Fromson
ticks off the warning signs: verbally abusive behavior, tardiness,
unexcused absences, inappropriate sexual behavior. The signs of
strain tend to come first in a doctor's personal life. "When
things happen at the workplace," he says, "usually they
have been going on for a long time." Even then, he says, the
problem may not be confronted, because most doctors are self-employed
and only loosely supervised, and hospital management is often
hesitant to call doctors on questionable behavior for fear that they
will take their patient base to a hospital across town.
All
of this means a doctor's substance abuse problem can go unchecked and
then trigger a downward spiral.
And
if the drug of choice is crystal meth, or speed as it's also known,
the narcotic at the center of Arndt's charges, the spiral can move at
dizzying speeds. In his job with the San Francisco Department of
Public Health, Grant Colfax has done some pioneering research
documenting the prevalence of speed in the gay community. "For
many gay men, crystal meth has just completely destroyed them,"
he says. "People bottom out. It's a question of how far down
you've fallen, and if you can get back up."
For
the full story, go to What
went wrong?
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