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The identities of a ll pati ents described in this art icle ha ve been disguised to protect their privacy. Sooner or lat er every physician encounters an alcoholic pat ient wh o deals with heavy drinking in ways that our treatment models explain poorly, ifat a ll. Mrs. Smith was a 73 yea r o ld black woman who had dran k heavily for ma ny years, usually to intoxication. Her husband was alco holic an d th ey often got into serious fights, someti mes with one or the other hosp ital ized. Mrs . Smith th ou gh t she too might have been a n alcoholi c, though no one ever called her this. He r husband left her a nd sh e drank even more heavily. Her da ughters comp lained that she was killing hersel f with drink and begged her to quit. T hey urged her to go to A .A. Once twenty-five or thirty years ago Mrs. Sm ith had gone to an A.A. meeting and had decid ed she wanted no pa rt of that. " Was j ust like ch urch, " she exp laine d, "only worse . . . no music." Mrs. Smith, howeve r , decided her daughters were right : so she stopped drinking. T ha t was 15 yea rs ago. She never ha s alcohol and wishes that some of her friends would quit too. It wasn 't easy to quit , she admits, but then she' ll add, her drinking wasn 't easy e ither. Mr. Cocina had a six pa ck of beer most evenings but on week ends went through a I 2-pack and oc casionally a 24-pack daily. He worked night shift in a fac tory . He never missed work and never drank at wo rk . Sometimes when he got off work in the mornings he was shakey. He felt he needed a d rink at th ese tim es so he'd have one and th en go to bed. His family had man y fina ncial problems and his wife left him for a period, after attempting suicide when his two da ughters were 3 and 5. The girls told h im he sme lled bad wh en he d rank and complained when he forgot the things th ey needed fo r pre-sch ool. Otherwise he cared well fo r th e ch ild ren e ven th ough he 'd been brought up in a cultu re where men didn 't do that. Mr. Cocina had been told that he was an alcoholic and had had

Book Reviews: Clinical Experiences, Indoctrination and Education in Alcoholism