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From Harvard to Hell…and Back: A Doctor’s Journey Through Addiction to Recovery

Sylvester “Skip” Sviokla, III

Las Vegas, NV, Central Recovery Press, 2013, 169 pp., $16.95, paperback

It is sometimes easy to forget physicians are patients, like everyone else. They contract the flu. They take medicines for hypertension. They inherit genes for cancer. Sylvester “Skip” Sviokla, MD, has another problem—opiod addiction:

“As I opened the pill bottle with great anticipation, one Vicodin lost its way and landed on the floor, skipping and sliding across to parts unknown. Since I took 150 of these little babies each day, what was one stray pill to me but a penny to a millionaire? Yet I immediately dropped to my knees, searching for it like a near-blind man feeling around for a precious contact lens. I didn’t care who saw me or what I looked like. If I couldn’t see or feel the pill, I would have licked the floor to try to grasp it with my tongue if I’d had to.”

Above is the disturbing introduction to Sviokla’s memoir, From Harvard To Hell…and Back: A Doctor’s Journey Through Addiction to Recovery. In some ways, it’s a typical immigrant story, with a twist. Sviokla’s Lithuanian family immigrates to the ghettoes of Brockton, MA, where his demanding father sets high expectations for his son to succeed in America. Sviokla is smart, athletic, and ambitious. He attends the prestigious Boston College High School. Harvard College. Harvard Medical School. He becomes a respected surgical resident, then an emergency medicine physician. Although he admits to early problems with alcohol, it’s not until years later (after a gastric bypass operation) that he gets hooked on opiods. The memoir details the destructive behaviors that lead him to addiction hell, followed by his uphill climb back to sanity and health.

Although the book is well written, the author’s arrogant tone grates a little. Harvard this, Harvard that—Sviokla is clearly enamored by prestige, success, and wealth: “When you’re downing drink after drink at The Harvard Club or some other ritzy joint, surrounded by the high and mighty, you get just as drunk but you feel like a winner.” He brags about business successes and his stint as a doctor for rock and roll stars. He admits his cockiness may be a cover for deep insecurities, in part brought on by a harsh father (“He was a miserably bright son of a bitch”).

There are certainly other “comeback” stories out there in the addiction literature. However, busy physicians will find Sviokla’s story concise (169 pages, big print), easy to read, and entertaining. It will be particularly helpful to family medicine educators, who can use it to stimulate discussions about not only substance abuse but also “success,” the temptations of money, burnout, and other lifestyle issues pertinent to residents and medical students. Readers looking for new insights into the psychology of substance abuse will not find them in this book, nor is there much on the psychology of recovery.

Sviokla is not unlike many physicians today, in this respect: he is ambitious and anxious to succeed in a very competitive business environment. Physicians, at times, will see themselves in the story. It is a warning to them, that under the right (or should I say, wrong?) conditions—emotional insecurities, genetic predisposition, money pressures, and easy access to controlled substances—they can find themselves flat on the floor, licking it in search of one more pill.

How to avoid the addiction trap? Sviokla does not say. Developing self-awareness is a start—and reflecting on a true tale like this one.

Dean Gianakos, MD

Lynchburg Family Medicine Residency

Lynchburg, VA

Copyright 2018 by Society of Teachers of Family Medicine