The first day I stepped back into work, I limped back into a daunting hall.  A hung head, a tremoring hand, and a flushed face with an encircling sense of foreboding.  I did not feel ashamed.  I was a shame. 

I spent the prior 6 weeks off work, seeking professional treatment for a self-disclosed medical condition, alcohol abuse and depression.  As a medical doctor, I made the decision to help myself before I could help anyone else.  I sought the help I desperately needed to combat the rising demons in my own life.  And it helped spark the change needed to move forward, day by day, in a journey that continues to shape the rest of my life.

In the days, weeks, months and then years after my return to work, I was a failure.  Lazy.  Unreliable.  I did not act professionally.  I was a risk.  I was weaker because of seeking treatment.  A black eye on the veil shielding the integrity of a faux ideology contrary to the tenants of the missions we all serve.  To heal those that are suffering.  Irony does not capture the sense. 

In a medical system of subspecialty based disease model of care, I am an alcoholic with a history of depression. 

In a medical system meticulous in the algorithms and pathways of treatment, I was treated.

In a medical system rooted in mortality based outcome measures of achievement, I was alive.  N = 1, 100% survival rate.   

In a medical system grounded in the merits of pharmacologic efficacy, I was responsive.  Therapeutic effect. 

In a medical system preaching the importance of early detection and interventions, I detected. Self-disclosure.           

In a medical system expecting compliance with medical recommendations, I obliged.  Compliant. 

Yet, the system told me that I was a failure. The system hung my head.  The system tremored my hand and flushed my face. The systems we have created convinced me to integrate shame into the identity of my recovery.  I should be ashamed of my own success. 

In the modern medical systems, individuals treated successfully for medical conditions are success stories.  And mental health and substance abuse conditions are medical conditions.  If we want to play by the rules outlined above, I am only a success.  You are too.  If we want to play by the rules…..well, we can’t have it both ways. 

                                                                         - Adam B. Hill, M.D.