Bottle of Wine, Fruit of the Vine

Arguably, one of the stars of the TV show M*A*S*H was the glass-and-copper still that sat in the middle of “The Swamp,” the tent that housed the show’s surgeons (Hawkeye, Trapper, Spearchucker, Frank, BJ and Winchester) for eleven TV seasons and 3 years of the Korean War.

The still never spoke a word, but it reliably cranked out moonshine week after week so the war-weary doctors could have their painfully dry martinis.

Like all the show’s main characters, the still was neither the good guy nor the bad guy.  The war was the bad guy, and everyone else in the show, including the “enemy” soldiers, had high and low moments in dealing with its realities.  The still, and the booze that flowed from it, was no different.  Sometimes alcohol played a key role in the show’s most sublime moments, like when Colonel Potter opens and shares a bottle of whiskey after learning that he is the last surviving member of a band of brothers who first laid hands on that bottle in WWI.  At other times it highlighted how far the show’s heroes have fallen, like when Hawkeye walks into the Officers’ Club one morning with a small box of Wheaties and orders “a beer and a bowl: The Breakfast of Ex-Champions.”

After the Flood, Noah has a beer-and-a-bowl moment.  Vayahel Noah, ish ha-adamah, vayita carem.  Vayest min hayayin vayiscar, vayigal b’toch ohalo.  “Noah, man of the soil, began and planted a vineyard.  He drank of the wine and became drunk and he was exposed inside his tent (Bereishit 9:20-21).”  Commentators from Rashi to Rabbi Adin Steinsaltz in our own time have criticized Noah for “beginning” with a vineyard, planting wine grapes with the seeming intent of getting drunk, when he should have, as Rashi puts it, “Planted something else.”  Steinsaltz specifies that he should have planted grain, or some other more nourishing crop, not a luxury and an intoxicant, if he really meant to reestablish the destroyed world.  It is almost as though the event of the next line, where he is “exposed” and embarrassed by his middle son, flows naturally from this poor choice.

Have some mercy on the poor guy.  Remember Micha 4:4?  “Everyone will sit beneath their own vine and fig tree and no one shall make them afraid.”  That grapevine was the first symbol of permanence for Noah after a year of being adrift in the ark.  It was as bold a statement of hope, that he could believe Hashem’s promise of a world that would never again be destroyed by Divine wrath, as was Jeremiah’s decision to buy a plot of land in Eretz Yisrael at the very moment that the Babylonians were driving the Jews out.

Targum Yonatan even suggests that the vine Noah planted was one he found, floating down the river from Gan Eden after the waters receded, that flourished and ripened in a single day.  Calling Noah ish ha-adamah, man of the soil, might even mean that this fast-fruiting vine grew because of Noah’s prodigious skill at viticulture (Ibn Ezra).  If so, the vine could have looked to him like a Divine sign (the dove brought an olive branch; the river brought a grapevine) and its rapid growth a message that God had favored him with this special ability.

Let’s also not forget that in the year he was in the ark, Noah and his “flood bubble” of his immediate family had to internalize a tragedy that dwarfs even our current pandemic, Hurricane Katrina, or the civil war in Syria, not in sheer numbers but in proportion – the destruction of the entire known world.  Familiar landscapes, friends such as there were (even in a world filled with violence and evil, surely Noah had some drinking buddies?  Guys he played fantasy football with?), neighbors’ children, his own livestock save the fourteen of each kind he brought along with him – all gone forever.  “Rabbi Chanan said, ‘Wine was created for nothing else than to comfort mourners…’” (Midrash Ein Yaakov).

A recent RAND study chronicled a steep rise in alcohol consumption in the US since the beginning of the COVID-19 pandemic.  The study asked what people were doing, not why, but I think I know why.  Faced with overwhelming stress and unimaginable tragedy, dulling the senses makes sense even if it isn’t sensible.  How many of us are surprised that Noah, at the first opportunity, pops a cork and pours a cup?  Or a couple?  Who could see what he saw and not be a little tempted to do the same?

Tragedy and trauma don’t have to happen on a global scale to propel people in this direction, either.  My patients and colleagues alike sometimes elect to block out the badness and calm the crazy with alcohol.  Paralyzing anxiety, family guilt and conflict, loss, frustration and anger can all literally drive a person to drink; once they have been so driven, it is not long before they find that there are no brakes.

Once they are careening out of control, our tendency, like the commentators, is to blame the drinker for turning to drink.  We stage “interventions.”  We set conditions.  We revoke licenses.  Obviously, in many cases we have no choice.  As badly as I felt for one man who ended up behind bars after driving under the influence at least four times in a six week period (I say four times because those were the only times he got caught), when taking away a man’s license won’t keep him out from behind the wheel, something else has to.

The last several decades have seen an improvement, a move away from the “character flaw” or “bad habit” models of addressing alcohol abuse to the disease model.  We now conceive of alcohol abuse as a chronic sickness much like diabetes – and with much the same problem: a legally available substance that people freely consume all the time, but which is off limits for this person because it could kill them (and in the case of alcohol, kill others as well).  But even with this shift, there is a heavy reliance on the person changing their own behavior, as if the disease sometimes happened in a vacuum, rather than against a backdrop of prior abuse, abject poverty, or survivor guilt.

Further complicating matters for even the most determined person trying to overcome alcohol abuse is the way their disease becomes invisible in society.  Advertisements everywhere promote more drinking, not less (as long as we “enjoy responsibly.”).  Alcohol “gladdens the heart” and is at the core of every celebration from Shabbat dinner to winning the NBA championship (although I’m pretty sure you don’t actually get drunk by bathing in champagne, only by drinking it).  Even friends who would never knowingly thwart a person’s quest to get well may inadvertently offer them a drink before that person has “come out” to them as an alcoholic.

People who develop disorders of abuse of other drugs don’t have such an easy time; there’s no readily accepted societal place for heroin or crack cocaine.  Even people who have struggled with alcohol abuse struggle equally with the stereotype that they are somehow “different” from “those people” who abuse street drugs.  There are even separate 12-step organizations to deal with these diseases, almost institutionalizing the idea that perhaps they shouldn’t mix.

Medically, the diseases are different.  12-step programs have some track record of success with alcohol abuse.  For opioid use disorders, there is mounting evidence that medication assisted treatment (with a growing arsenal including methadone, buprenorphine, and naltrexone) is much more likely restore a person to living a productive life.  Cocaine and amphetamine addiction still await their “silver bullet” cures; one can’t help wonder whether the lack of progress here is due to the fact that when the crack cocaine epidemic hit in the 1980s the beneficiaries were cartels in South America, while the opioid epidemic began in a concerted effort to line the pockets of American pharma companies.  The first documented cases of morphine addiction, in the 1800s, were recognized by the same physicians who had prescribed the medicine – and treated with the same amount of compassion they had shown toward the pain for which they gave that morphine in the first place.

Keep coming back to that thought – addiction to morphine was first recognized by the doctors who had initially prescribed it to treat pain.  However different the pathophysiology of the addictive disorders, all of these intoxicants, all of these analgesics, “were created for nothing else but to comfort mourners” – to relieve pain, diminish suffering, and numb their users against tragedy.  That they can sometimes be used, legally or otherwise, to enhance celebration and mark holy time doesn’t change the fact that for many people, many more than most of us realize or admit to, they are the only thing that keeps the world from falling apart, even as they accelerate its decline.

The compassion that those 19th century doctors showed their patients who became dependent on morphine is often in short supply when people develop substance use disorders.  When Noah passes out in his tent, his son Ham discovers him and runs to tell his brothers.  What does Ham tell the others?  Most commentators assume he comes to them laughing, inviting them to join in gazing on their father’s humiliation.  I wonder, to be honest, if he doesn’t come to them and tell them out of his own embarrassment (like there was anyone left in the world to know, but that’s beside the point): “Would you look at Dad?  He’s such a disgusting drunk!  You guys need to help me do something about this.”  Noah invents wine, Ham invents the intervention.

But Shem and Yefet don’t play along.  They gather up a large garment and walk backward toward Noah.  Are they literally turning their backs on their drunk father?  No, they are averting their, so as not to see him in his degradation, and throw it on top of him to cover him up.  Family members who have lived with a person suffering from alcohol abuse disorder may look at this and sniff, “enablers!”  Enabling is the behavior that co-dependent friends and family engage in to protect the person with the addiction from the consequences of their behavior.  The thinking goes that only by having to suffer the repercussions of their actions will people with addictive disorders admit they need help; enabling behavior allows them to squeak through unharmed.

The Talmud often encourages us to re-read a Hebrew word with a different vowel, or change an alef to an ayin or substitute other letters in subtle punning, in order to uncover a new meaning.  So let’s do that here in English: “Don’t read “enabling, but ennobling.”  Shem and Yefet still see the dignified, purposeful man who took on God’s mission and saved the living world from destruction.  They also see a man who was broken by that effort and needs help to build himself back up.  Nothing is to be achieved by mocking or berating him in his hour of stupor; the best that can be done is to mercifully shield him from ridicule until he is sober.

At the end of an episode of M*A*S*H during which Hawkeye decides he is going off the bottle, and becomes an absolutely intolerable person in the process, he barges into the Officers’ Club and orders a drink.  Everyone stares at him, knowing he’s trying to quit.  “What?!  OK, OK, I need this drink!” he says.  As everyone continues to stare but says nothing, a long pause ensues.

Finally, he pushes back from the bar, stands up, and says, “I’ll have this drink when I want it, not when I need it.”

It’s the rare person who gets to simply decide the way Hawkeye did.  When the dust settles from the election, and the flood waters of the pandemic eventually recede, there will still be an epidemic of people struggling to escape the grip of opioids, and others grappling with alcohol problems old and new.  If we are to help them, not further traumatize them, we would do well to remember that most of them – and probably most of us – are just like Noah.  We would do well to make sure there are adequate resources for them to get well.  And we would do well to treat them the way Rabbi Menachem Mayir Vogel, who heads the Aleph Institute here in my community, does for people striving to remain sober.  Each year in pre-pandemic times, he hosts a seder which promises a full, kosher, and completely “dry” experience.  The participants get to celebrate, fulfill the mitzvah of a seder meal, and be in company with one another, while never being tempted to over-indulge in alcohol.  Ennobling, not enabling.  How could the rest of us do the same in our own spaces?

About the Author
Jonathan Weinkle MD, FAAP, FACP is a primary care-physician in a community health center in Pittsburgh. He is not a rabbi, though he has often been accused of being one. He is an amateur singer-songwriter, teaches at both Chatham University and the University of Pittsburgh, and is the author of the book Healing People, Not Patients.
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