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Opinion

Strangers on a plane


Hester Wilson


19/09/2019 3:35:45 PM

Dr Hester Wilson reflects on a serendipitous encounter with a fellow passenger.

Passengers on a plane
On a routine plane flight, a stranger decided to open up.

Travelling on a two-hour flight the other day, I happened to sit next to another middle-aged Australian woman. I’ll call her Michelle.
 
We quickly got chatting and Michelle told me she has always been very anxious about flying, but she had recently started to change her life.
 
She now found flying a little easier.
 
Michelle asked me what I did and, after I told her I was a GP with an interest in assisting people with tobacco, alcohol and other drug issues, she gave me a meaningful glance.
 
Then she told me about her alcohol use.
 
Michelle drank one or even two bottles of wine every night. In fact, she had not gone a day without drinking for years.
 
My fellow passenger told me she knew full well that her habit wasn’t helping her. She knew it made her feel depressed and hopeless, but she also found it desperately hard to change.
 
Michelle then gave me another look, one that spoke volumes. She very much did not want to be judged.
 
‘I know I’m not an alcoholic,’ she said.
 
I paused, then asked her what that word – alcoholic – meant to her.
 
Michelle didn’t answer for a moment. Then she said, ‘I can’t be that ’cause then I’ll never be able to change.’
 
I nodded.
 
I talked about my experience working with people who had problems with alcohol and how many were able to modify their use with support and treatment.
 
Michelle listened.
 
‘You’re not going to like this,’ she said, ‘but I’ve cut down on my drinking by replacing wine with alcohol-free wine. Now I’m now only drinking three days a week.’
 
She noted that she’d been ‘a bit shaky’ when she first cut back.
 
I told her I thought that was a brilliant solution and asked why she thought that I wouldn’t like it.
 
She smiled awkwardly. ‘You know, doctors always say you have to give up completely. So this means I’m cheating.’
 
As we spoke, the air stewards were wheeling the trolley down the aisle. One handed us our meals and offered a 185 mL bottle of wine.
 
We both took up the offer. Michelle finished hers quickly and was offered another. She paused, then took it. She drank a little of the second bottle, before looking at me shyly.
 
‘Guess I better not drink that,’ she said.
 
We both laughed.
 
There’s something about air travel that brings out the confessional. For the rest of the flight, we talked about everything under the sun – life, kids, getting older, ageing parents, relationships.
 
At the end of the flight, Michelle thanked me for the talk.
 
‘I think I’m ready to cut my drinking down further,’ she told me.
 
I wished her all the best, suggested she see her GP for more support and we shook hands.
 
It’s not the first time this has happened. I often have conversations about life and substance use in my travels. I’ve had conversations about giving up smoking in taxis, deep discussions with people trying to support family members using methamphetamine on trains, and chats when I run into my patients on the street.
 
While I try to steer people to their existing support structures, I believe these serendipitous conversations are important.
 
They’re part of the precious human interactions that may help people with a dependency to find their own way to the changes they want to make.
 
These encounters are a single ripple. By themselves, they may not be enough. But when supported by other ripples – family, friends, their GP – they can become part of a tide of change, leading away from the habits that they now feel are holding them back, and on towards a brighter future.
 
I’m glad that Michelle chose to open up to me, a stranger on a plane.



alcohol column dependency


newsGP weekly poll Is it becoming more difficult to access specialist psychiatric support for patients with complex mental presentations?
 
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newsGP weekly poll Is it becoming more difficult to access specialist psychiatric support for patients with complex mental presentations?

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Dilip Dhupelia   20/09/2019 7:39:43 AM

A 2 hour Level D consultation for free, that may change Michelle’s life forever. Well done Hester!


Dr Alireza Ahmadvand   20/09/2019 8:51:47 AM

What a heartwarming story...beautiful writing too!
Thank you for sharing.


Dr. Patrick McSharry   20/09/2019 9:37:17 PM

Great story Hester . I fly a lot - as worked on 4 continents - so far :) and have encountered this scenario more than once . (Being Irish , folks not too reticent of discussing Alcohol use with me - good and bad to that also :(
Agree with Dilip, I'm sure it helped your fellow traveler a lot (and I find it fun to chat , the time goes faster , I'm sure you found that too.)
Interesting point thought emerged from your chat with fellow passenger (which I think you were hinting at in this piece , the growing evidence that "Abstinence Based " treatment for AUD (DSM V ) is now considered inferior to reducing intake (especially when Naltrexone or other MAT is used )
Depot MAT (such as BUP for OUD and Naltrexone for AUD ) with counseling having the best outcomes I believe. ?
Best Regards
Patrick


Dr Christopher Charles Davis   27/09/2019 10:27:15 AM

Motivational interviewing at it's best! Keep on chatting!


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