A True Story of an Alcohol Blackout

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Dr. X, a respected and well-liked surgeon, started his hospital rounds one morning as he had routinely done for the past 15 years. As he breezed from one patient to the next, checking on those he had recently operated on and comforting those he would see in the operating room later that day, he was suddenly shocked to come upon a patient who had called him the day before complaining of abdominal pain. Dr. X had told the man to come into the emergency room if the pain worsened over the next few hours. That was the last he heard from the man, but there he was, lying in bed after someone had taken out his appendix last night. Confused and instantly irate at not having been called about the patient, Dr. X hid his upset and immediately began reviewing the patient’s chart.

He turned to the post-operative note summarizing the diagnosis and each step of the surgical procedure. The note was complete, well written, and, most incredulously, signed by himself. How could that be? He did not have a scrap of memory about having performed the surgery. In fact, he had almost no memory of anything last evening.

He had enjoyed a lovely meal his wife had cooked. He remembered opening a special bottle of wine, only to be told by his wife that her stomach was a little upset, and she was going to pass on the wine that night. Dr. X distinctly remembered being disappointed she would not be able to enjoy the wine he had carefully chosen to go with the meal she had prepared, but that meant there would be a bit more of the bottle for his own pleasure. Beyond that, his memory of the evening was a blank.

Had they watched television that night? Probably, since they both were fans of their local NBA team, and the basketball playoffs were well underway. But he had no memory of the game and had only learned his team won on the radio news this morning as he drove to the hospital. Strange that he had no memory of the game. He must have been tired enough that he went to bed early and didn’t watch it all—or so he decided.

Dr. X went back to speak to the man who lost his appendix last night. He approached his patient circumspectly and spoke only in vague terms, like a detective intent on avoiding leading a witness. He pretended that testing his patient’s memory of the preceding evening was part of a routine post-operative evaluation. The man recalled his call to Dr. X mid-evening, meeting him in the emergency room around 9:30, and being wheeled into the operating room where Dr. X had joked with him about how this was like how all the ladies waited until nighttime to deliver their babies. And then, apparently, he had successfully “delivered” his patient’s appendix.

Dr. X was deeply chagrined. He felt profoundly rattled and disoriented. But he was excellent at hiding his emotional upset and confusion. As soon as he had an opportunity to speak to the nurse who had assisted him the night before, according to the chart because he had no idea himself who had been in the operating room with him, he asked if she had noticed anything different about his surgical technique or demeanor during the appendectomy, explaining that he had been particularly tired. She said only that he had been less talkative than usual, maybe a little slower than usual, but he was just as methodical and competent as always.

When the doctor’s blackout began, he had lost no memory of his life prior to the blackout. He knew he was a surgeon, remembered all his practiced skills, and still recalled talking to his patient earlier in the day. The blackout was only erasing the memory of everything happening during the blackout except for the last three minutes.

When he got to the hospital that evening, he had no memory of the call telling him his patient was in the emergency room. Dr. X had initially followed his usual routine of going to the surgical floor, where a nurse told him the patient had not been transferred yet from the ER. When he reached the ER and saw the patient, everything became routine. Pain in the lower right abdominal quadrant meant probable appendicitis. His training took over, and he verified the diagnosis, then prepared for surgery.

During the surgery, it was always obvious, given his memory of the last three minutes, what next steps should be taken. If a good surgeon walked into an operating room during an appendectomy, he or she would immediately know at a glance what surgery was being performed, how far along the operation was, and what step should be taken next. But the next day, there would be no memory that the entire operation had taken place.

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Dr. X was lucky. So was his patient. Others have told me wilder stories of their blackouts. One man had gotten in his car, he thinks to drive to a liquor store that was more than three minutes from his home. Somehow, since he was driving toward the airport, he got it into his mind that he was headed for a flight to meet a friend in a city 600 miles away. When the blackout ended, he suddenly found himself standing outside his friend’s front door after having rung the doorbell. Surprise!

As I explained in a previous post ("Why Alcohol Blackouts Are No Joke"), while blackouts may make good stories, they can be evidence of a serious vulnerability to alcohol. If you have ever experienced a blackout, and nearly half of young drinkers do, you may be tempted to laugh at it, but it would be wise not to shrug it off. For many, it is a harbinger of increasing drinking over the years.

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