Harry was a fellow I was asked to consult on up north. As a psychiatrist, I would fly to northern communities every few months to hold a clinic for people who would otherwise not have such an opportunity. Harry had been on the roster of patients the nurse had given me on my previous couple of visits but had not showed up for the appointment.

His family physician said he had a neurological condition, a tremor, that was directly related to his drinking. Harry had seen a neurologist already; the neurologist had agreed with the family physician that the tremor indeed was alcohol induced. But Harry was not satisfied and wanted to have a second opinion. Understandably, the family physician did not want to waste health-care dollars sending him down south—again—when it seemed obvious what the problem was. Instead, he decided to take advantage of my visit to give Harry his “second opinion.”  

Despite the fact that Harry decided not to show up for his appointment when I was in town, this did not change his view of the local doctor, who he continued to bad mouth all over town. Although the doctor was mildly annoyed by this, it was decided that the local taxi would bring Harry to the clinic first thing in the morning—no matter what—to finally put an end to all of this. That’s where I came in. I arrived at the clinic to find the taxi driver standing outside his cab waiting for me.

“Doctor, I’ve got your patient here to see you.”

“Well, ask him to come in.”

“You’ll have to come out to him.”

I followed him to his cab where Harry laid passed out in the back seat, reeking of booze and totally unresponsive to all my attempts to wake him up. He would only flail about, unable to gain consciousness.

“Well, I can’t very well interview him in that state,” I told the cabbie. “Could you bring him back when he’s sober.”

“He’s never sober,” the driver said.

“Well, when he’s more sober.”

“Oh, all right.”

Harry came back in the afternoon. When the taxi pulled up again, the driver went around to the back of taxi and hauled Harry to a standing position. With much aplomb and dignity, Harry pulled his arm away from the cabbie, and, walking broad-based, came steadily into the clinic. I decided to see him immediately rather than ask him to have a seat in the waiting room. 

Harry was a sight. He wore blue wool pants, big lumberjack boots and a dirty parka open at the front to reveal a somewhat stained white T-shirt. He was partially shaved, as a patch here and there had escaped the razor. His hair was mussed and his eyes bloodshot. Nicotine stains were prominent. Both hands shook severely—not fine tremors, but gross tremors, which improved somewhat with intention.

“Glad to see you again, Harry,” I said congenially.

“I’ve never seen you before in my life,” answered Harry. 

“How may I help you?” I asked.

“I want a second opinion. I can hardly pick up anything with my hands like this.”

When he showed me his hands, they became even worse when raised.

“The damned doctor here thinks it’s alcohol and he sent me to some temperance-type nerve quack who agreed with him. It’s not alcohol. I’m not an alcoholic. It’s got to be something with my nerves. You’ve got to give me a pill or something and write me a pass for the plane, doctor. I need to see a nerve specialist. No offence to you, but I’m not a head case. The doctor here is a head case but I’m not a head case.”

“The doctor here told me he’d send you south if you stopped drinking,” I replied.

“I’ve stopped drinking,” he said.

“When was your last drink, Harry?”

“I haven’t had one since this morning. See? I can give it up if I want to. It doesn’t make the hands any better. The booze helps them a bit, too.”

“I don’t think so, Harry. I have to agree with the other doctors that your tremor is caused by drinking. It’s an alcohol tremor. You’ll have to stay quit from drinking before any nerve specialist could give you anything for it. The medications they use can’t be given when you’re drinking.”

“So, you’re just like the other temperance doctors. Deny a man a drink. I’ve quit. I told you. You’ll see.”

Harry then left and shuffled back to the taxi.

Later that day on the way back to my room in the hotel I passed the bar, and there was Harry drinking with his cronies. He saw me and called out loudly to his fellow rogues: “There’s that temperance doctor who doesn’t know anything about medicine. I told you about him. There he goes now.” 

Everyone looked around. I smiled and waved. What can you do? In Harry’s mind he doesn’t have a problem with drink, just with his tremors. It’s like a story I heard attributed to Keith Richards: “I don’t have a drug problem. I have a police problem.”

Well, Harry didn’t have a drinking problem. He just had a doctor problem.  

William Hay is a psychiatrist and addictionist in Vancouver.