A funny thing happened on the way back to rehab.

My friend Lisa was diagnosed with multiple myeloma, a bone marrow cancer, after she spontaneously broke a rib. It was discovered that her bones were not becoming brittle because of garden variety osteoporosis, but because cancer cells had eroded the outer shell of bone that normally surrounds the marrow. Most people who get multiple myeloma are in their 60’s or 70’s. Lisa was 49.

There is no cure for multiple myeloma, and Lisa knew that she would almost certainly die prematurely from this disease. But there are treatments that can decrease the severity of symptoms and prolong life, and with young boys, she wanted to live. Lisa received a stem cell transplant with bone marrow cells donated from her sister. The transplant itself was a simple infusion, but before it could take place, she underwent high dose chemotherapy to decimate her body’s immune system so the transplant wouldn’t be rejected.

I visited Lisa during her chemotherapy and what I saw horrified me. She looked ten years older, was stooped, shrunken, and frighteningly thin. She couldn’t eat because of a raw throat and the almost unendurable taste of heavy metals in her mouth that made all foods unpalatable. She needed a walker or cane to move, her hair was gone, and she was constantly, violently nauseated. There were several times when I excused myself to go to the bathroom, where I wept for her.

The stem cell transplant was successful and, for a while, Lisa enjoyed remission. But more than five years later, she had a recurrence. She would need another transplant, and another toxic course of chemotherapy…

About a month ago, I read a short piece about how Chevy Chase had again entered a drug rehabilitation program. Chase has long struggled with addiction, in fact, in the late 1970’s, after he became an original member of Saturday Night Live, it was reported that his consumption of cocaine was in excess of two grams each and every day. That’s a lot.

Chase also started using prescription painkillers. The explanation was that he began taking them after a back injury caused by one of his signature pratfalls. Dependence followed and, in 1986, Chevy Chase was admitted to the Betty Ford Center to deal with what had become an addiction to prescription painkillers.

Years later, in 2010, Chevy Chase was quoted as saying said that his drug abuse had been “low level.” Not sure what that meant, exactly, because, while all are welcome at the Betty Ford Center, “low level” users tend not to be their biggest customers.

About a year ago, Chevy Chase entered Minnesota’s Hazelden-Betty Ford Center for treatment of an alcohol-related issue. I’m guessing he’d have described that as “low level” too.

And just a couple of weeks ago, after having again fallen victim to a relapse of unconfirmed severity, it was reported that Chase entered a rehabilitation center to regain his sobriety.

This was described as returning to treatment for a “tune-up.”

Now I don’t know Chevy Chase, and I’m guessing that his publicist is at least partially responsible for these kinds of communications. But what jumps out to me is the way a clearly serious substance use disorder is minimized and euphemized. No one goes to rehab for a “tune up.” People go to rehab because they’ve experienced the recurrence of a cunning disease that will, if left untreated, utterly destroy them.

When Lisa had her recurrence of multiple myeloma, she returned to the hospital fully aware that what awaited her was not a “tune up,” but a full press, aggressive, unpleasant course of treatment and a fight for her life. And that’s what undoubtedly greeted Chevy Chase when he returned.

Celebrities, for better or worse, have influence in America. We care about the shoes they wear, the cars they drive, and the candidates they vote for. When they advocate for a cause, we listen.

When a celebrity talks openly about a medical condition, it helps all of us. And when a celebrity gives a face to a stigmatized disease, it’s transformative. Magic Johnson taught us that we can live with AIDS. Katie Couric convinced millions to get a colonoscopy. And much to the chagrin of married octogenarian women who just wanted to be left alone, Bob Dole persuaded legions of their shriveled husbands to ask their doctors about Viagra.

Chevy Chase has, so far, squandered several opportunities to speak openly about addiction and help all of us understand it better. In fact, he’s contributed to misunderstanding. A “tune-up” is something you choose. It implies making an improvement to something that’s already working pretty well.

Addiction is a disease that impairs the ability to make good choices. And people enter treatment only after their ability to make good choices is held hostage by alcohol or other drugs, and their lives are not working well at all. No one goes to inpatient treatment because they need a little tune-up.

I wish that Chevy Chase was less concerned about the optics associated with addiction and treatment, and less fearful about the judgment or criticism associated with its recurrence. Those of us who work in this field know that it’s the nature of the beast: addiction is a chronic, recurring brain disease. Most people are not magically cured in 28 days. For most, it’s a lifelong fight. There should be no shame in that, just as there is no shame in the recurrence of any other treatable but incurable disease.

Stigma lives when uninformed people see addiction not a disease, but as a conscious choice to behave badly. The initial decision to use alcohol or drugs is a conscious choice. Addiction, however, is fueled not by choice, but by a malfunctioning brain, where the reward center—the place where our core survival drives (e.g. food, sex) are associated with pleasure—is damaged, and the need to use drugs (not to get high, but just to feel kind of normal) becomes uncontrollable.

Recovery, as millions know, is difficult but eminently possible. So I hold out hope that Chevy Chase finds sustainable, long-term recovery. But I also hope he finds the courage to talk openly and honestly about the long and perilous journey he took to get there. It’ll be good for him, and it’ll be even better for the tens of millions of Americans who are, themselves and with their families, wrestling with this terrible disease.

My friend, Lisa, is asymptomatic and in remission. It’s been ten years since her diagnosis. She has a full head of curly hair, a spring in her step, and has watched her boys grow up. She still has the disease, but she lives a full life and is grateful for every new day. If she has a recurrence, she will face it head on, without shame, and with a powerful will to find remission and recovery. I wish the same for Chevy Chase.

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