4 - Alpha Omega Alpha

Drinking
in
earnest
Gregory H. Miday, MD
Alcoholic paradigms in Hemingway’s
For Whom the Bell Tolls
The author is an intern in Internal Medicine at Washington
University in St. Louis. This essay won third prize in the
2008 Alpha Omega Alpha Helen H. Glaser Student Essay
Competition.
A
cold crisp glass of Cava while watching the bullfights.
Absinthe, emerald green poured over sugar, shared
between young lovers. And cocktails—before reading,
before dining, before dancing, before everything. Scenes
from Hemingway are inexorably bound to drinking, so it is no
surprise that his work may inform us on the topic of alcoholism.
The pages of his fiction are figuratively soaked in booze
and, in many cases, probably literally as well. The descriptions
of distinct and complex alcohol- related behaviors range from
abstention to healthy social imbibing to pathologic, chronic,
and relapsing alcoholism. Hemingway describes the disease
with such vividness and clarity that medical professionals
might benefit from studying the models presented in his novels.
The author once remarked, “I’m trying in all my stories to
get the feeling of the actual life across—not just to depict life—
or to criticize it—but to actually make it alive. So that when
you have read something by me you actually experience the
thing.” 1p153 He succeeds, and his pen strokes illustrate both the
full-blown end-stage alcoholic and early alcoholism, as well
as the many gradations between the alcohol abusive problem
drinker and the alcohol dependent. His works capture the
diverse symptoms and complications of pathologic drinking,
going beyond the pathology well known to medical students:
neuropathy, cirrhosis, encephalopathy, delirium tremens, etc.
These organic consequences of alcoholism, while medically
important, are dangerously late manifestations of the disease.
Hemingway conveys the subtle and sometimes not so subtle
nuances of the alcoholic, including but not limited to comorbid
psychopathology, personality changes, “craving,” isolation,
obsessive thinking, and compulsive behavior.
Another compelling reason to regard Hemingway’s fiction
as a potent source for understanding alcoholism is the concept
of “autopathography” put forth by Dr. Stephen Moran, which
describes “a type of literature in which the author’s illness
is the primary lens through which the narrative is filtered.” 2
Papa pours a shot…
Photo by Tore Johnson/Pix Inc./Time Life Pictures/Getty Images.
4 The Pharos/Spring 2009