Healing the Healer: Dr. Schenewerk's Fight Against Addiction Stigma
Christopher Schenewerk, MD, discussed his history with alcohol abuse and how he works to break down the taboo of substance abuse among medical professionals.
While 1 in 10 physicians will struggle with substance abuse at some point,1 the topic remains taboo. However, some are working to break the stigma, including physicians like Christopher Schenewerk, MD.
In an interview with Targeted OncologyTM, Schenewerk, a board-certified family medicine physician in Columbia, Illinois, reflected on his own history with alcohol abuse, including the pivotal moment he realized alcohol as no longer a social habit but a significant problem in his life. Schenewerk also candidly opened up about his recovery process and return to work, including the roadblocks surrounding addiction for health care professionals.
“Unfortunately, we are bred in medical school and residency that to fill our cup, we have to take care of people. No, that's so false. I learned that I have to come first. And if I do that, I will be the best person I could ever be, and [I will] be able to take care of people better than before. Hindsight is 20/20, but if I would have known, I would have gotten better years before. But ego is the big thing with doctors,” Schenewerk said.
Schenewerk’s advocacy and experiences offer valuable perspectives on how medical professionals can better support patients, themselves, and their colleagues struggling with addiction.
Targeted OncologyTM: When did you realize alcohol was becoming a problem for you?
Christopher Schenewerk, MD
Schenewerk: Before the alcoholism, I was a social drinker. I was always the person that went to bed last. I just love when I work hard and I play hard, but I never had blackouts, and I would never drive if I drank. I do not want to say I was a normal drinker—I do not know what a normal drinker is.
Just over 15 years ago, my wife—we have 2 boys together—asked for a divorce. I thought, especially as a doctor, I was prepared for anything, and I was not prepared for that. And that is when I started leaning on alcohol to cope with my situation. Being that I had always drank, I did not find it to be a problem. I thought alcohol was the solution to my anxiety, my depression, everything. Then it became, slowly, to where I [was] drinking daily, blacking out, missing work, making poor decisions, and I was to the point where everything started to be affected and become, as they say in the first step [of the 12 steps], unmanageable.
On November 8, 2018, I just said enough, and I went to seek help. That is when I went into rehab.
What did your recovery process look like?
When I went to rehab, I remember walking in those doors and thinking my life was over. I [thought I] was going to be fired, even though nothing had happened [at work]. Tons of things could have happened, certainly, but it is all this fear that builds up inside that you feel that you are out of hope. I was bankrupt emotionally, mentally, physically, and spiritually, and I was scared to walk into that rehab.
It was a small rehab located about an hour from my house, and I detoxed, which was not fun. After 4 or 5 days, I went to residential, and there I started learning about the 12 steps [and] what my disease is about. I was helping other [patients with addiction] before then, but I could not understand what was going on with me. It was obvious. If you presented my case to any other doctor, they would go, “The guy's an alcoholic.” But when it is you, you cannot see it. The constant lies to yourself, denial, all the character defects come out.
I did 4 weeks [in residential], and my therapist team [told me] doctors are one of the most studied professions with alcoholism, and it's recommended that [I] do no less than 90 days. If [I followed] that, the success rate at 1 year is 85%. So, I said, “I'll do whatever you tell me. My life's in your hands. I am no longer a doctor. I am a patient.”
I went for 2 more months of recovery in San Diego, and that changed my life. San Diego was just filled with both addiction and recovery, but because of that, it led me in the direction of finding a sponsor. While I was there, we went to [Alcoholics Anonymous (AA)] or [Narcotics Anonymous (NA)] meetings daily. We had classes daily, and I started the 12 steps while I was there, too.
Was there something about being a physician that made it harder to see your alcohol abuse as an issue in yourself than it would have been to see in a patient?
Absolutely. At the end of the day, that's just ego speaking. When I got out of [medical school and residency], I became the first doctor in the town I was born in, and it was welcomed. I was the golden child; I was the kid that came back. One of my biggest character defects is disappointment, so there was that fear that I was going to disappoint everybody because I have a problem.
Then there is [the fear that] if I turn myself in, am I going to get fired? It is funny with doctors, [they will] work until 75, 80 years old, they retire, and they drop dead a week later. It is like that's the only thing we know to do, is to care for people. Unfortunately, we are bred in medical school and residency that to fill our cup, we have to take care of people. That is so false. I learned that I have to come first. If I do that, I will be the best person I could ever be, and [I will] be able to take care of people better than before. Hindsight is 20/20, but if I would have known, I would have gotten better years before. But ego is the big thing with doctors.
What has been your experience working break down the stigma about alcohol and substance abuse in the health care profession?
I can say that within medical systems, there are very few [that] have a person for this [that can help you get] help. [Usually], you’re fired. And when I got out of rehab over 6 years ago, I flew home on Sunday, went back to work on Monday, and met with [human resources] on Tuesday, and I said, “Hey, I've been working on a program because I'm not the only one that's an addict. It's impossible, and I was afraid to come forward. So, let's do things.”
First [was] primary prevention. Let's tell my story to everyone, and then maybe those that are affected will slowly start to reach out, because they will feel comfortable and safe. And then, we cannot have a no-tolerance policy, because no one will come out, and [then a] disaster will happen, and then that is when we find out. We want to prevent a disaster from happening, so let's have something in place.
That was over 6 years ago. I am still trying to find out who I need to talk to next to try to change our policy. It is sad, because every one of us are patients in the world. So, why is there this struggle? It just keeps passing around instead of [tackling] the problem. And that is the way it is in [many] health care systems.
What support systems need to be in place for medical professionals regarding alcohol and substance abuse? What are the gaps that need to be filled?
I think [it needs to start] in medical school. The only addiction training I had was I was told to go to 1 AA meeting and 1 NA meeting. I went to an AA meeting, and it just happened to be a very poorly run meeting. I just thought, “What a waste of time this is. AA doesn't work. This is stupid.” So, I lied about going to an NA meeting, and then that was it. For 19 years, until I got help, I never recommended AA, NA to anyone because of that experience. That is on me, because if I was as curious then as I am now, I would have found out more.
We need to do more for these students to not only learn about addiction and how to deal with an addict, but also that these medical students need to learn to start taking care of themselves, because it is such a demanding job. That is why our suicide rate is higher than the general population. I know addiction is tied to that, so we need to start there. I think that [message] should transfer into residency, and then really starting in those programs from medical school, residency, and then whatever system a person joins, we need to have a program where it's part of the introduction. Like, if you suffer from addiction, we have this [process in place], and what does this [process] look like? You can come to us anytime, anonymously, and we can get you help. We can start with outpatient. We can introduce you to meetings, or we can start with inpatient. If somebody comes forward, we will help you through that process.
If someone is caught, we need to help you with this. If you had cancer, we would help you get an oncologist. If you had heart disease, we would set you up with cardiology. What we would do is we would say, “Look, you have a choice. You are either going to inpatient rehab, [and] we have everything set up for you, or you have to leave your job, because if you are not going to do anything about your disease to the point to where it's affected your patient care, then you can no longer work here.” But at least we have something set up to where people know from the beginning that that they can go to somebody anonymously and get help if they have this disease.
How has your approach to treating patients struggling with addiction changed?
[This] was a turning point in my life [and] career, about 2 weeks before I left rehab. It was 2 weeks before my 90 days was up; my team got together and they said, “We need to get your discharge planning. What you need to do? You need to continue sponsorship. You have to finish your steps, and you have to go to meetings.” I already had a therapist set up I had been using through our system. I said, “Well, I guess I am going to have to go to meetings, like, an hour away, because I do not want anybody to see me [and] to know I am an alcoholic.” [My team said, “You could do it that way. That will add more time to your recovery. It will be more cumbersome, possibly more overwhelming. But what if you just wear it on your sleeve? What if you come out from the beginning, and when patients ask where have you been, you tell them [that you had to go] to inpatient rehab for alcoholism.” They said that all this fear that [I had] that patients are going to leave in droves, and your peers are going to leave you behind too, it is a lie that your disease is still telling you, and your practice will grow beyond belief.
[You have to] shower [patients with addiction] with kindness, but you have to be stern, because at this point, you are trying to save their life. I understand exactly what they're going through and all of the fears, but we also have to be tough. That is how I am, and it has kept a lot of people coming back, and a lot getting clean and sober.
The other thing I did was I went to the other primary care providers, and said, “Look, if you need help, just send your patients my way. I will get them going if I can, and then they will come back to you for their regular stuff.” That is that has been a big thing that has happened, at least in the past 2 years. It takes a while, but now that that people have seen that work, it is fun to help my other providers. These no-tolerance policies are made by people that are not addicts. They do not understand that I do not purposely drink 3 or 4 of or a fifth of vodka every night because I am partying. It is survival. We have to approach our patients in that same way.
