of that liquid he used to down the pickled herring that he lived on. My throat still burns from that gulp, and at 4 years old I became abstemious.

As a physician, one frequently encounters the inexplicable and routinely hears the explanation, “I was drunk.” Since the 1960s, this has often been replaced by, “I was stoned.” Throughout history, the alternative explanations have included, “I just followed the crowd,” and “I was part of the mob.” Lynch mobs and political rallies can elicit similar hormonal responses and produce similar outcomes. Albert Speer, the well-educated, middle class architect for the Third Reich recalled after his release from Spandau prison the intoxication he felt when he attended his first National Socialist Party rally. His response to that intoxication was to join in the gang rape of several nations.

I am not advocating the re-instatement of Prohibition or the criminalization of intoxicant drugs or the banning of political rallies, but I would like to see safeguards established to protect those of us who do not get drunk, get stoned, or join lynch mobs. Having observed the aberrant behavior associated with alcohol, drugs and mobs, I believe these agents do not cause people to be stupid: they allow people to be stupid. Devoid of inhibition, whether it be chemically or socially induced, the affected individual becomes a danger to himself, herself, and ourselves.

Some safeguards are obvious and easily achieved.  The carnage on American highways inflicted by drunk or stoned drivers could be greatly reduced by adding an entry code to the ignition. When I am not totally coherent, I have trouble entering the 8-character password with one upper case letter, one lower case letter, at least one digit, and at least one non-alphanumeric character to view my electric bill.  Why I need only press a button labelled “Start” to mobilize a vehicle capable of maiming or killing is one of our nation’s great mysteries.

I have witnessed and worked with physicians who have come to work drunk or otherwise impaired.  This presents an ethical dilemma because calling out a physician who is impaired by alcohol, drugs, depression or distraction is likely to be a career ending event, not for the impaired physician, but for the whistle-blower. Medical institutions are sensitive to their public image and have no patience for “trouble-makers.” As an inveterate trouble-maker, I was often reminded of this. 

One notable case in point was that of a resident physician (a man in his third year of postgraduate training) with a well-recognized drug habit who I found doing consultations while “under the influence.” I urged him to stop working and sober up. He refused and continued to see patients.  I went to the chairman of the department and reported my concerns. He assured me my concerns were overblown, and nothing need be done.

Nothing was done, and within a week the resident died of a drug overdose.

Obviously our species is vulnerable to excess, whether it be chemical or ideological. Let me be clear, I am not referring to substance addiction. There is substantial evidence that chronic alcoholism and opiate addiction depend upon particular configurations of brain receptors.  This means that those problems are amenable to a cure.  We have not yet found that cure, but there is no reason to doubt that it will be found. What is much more problematic is our inherent and incurable addiction to domination and bloodlust.

I treated a woman who had been shot in the head by her husband.  She said he was drunk and promised never to try to kill her again. I reviewed the case of a woman who had been stabbed about the face and head six times by her boyfriend. She was brought to the emergency room with six steak knives sticking out of her head. The boyfriend apparently assaulted her while he was stoned. Perhaps these acts of violence were associated with alcohol or opiate use, but there can be little doubt that the men involved exulted in their abuse of a fellow human being. 

On Jan. 6, 2021, a mob invaded the U.S. Capitol and attempted to restructure through force the government of our country. I suspect that many of those people forcing their way into the seat of government and terrorizing the legislators they had elected would deny they could possibly do such things when they sat at their kitchen tables two months earlier. Yet, after misleading news reports and speeches calling for “combat,” thousands of our fellow Americans joined in a riot that left at least five people dead. You cannot blame good liquor or bad drugs for this violence. I attribute it to the deranging effect of adrenaline. Adrenaline is a material made by the adrenal glands and released in case of emergency, real or imagined. It facilitates “fight or flight,” but it certainly does not facilitate thinking.

What Albert Speer experienced and recognized when he attended his first National Socialist rally was the intoxicating effect of passion aroused to the point of self-destruction.  If he were still alive, I am sure he would have been delighted to see many of the symbols he designed carried through the halls of Congress.  He would have shed tears of joy at hearing slogans and seeing clothing emblazoned with fascist rhetoric that he helped craft.  He died years before the “fine people” he helped inspire for their torchlight march in Charlottesville shouted, “The Jews will not replace us,” but obviously his spirit lives on. That spirit, not good liquor, is blameworthy for many a bad deed.

Dr. Lechtenberg is an Easton resident who graduated from Tufts University and Tufts Medical School in Massachusetts and subsequently trained at The Mount Sinai Hospital and Columbia-Presbyterian Medical Center in Manhattan.  He worked as a neurologist at several New York Hospitals, including Kings County and The Long Island College Hospital, while maintaining a private practice, teaching at SUNY Downstate Medical School, and publishing 15 books on a variety of medical topics. He worked in drug development in the USA, as well as in England, Germany, and France.

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