From glamour to squalor and, finally, recovery
From Harvard to Hell and Back: A Doctor's journey through addiction to recovery
Books about drug addiction and recovery took an awful beating several years ago when “A Million Easy Pieces” became a best seller, only to be ignominiously exposed as fiction. It not only embarrassed the people who recommended it to people in recovery, it also made people who were inspired by it to doubt their own perception. What should have been red flags that revealed it as fiction were missed almost as an act of will.
The truth is, James Frey was phony and preyed on the need of recovering people to find some reason to believe by feeding them a lie.
Now, at last, there really is a narrative of redemption and hope that is all too willing to tell the unvarnished truth about how alcohol and drugs can bring even the most exalted figures down. Sylvester “Skip” Sviokla’s “From Harvard to Hell and Back” is the real deal. His personal story takes you through the ups and downs of a boy from the ethnic ghetto of Brockton who became a doctor to the stars in California and Massachusetts before he finally fell all the way down.
And it was down, indeed.
Imagine going from a six-figure income to working in a sandwich shop and showing yourself and everyone else that you couldn’t even hold on to that anymore … and getting even worse than that. We have heard the old story of decline, fall and resurrection before, but the candor in Sviokla’s book and the authenticity of his résumé set this book apart. Harvard is just as well known for the massive egos that matriculate from there as it is for academic excellence. Fans of the sit-com “Frasier” are familiar with the type. For the Crane brothers, Harvard wasn’t the best school in the world: It was the only school.
Sviokla, who admits he felt inferior to his classmates while he was there, is equally candid when he reveals how much he relied on his Harvard connections in a number of different ways, financially and psychologically, to get him through. The success he enjoyed didn’t end his troubles. Actually, being a doctor with plenty of money made it much easier for him to slip into opioid addiction. The easy access to the drugs and a real talent for lying to himself and others, Sviokla began to take advantage of friends, co-workers and even his patients’ names to keep himself supplied with Vicodin. When that caught up with him and he had his license suspended, he went back to drinking, an addiction he wasn’t really aware of when he was on the opioid treadmill.
“Frankly, for a guy who was supposed to be so damn smart, why did it take me so long to see it?” Sviokla asked rhetorically. “For me it was a matter of perception. It was like on of those Escher drawings that you stare at forever. You can see all these things in it and think you know what it is and then your perception changes and you see something else. It was there all along but why didn’t I see it? I stopped saying ‘I’m a lot like these people’ and said, ‘I am one of these people.’ It takes that perception to begin recovery.”
In reading Sviokla’s story, you are frequently compelled to stop and say, “What an a******.” In the chapter called “Down in the Gutter, Up on the Roof,” he describes how his daughters, with fear in their eyes, walk into the hospital room holding each other’s hands to deliver him from detox:
“I was not all right…This was still not the end of my drinking. For the next month or two I was every bit the incorrigible addict. I drank as much as I could get my hands on and I drank to get drunk and pass out. I stole form Maurine [his wife] and I stole from the kids. I had no shame whatsoever. If I saw a buck, I’d grab it and take it to the liquor store. I’d have half a bottle in my gullet before I reached home. I didn’t care.”
To avoid hearing his wife complain, he took to going up on the roof to drink. By then, even suicide was too much of an effort for him. Three-story buildings are notoriously unreliable for the death plunge:
“I might simply hurt or cripple myself, which would make me even more miserable than I already was. The mode I was in was death by habit, suicide by personal neglect. I was like a 500-pound man eating bacon burgers morning, noon and night. I knew what I was doing. It was simply more pleasurable than putting a bullet in my head.”
Fortunately for Sviokla, he woke up on the roof one night and had his moment of clarity:
“Something flipped in my brain. I was not forgiving myself or denying to myself that I was an addict. But I wasn’t this kind of addict…A flash of insight or a spiritual awakening? I’m not sure which it was, but it started me on the road back. Although I tend to believe it was my higher power, I leave that to those who are more spiritually certain.”
But there was no miracle. To stop drinking is just the first step. Rebuilding the trust and affection that has eroded from one’s family life remains. The real insight was knowing that the “one day at a time” mantra for recovering addicts became very useful.
“I started a new ritual in our marriage,” he wrote. “Every day, I would make a point to walk up to her and kiss her. It wasn’t about the affection. It was usually a quick kiss on her cheek or neck, but what I really wanted was for her to smell me.”
Sviokla honestly says that his wife was not thrilled with the new routine but he said nothing – just kept at it – with no preamble of promises and proclamations.
“The kiss was proof I was telling the truth,” he said.
Sobriety allowed him to take a job he didn’t like but he did it anyway and before he was tempted to drink his way out of the job, they promoted him. But then they let him go when his past addiction and blacklisting voided the clinic’s eligibility for Medicare payments and he was unemployed again. He was facing criminal proceedings and there was no guarantee he could get his license back. Fortunately, although getting controlled substances fraudulently is still a crime, the records showed that Sviokla’s biggest crime was against himself. His incredibly large dosages convinced the DA that he had to be selling drugs but the judge believed there was no testimony from any of the people deposed about the matter and gave him probation. The real frustration was getting his license back from people who didn’t care about him personally and some who apparently actively disliked him. Perhaps the Frasier Crane character rubbed some people the wrong way, but not everyone from Harvard deserves to be treated like an a******; a fact that apparently was lost to California bureaucrats.
Eventually, Sviokla realized that his own recovery was a self-administered treatment and what he learned could become a specialty, but it was his wife convincing him to contact Dr. David Lewis at Brown, who had been specializing in addiction medicine since he graduated from Harvard. He wasn’t an addict himself, but nobody’s perfect. He did see the value in having a doctor who was an addict treating addicts. Once the “street credentials” of a doctor are established, addicts are less inclined to lie to him. Almost uniquely qualified for the job.
“We’re the best liers in the world,” Sviokla said of addicts. “We are in a position to know that, and if something is not right with a patient, we know enough to revisit the [using of] drugs. We are more realistic about it and pick up on it earlier.”
Now Sviokla trains the same people who are aspiring to be doctors but are not always aware of their own vulnerability and teaches them to see the early signs of problems in themselves and their patients.
“I tell them, ‘Don’t fool yourself.’ Early interventions have the best chance of success.”