Recently, a close acquaintance struggled through the physical and emotional ordeal of a marrow transplantation for leukemia. It was managed magnificently at a renowned academic health center, but he nearly died during an alcoholic binge following discharge. He had had many disastrous episodes with alcohol in the past. But when he tried to discuss his drinking with his doctors, they downplayed and scoffed at his suggestion that he was in trouble with alcohol. After all, he was a strong man who, with their help, had destroyed his cells run amok. See also p 663. Walsh and colleagues 1 bring us both good and bad news in this week's issue ofTHE JOURNAL. Welcome is their suggestion that when doctors address alcoholism with their patients, the outcome may improve. Confirming earlier reports, however, the bad news is the continuing inference that doctors are often loathe to intervene with patients who abuse
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Thomas L. Delbanco (1992) studied this question.