COLLEGE COURSE 3/ PSYCHIATRY 606

SPRING 2006

EVALUATIVE RESPONSES

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   Over the past eight weeks, this course had given me a thorough foundation of knowledge about alcohol and addiction medicine. This course’s strongest features are its interdisciplinary nature and the quality of the guest lecturers. This was also one of the few classes I’ve taken at Dartmouth where I can say I genuinely enjoyed almost all of the reading, and if I didn’t manage to finish it by the class it was due, I still finished it simply because I found it interesting. This course’s only real weakness was that the constant guest lecturers made it a bit disorganized. However, I thought Professor Nelson did a good job of communicating with the class and keeping things structured most of the time.

   This was the first class I’ve taken at Dartmouth that was labeled as interdisciplinary. At first, I was a bit hesitant. As someone who is pre-med, I wanted a class that would teach me more about the medical and scientific side of addiction. Through readings such as Stuart Gitlow’s book and the Clinical Manual of Substance Use and lectures such as Mark Reed and Stuart Gitlow, I definitely learned a great deal of new medical information about alcohol. Before Gitlow’s lecture, I had never really understood the physiological basis of alcoholism. I thought Gitlow was one of the most effective lecturers. He had a great ability to articulate alcohol’s effects on the brain while keeping the class engaged.

   In addition to the medical and scientific perspective that I expected, I also loved how this course looked at alcohol use and abuse from a literary/humanistic perspective as well. One of the very first books we had to read, The Tennis Partner, almost left me in tears. I thought this class did a particularly excellent job of assigning reading that was not only relevant to the class themes but was also very beautifully written. My favorite literary works were The Tennis Partner and The Broken Cord. I found The Broken Cord especially painful to read. Before reading it, I had theoretically known that it was unwise to drink while pregnant, but I wasn’t fully aware of the heartbreaking consequences. Reading Michael Dorris’ story inspired me to someday send time working as a physician in a native community, in order to help improve the prevalence of fetal alcohol syndrome.

   Another literary work that I really enjoyed was The Bacchae. I had read the play several times for various classics classes, but I had never really examined the role of wine in the play before. I thought both the Bacchae and From Moscow to the End of the Line did an excellent job of showing how a cult can develop around a specific kind of alcohol. I also thought Professor Kopper did a great job lecturing on both of these topics. Listening to him discuss the need for balance between the Apollo and the Dionysus within each one of us gave me an entirely new perspective on the play.

   Of all the guest lecturers, I think my favorites were Dr. Koop and Christopher Wren. I have listened to Dr. Koop talk on several occasions, and each time it was been an amazing experience. I don’t think anyone else would be so effective at explaining what it’s like to have been at the front lines of the public health debate regarding smoking and alcohol use. Listening to him really made me rethinking my views on smoking, even if it’s only done socially. Christopher Wren was amazing. He actually made me think for a second that I should give up my medical career and become a New York Times writer! I loved hearing all his stories about traveling the world and examining all aspects of the drug trade. His remarks really coincided well with watching the film Traffic. I especially liked how it seemed like Wren never lost touch with the human side of the issues he was reporting on. Listening to the personal stories he had heard from addicts was very moving.

   This class was effective in showing both the medical aspects of alcoholism and how the disease of alcoholism can affect specific individuals. One theme of the class that I will take with me as I continue to study medicine is the importance of respecting patient’s humanity and of trying to empathize with them, even if what they are going through is difficult to understand. I thoroughly enjoyed this class and feel that it has really given me the tools to make a positive difference in the field of alcohol and addiction medicine. Thanks for a wonderful term!

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I found this course to be supremely satisfying. It wrapped up several years of experience with this topic, while expanding my knowledge in areas which I had not considered or thoroughly contemplated before. It also forced me to articulate my own thoughts and experiences with and about drugs and alcohol, and in the process, helped me to understand and recognize my own relation to them. That is what I will be able to take away from the course, more than anything else. This process was facilitated by the relaxed atmosphere of the classroom (the snack food was a big plus), as well as the provocative reading and lectures.

   I also have to say that it was particularly exciting to consider this topic from a cultural/literary perspective. As someone who primarily has approached the significance of drugs and alcohol from technical/statistical/medical point of view it was enlightening to place them in a subjective, and consequently more emotionally salient, context. I’m glad that the effort was made to provide a multidisciplinary set of perspectives on these topics. Having said that, the material was somewhat humanities-biased and more scientific content would have been helpful, particularly for those with less science experience (though I understand why more technical scientific information might not be appropriate for such a broad audience).

   The only other suggestion I would have is to encourage more discussion among the students during class time. I know time is limited, but it would be really interesting to more directly hear about people’s personal experiences and thoughts, rather than only by passing mention when making a comment to the lecturer of the day. It seemed like people had a lot of knowledge and information just sitting under the surface that remained untapped.

   Overall, this class, like few others, I can call an experience rather than a course, and am glad I decided to join it. Thanks!

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I really enjoyed Alcohol and Addiction Medicine. My favorite thing about the course was the wide range of topics that we covered, from the medical aspects of the disease to the affect of alcohol and drugs on communities, including Dartmouth’s own student community. It was mostly new information for me and was fascinating.

The most valuable aspect of this course for me was the awareness that it gave me. I learned that anyone can become an addict, no matter how much money they have, or where they live. This course challenged me to take a closer look at my own drinking habits and the habits of others around me. Since alcohol and drugs are such a huge topic on our campus, I feel like this would be a great course for anyone to take. While I doubt it would radically change the drinking habits of the student body, I think it might improve awareness about alcoholism, which really isn’t discussed or considered until later in life, often when it is already too late.

That being said, I think that the workload of the class (particularly the 15-20 page research paper) drove away many of my peers who were interested in the class. I think that given the significant amount of reading and writing done in this course, more people might consider taking it, or even picking it up as a fourth class, if there was an option to do all the work and get a SOC and CI credit or to do less work (such as the requirements for 1 st and 2 nd year med students) and only receive a CI distributive requirement. Maybe that’s unreasonable, but I think it would encourage more people to take this outstanding and valuable course.

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Overall, I’ve been happy with and impressed by the course. The information given on the physiological effects of alcohol on the body were all very good. I was especially happy with Stuart Gitlow in this regard. I believe that my favorite speaker was probably C. Everett Koop, who I feel privileged to have been able to have learned from. Also, Christopher Wren’s presentation on his experiences were insightful and interesting. I thought that the way that he dealt with the complexities surrounding the “war on drugs” and the social and political implications of that institution was very useful for out purposes. Finally, I was very pleased with the conversations that we had in class with the community members from AA who came to candidly tell us their stories. While this wasn’t a new experience for everyone, it was for most, and everyone has a different story and most alcoholics seem to lead lives that explain their disease to us.

   I was less happy with the presentations from [another professor] because I don’t think that his discussions were in any way useful for me. The discussions that he had exemplify that kind of intellectualism that isn’t carefully rooted in reality or practicality, so one finds difficulty applying the point of the discussion to her everyday life. I thought that this was especially evident when [he] immediately followed [another professor], who bears no traits of gratuitous intellectualism. After having just sat through [the first professor's] interesting and tangible presentation, it was very difficult to sit through [the second's].

   I had a similar problem with [a third professor] who has a tendency to talk for a long time . . . . While he seems to be a very nice person, the time that we spent with him in class didn’t benefit me very much. . . . .

   One other problem that I had with the class was the distribution of the course reading material. On some weeks, we would have an unmanageably large amount of reading, while at other times we would have very little. This inconsistency became very annoying as time went on.

   As for the material covered in class, I thought that the most important and most useful themes were that alcohol is an disease in the medical sense of the term, with genetic ties and useful treatment options; that addiction should be treated as the problem affecting real people that it is, rather than treating it as a crime to be fought against and have war waged on; that college campuses are something of an anomaly as relating to drinking, and that although college drinking doesn’t necessarily translate into alcoholism, it’s something that we need to be wary of and attuned to; that the way that alcohol will effect someone is largely an effect of culture, and that peoples with different backgrounds will have differing experiences with addiction depending on their culture; and finally a general overview of the physiological effects of alcohol, dispelling rumors and conjectures that tend to permeate our everyday lives.

   I thought that the information on alcohol in, say, ancient Greece and Rome was not particularly useful or interesting. I feel as though this time might have been better spent on exploring the effects of alcohol on non-western cultures, perhaps in African, Asian, Aboriginal Australian, Maori, or other Islander societies. It would have been interesting to hear about how these cultures used alcohol before contact, how the introduction of western alcohol affected them, and try to draw conclusions based on that information. Basically, I just think that there are things more interesting than ancient Greece and Rome that our time might have been spent on.

   Overall, I’ve been very pleased with the course. I hope my frankness and forward suggestions don’t imply otherwise, because I am very happy that I took this course, and I would recommend it to anyone else with an interest in the subject.

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Final Response: Summary and Thoughts

   I must admit that I am relieved to be finishing with college and the undergraduate academic scene. I have stayed longer than is normal, have survived stressors that demand more than should be expected of a student, and have profited in mind, determination, and discipline from the experience. This class, moderated by professor Gail Nelson, could not have been a more appropriate or welcome feature of this closing term. The classes were interesting and refreshing without being prescriptive. Part of the frustration I have had with Dartmouth include a kind of inaccessibility to education. Compartmentalization of academic departments, the stodgy resistance to cross communication among faculty and disciplines (even and especially within departments) invites a similar attitude among students. Collecting support for projects that fall outside the pale, determined to integrate students and strengths, tend to be crowded out by the territories that are predetermined. Even as a student, I felt as if I were filling a predetermined role, a template for a student that existed prior to my arrival and will exist after I leave. This may be a generational concern, but I think it appropriate to air it in some written way at least. All of this is to say that the course, and its guidance, has positions itself to challenge compartmentalization and its maladies. To welcome this atmosphere while simultaneously pursuing the goals of help, of assistance and recovery from drug and alcohol addiction, is a message of hope for courses currently relegated to the fringes of teaching.

   Initially, I was interested in this course only for its status as a distributive requirement (one that no longer exists for the graduating class, but applies to me nevertheless). That’s not to say that I was hesitant or resistant to the spirit of the course and its material, but I did not give it so much thought, believing it tenuously applied to my interests. Now, I can’t help but see markers of the course’s exploratory routes everywhere. I have been no stranger to substance use during my time here, and to notice it more fully, the environments that surround its spokespeople, the translations between use and abuse, the idea of disease and victimhood and its corresponding notion of the will-powerless addict, has primed a fascination that encourages sober and serious thinking devoted to the course’s tributaries. This is a glowing recommendation for the course, but I stand by it and challenge anyone who would cry, “hyperbole!”

   I do, despite my satisfaction with the implicit paradigm and philosophy of the course, have a few recommendations. First, the medical perspectives replete through our sessions, while absolutely necessary and topical for the heavy population of medical students, tended to resurface to a point where they became a little repetitious. Perhaps the course could invite faculty from departments like geography. I understand the newly tenured professor Sneddon in the Geography department regularly teaches a course on qualitative research methods, even employing a text from a researcher who has championed the field into greater acceptance by interviewing and studying populations of drug abusers. Also, a study that hails from a socio-economic standpoint could be useful. Why do drug types and alcohol cleave along class lines? Who gets treated? How, where and why? I don’t mean to suggest that the course become more diffuse, threatening a dissolution into thin air, but that it continue to push in many directions from a strongly determined center. Alcohol, as an icon so strongly associated with our campus, is plenty fertile ground to stimulate brainstorming, cooperation, and leadership among disparate faculty, which would be a welcome sight.

   Second, is it possible to hire a TA? Or two? The efforts of coordination for our weekly sessions seem enormous, and a tall order for one person who expects to involve themselves in other projects during the term. Perhaps a student with whom the course resonated to a noticeable and commendable degree could be taken on with some appropriate responsibilities.

   Third, simply, keep up the good work.

   I wish you the best of times with your work and livelihood. Thank you for the experiences of a class open to interpretation, interaction, and interplay.

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   In taking this course, I did not initially realize the extent to which it would affect my own life. It has taught me the importance of support in treatment. Someone very close to me has recently sought treatment for his alcoholism and is my hope that on his return, with the information I have learned from this class, I will be a better tool in his recovery and in his family’s recovery. Through this course, I have learned the important role as a basis of support that family members hold in the recovery from alcoholism. While some may believe that the effects of alcoholism are only present when the alcoholic loses their job or when their marriage fails, this course has explained the numerous effects that are exhibited in the family member’s behavior patterns and in the day to day lifestyle of the family itself.

   In the unit on Alcohol and Families, I was impressed by the portrayal of family systems in Traffic and Long Day’s Journey into Night. While Traffic dealt with the issue of drugs instead of alcohol, it was a troubling portrayal of what addiction is capable of doing. By witnessing the break down of the family due to a child’s drug abuse, it showed both the influence of the family in the progression, as well as, the treatment of addictions. In Long Day’s Journey into Night, O’Neill succeeded in creating a picture of an entire addicted family, one very similar to his own as a young person. The characters all played off one another’s addictions in hopes to draw attention away from their own. This created a very hostile environment within the home as every one of the characters became co-addicts.

   One film that I felt gave the most troubling depiction of the effects of alcohol for me was that of When a Man Loves a Woman. This film demonstrated how perceptive children are within an alcoholic home and how sensitive they are to the effects of alcoholism. Though the mother had been showing signs of alcohol addiction for some time, the father was not aware of the extent, whereas the children noticed when their mother cried in the shower or wrapped up vodka bottles to be thrown in the trash so the neighbors would not see. The awareness and the effects of alcoholism on young ones is, for me, the most troubling aspect of this disease.

   Speaking of disease; before taking this course, I was aware that alcoholism was a disease but only mildly. In the first lectures, we were introduced to the physiological aspects of alcoholism. This really allowed me to understand the extent to which alcoholics have a continuous need for a drink. I have always heard people say, “Though I do not drink, I will always be an alcoholic.” Before this course, I did not understand the overwhelming truth of this statement. Through the progression of the course, I witnessed the effect of genetic predisposition, physiological effects, and family dysfunction on the development and advancement of this disease.

   Overall, I felt that this course was amazing and that some form of it should be a requirement in colleges like Dartmouth where it is extremely relevant due to the intense drinking culture. The best part of the class was the intense concern and interest that Gail Nelson showed for the subject matter. She was able to demonstrate the relevance of the subjects covered and brought about a much needed awareness to the entire class. It is important, in this type of course, to have a person whose interest in the subject matter is so intense that she makes each lecture draw the students in, which is exactly what Gail was able to do. Her passion for the subject was contagious!

The readings assigned were very diverse and the course offered the chance to meet many of the authors that we read. Each day had a variety of lecturers, offering many different perspectives on alcohol and drug abuse. Most of all, this course has allowed me to re-evaluate my own personal drinking and that of those close to me. I hope that everyone has enjoyed this course and gained as much knowledge as I have by studying this illness and its effects.

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   I thoroughly enjoyed this class. I took it because of it’s relevance to my major, Psychology. But it ended up being a lot more interesting and broad than I anticipated. I enjoyed examining alcohol and drugs from all angles either physiologically, psychologically, how governments deal with them, and even how it’s portrayed in movies, books and other media.

   All the material we went over was relevant and very interesting. A couple of the books were just fantastic works of literature. I’m glad I took this class so I could become acquainted with some of this material. All of those who spoke did a great job preparing and had things to say that made me think. The alcoholics speaking to us was especially great, because it was interesting to here their story from them and get a glimpse into what that life is like.

   The best part of the course, however, was the student presentations. The research was all interesting and some of the ways the other students chose to look at how alcohol is treated and affects modern culture was very interesting. The more creative presentations, the slam poetry/rap, and the stories were great. The students were very effective in getting across the emotions in the works.

   The one thing that could possibly be changed about the class was the balance of the workload. It seemed like the first few weeks had more readings than the second half of the term. But I guess this is to give more time for the research paper in the second half of the course. While the 3 hour class period is a bit trying to sit through some times, the breaks and snacks, which were provided graciously, were great. They really helped to make the class go over much smoother.

   Two of my favorite readings were Abraham Verghese’s The Tennis Partner and Benedict Erofeev’s Moscow to the End of the Line. Both books were beautifully written and showed the plight of those with addictions. I actually recommended both of these books to some of my friends to read. Both books are excellent even outside of the framework of the class. I also enjoyed the movie Traffic and the article which talks about how the movie is some what based in reality. The best part about the course was probably just how well all the material went together. Each class had a clear cohesive theme that was interesting.

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I almost did not take this class—how glad I am that I did! Granted, it had its frustrations and challenges (which I will describe later), but generally the class was relevant, interesting, diverse, and engaging. Highlights include Doctor Koop, Christopher Wren, reading the Broken Cord, watching Traffic, and many of the student presentations. Unfortunately, due to illness, I missed the community members’ speeches to the class, but I hear they were moving and wonderful.

   The interdisciplinary approach is really the only way to address such a topic as alcohol and addiction. How can one appreciate the futility in the stories of the alcoholics if one does not first understand how it truly is a disease by seeing the neurological processes that occur? But also vice-versa: what does the neurology mean if one cannot also see how desperately it affects people’s lives? The various cultural approaches were also pertinent and fascinating, but I wish we had done more. What about those cultures that use substances in a sacred and traditional way? How does it sometimes (but other times not) transform from a ritual and into a massive societal woe? Or perhaps more historical context would be nice too, such as the Gin Epidemic in England in the 1800s—that was never mentioned.

   Along those same lines, more attention could have been given to substances other than alcohol. Or what about addictions to non-substances, like exercising, sex, or eating disorders? That really should be covered in the course.

   The course began at an amazing and exciting pace, but slowed down considerably as the term progressed. I would recommend maintaining the pace if at all possible. This had a lot to do with the quality of the speakers and the readings. The novels were the best readings, by far; I would suggest one a week. HOWEVER, another problem was the inconsistencies of the reading assignments. Some weeks there was too much to fathom, and others it was shockingly low. A book a week is reasonable, perhaps supplemented by an article or two, but no more. The Tennis Partner was a great read, as was Moscow to the end of the Line, but the accompanying lectures were disappointing. For example, we discussed the Tennis Partner for barely more than five minutes. Many of us dedicated several hours to reading and considering the book, so this was a massive let down.

   The part of the course that frustrates me most is the fact that [another professor] will be grading us . . . . Please please please do not do this in the future. Gail is the only person qualified to grade us. Additionally, [another professor] was a poor lecturer.

   Moving on…having had an alcoholic in my family, this course was a perfect way to finally remove myself from my situation and see it from a whole new angle. It is often difficult to assess something when it is right in your face, and this gave me a wider perspective. For that I am incredibly grateful that I wound up enrolling in the class. It is one that I will remember long after graduation.

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   Before I discuss the content of the class material for “Alcohol and Addiction Medicine,” I briefly want to address the atmosphere within the classroom. I think Gail did a really great job encouraging us and making us feel comfortable in the classroom. She never made us feel like our answers or opinions were wrong, but really supported our ideas, reactions, stories, and questions. I also appreciated how she understood that it can be difficult to sit through three straight hours of class- the breaks were always so wonderful to regain concentration. Because her compassionate and understanding nature and the sensitive subject matter, Gail is the perfect match as the professor COCO 3.

   I initially thought that writing a response to the weekly readings was going to be pointless and nonacademic. However, I found the response papers to be a great opportunity for me to reflect on the stories, the actual lives of real people, and I do not think this is something other classes traditionally allow us to do. Rather than analyzing the material for accuracy or more technical terms, the responses allowed us to think about our own lives, our friends, our family members- and this is ultimately the most important thing. To be able to apply college-learned material to our own personal lives is one of the greatest opportunities we could possibly acquire as Ivy League students.

   I really enjoyed the flexibility with which we could choose the topic for our research paper. I thought it was so interesting to watch the presentations- everyone had such different interests; the range of issues involving alcohol was so wide and included so many different aspects of life. My interest in psychology and families really drove my interest in writing the paper, and I had a great time learning about all the material. I am so grateful that this class allowed me the opportunity to study in depth something that I am truly interested in and relate it to class material.

   My favorites: I loved reading the Broken Cord and The Scalpel and the Silver Bear- really beautiful, poignant writing that moved me deeply. I also enjoyed Alverson’s perspective on Dartmouth life- it is always very grounding and interesting to hear another person’s insight on you own lifestyle! The movies were a great break from the readings, but have two in one week (the first week) was kind of rough- I would limit it to one a week. The Dartmouth alumni panel was definitely something that hit closer to home- I think this is a great opportunity for Dartmouth students to really realize that alcoholism can get anyone, even Dartmouth graduates. I also particularly liked Emily Grandey’s lecture; she has a really fascinating story to tell.

   Suggestions: I did not particularly enjoy one of the main professors who came to speak to us a few times- when he led class discussion, I did not get a sense that he had really planned a lesson or talked about some of the topics we were really interested in. I think when a class is three hours long, students do not appreciate feeling like the professor is not fully vested in the lesson. It is a shame to feel like time is being wasted in the classroom. I also did not like how many students would leave before the end of class. I understand that three hours is long, but I think it disrupts the feeling of the classroom and implies that some students are not taking the class seriously.

   Overall, this class was a pleasure to go to! I enjoyed the set up of the class- different guest lectures speaking about topics relating to the readings/movies we were assigned for the week. This is a great way to keep students interested and coming back every week! Gail, keep up the great work! And thanks for tasty snacks!

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   Alcohol and Addiction Medicine was easily one of the classes that I have most enjoyed in my Dartmouth career. I was so able to relate the material from the reading and from class lectures to my own life, to different kinds of alcohol use, different cultural understandings, or family interactions over alcohol. After four years at Dartmouth and about six years of drinking alcohol myself, I have witnessed a great deal of different types of alcohol use among my peers and family members. It was incredibly effective to learn about alcohol use, abuse and addiction in the context of the classroom, as I am now more able to understand my own alcohol consumption and to understand the unique ways in which alcohol affects us.

I found the weekly readings very entertaining, quick, and interesting. I liked the idea of using different forms of media (videos, articles, books, poetry and stories) to learn about the topics, and I enjoyed the change of pace from courses where I’m always reading textbooks. Honestly though, I think that the reader was a huge rip-off. I think that the professors need to scale down the additional and “recommended” readings, as we are clearly charged by Wheelock Books for the extra (generally unused) material that was put in the packet. It also would have been really nice if the reader was bound, as a huge binder was another unnecessary cost for this course.

The general ambience of the class was excellent. I enjoyed our speakers, and the variety within the class time. I wish that we had all spoken up more during discussions, but the 3-hour setup with different segments and lectures was really engaging and effective. The snack break was a very nice touch and served to liven up the class with some fresh blood sugar and to stretch out.

I think that it was also very insightful to turn the spotlight back onto the students at the end of the course and for us to present our research topics. While I had my own thoughts about what we were learning and what topics I thought of as most important, it was equally exciting to hear about others’ interests and understandings of the material.

Overall, I am very glad that I took this course during my last term at Dartmouth. It offered me a great deal of insight into my own behaviors and the culture of alcohol in my direct social circle, at Dartmouth, and in this country and in other cultures.

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I also wanted to let you know how much I enjoyed this very unique, incredibly interesting course. As I am finishing my paper, I realize how much I have learned and how relatable this material is to our lives. Thank you for taking the time to create such an interdisciplinary approach to alcohol use and abuse, I think that many students have thoroughly enjoyed the course -- and I am one of them!

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Being a member of the class of 2007 here at Dartmouth, I have taken a great number of courses at this institution. None of them, I can faithfully say, have been as relevant and stimulating as this one. I am not saying that it was necessarily the most academically enriching, or even the most important class I have taken, but the issues and topics discussed are such that I think every student at Dartmouth who has ever had a drink of alcohol would be well suited to become more familiar with. As a member of a Greek organization, I fully appreciate the extent to which alcohol is pervasive on this campus, and in spite of the college’s efforts to educate students on alcohol use, ultimately many students go through their time at Dartmouth without really scrutinizing their relationship with this incredibly powerful and mysterious substance.

   Personally, I can recognize that my relationship with alcohol has been a confused one. When I was younger, I would drink solely for the purpose of getting drunk in spite of its unpleasant taste. Now, it is almost impossible to discern motivation for drinking, as it has become such an integral part of my social life. Despite concern from my parents, this class has allowed to scrutinize my own usage and really come to terms with the role that alcohol plays in my life, and I feel like I am in a better place than I was before I took this class, not because my habits have changed, but rather my perspective on said habits. I understand now the dangers of excess of alcohol, and the slippery slope that it is so easy to slide down. I feel confident moving forward that the role alcohol plays in my life is one that I am comfortable with, and I feel like, furthermore I am aware of the warning signs that come with early stages of unhealthy alcohol use.

   Not only has this class been significant to me on a personal level, but also the interdisciplinary nature of the class is something that appeals to me greatly. More classes at Dartmouth should approach academia in this way. Rather than rigidly insisting on a syllabus that is structured towards a specific path of learning set out by a given professor, this class allowed for students to bring their own experiences and interests. I was able to focus on the aspects of the course that interested me, which made the entire learning process that much less abrasive. My interests happened to be rooted in the artistic aspects of social depictions of alcohol, particularly through film, and I was able to explore that to an extent that satisfied me, as well as other aspects of the course, including anthropological, and sociological approaches. Others in the class, however, were allowed to take completely different approaches to the class, that they found enjoyable. The value of this cannot be stressed enough in my opinion, and courses like this are absolutely essential to a well-rounded liberal arts education.

   Ultimately I think my decision to take this class was one of the best I’ve made here at Dartmouth. Not to mention the 3 hour, once a week, meeting which was very tolerable, in my opinion, especially considering the eclectic nature of the course, which helped prevent things from getting boring. I would recommend this course to anyone, and in the world of shopping for courses, I consider myself a very satisfied customer.

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I thought Alcoholism and Addiction Medicine was a wonderful course. The Professors, speakers, reading material, and assignments collaborated in the achievement of a unique and appropriate interdisciplinary balance. Because addiction is a somatic, but also a psychological infliction, the instigating sources are not singularly scientific or experiential. Addiction is case-specific and multi-faceted. The course eloquently captured this reality through scientific articles and movies, novels, and personal stories. This method was unlike anything I have encountered in a Dartmouth course. The experience was stimulating and refreshing.

I am a premedical student and a biology major. The biology department at Dartmouth is very focused on genetic and molecular processes and the Professors largely work with model organisms. This has been a source of frustration throughout my Dartmouth career. I love science but believe that its ultimate purpose is to benefit people and the world. The majority of biology courses I experienced lacked an important human dimension. I believe that even “hard science” should be actively connected to human lives and that those connections should be studied and emphasized with the same energy and rigor as the science itself. Consequently, I was so thankful to participate in this addiction course, which seemed to be the corporeal expression of these very ideas. I will remember COCO 003 as one of the best courses I took in my college career.

Thank you!

Thanks . . . for a wonderful term! This course has been one of my very favorites - what a lucky experience to have my final term at Dartmouth!

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Although this course fulfills no distributive requirement for me, I am very glad I chose it. I enjoyed the class very much and at this point, it is one of the best courses I've taken at Dartmouth. The interdisciplinary approach is definitely something many students do not ever get to develop during their educational years. I was very interested in the topic matter conning into the class, especially alcoholism. Now I am still fascinated in this matter and understand a little of where my own fascination comes from.

The course load was appropriate both in content and quality. Different perspectives were introduced at a moderate pace, which helped me to think creatively about the readings and gave me the freedom to make connections I would not have made if the course had moved faster and were focused on memorization.

After looking over my own response papers, I realize that not only did I learn more about alcohol and addiction medicine over the course of this term, but I also began thinking of them in a different light. Before, most of the information I knew about this subject was restricted to popular media and health classes. Neither made the subject seem very real. The wide range of perspectives on addiction I've been exposed to in this class has contributed to a better understanding of this phenomenon for me. I've been interested in alcoholism in part because I come from a culture that has a very low prevalence - or does not recognize - alcoholism. To me, things like cocaine or morphine addiction fit the disease model better, because of their great physiological impact. I grew up watching adults drink in front of me, and they rarely had a problem with thesubstance. It was amazing to me how devastating the effects of such a weak drug can have on a person.

As I read more accounts written by alcoholics, I grew to sympathize with their past situations and was able to draw parallels between alcoholism and my experience with an eating disorder. This helped me understand why alcoholics behave the way they do. Of course often in addictive, self-destructive behaviors, there is no why, exactly. I guess I mean to say I understood how it feels to lose control while trying to gain control through the use of a substance. It may not even be about control. I still don't know. One thing I know for sure, though, is that in order to get where I am today, I had to do an about-face in terms of my outlook on life and create new answers for questions such as "does God exist?"; "what is love?"; and "who am I?" On the surface, these questions might not look like they have much to do with inhibiting addictive behavior, but I think addictive behavior does not come about just because someone likes something too much. The relationship between the object of addiction and the addicted is one of one­sided love/hate on the part of the latter. An alcoholic calls his favorite drinks by pet names but later hides his beloved or throws it to the garbage bin, because he recognizes what it is doing to him. He begins to despise even the relief that comes with drinking, but he cannot stop. I don't think alcoholism is a disease in the proper sense of the word, but it should be treated like one so long as mental illnesses are not recognized on the same level as physical illnesses. Some people believe that mental illnesses are valid only if the person has some sort of chemical imbalance in the brain. But I think this is a bit bullheaded, because if it's a chemical imbalance - well, the brain is still an organ, so a chemical imbalance is equivalent to a chemical imbalance in the blood, liver, or kidneys. It is still a physical disease. As long as mental illness experts keep harping on physical factors, using the same standards as internal medicine practitioners, we are absolutely nowhere.

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Course Evaluation

I thought this course was very interesting and very well organized. I liked having

speakers from across disciplines and getting a different perspective on alcohol and drug addiction. I also thought the course load was great. I liked turning in papers once a week to respond to the course material which was also very interesting. I really liked the personal stories of overcoming addiction. I connected more to that type of material then to the more scientific material about how the brain responds to addiction. My favorite class was having the recovering alcoholics come and in and speak to our class. I thought it was a very engaging and I really liked listening to people's life stories. I would keep that part of the course and possibly bring in more speakers like them if possible.

I didn't like class speakers who talked for long periods of time without engaging the class. I wish there had been more class discussion and engagement around the issue of addiction. I wanted to hear more about what other students thought about addiction and about others personal experiences. I feel like most students tuned out when we had speakers who weren't engaging.

I liked the diversity of class presentations a lot. I learned a lot from the class presentations. I liked the absinthe presentation, the alcohol in popular culture presentation, the meth play, and I really liked Daniel's poem. I thought the poem was very moving and a creative way to present alcohol as a problem in Native Cultures.

Overall, I think this course was awesome and should be a required course. Alcohol affects so many students on campus and many just don't understand the affects and don't understand anything about addiction. I think this course would be a good way for students to develop critical thinking about their own drinking behavior and the behavior of those around them.

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Coco 3 has been a truly great course. Its interdisciplinary approach is unique and allows for a holistic understanding of alcohol & other drugs at Dartmouth, in the United States and beyond. Because of this approach it also draws a wide variety of students, which is not only great for discussions but it also encourages science majors to utilize poetry and vice versa. The movies and fiction stories were excellent examples of the subject matter and have made me think more deeply about their consequences in pop culture. The weekly reading responses allowed one to not only read the material but also think about it and come to class with questions and ideas on paper. Many courses at Dartmouth encourage students to come to class ready to be engaged but this course achieves and thrives on this energy that students bring to class.

The guest speakers were very valuable and it was really neat to hear from such a wide variety of experts. This brought the material to life and allowed for great discussions. These presenters ranged from a NY Times reporter one day, C. Everett Koop the next, and a Dr. from DHMC who deals with addiction medicine on a daily basis. It would be really neat if the Dartmouth Alcohol & Other Drug Health Service program could offer some additional training to students in this course in order to become a Drug & Alcohol Peer Advisors (DAPAs). In this manner students could use the information from class right away and also increase the number of DAPAs on campus which would thereby spread the word about recognition, treatment and educational opportunities related to alcohol & other drugs.

The final presentations were really enjoyable because of their scope and also because many of them brought out students personal passions or backgrounds. Perhaps it would be interesting to order them in a sequence related to their topic. The variety was very enjoyable but it was unfortunate that there was no time for discussion. Perhaps if the presentations were a bit shorter but there was more time for discussion then everyone could be more involved throughout the presentation days. If there were time it would also be really neat to hear presentations from the DartmouthMedicalSchool students in the class. I had the chance to meet two of them and I am very interested to hear how they are going to utilize the information from the course and what other addiction related training is a part of the Medical Schools program.

Although this class was a little bit depressing at times due to the subject matter by the end of the course I feel that there is hope and there are some great people and great programs enacting change locally and abroad. I never realized it is such a wide field and it is interesting to see how many manners there are to improving education and treatment of these drug addictions. I know that I will take the material learned in this class with me for a long time. Thank you.

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This has been one of the most unique and extraordinary courses I have taken to date at DartmouthCollege. Every week brought a fresh topic and each of week's three speakers had a different and interesting way of addressing the matter at hand. The readings were diverse and relevant, and the films were both entertaining and instructive. I especially enjoyed how the course approached the problem of alcoholism from so many different perspectives, leading to a truly multidisciplinary experience.

I think one of the most important things I learned about alcoholism is that the disease not only harms the alcoholic, but it also can be very hurtful to the friends and family. All those stories we read about families coming to the bedsides of their alcoholic relations and trying to understand the disease but not knowing just how bad these people wanted to drink really affected me. Watching the film When a man loves a woman was a great way of making this idea come alive and putting a face and tangible emotions to the essays we had been reading on the topic.

I also found the different ways authors used alcohol in their literature throughout time and across the world was quite interesting. There are few substances that can be found in practically every culture on Earth, even though it is viewed so differently by so many groups of people. What seems like a substance used only in ritual by respected elders of the ancient tribes of pre­history has become a billion-dollar industry. I also learned that some cultures are highly susceptible to the harshly negative aspects of alcohol, namely the Native American Indians and modern-day Russians.

What might be most applicable to the class (at least at this point in our lives) is drinking at Dartmouth, and American colleges in general. I found Hoyt Alverson's study fascinating- to take something that the faculty and administration completely know about, but does not like to address in a non-negative manner, and study it objectively is an honorable task, and he should be commended for it. While I do not know how unique Dartmouth is in characterizing its drinking as "ritualistic", I do agree with Alverson's opinions and observations.

Overall, this has been a great class, and I would change very little about it. Possibly consider, shortening the reading list a bit so that speakers can more effectively concentrate on the most important aspects of the text. I would definitely keep the once-a-week format for the class. It allows everyone enough time to read all of the material and form an educated and well-thought out response. Definitely keep inviting local and alumni alcoholics to the class; that might have been one of the most memorable afternoons of my term. Keep up the great work, and I hope to see the class offered again next spring. I will definitely recommend it to all my friends.

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This class has been meaningful and very educational. I have found my time in this class useful, and I have learned how to look at the many areas of addiction. I now understand how addiction is masked by many different substances. I have learned to look at alcoholism and addiction medicine objectively- without judging.

One thing that has moved me is the many different ways that we are allowed to reflect. I find that my liberal arts education has given me the ability to respond through poetry, short stories, and pictures. I feel that this course is the first, and only course, where I was able to express my response to the material in a very real way.

The presentations on absinth, meth, and sports drugs were really meaningful to me. I understand how these drugs are connected in our American society. I don't know if there would be anything that I would change about this class. I think that the stories, books, poems, and quantitative research were so interesting. The amalgamation of these liberal studies has been the most useful part of this class.

Honestly, I don't know what to say about this class because each part of it was excellent. There are places of improvement, but I have yet to find them. Thank you all for allowing this class to be liberal and dynamic.

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This class was terrific. It involved a very wide range of resources including professors from the college and med school as well as prestigious guest speakers. The set up of the class was also well done, with the responses once a week. 1 enjoyed reflecting on the readings, especially those that dealt with Dartmouth. The most meaningful class to me was when the alums and loclas who are alcoholics came to speak with us about their experiences. Gail is the kindest professor I have ever had and it was a pleasure to come to class every week.

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I thought that this was a very comprehensive class, and it has made an impact on how I view alcohol. One thing that I struggled with was whether or not I would become an alcoholic in my lifetime. This is not because I drink or because my family has a history of alcoholism. It is simply because I became hypersensitive to what alcoholism is like and certain "personality traits" that are common in alcoholics. Perhaps, in the beginning of the course, a person could address the issue of becoming hypersensitive to this disease.

I really enjoyed the class where we had recovering alcoholics come and talk to us. I felt that added a significant personal touch to the subject matter. I know it's hard to get younger people, but I really would have liked to see more. I could relate the most to [SA] because she is still part of the young culture that is here today. Other speakers I loved were Emily Grandy, Dr. Gitlow, Christopher Wren, and Dr. Lori Alvord. They were all very dedicated to their work and were very inspirational.

The one topic that I disliked in the course was on Russia's drinking. I did not feel that reading The Bacchae added much to the course, and found [one professor's] lecture not as interesting as the other speakers. Perhaps this is because I am not interested in classics or politics, but medicine. I felt that a different approach on Russiawould have worked better. Another community I would have liked to learn more about is the Native American community. I know that this is hard to do, because they are so private. Perhaps there are articles or movies one can watch? I don't think that if they came to talk, we would get much out of them, for that is the Native American way (personal issues stay personal).

There were many aspects of alcohol (and addiction medicine) that could not be covered in the brief class-times that were offered. For example, on a smaller scale, how the college handles alcoholism. I think that it would be nice if the class size was smaller too. I would have liked to engage in conversations with my peers, but the size of the class and how the room was situated barred against that.

A few things made a strong impact on me in the class. First of all, Dr. Gitlow's graphs were invaluable in a personal way. I understand the mechanics of alcoholism much better and they also helped me understand why alcohol is an addictive substance with a downward spiral (due to tolerance and the nature of the substance). Dr. Emily Grandy made me think I would like to go into addiction medicine. The way that she talked about her work and how she was introduced to alcoholism through her first patient made a huge impression on me. And lastly, [S.] made a big impact on me. This may be because she had relapse not too long ago. She brought the realness of the disease to me. The other speakers we had either were years separated from alcoholism or were speaking through the caretaker's point of view. However, with [S.], I felt that she was just coming to terms with her alcoholism, and that she still wasn't fully ready to accept it yet.

I know that we glossed over other drugs, and due to the nature of the course (addiction medicine), I understand why. However, I felt that we should have either covered more or not at all. It's so hard to cover the societal, cultural, individual, familial, and chemical aspects of one substance in nine weeks, but when other drugs are added into the mixture, it's near impossible. I do like that we covered the medical/chemical aspects of addiction before going into the cultural. I would have liked a little more information on fetal alcohol syndrome. Perhaps, next year, a speaker could come in and talk about it? The book that we read merely introduced the concept to me, but I would have liked to meet someone who is reacting against this problem.

I loved the readings and the films. When a Man Loves a Woman really helped me understand the nature of alcoholism in a family context. A few books I disliked were The Bacchae and Long Day's Journey into the Night. Books I won't be selling back to Wheelock Books are The Scalpel and the Silver Bear, The Broken Cord, and The Tennis Partner—they deserve a second, more leisurely reading!

Overall a wonderful class, and I hope that it will continue in the future.

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I am honestly saddened by having to write this final response. This course has supplanted all other courses I have taken at Dartmouth as my favorite. On the one hand, the subject of the course is pertinent and interesting; on the other, the lecturers and presenters were thought provoking, intelligent, and human. This was not a class where a professor would stand up, lecture, not know anyone's name, and then assign some arbitrary grade. Instead, this course was led bysome of the most compassionate, interested scholars such as Prof. Nelson.

While other classes often require excessive amounts of work, the workload for this course actually allows students to think about what they are reading as well as to digest a plethora of information. My only contention is that course reserves are so hard to come by particularly for students who have extremely busy schedules. A wider, online selection of articles and books would be so helpful. The reason for my use of the course reserves was because the books and course reader are just so expensive especially when bought all together.

It would have been nice if there was more opportunity to share our own experiences with the class and the professors. Other than that, everything else was perfect. Repeating myself, this class was perfect.

The final presentations were also very interesting, although I was not a big fan of the more sociological and philosophical ones. I did really enjoy the presentation on Hip-Hop music, although I wonder what research was done and, better yet, how does one research such a topic. My favorite class was the one where the reporter (I can not remember his name) came in and shared his experiences. His stories were so real: subjects from which movies are made.

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The information and material that we have discussed this term has been beneficial for many reasons. Here at Dartmouth, the social culture predominantly revolves around binge drinking. Pong is the most popular activity at Dartmouth, and it involves chugging cups of beer to the point of extreme inebriation. As students, we enjoy this activity but fail to think about the physical or social consequences of performing such actions. Since I don't smoke tobacco, and most of the course focused on alcohol, my response to this course is based upon the alcohol material associated with our discussions.

When we first began the course, we read various materials concerning the biological and physical responses to the extreme consumption of alcohol. I felt that this was a good way to begin the course. It gave a broad overview of all the effects of alcohol. I found the sedative/agitation chart very interesting. After a few drinks, the user's body relaxes, or becomes "sedated." However, after some time, that relaxation phase goes away and the user's body reaches an agitation level much higher than one's base level. These are the withdrawal symptoms that people feel after drinking alcohol. Examples like this were very interesting because many of the feelings I would experience before, during, and after drinking were explained in scientific and medical terms.

As the course progressed, we read some material concerning alcohol and literature. I found this aspect of the course the most captivating. We read a book written by a doctor called The Tennis Partner, and it was quite emotional in describing drug abuse and its effects on those who around you. Once I started reading this book, Icouldn't put it down and finished it in one sitting. Another book, The Broken Cord, was another extremely emotional story pertaining to fetal alcohol syndrome. I really enjoyed reading this material and I'm sure the book had a profound effect on any expecting mothers who read the book. Other works like A Long Day's Journey Into Night, and Last Train to Moscow are considered literary masterpieces, and it was a great addition to the course to have us read these.

Later we delved into drinking at Dartmouth, which I found surprisingly honest and realistic. Dr. Alverson, an anthropology professor at Dartmouth, compiled a study in conjunction with his students that researched the drinking and fraternity culture and Dartmouth. Using actual quotes from students who had experienced the drinking culture first hand, the study provided many revealing observations of the social dynamics of drinking at Dartmouth. I found many of the sections amusing, which described the fraternity rituals of providing beers in basements. Being a fraternity brother myself, I have to admit that many of the observations are true, however, the study was overwhelmingly stereotyped towards certain fraternities. It was slightly unfair toward many of the fraternity basements, but I understand the study couldn't adequately compound all the fraternities into one simple conclusion.

If the focus of this course was to educate on the effects and consequences of alcohol and addiction, then I feel it succeeded. If it was to deter students from their current drinking habits, then I don't feel it made any difference. Those who drink heavily are already aware of the negative consequence from alcohol abuse; after all, these are Dartmouth students. Secondly, the students are quite experienced in drinking after many years of high school and college socialization, and after little to no major consequences todate, they will probably continue to feel that they are immune to the most dangerous problems. Most Dartmouth students who binge drink consistently are also responsible in having their priorities straight, if that makes any sense. They always make sure to finish their work first, and when inebriated, never enter a car to drive. For those students who have abstained from drinking throughout their life, then this course will only reinforce their perceptions on drinking. The course provided no logical reasons why one should drink, and provided many sensational reasons why one shouldn't drink. I'm sure every student took something different and unique away from this course, which was educational and enlightening.

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This class has proved to be more informative and personally enriching than I could have ever imagined. Forget English 5 and a freshman seminar—this course should be a requirement for all Dartmouth students upon arrival here.

I wonder at times if the adults at this school have any comprehension of the intensity of social life here, and how profoundly it can bleed into academic and personal responsibilities. For many professors, the only legitimate excuse for turning in a paper late or being unprepared for an exam or simply not finishing the assigned reading for class is extreme illness or near death, but nothing is said for the student who is awake until 5 or 5:30 in the morning three or four nights a week holding her roommate's hair out of a trashcan as she vomits for two hours straight after another long evening of heavy drinking, or watching her for an hour or two after she passes out to make sure that she is still breathing and it's safe to leave her alone. How do you tell a professor that you are unable to give your work the attention that it deserves because you have been too busy going with your friend to counseling appointments and convincing her that her alcohol problem is bad enough to warrant a medical leave? It is amazing how quickly things can get out of hand here.

I will be honest—I chose to take this class because last spring, I was the girl in the above anecdote who partook in an intervention to send a friend home for alcohol rehab. And while I expected her back from her medical leave long ago, she has relapsed numerous times since her departure and I no longer expect to see her back. I entered this course, then, not understanding alcohol addiction or how it could completely poison the life of an otherwise brilliant, fun-loving, sincere young girl. This course has really helped me to understand my friend's disease, to accept that it is in fact a disease and to better cope with the fact that it could be a very long time before she ever gets better, and that to some degree she will never be 100% "better".

The highlight of the course for me was the class during which numerous members of the Dartmouth and Upper Valley community came to speak to us about their own unfortunate experiences with alcohol, how they have dealt with the recovery and healing process, and how they have managed to get on with their lives despite carrying this crippling disease. One young woman was sober for years before she recently relapsed, reminding me of my friend who is away and reaffirming what the class readings and lectures had already begun to teach me—that alcoholism is a disease that needs to be fought individually and daily. There is no magic potion you can drink to cure it, no abracadabra to be said and no healing pill to be swallowed, and that is as difficult a realization for friends and family of alcoholics as it is for the alcoholics themselves. But I have learned that life does go on, and that we each play different roles in helping to ensure that life goes on. For the alcoholic, that role may be simply taking things one day at a time, giving oneself over to some higher power and trusting that higher power with decisions and interactions. For people like me who are watching others go through this disease, it might simply be lending a listening ear or a few words of encouragement just to say that I am there and that I care, but it does not need to be at the expense of my own well-being and health as I thought it was when I first enrolled in this class. And for other people, like Professor Gail Nelson, it might just be inviting a student like me into heroffice one afternoon for tea and sharing her knowledge and genuine empathy with me. I cannot thank her enough and cannot say enough about the sincere investment that she has in her career and in the students she mentors. She has helped me to grow immensely this term—the course has helped me to grow. I can only hope that Dartmouth will continue to make more steps like this course toward alcohol education and awareness programs and groups on campus, and making them more accessible to the enormous population of students here who can benefit from them.

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This course accurately matched its description. I enjoyed the survey of the symbolic and substantive roles of alcohol use in the lives of diverse individuals, families, and societies. As a psychology major, I had read some medically-based and social science texts. I find these texts extremely interesting, although I also enjoyed reading the literary texts and newspaper articles. All of these different types of texts helped me develop a fuller understanding of alcoholism. It is amazing how universal the theme of alcohol and other substance abuse is over a period of many years and involving many different cultures.

I enjoyed the format of the course. It is clear that Professor Nelson spent a great deal of time organizing the course reader and speakers for each class (often authors of the texts we read!) One suggestion I would have for future years is to have less reading per week but to make students more accountable for what they read. To be honest, I enjoyed most of the reading and videos that were assigned, but I often found the weekly workload overwhelming. While I am not suggesting the implementation of a midterm or a final, I think students would be able to better demonstrate their thoughts on the topic in a larger paper. However, since there is already so much reading per week, I don't think it would be possible to assign a longer weekly paper without otherwise reducing the workload. I think students could also be encouraged to somehow incorporate texts we have read for class into their final research papers.

I have seen the negative impact that alcohol abuse has on many individuals, and I was curious to read more about the subject about alcoholism. I feel I learned a great deal, not only from the texts and the movies we studied but also from course discussions and the student presentations. Overall, I think this was an excellent course. The material covered in this course was much different from that explored in a psychology course, and I enjoyed its interdisciplinary nature. I would certainly recommend this course to other students.

The class was really great. Thank you for putting all the hard work into arranging the speakers. I really got a lot out of it, and I feel the other students in the class did as well.

I will turn in a copy of my paper to each of you today. I will also provide you with a printed copy of my slideshow and am attaching an electronic copy.

The sorority presentation went well. There were about 10 or 12 people there, which I thought was a good turnout given all the thesis presentations and other things that are going on. The people who attended were all either sorority women or unaffiliated men (no non-Greek women or Greek men came). I think they were interested to hear what I had to say; even though the findings weren't particularly "surprising," it is sometimes nice to see your suspicions confirmed empirically. Thanks for checking in.

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I am organizing a dinner discussion with friends later on this week/early next week. When is the actual due date for our community group presentations? My housemates and I have organized similar dinners throughout the term which have generated fascinating discussions. As a senior looking back on my Dartmouth career, perhaps the most invaluable aspect of my college experience has been interacting with an amazing group of peers. I am excited to discover what this particular group has to say about the topic of my research.

How should I document the event? Do I need to complete a write-up/summary following our discussion? I will certainly be taking digital pictures for my personal collection, but I could send them your way as well. Let me know what has worked well in the past!

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Thank you for giving me the opportunity to do something like this. I enjoyed the process and hope to undertake similar projects in the future. I will drop off a DVD and manuscript with my final research paper.

Thanks again!

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