Terms of Endearment: Dr. Silkworth and AA

daily gratitude list 11.15.22

I’m grateful for a really amazing day. I’m grateful for my new writing digs at the library. I’m grateful for a walk in the park on a pretty afternoon. I’m grateful for two pretty lovely children. I’m grateful to be sober today.

I have loved libraries and books since I was a little, little kid. I can remember my Dad taking me to the library to get books about dinosaurs and making him read everything we could check-out. When we moved to Iowa City, I’d get to tag along with him on trips to the big University Library and he’d often turn me loose while he was doing whatever work he had come there to do. I can’t tell you how exciting I found that. My stomach still gets that happy twist of anticipation when I even think about it.¹

The Card Catalogue was gigantic! In my mind’s eye, it looks like the size of a football field, but I’m pretty sure it was considerably smaller I found the idea that I could look up virtually any topic, any name, any bad word, and find a multitude of books on the subject, along with a nifty code that told me exactly where to find them, completely intoxicating. You may get the idea that I didn’t take too much that seriously, I took the Dewey Decimal System very seriously. I paid attention and learned that.²

I also have strong feelings about mass transit and I understand the connection: The libraries and the city buses were what gave me freedom as a kid—they let me start building the independent me. I loved the library and a big part of the reason that I was a good debater and later a lawyer, I didn’t just do the research, I loved the research. What constitutes “research” can be a trickier question. There were lots of nights at the UI library where I was not doing homework or debate research, but was sitting in the Bound Periodicals stacks on the 3rd floor reading old New Yorkers.³

Here on the Upper East Side, I discovered the New York Society Library on 79th Street. It’s quaint, has a lovely reading room on the second floor and lots of carrels and tables and rooms in the stacks to work. I love that and I think it’s kind of a secret hub for writers in the neighborhood. I don’t know that for sure, but given the paranoia and distrust and the general “what are you working on here” vibe I get, well, it seems like a pretty good guess. I like it there quite a bit.

I was there yesterday and had occasion to use the card catalogue. You can see the topic of my research—but that’s a challenging code and I couldn’t figure out where it would be located from the stack map. I consulted the librarian, she looked at the above photo and she let out a little laugh: “Oh, you used the card catalogue! I’m not so sure that’s accurate anymore, let me look it up.” I felt a tangible sense of disappointment as she started typing in the book information, the author’s name, not even the Dewey Decimal System code. But I thought this exchange was funny:

Librarian: What’s the name of the book again?

Me: Bill W. It’s a biography.

Librarian: Oh, is it this one, “Bill W.: A Biography of the cofounder of Alcoholics…”

She caught herself saying the word “Alcoholic” pretty loud and in a library, and dropped her voice so low, I could barely hear her say “Anonymous.” She looked at me, plainly embarrassed, I smiled and said, “yup, that’s the one.” There wasn’t a bit of rancor or disdain in this exchange—it just shows what the word “alcoholic” means to most people—and it’s not terribly positive. I’ve had other alcoholics react to the name of the podcast with things like, “that’s kind of a harsh name,” “you know, you don’t have to call yourself an alcoholic outside of meetings.”

As I like to tell people, it’s a diagnosis, not an insult.

This is an area where I don’t think the anonymous thing helps us alcoholics, but I’m not getting on that high horse today. I went into the stacks and didn’t find the book I was looking for, but I found another one and it had these awesome photos:

The top picture is Bill and Ebby Thacher and the inset is Dr. Silkworth.

I really got a lot out of putting together “Bill W. Gets Sober” and hope you had a chance to listen (or read):

Breakfast with an Alcoholic: Episode 26

I just think it’s such an amazing story and I think Dr. Silkworth deserves a lot more credit for what happened. Letting Bill W. start deploying his untested, not scientifically-based methods, his crazy theory of alcoholism (developed, of course, while drinking) on the other patients at Towns Hospital, well, it seems crazy. I think it speaks to the power of Bill’s conversion and his beliefs, but it also has to do with the fact that medicine didn’t really have much of an answer for alcoholism. I always marvel at the emotional strength and resolve it must take to be an oncologist, dealing with such a hard disease with so many bad outcomes. Think about treating alcoholics in the 1930s—there’s a lost cause for you.

Dr. Silkworth plainly didn’t see it that way and Bill correctly recognized just how valuable Dr. Silkworth’s contribution was:

As we looked back over those early scenes in New York, we saw often in the midst of them, the benign little doctor who loved drunks. William Duncan Silkworth, then physician-in-chief of the Charles B. Towns Hospital in New York, and the man who we now realize was very much the founder of AA.

Gravevine, August 1957

Dr. Silkworth was a witness to Bill’s spiritual awakening:

In December 1934, this man of science had sat humbly by my bed following my own sudden and overwhelming spiritual experience reassuring me: “No, Bill,” he had said, “you are not hallucinating. Whatever you have got, you had better hang on to; it is so much been than what you had only an hour ago.”

ibid.

Dr. Silkworth pushed Bill to continue to try his methods on the patients at the hospital, even though the initial results were pretty discouraging:

After six months of failure on my part to dry up any drunks, Dr. Silkworth again reminded me of Professor William James’ observation that truly transforming spiritual experiences are nearly always founded on calamity and collapse. “Stop preaching at them.” Dr. Silkworth had said, “and give them hard medical facts first. This may soften them up…so that they will be willing to do anything to get well. Then they may accept those moral psychology ideas of yours, and even a Higher Power.”

Ibid.

Bill estimates that Dr. Silkworth “twelfth stepped” 40,000 alcoholics. That is a staggering number. Bill wrote this pretty moving tribute:

Thousands [of these alcoholics] he patiently treated long before AA when the chance for recovery was slim. But he always had faith that one day a way out would be found. He never tired of drunks and their problems. A frail man, he never complained of fatigue. He never sought distinction; his work was his reward. In his last years he ignored a heart condition and he died on the job—right among us drunks, and with his boots on.

Ibid.

The story of my sobriety is built upon some pretty crazy coincidences and happenings, synchronicities, I’m not sure what to call them—but I see now that they were attendant to my own spiritual awakening. I didn’t do anything to usher in these events, these people, into my life, they just showed up and not according to any plan or desire that I had. My contribution to the endeavor: I mostly shut-up, stopped writing my crazy narratives and started opening my heart. I’ve written this ten times in the last two weeks, so this will be eleven, the key to all of this was pretty simple:

It was only a matter of being willing to believe in a power greater than myself. Nothing more was required of me to make my beginning.

Big Book, p. 12

Dr. Silkworth’s medical training was probably not the thing that let him recognize that a hopeless, crazy drunk might have figured out the way to treat alcoholics—while drinking of course. I’m guessing that was Dr. Silkworth’s heart at work. He risked his career and his reputation for a drunk who may have been wearing a bathrobe when he made his pitch to be allowed to start treating alcoholics at Towns Hospital.

And the part about Dr. Silkworth living, working “right among us drunks” right up until his heart literally gave out? I think that is pretty powerful evidence of this proposition:

Nothing, absolutely nothing, happens in God’s world by mistake.

Big Book, p. 417

You often hear people at meetings say things like “God must love drunks” as they describe some narrow escape from some horrible fate that preceded the discovery of the path to recovery. I think Dr. Silkworth’s life, “a benign little doctor who loved drunks” is pretty solid evidence of that proposition, too. I don’t think Dr. Silkworth ever lowered his voice apologetically when he said the words “alcoholic” or “drunk.” Those were terms of endearment, expressions of love to him, and that’s how I look at them, too.

Thanks for Letting Me Share

1. I get that same feeling in really good used bookstores.

2. My college girlfriend got a masters in Library Science, that’s how seriously I took it.

3. Somehow, I waited 40 years to act on the desire to live in New York.