BY JEFF STILLWELL

HAT MORNING WILL ALWAYS REMAIN partially obscured in my memory. I remember the feeling of the vinyl mattress under my fingertips. I could hear muffled voices coming from beyond the thin wall. The tile floor was cold to my feet. The smell of cigarette smoke was strong. Was this reality or a nightmare? The past 48 hours seemed like something out of a bad movie. I had been a surgeon yesterday; today I was a drug addict in a treatment facility.

It all began in September 2001. I had injured my knee while descending an extension ladder from my father's barn loft. I slipped on the top rung and fell, catching and twisting my right leg between the rungs. I remember a loud pop: the pain in my right knee was intense.

Once off the ladder, I examined my knee. My initial thought was to call one of my orthopedic friends for a quick evaluation the next day. But the next day was Monday, and I had a full schedule in the operating room. I quickly convinced myself that I had treated many similar injuries in the emergency room during my years of training. Rest, elevation, ice, and ibuprofen would do the trick.

At first my self-prescription seemed to work. Although the knee would sometimes swell, I often forgot about it. Over time, however, the knee began to ache at the end of long days of standing during surgery. Sleep became difficult at night. Again I thought of calling one of my knee specialist friends but ultimately dismissed the thought: I couldn't afford to be laid up with knee surgery.

The solution seemed simple enough. I had samples of pain pills back at my office. It's not right--legally or ethically--for a doctor to treat himself or herself. But soon I was swallowing two pain pills at the end of long days of surgery. This would last only for a few days, I promised myself. As soon as my schedule slowed some I'd take care of myself and have the needed treatment and rest.

At first I took the pain pills only at times when I wasn't on call. It was wonderful to have the pain gone at night, and I rested well for the first time in months. I also noticed that when I used the pain medicine, I not only experienced pain relief but also felt more energy. I seemed to get so much more work accomplished around the house. Though I didn't know it at the time, I was simply high. I was experiencing the euphoria narcotics are famous for.

Before many days had passed, when facing a stressful situation I would think, I need a couple of pain pills. I congratulated myself that I never took the pills in the mornings, prior to seeing patients. I still thought I was able to control the drugs.

A full week on call soon followed, and I convinced myself that I wouldn't need the pills while on duty. But by the fourth day it seemed like I had a horrific case of the flu and a bad head cold all at once. My nose began to run, my joints ached, and I had no appetite. I was experiencing the first stages of narcotic withdrawal, but couldn't admit it.

As soon as my week of call was completed I began to use the painkillers again, commending myself for having avoided them all week. How could I have a problem with substance abuse? I had been raised not to use tobacco or alcohol. I was a vegetarian. I was familiar with healthy lifestyle principles. It seemed impossible that I could have a problem with drugs.

As the weeks passed, the number of pain pills required to achieve the same effect increased. Pain relief was no longer the priority; now euphoria was the goal. When not using, I was melancholic and despairing. I knew that what I was doing was wrong, but had no idea where I could turn to get help. Repeatedly I promised myself that I would quit, but the pledged dates came and went.

My practice became busier, and the number of my surgical cases increased month by month. "Maybe my problem isn't that bad," I told myself. But some of my staff had been asking me for weeks if I was feeling well. "You look exhausted," they told me. I mumbled something about how I would bounce back after a good vacation.

But the situation at home was worse. By the time I pulled into my driveway each evening, I barely had enough energy to make it out of the car and into the house. I had been refusing to eat supper for weeks. I had lost 20 pounds. My cheeks were sunken, my skin a grayish color. My eyes were often bloodshot and sunken, as though I suffered with a terminal disease. It was true: I was slowly dying from addiction.

But everything felt better when I took more pills. The future would be just fine, I told myself, as long as I could get more pills.

The withdrawal symptoms were now severe. A major holiday was approaching, and I wasn't on call. I planned, again, to take myself off the pain pills, using a sedative to abate the withdrawal symptoms--to "white-knuckle it" and get off the drugs. On the holiday morning I used the sedative. But it made me so drowsy that I slept the entire day on the living room couch. My family began to ask tough questions, but I reassured them that I just needed this holiday vacation to rest. The next day, however, I used the sedatives again. I couldn't walk without stumbling, and my speech was slurred. I was exhausted, broken. I finally let my family take me to a rehabilitation facility.

I sat on the edge of a bed, explaining my history to the admitting nurse. I was ashamed and embarrassed as never before in my life; never before had I been in such an emotionally dark place.

Over the next few days I talked at length with other patients--other health professionals--who also had experienced a "crash." I was placed in a rehabilitation community of 30 to 40 other health professionals, yet felt particularly drawn to the other surgeons in the program.

Treatment was multifaceted, continuous, and extremely intense. Our days were highly scheduled: group therapy, individual therapy, pain management therapy, coping skills, stress management, "grief" class, relapse prevention, "speaker" meetings, physician lectures, art therapy, community AA (Alcoholics Anonymous) or NA (Narcotics Anonymous) meetings seven days a week, meetings with my AA sponsor from the community, Caduceus meetings (for physicians or their family members dealing with alcohol or drug problems), nutritional therapy, "men's group," family therapy (conjoint with family members), and a number of educational and exercise programs. Small group therapy led by my addiction therapist met every weekday for up to four hours a day. I met for individual therapy with the same therapist one or two hours a week.

Within a few days I realized how attached I had become to my roommates and the rehabilitation staff. When people travel through fearful times and places, a bond unlike any other is formed. I had discovered a group of people who looked at me for my "inside"--people who saw in me a human being with qualities worth saving.

In the AA and NA meetings I heard much about a "higher power," and this produced great guilt and confusion. As a lifelong Seventh-day Adventist I have had a Higher Power all my life. How could I have an addiction problem when I had God in my life? I had been ordained as a deacon at the age of 14, as an elder in my late 20s. I had taught Sabbath school for years and had preached many times as a lay pastor in my church. If a Higher Power was all one needed, why did I have addiction in my life?

At first I didn't see that I had much in common with those I met at AA and NA meetings. But as with so many other things about my recovery, I soon learned how very wrong I was. From their honest stories I learned how emotional pain can be as intense and destructive as any physical pain, how much of my life had been dominated by an unhealthy desire to please everyone around me.

When they talked about unmanageability and powerlessness, I understood this. When they spoke about needing a Power greater than ourselves to restore us, I was in full agreement. I began to pray to my God again, many times each day. I learned that I must make a decision to turn my will and my entire life over to the care of God.

As strange as it may seem, this too was frightening at first. Through the years I had grown confident in my ability to accomplish, to succeed in life. Now with gentle instruction and direction from my counselors I reached out to God in prayer. I learned the skill of quiet meditation and practiced filling my mind with God's peace and serenity each morning.

After the first month in recovery I was granted a pass to return home for a long weekend, during which I was expected to attend an AA meeting each night. One night, however, a snowstorm precluded safe travel to a meeting. I wondered what to do. Then I remembered a credit card-sized piece of cardboard I carried that had an outline of a typical 12-step AA meeting. I gathered my family around the fireplace and explained that we were going to have a family meeting. I opened the evening with the serenity prayer. I then read aloud the 12 steps and 12 traditions to my family, and we discussed how that works. I explained to my children that a meeting such as this is one of the things I do while I'm away. I explained that addiction comes in many forms and that, according to genetics, any one of them may become addicted to chemicals as well. We talked about how each of them can help me with my recovery. I explained to them how important it is for me to talk with other people who have struggled with the same disease and have been victorious. That's why I go to meetings, and that's why I will need their continued support in the future.

I returned to the recovery center with great anticipation for my continued recovery. It was often very difficult to discuss painful issues in my life, but day by day the emotional pain began to lift. Slowly I came to understand ways to turn such feelings as resentment, anger, loneliness, failure, self-pity into strengths. Hearing how others struggled with similar issues offered me strength. Some had terrible pain at home; some had already lost their families. I began to realize how blessed I was. My wife encouraged me daily and prayed for me daily. My pastor traveled hundreds of miles just to meet with me, encourage me, pray with me. I received dozens of cards and letters from friends back home.

The injured knee that had launched this cycle of addiction was also surgically repaired while I was in the rehabilitation program. At every stage I discussed my recovery with each physician, including the anesthesiologist, and we designed plans for me to be treated without the use of narcotics.

Now I awake each morning not knowing what the future holds personally or professionally. I'm learning to take each day as a true gift from my Higher Power, my God, who has always been there for me. Through His strength, and with the continued support and encouragement of those who love me, this dark journey will lead to a point at which I am one day physically, emotionally, and spiritually whole.

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Jeff Stillwell is a pseudonym.