What follows is my view and thoughts on this. Some may agree and some may not. Also, you may sub in the word "addict" and "drugs" for "alcoholic" and "alcohol" as being hooked is being hooked, only the poison is different. Also, this may get long.
I have learned there are two things that separate the alcoholic from the normal person. Control and choice.
First "control":
Some people say that if one can control the amount one drinks, say have 5 drinks every day and no more than 5 drinks, that they are not "true" alcoholics. For me the line gets blurred here. If someone "must" have 5 drinks every day, then, to me, they are addicted to the drug. The reason they have those drinks every day does not really matter, be it withdrawal fears, anxiety, stress, whatever. These people may be classified as "functional alcoholics" as to the outside, they appear normal and can function. I would guess your surgeon needed a few drinks to steady his hands every morning and perhaps during the day. Been there, done that.
I was a functioning alcoholic for a long time. I would go to happy hour each day after work. Drink from 5-5:30 until 7pm when the bar tenders finished their shift then go home. I did not drink when I got home and did whatever chores needed doing when I got home. Lied to the wife that I was working overtime and, being an exempt employee, the pay didn't change. So for most of the time she didn't know. I still functioned. Maybe I was an "alcoholic in training" or a “borderline alcoholic” or whatever.
But looking back I can see where I first had a few beers and it wasn't every day at the bar. Then it was every day, then a few beers and a shot then a shot with every beer, just to get to the same point (buzz?). Tolerance has gone up and so does the consumption. At some point one cannot drink enough, when the alcohol does not work anymore. One no longer gets the buzz, or the feelings one is escaping from do not go away from drinking. That is the point of no return.
What I do recall was that even when I stopped for the night, I still had the physical "want" to keep drinking. That's what we call the “physical allergy”. That once one has the first drink, stopping is not really an option for the true alcoholic.
My uncle (another alcoholic) used to say “drink til you get the glow” then back off and just maintain the glow. But that quickly goes to uncontrolled drinking. And when one tries to control the drinking they get more and more miserable.
Even early on in my drinking, for the most part, I drank to get drunk, to get the buzz and to stay buzzed. Others would drink and stop but not me.
But all of this is the “physical” part of alcoholism and alcoholism is really a “2 part” problem although some call it a 3 part disease.
more on the 3rd part sometime later
The second part is “choice”.
This is where the brain comes in. The physical allergy can be alleviated by not drinking for a week or so. The body no longer craves but the brain continues to.
At some point in our drinking career, we reach the point where we no longer have a choice of whether or not we are going to drink. That the obsession to drink becomes an all-powerful overbearing gorilla that constantly nags on one’s brain. It makes us drink when we don’t want to no matter the circumstance. No job, no loved one, no DWI no loss of possessions, nothing is going to keep us from the drink. Bad days, good days, mediocre days, threats of divorce, children leaving never to talk to you again, family disowning you, it doesn’t matter as we have lost the ability to stop. And after drinking for a night, a day, a week a month, we wake up and swear we are going to stop and never drink again and by mid-day or the next day or the next week we are right back drinking again. And not just a few, as many as we can physically consume until we pass out and then start again. The choice has been taken from us. Alcohol is our higher power and we will do anything to get it. And after each bender, we swear we will stop, but it’s too late.
And I have found, no form of will power can remove the obsession to drink. For me, working the steps of AA has removed the obsession to drink.
I am guessing your surgeon has either stopped completely or has become a full blown alcoholic. Either way, I hope he is doing well.
Hope this helps you understand the minds and body of the addict.
ETA
Forgot to answer this question directly:
In your experiences with AA do you run into many like that or have you known many? I would imagine that many of them maintain the status quo and not even try to stop, at least until serious health effects appear.
It has been my experience that most alcoholics start out this way. Many in the rooms were once this way, myself included. To continue on, the result will
most likely be true, hardcore, alcoholism. But one can hope not.
