The Courage
to Change

UNR Med students spend a week at the Betty Ford Center

Contributors: Denise Julian, Katrina Marks, Megan Rescigno and Sarah Toti

Denise Julian, UNR Med Class of 2022, displays the coin she received on her final day at the Betty Ford Center. Photo: Brin Reynolds

Each year at the Betty Ford Center in Rancho Mirage, California, medical students learn about addiction treatment for substance use disorders directly from clinicians, patients and families. Through a competitive process, 17 first-year UNR Med students were accepted to attend the weeklong, immersive educational program—the 2019 Summer Institute for Medical Students (SIMS)—which was fully sponsored by the E. L. Wiegand Foundation in partnership with the Hazelden Betty Ford Foundation.

We invited UNR Med students to journal their thoughts throughout this life-changing experience.

Sarah's Story

Block 3 is over, and we can finally look forward to our spring break. I’m excited to be heading to warmer, sunnier weather, but also anxious to see what this SIMS program entails. The program director, Joseph, sent a vague email in the weeks prior, notifying us that our days would be long and structured with expectations of active participation leading to self-discovery. I’m not so sure about this latter statement, but I do believe I will be leaving this experience knowing more about treatment and therapy for the disease of addiction.

It’s Monday morning at 6:50 a.m., and we are on the official Hazelden Betty Ford shuttle heading to campus. Shortly after arriving, we underwent an orientation which highlighted expectations for the week. We then went to the residential halls, and I met my “buddy” for the week, who showed me the ropes and told me about her experience at the Betty Ford Center. Many of the patients were open and welcoming toward me, which put me at ease. As I met more people throughout the day, I realized that this disease of addiction shows no preference for its host. I met executive businesswomen, grandmothers, nurses, teachers, teenagers, waitresses, college students, engineers and countless other amazing women—all with at least one thing in common: addiction. I’m not sure what I thought addiction looked like, but this wasn’t it. Alas, I was awoken on the first day to an unknown bias and stereotype I possessed, which greatly humbled me.

Heading into today, I felt more self-aware of my thoughts and was ready to uncover more truths about addiction and the people it affected. At the group therapy session for the day, patients had to talk about 10 consequences of their drinking (or substance of choice). I liked to think of myself as a highly empathetic person. Yet again, I was shown I could do a whole lot better in this department. I listened to patients speak emotionally about their consequences, and I never realized the amount of shame that accompanies addiction. Every patient discussed the guilt they carry from actions committed under the influence of a chemical substance, and it seemed the guiltier they felt, the more distanced they became from their values. Prior to this session, whenever addiction was presented to me in clinic or everyday life, I tended to only think of the pain felt by family members, friends, spouses and co-workers—not of the person with the actual disease. I never thought to truly put myself in the patient’s shoes to try to understand their confliction with the addiction and how it furthers the vicious cycle of substance use.

One of the most meaningful events from today was sitting in on a Caduceus Alcoholics Anonymous meeting. Hearing nurses, medical students and physicians talk about what lead to their addiction was eye-opening for me. A lot of the fears, pressures and expectations they discussed, I could relate to on many levels. I saw a lot of myself in the people that spoke, which scared me, but also challenged me to monitor my own behaviors and reach out to any colleagues who may be struggling. It was inspiring to see how successful some of them are doing now in recovery—having phenomenal careers and happy lives—giving hope to any medical professional dealing with addiction.

Megan's Story

Day light savings time and a very early flight made us medical students very tired for the remainder of the day. At this point, I am very nervous for what this week will bring, but I am very excited for the opportunity to learn at one of the best facilities in the world.

First day at the Betty Ford Center. We are introduced to the layout of the center and assigned a patient group to be with for the week. I was assigned to the Day Treatment group, which is comprised of patients who live offsite in sober living houses and come to campus every weekday for therapy and educational sessions. This group of women is small, and the setting is rather intimate. We sat in a circle during the designated group therapy time and shared our thoughts, feelings and struggles. I initially thought the patients would refrain from opening up in the session, because I was a complete stranger to them, but to my surprise, they were able to share some of the most intimate details of their lives with me. I was shocked by their stories, but also extremely impressed with their resilience and commitment to living a sober life for themselves and their loved ones. I can already tell you that this is going to be an emotional week.

One thing that has always confused me about the 12-step program is the religious aspect of it. God is mentioned several times when it talks about recognizing your higher power, but there are so many people who this does not work for. Today I asked members of my group what their higher power was, and to my surprise, only one out of four said God. The others talked about nature, their families or the group itself. They said the idea of a higher power is when you find yourself unable to overcome your addiction on your own and therefore turn to something greater than yourself for help.

Today in our therapy group, we talked about the need to control everything around us and the need for perfection. In talking, I realized how much I struggle with this myself. We also attended a Caduceus Alcoholics Anonymous Meeting, which is traditionally for medical professionals. Here I realized that physicians can struggle with addiction like anyone else. It was inspiring to hear how they got sober and how they have used their own situations to teach and help others.

This was a day of tears for all of us. We learned about the family dynamic that takes place around addiction. The Betty Ford Center has a phenomenal family and children’s program that seeks to separate the disease of addiction from their loved one and make them two separate entities of thought. We heard powerful stories about children facing a parent with addiction and overcoming adversity to try to break the cycle of addiction that is often seen generation after generation in families.

Denise's Story

I’m uncomfortable with being uncomfortable. Uncomfortable that these stories and struggles are making me feel trapped. Trapped for the ones who are trapped in their private hell that never really was private no matter how much they thought nobody was seeing them. Checking out to avoid feeling trapped, then reminding myself that it’s okay to actually feel. That’s why I’m here. We’re all human, and today I remembered that that’s what makes me a caregiver—my emotional openness and ability to embrace vulnerability. This first day was difficult in ways I didn’t expect, but also quite special, and I’m curious to see how I feel four days from now.

I’m feeling more well-equipped. Better-prepared for the flood of emotions and better-prepared to handle the personal demons being disclosed and unmasked, being spoken about so candidly. But my head is still spinning and the world is feeling very different as I work to reconcile how people who look and talk and laugh just like me can be going through such misery and pain. It’s so sobering (no pun intended). So many wrongs they’ve dealt and been dealt. And here I worry myself about such insignificant things by comparison. I guess it’s all just relative; we’re all just human after all.

I feel so much more like myself, like a little flower who has taken root in the sunshine of the desert, as I walk by the lake before afternoon lecture and wonder how long until the patients feel the same gratitude and zest for life again. I only wish for every single one of them that sooner rather than later they can step out of their own way enough to let the magic of life be their guidance through this unbelievably challenging journey. Every day they wake up is truly a gift, and for the rest of the day, I imagine all the opportunities that await them in sobriety.

We never know just how we can be a lighthouse for someone. The tremendous gift we’ve been given to stand here with open arms and use them to heal. To use our eyes to truly see when someone is suffering, to use our ears to hear the pain hidden in their voice from the child that was drowned out and forgotten long ago. When everyone else has given up on you, I will be here. When you have given up on you, I will be here to help you open your eyes and look for life. And as far as I go, I will fill my own cup so I always have more to give. Always remember that the wisdom we need is usually hidden in the last place we look—within.

Our last day. Our “coin-out” day when our groups put their thoughts and wishes for us into a coin with one straight edge that represents that recovery is never perfect nor complete. As the patients go around and say what they feel and wish for us medical students all I can do is hold back my tears of gratitude for them and the gift they have all given me this week. I feel so infinitely blessed and changed forever; my eyes are more open than I imagined they’d be on Day 0. As we drive away at the end of our last day, I think about how I can walk away from all of this, and they can’t—they have to live with addiction for the rest of their lives. But I am now just a bit more well-equipped to be that hand that reaches for theirs when everybody else has walked away. That’s what I was put on this earth to do. And when the youngest member of the group charges my coin by saying that we’ve inspired her to become someone like us one day—to work hard and passionately for something and become successful—I know I’m on the right path. I couldn’t be more grateful for this week at the Betty Ford Center in Rancho Mirage.

Katrina's Story

I decided to come to the medical education program at the Betty Ford Center for a number of reasons. I am interested in the field of psychiatry and want to get to know different aspects of it better, but I’ve also witnessed my own family’s struggles with addiction. Despite having family gone through recovery and even being treated here at Betty Ford, I realized I knew very little about what the process was like. I know that AA is important and there are certain medications you may (or may not?) take, but other than that I’m clueless. I’m eager to get involved and learn more about what goes into recovery as well as how to better support my family and future patients.

Because I have so little knowledge about how recovery and rehabilitation centers work, I’m nervous about what to expect. I’m admittedly a very emotional person even on a good day, so I’m worried I may let my feelings get the best of me. My goal for the week is to try to just deal with these emotions as they come – positive or negative – and use them to help me connect with the patients on a more meaningful level while I’m here.

Today was our first day here, and I’m left exhausted but in such a reflective way. After some orientation meetings about what to expect during our week, we were dropped right into patient small group sessions. In all honesty, I was nervous. I was nervous that the patients would think we were judging them, or they wouldn’t want to share their stories with us. While they initially were hesitant, as soon as I shared my own background with the struggles my family has seen, you could see how much they relaxed.

It’s been eye-opening to see how “normal” addiction is. When our cohort sat in our first lecture, we were pretty well dispersed among the patients. I looked around to see where my classmates were sitting, and I was struck by the fact I couldn’t find them. The patients looked like my peers, and my peers looked like the patients. It sounds cliché but couldn’t help but realize how similar we all were. The media makes addiction out to be something dramatic that only happens to a select few people who “took a few wrong turns in life,” but today made me realize that isn’t the case. Addiction is a disease as much as cancer or diabetes, and it makes just as little effort in discriminating who it claims.

Today was our second day at the center, and what stood out to me most was the patients’ raw and unbridled honesty. We sat in on a spiritual counseling session with some of the patients, and they each shared a challenge they are facing in sobriety and how they plan to overcome it. Their challenges ranged from worries about dealing with family members over- or under-involvement to their own insecurities in confronting themselves sober. It was incredible to hear them face such massive issues and then ways to face them. Even more inspiring was hearing them support each other. Whenever someone expressed worries about making it through a particular struggle, their peers chimed in to express support and love toward that individual.

What was equally as powerful was hearing how their struggles are the same struggles we face every day – anxiety, feelings of inadequacy, control issues – our worries and fears are the same. While it helped us relate to the patients more and made them feel more comfortable, it also reminded us just how vulnerable we all are.

Today was by far the most meaningful day I’ve had here so far. In our small group meetings, we heard patients read aloud their assignments, which were to write themselves a letter from the perspective of addiction. Hearing how negatively and darkly their addiction “spoke” to them was difficult to hear. It showed me just how strong of a grip addiction can hold and how hard it can be to leave. As someone who has never experienced addiction personally, it helped me understand the depths to which this disease can take its victims.

In addition, we had the opportunity to sit in on the Caduceus meeting today, which was a meeting of recovering health care professionals. It was eye-opening to hear stories from people so relevant to us, and it made me realize just how addiction can affect anyone.

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