Dr. Silkworth

The Little Doctor Who Loved Drunks

A.A. Grapevine, Inc, May, 1951

A drunk is lying on a bed in a hospital, and a doctor is sitting beside the bed. The drunk is talking earnestly to the doctor. “…a wave of depression came over me,” the drunk is saying. “I realized that I was powerless – hopeless – that I couldn’t help myself, and that nobody else could help me. I was in black despair. And in the midst of this, I remembered about this God business.. .and I rose up in bed and said, “If there be a God, let him show himself now!”
(A doctor specializing in alcoholism hears all kinds of crazy stories from drunks in all stages of de-fogging. You’d expect him to have his tongue in his cheek at this point.)

“All of a sudden, there was a light,” the drunk goes on, “a blinding white light that filled the whole room. a tremendous wind seemed to be blowing all around me and right through me. I felt as if I were standing on a high mountain top…”
(You’d think a doctor would become hardened after listening to these drunks rave day after day. It’s a discouraging, thankless field… alcoholism.)

The drunk continued: “I felt that I stood in the presence of God. I felt an immense joy. And I was sure beyond all doubt that I was free from my obsession with alcohol. The only condition was that I share the secret of this freedom with other alcoholics and help them to recover.”
The drunk paused and turned to the doctor. “Ever since it happened, I’ve been lying here wondering whether or not I’ve lost my mind. Tell me, doctor – am I insane – or not?”
The drunk was Bill W.
Fortunately for Bill — fortunately for A.A. — fortunately for the thousands of us who have come after – the doctor was Dr. Silkworth. By great good luck – or by the grace of God (depending upon your viewpoint) – the doctor was Dr. Silkworth.
It would have been so easy to dismiss Bill’s experience as hallucination, one of the many possible vagaries of a rum-soaked brain. And a disparaging word from the doctor right at this point could have choked off the tender shoot of faith and killed it. Alcoholics Anonymous might have got started somewhere else, somehow. Or it might not. Certainly it wouldn’t have started here. Very possibly the life of every one of us A.A.’s hung on the doctor’s answer to the question, “Am I insane?”
It was there that Dr. Silkworth made the first of his indispensable contributions to A.A. He knew – by an insight that no amount of medical training alone can give a man – that what had happened to Bill was real, and important. “I don’t know what you’ve got,” he told Bill, “but whatever it is, hang on to it. You are not insane. And you may have the answer to your problem.” The encouragement of the man of science, as much as the spiritual experience itself, started A.A. on its way.
When Dr. Silkworth died of a heart attack in his home in New York early in the morning of March 22nd, even those A.A.s who knew him best and loved him most awoke to the realization that we had lost a greater friend, a greater doctor, a greater man than we had ever realized. It was particularly hard to appreciate the greatness of the man while Dr. Silkworth was yet with us, because of his profound personal modesty and the disarming gentleness, the unassuming and almost invisible skill, with which he accomplished his daily miracles of medical and spiritual healing.
We know that he was a prodigious and relentless worker, but still it was a shock to discover that in his lifetime of work with those who suffer our disease, he had talked with 51,000 alcoholics – 45,000 at Towns Hospital and 6,000 at Knickerbocker!
Yet he was never in a hurry. And he had no “formulas,” no stock answers. Somehow he found out very early that the unexpected was to be expected in alcoholism, and for a man who knew as many of the answers as he did, he came to each new case with a wonderfully open mind… the great and classic example of which is his handling of Bill.
And this gentle little doctor with his white hair and his china blue eyes – child’s eyes, saints eyes – was a man of immense personal courage. It must be remembered that he went much farther than merely encouraging Bill’s faith in his spiritual experience, he saw to it that Bill was permitted to come back into Towns Hospital to share his discovery with other alcoholics. Today – when “carrying the message to others” has become a very respectable part of an undeniably effective program – it is easy to forget that “carrying the message” in the beginning was a highly unorthodox undertaking. It had no precedent and no history of success; most authorities would have turned thumbs down on it as just plain screwball.
Again, we forget how our technique has been mellowed and refined by the wisdom of experience. We know that the blinding light and the overwhelming rush of God-consciousness are not necessary, that they are indeed very rare phenomena and that the great majority of recoveries among us are of the much less spectacular gradual and educational kind. But in the beginning, the “hot flash” was stressed – nay, insisted upon.
Dr. Silkworth had his professional reputation to lose, and nothing whatever to gain, by permitting and encouraging this unheard-of procedure of one God-bitten drunk trying to pass on his strange story of a light and a vision to other alcoholics – most of whom at that time received it with lively hostility or magnificent indifference.
Then Bill met Dr. Bob, and the first few drunks, incredulously, began to make their incredible recoveries. The infant society, without a book, without a program really, and without a reputation or standing of any kind – began its growth. We forget how halting and feeble that early growth was, how bedeviled with obstacles in a world skeptical of spiritual experience and often hostile to it.
Dr. Silkworth from the beginning threw all of his weight as a doctor, a neurologist, a specialist in alcoholism, into aiding the progress of this mongrel and highly unpedigreed society in every possible way. He committed social and professional heresy right and left in order to publish and implement his burning faith in a movement which as yet only half-suspected its own destiny and which had to grope rather blindly to find terms for its own faith in itself.
When there was need for money to publish the book Alcoholics Anonymous, Dr. Silkworth used his personal influence without stint to help raise the money. As a preface to the book he wrote the chapter titled, “The Doctors Opinion,” giving A.A. his praise and approval without reservation or qualification- at a time when there were only a thin one hundred of us dried up!
He was indeed our first friend, and indeed a friend in need. His faith in us was firmer than our faith in ourselves. Bill says: “Without Silky’s help, we never would have got going – or kept going!” Again, his contribution was indispensable.
Why did he do it?
The answer to that is the answer to Dr. Silkworth’s whole career: he loved drunks. Why he loved drunks is a secret known only to God and the doctor – and perhaps the doctor himself did not wholly understand the mystery. “It’s a gift,” he used to say, his eyes twinkling.
He discovered his gift very early in his medical practice. He was graduated from Princeton in 1896, and took his medical degree at New York University in 1900. Then he interned at Bellevue; and it was while working at Bellevue that he found he was drawn to alcoholics, and they to him.
When nobody else could calm a disturbed drunk, Dr. Silkworth could. And he found, rather to his amazement, that even the toughest and most case-hardened of drunks would talk to him freely – and that many of them, even more amazingly, wept. It became evident that he exerted – or that there was exerted through him – some kind of thawing influence on the life-springs of the alcoholic.
Yet the years that followed were full of discouragement. There were two years on the psychiatric staff at the U.S. Army Hospital at Plattsburg, N.Y., during the first world war, followed by several years on the staff of the Neurological Institute of the Presbyterian Hospital in New York. Twice he entered into private practice, only to be drawn back into hospital work with alcoholics. His work continued on at Charles B. Towns Hospital, New York, a private hospital specializing in alcoholism and drug addiction. Here, Dr. Silkworth’s special skill with alcoholics – and his growing understanding and love for them had full scope. Yet he estimated that the percentage of real recoveries among the alcoholics he worked with was only about 2 per cent. The large number of hopeless cases, and the deep degrees of human tragedy and suffering involved, weighed heavily upon the gentle doctor. He was often profoundly discouraged.
Then came Bill – and A.A.
One who has known the doctor intimately over many years has said this about it: “Silky never told me this. It’s my own opinion. But I believe that A.A. was Silky’s reward. All those years he plodded along – treating drunks medically – defending them – loving them – and not getting anywhere much. And then God said: “All right, little man, I’m going to give you and your drunks a lift!” And when the lighting struck, there was Silky, right where he belonged – in the midst of it!”
Early in his career, at a time when alcoholism was almost universally regarded as a willful and deliberate persistence in a nasty vice, Dr. Silkworth came to believe in the essential goodness of the alcoholic. “These people do not want to do the things they do,” he insisted. “They drink compulsively, against their will.” One of the early drunks whom Dr. Silkworth treated, a big husky six-footer, dropped on his knees before the doctor, tears streaming down his face, begging for a drink. “I said to myself then and there,” Dr. Silkworth related, – this is not just a vice or habit. This is compulsion, this is pathological craving, this is disease!”
He loved drunks – but there was nothing in the least degree fatuous or sentimental about that love. It could be an astringent love, an almost surgical love. There was the warmest of light in those blue eyes, but still they could burn right through to the bitter core of any lie, any sham. He could see clean through egotism, bombast, self-pity and similar miserable rags that we drunks use so cleverly to hide our central fear and shame.
All this he did – without hurting anyone. While insisting rigorously that recovery was possible only on a moral basis – “You cannot go two ways on a one-way street” – he never preached, never denounced, never even really criticized. He brought you, somehow, to make your own judgements of yourself, the only kind of judgments that count with an alcoholic. How did he do it? “It’s a gift.” Just coming into his presence was like walking into light. He not only had vision – he gave vision.
There is not room here – nor has there been opportunity for the necessary research – to consider his status as a medical man. It can be said that he held a position of very high eminence in his profession. He encountered opposition to some of his views, and he was latterly the recipient of very widespread recognition and praise for his work. It is literally true that he was the world’s greatest practical authority on alcoholism. His pioneering work in the concept of alcoholism as a manifestation of allergy has been validated by later experience and has been the subject of a great deal of medical interest and research just recently.
Dr. Silkworth’s was a great contribution to the establishment and development of the alcoholic treatment center at Knickerbocker Hospital in New York. In later years, he was sought out for consultation and advice by doctors and by those in charge of state and city alcoholic treatment projects. There was a steady stream of visitors, some of them from foreign lands. Also, every day, there were long distance telephone calls from those seeking further help, those seeking his advice – all over the U.S.
There remain these things to be noted: Dr. Silkworth was a small man, well under medium height. His complexion was ruddy. His remarkable eyes have been mentioned. His hair was snow white and no member of A.A. knew him otherwise, for he was already well along in years when our relationship began. You would say that the habitual expression of his face was a smile you thought about it, and realized that the features were really nearly always in repose, and the impression of a smile arose actually from a certain light about his face. ( Too many of us have noticed it to be mistaken!)
He loved to be well dressed – was, in fact, quite dapper – and in this he was not without a certain whimsical and self- recognized vanity. Nurses – the hospital staff – everyone who worked with him quite plainly and simply adored him. He was unfailingly gentle, courteous, thoughtful. He was happily married, and he and Mrs. Silkworth shared a delight in growing things – in flowers – in gardening.
He was utterly and completely indifferent to money, to position, to personal gain or prestige of any kind.
He was a saintly man.
We drunks can thank Almighty God that such a man was designated by the divine Providence to inspire and guide us, individually and as a group, on the long way back to sanity.
And now – in this anonymously written journal of an anonymous society – I hope I may be permitted, in closing, the anomaly of a personal note. You see, Dr. Silkworth saved my life. I was one of those “hopeless” ones whom he reached and brought back to life – to A.A. – and to God. And I have wanted very much to write this tribute faithfully and well, in the name of all those who share my debt and gratitude. And yet I have realized from the beginning that this article will please nobody. To those who knew and loved the saintly doctor, it will seem insufficient. And so, some of those who didn’t know him will think it overdone, for the truth about Dr. Silkworth is strong medicine in a materialistic age.
This dilemma would be tolerable, were it not for a third difficulty: I have written all along in the uneasy knowledge that what is said here is by no means pleasing to the doctor himself. The incident of physical death certainly has not placed him beyond knowledge of what goes on here below. And that he will not be pleased with all this, because while he was stern about very few things, he was sternly and seriously opposed to the publication of his own name and fame.
I take comfort, however, in the fact that his sense of humor most certainly will have survived his recent transition to a new home. And I feel sure that his disapproval of the present essay will be tempered by amusement, and by the priceless gift he gave us all so freely while he was yet as we are – his great love.

Dr. Silkworths Obituay

Dr. William Duncan Silkworth died of a heart attack in his home in New York, Thursday morning, March 22. Thus we of A.A. have lost the physical presence of the great doctor who was our first friend. He gave deep understanding and great encouragement to an infant society in the days when a lack of understanding or a word of discouragement might easily have killed it. He freely risked his professional reputation to champion an unprecedented spiritual answer to the medical enigma and the human tragedy of alcoholism. Without his blessing, our faith might well have died in its birth. He was a luminous exception to the rule that only an alcoholic understands an alcoholic. He knew us better than we knew ourselves… .better than we know each other. Many of us felt that his medical skill, great as that was, was not at all the full measure of his stature. Dr. Silkworth was something that it is difficult even to mention in these days. He was a saintly man. He stood in an unusual relationship to truth. He was able to see the truth of a man, when that truth was deeply hidden from the man himself and from everyone else. He was able to save lives that were otherwise beyond help of any kind. Such a man cannot really die. Our friend has only left us….for a while.

Copyright © The A.A. Grapevine, Inc., April 1951

Silkworth.net

Back To Top