Photo courtesy Faye Jamali
In 2007, Dr. Faye Jamali broke her wrist. What happened in the next few months jeopardized her career as an anesthesiologist and made her understand pain in a new way.
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I don’t want to say it’s unusual but for me it was unusual -- because never in a million years did I think I would ever find myself addicted to opioids.
I had never had issues with heaving drinking, using drugs. I even graduated Berkeley without even trying pot.
It was scary how much raw talent I had for being an addict. For someone who had had no history of it, I showed great skill.
At age 40, this is after I’d been an anesthesiologist for almost 15 years, I broke my wrist at a birthday party for my children. This was back in 2007. Had a couple of surgeries. Had some pain. The surgeon, who was actually a friend,, prescribed me a big bottle of pain pills. And back then it was not unusual to do that. We were taught in medical school, in residency, and even in my clinical work place, that we had to treat pain very aggressively, and that if patients were being treated for surgical pain, the chance of addiction was minimal. That was what we were taught. So to me, it wasn’t unusual that he prescribed me a whole bunch and he also said, “I don’t want you to have to call for a refill. Here you go.”
And I took the pills as directed -- every three to four hours when I had pain. Funny thing happened. I noticed that when I had those pain pills in my body, things didn’t bother me as much. I was just less stressed out about everything.
At that time, I had two small children, a two-year old and a five -year old. Life was pretty stressful. I was a full-time anesthesiologist. My husband was a full-time surgeon. Hectic life. But I found out that hey, if I took one of these Vicodin pills, it just smoothed the edges. I just felt like Oh, this is kind of cool – and it’s prescribed!
So I just started slowly taking things once in a while when I was stressed out. But it muddied the water for me.
I also have a long history of very severe migraines that I had gotten all kinds of treatments for. Botox injections in my scalp. I would occasionally find myself in the ER having injection of a narcotic. I was at work when I had a very bad migraine. It was towards the end of my shift. And at the end of the shift as an anesthesiologist, whatever leftover narcotics we have from the cases we’ve done, we waste them. As I was in the bathroom just dealing with this really bad migraine at the end of my shift, I thought, Oh my god, I have this narcotic. This is the exact same medicine they’re going to give me in the ER. And I don’t have to wait. And I don’t have to do anything. And I’m a physician. And I can inject. Let me just do it!
I did it. The headache went away. But I felt so guilty. I felt like I had just crossed a line that should never, ever be crossed.
The next day I got a migraine again. I tended to get them during my period. And I thought this time, Oh, I know exactly what to do. I went and injected myself again. This time though, I felt a rush of euphoria, not just pain relief. It was a euphoria that made me stop, and think, and be angry at myself for having had access to this amazing drug all these years and I never used it!? I mean, what kind of idiot was I?
Over the next three months, I just was chasing that euphoric feeling. And within a three-month period, I had increased the dosage of medications I was taking by close to tenfold. I was terrified. I kept thinking, Well, this is wrong but no, no, no, I’ll stop. It’s just really stressful right now. I’ll stop.
But something would trigger it, and I would just like I just want to feel good again. And I would find myself doing it and feeling worse afterwards because no matter how much I tried, I couldn’t quite stop myself. But I kept thinking, Look, I’m a smart person. I’m a doctor. I have good will power. I can beat this.
Nobody knew. Nobody. No, I did not tell my husband about this. He had no idea. I never used when people were around. It was always in private. And I would use on the day that I wasn’t working. Children were at daycare or at school. I hid it pretty well. I also didn’t know how to ask for help. I felt so ashamed. I kept telling myself, But I can’t be an addict. I’m a doctor. I’m a soccer mom. This is not addiction, this is just some phase.
But I -- I was scared. Anesthesiologists died from overdose but I never thought that that would be me. And I was afraid that if I overdosed and died, I would leave two small children without a mother.
So I had this brilliant idea one day. I would inject into my arms. So I put my daughter’s name on my arm where the vein was, and my son’s name on the other arm where I used. And I told myself, Just think of it, next time you’re injecting there, just tell yourself you’re injecting into their eyeballs. You would never do that, would you? But the craving would hit and I would rip that Band aid off, and I would inject, and I would feel a thousand times worse, because what mother does this? What mother would do this?
The worse I felt about myself, the more I needed relief. And the more I did it, the further down I would get. I would go two or three, four, five days without using and I would see the light. Like, okay, I am crawling out of this crevice, and then fall back down again further.
I had a fight with my husband one night, and I drove to the hospital, went straight into the recovery room. It was like 8 o’clock at night. Said hi to the recovery room nurses, went to the narcotic machine, just picked a random name, a patient’s name, and checked out narcotics. Went into the bathroom and injected. And I woke up, maybe a couple of hours later. I still had a needle in my arm. There was blood. I had vomited. I had urinated on myself. I was horrified. Horrified at my husband for having made me do this. I was angry at him. This is the depth of the change that happens in your brain. The addiction in you does not want you to call it addiction because it’s an existential threat to its existence.
My workplace – they called me one day. They said, “We need to talk to you.” I walked into a conference room. There was like ten people sitting around this large conference table, and they just had all these records of medications that I had checked out that had nothing to do with surgery or the operating room, just a random patient, a patient who had actually died two days earlier who was still on the list and I had checked out a medicine under his name.
I just didn’t even have the presence of mind to say anything. I just said, “I don’t know. I don’t know.” I just didn’t know. It was shocking. They said, “Turn in your badge. You’re under investigation. Until the investigation is done, you’re on suspension.”
And I remember walking out of the hospital wondering, Now what? Oh my God.
And that evening actually we had a marriage counseling session because our marriage wasn’t doing so well at that time. We went home, put the kids to bed. And after things were quiet, my husband said, “Faye, do you want to tell me something?”
And I just looked at him. I thought, Okay, this is it. This is the lowest point in my life. This is how it just completely falls apart. I didn’t even say anything. All I did is I rolled up my sleeves – I used to wear long sleeves all the time -- I rolled up my sleeves, just showed him my arms. And then what he did, was he just picked me up, hugged me and said, “Sweetie, why didn’t you tell me? We’ll get you help.”
And I have never loved him more. Because to be that low, and to have someone offer you help -- it is the world to you.
And also that moment taught me no matter how hard the situation is, the truth is actually easier.
So the next day I called up my hospital and I told them. And I saw this physician who is a psychiatrist at my hospital who is an addiction medicine specialist actually. He had treated me years ago for depression, post-partum depression, so he knew me very well. He’s my angel. He said, “Faye, it’s going to be a long, rough journey, but we’ll take you through it. We’ll walk you through it.”
And I’ll never forget the first day I showed up at the recovery center. I had dressed nicely, wearing a nice pearly necklace, and I sat down and this guy next to me said, “So, hey, what are you here for? Alcohol?” And I’m like, “No, I shoot up drugs.” And he was shocked. Like I didn’t fit the profile of someone who injects. But that’s who I was.
I was extremely fortunate. I had a job where they gave me the opportunity to take a year off. I had insurance that would pay for my recovery program. I was in a physicians’ support group. I had therapy. I had group therapy. I went to AA – I just felt more comfortable in AA versus NA – but just like a 12-step program. I really immersed myself into recovery.
But at the end of that one year, the hospital said, “You can either come back to the job you had before, as an anesthesiologist, or you need to sever your ties with this hospital.” And I was terrified. I didn’t know whether I could go back to being around narcotics. So we came up with a plan for me to come back slowly, be monitored. For the first three months there was another physician with me on every case. I took naltrexone, an opiate blocker. I told people in my group, my anesthesia group, of what had happened. I wanted them to be part of my safety net so that if something looked off, that they would be there and notice it. So we had a big program set up and I was able to return to work.
Most states, except for three, have a physician health program. If a physician has problems with substance abuse, they can be referred to this program, and as long as they abide by all the program rules, like going to meetings, having therapy, urine testing – as long as that is going on, the medical board doesn’t plaster their name on the internet, as long as they are in recovery.
Unfortunately in my situation, California is one of only three states that to this day, does not have a physician health program. So what happens is that if you have a problem with substance abuse, the medical board reviews you. So the medical board took two years before they got to my case – not because they are lazy, because they are backlogged. I was already back at work practicing for a year before the medical board came down on me and said you are under probation for five years. During that time I had to get tested four times a week. I had to take an ethics course because according to them, it’s an ethical failing. I had to take lots of continuing medical education in addiction medicine which was great.
I don’t think being a doctor is a right – it’s a privilege. I was willing to do whatever to do this. But any patient who wanted to could go on-line, put in my name, Dr. Faye Jamali, and what does it say? It doesn’t say I’m in recovery. It just says that I am this addict. That’s hard as a physician. And I don’t think it does the public any good because now physicians go underground if they have a problem.
Who wants their problems on the internet being broadcast? Physicians in recovery actually do much better long-term, 80% recovery rate vs. the general population. Also we have access to good insurance. We have the means to get the recovery we need. The general population, unfortunately, doesn’t.
But in 2015, I was able to finish my probation. During this time of recovery, it’s not like life was peachy. Pain happens. What I learned from recovery were all these tools to deal with life and pain that is inevitable in life. I think prior to that I had wanted to become numb to the pain. I think as a culture we want to do that. We want to numb ourselves. It’s almost makes things worse because rather than actually dealing with the problem, we never address the problem because we just numb the pain. And pretend it’s not there.
I will forever be an addict in recovery. There is no cure for this disease. Your brain has changed. It is not a moral or ethical failing on anyone’s part. And just like a disease we need to have a treatment plan. And recovery is a treatment plan and we should support that, and there should be money toward that.
You know, I always think of this thing when someone is trying to quit smoking, everybody is rooting for them. They’re like, Good job! You can do it! Why can’t we treat it like that? Why can’t we say, Good job! You can’t do it! and be the support that they need. And that’s what I want to be.
We need to have good policies in place, have people buy into it, to realize that this could happen to anybody. Hey, if it can happen to a 40-year old woman physician with no history of this, it can happen to anybody. And, you know, it is happening to everybody.
There is something going on in the brain, a neurochemical disease. It is no different that any kind of other chronic disease. And we have to approach it as a disease, take the stigma away from it, and that way with facts and science, we might have a chance.
My name is Dr.Faye Jamali and this is my story.