The Tribune

By DR KENNETH D KEMP

IN the early nineteenth century, long before the Prohibition Act was passed, there was a lesser well-known movement in the United States to ban the manufacture, sale and transportation of intoxicating liquors, the consumption of which was conveniently blamed for all of society’s ills. The 18th amendment to the US constitution was eventually passed and the era of rum-running (colloquially referred to as bootlegging) began, lasting 13 years until it was repealed in 1933. But three centuries before that, in the 1600s and during the golden era of piracy, rum production in The Bahamas (albeit a more impoverished selection than the current varieties now readily available) was already in full swing and Prohibition in the US merely served to revive a tradition The Bahamas had long ago mastered.

While the quality has improved infinitely over the years, the effects in part remain the same. When alcohol is consumed, it quickly enters the bloodstream through the stomach and the small intestine and then travels throughout the body with the brain, lungs, kidney and liver being the primary organs affected. With each and every heartbeat, it is pumped through every cell and within five to ten minutes the effects are notable. The neurotransmitter dopamine is released by the brain, along with other neurochemicals, boosting mood and relaxing the body.

This effect, coupled with a wide spectrum of psychological, social, environmental, behavioural and medical problems, are directly attributable to alcohol dependence. Even still and despite all we’ve learned about the devastating effects of consuming too much alcohol, over-consumption remains ever more prevalent throughout our society. Recently, one of my patients relayed her experience growing up with an alcoholic family member and she shares her story with you today.

She grew up the youngest of four children in a tiny wooden home in Bain town, measuring no more than 650 square feet. She shared this home with her siblings, her parents and her paternal uncle. In the front section, the bathroom was divided from the kitchen by a sheet or, on special occasions, curtains tied to nails on the wall. Since they didn’t have indoor plumbing, the bathroom housed multiple, one-gallon, water bottles filled by her brothers daily from a nearby pump. They had an outside toilet that was frequently broken into by homeless men in the community and at one point it was burned in anger and had to be rebuilt after these vagrants couldn’t gain access. The back portion of the home contained one bedroom divided in two halves by a sheet hanging from the ceiling with a twin bed on one side where her parents slept and a bunk bed on the other side where all four kids slept. The beds were so close together that when their parents weren’t home, they’d move the sheet and jump from one bed to the next.

Her uncle was an alcoholic and he slept in the front section of the house on the kitchen floor. From childhood she remembered him consuming alcohol from morning until night. He was well known in their community. Neighbours would often come to the house to alert the family whenever he was passed out on the side of the road or conscious but simply incapable of walking because he was so heavily inebriated. Initially, she and her brothers pitied him but that emotion transformed into embarrassment when they moved to another home on East Street.

This house was only slightly larger than the last and the windows were still made of wood but the rest of the house was made of concrete blocks and it had real rooms with indoor plumbing so they felt like millionaires. The first night she and her siblings broke the faucet because they simply didn’t know how to use it but they learned to adapt to their new environment quickly. Their uncle, however, stood out more egregiously than in their previous neighbourhood and his drinking habits intensified. He was never sober at any given time of the day, he walked with a stagger and always had a strong putrid stench. He no longer took a bath and their new neighbours began to laugh and mistreat him. In an effort to fit in, she and her siblings began to do the same, often not letting him into the house if their parents weren’t at home.

Their view of him became even more distorted when he started to urinate and defecate on himself. They began to hide anything he used, like plates, cups, spoons and forks by throwing them on the neighbour’s roof or discarding them entirely. One day he was so weak, malodorous and dirty that her mother forced him to take a bath. Her plan was to escort him to the hospital once he was finished. He told her he’d be ready in a few minutes but those minutes turned into more than an hour. She realized he wasn’t responding to her door knocks or verbal pleas. As calm as she pretended to be, my patient and each of her siblings could hear the fear and desperation in their mother’s voice as she pounded the door and called his name over and over. My patient’s brother ran outside and broke the wooden bathroom window that was the only reminder of the home where they previously lived. He then climbed through the small window bruising his shoulder, knee and elbow in the process and unlocked the bathroom door for his father.

The next few minutes were heart-wrenching. She watched as her father pulled the body of his pale and near-lifeless brother onto a chair in the front room, utterly desperate but understandably ill equipped to save him. He promised their mother on her deathbed that he would always protect him but with foam coming out of his mouth, his baby brother took his last breath. The loud, piteous and tormented scream made by her parents in that instant is one she’ll remember for the rest of her life.

The friends they tried so hard to fit in with later retorted that their uncle died because his own family teased him and that he’d come back to haunt them forever. So, for many years following that, all the kids slept huddled together in their parent’s bedroom like a can of sardines, too afraid to be alone in their bedroom. To this day she and her siblings are inseparable, she only has a very small group of friends and she never drinks alcohol. That incident also inspired her to become a health professional.

The Bahamas became a key distributor of alcohol during the prohibition period and bootlegging was a lucrative time for the country and many of its citizens. Even doctors made a fortune by writing whiskey prescriptions. But when the prohibition of alcohol was repealed as the 21st amendment to the US constitution was enacted, the economy once again turned to agriculture as its core industry. Nonetheless, alcohol, its production, sale and/or consumption remains a pivotal component in the lives of many Bahamians.

Looking back with eyes that have become wiser with time, my patient wishes she could have been more compassionate. If only she had encouraged her parents to get her uncle the professional help he so desperately needed, she thinks things might have turned out differently. To this day she doesn’t know what trauma led him on the road of alcohol dependence but there was a palpable sadness about him that made his story all the more tragic. If he could have stayed sober for a few minutes and transform that into a few hours, then weeks, then at least 28 days, which is the typical time for inpatient rehab, with help he may have been able to walk away from his addiction. For my patient, and others facing a similar often protracted struggle, my counsel is to not blame yourself for another’s addiction. Instead, the best help they can offer is to routinely encourage their loved ones to fight to stay sober, for no matter how many minutes, days, months or even years that may be.

• Nicknamed ‘The Prince of Podiatry’, Dr Kenneth D. Kemp is the founder and medical director of Bahamas Foot and Ankle located in Caves Village, Western New Providence. He served as the deputy chairman for the Health Council for five years and he currently sits on the board of directors for the Princess Margaret Hospital Foundation in his role as co-vice-chairman.