Internist Jerome Lackner is honored as a "doctor who goes the extra mile" for his extensive unreimbursed care of substance abusers.
Like the Energizer bunny, Jerome Lackner never stops. The 73-year-old Sacramento internist has spent most of the last three years working at a California state prison by day and volunteering nights and weekends at the treatment center he inspired.
Even sleep barely slows him down. "I don't think Doc ever sleeps more than four hours, " says Amy G., one of thousands of recovered alcoholics and drug addicts who credit Lackner with saving their lives. "He sleeps with his beeper at his side."
During three-plus decades of specializing in addictive disorders, Lackner has counted many street people among his patients. He's succeeded often in treatingalmost always for freea population widely regarded as untreatable.
Lackner's awareness of addiction began at age 4, when he accompanied his physician father to "a state hospital where law enforcement officers and families brought their drunks and dope fiends." His interest was rekindled in medical school, where he encountered patient after patient hospitalized for other disorders while alcohol problems went undiagnosed and untreated. He acquired much of his knowledge about substance abuse by hanging out on park benches with alcoholics and addicts. "My professors were Wino Joe and Harry the Hype," he says.
Amy G. met Lackner more than 10 years ago, when she was being treated for liver disease and malnutrition. "This amazing-looking man with a white handlebar mustache the size of Wisconsin walked into my hospital room and asked if I wanted to go to an Alcoholics Anonymous meeting," she recalls. Before she could answer, Lackner had whisked her off in a wheelchair, IV pole in tow.
In her early weeks of sobriety, Amy says, Lackner phoned her every day. After she had a relapse, he welcomed her back with open arms.
Nancy H. Appelblatt, an ENT specialist in Sacramento, also attests to Lackner's devotion. "People can call him any time they get in trouble," she says. "But he's not a pushover." He requires that his addicted patients attend at least two AA meetings per week, work closely with an AA sponsor, and bring family or loved ones on visits to his office.
"Addicts can be very manipulative," Amy notes. "He tells their families, 'They'll be ready for help sooner if you don't enable them.'" Lackner, says Appelblatt, "embodies everything that's good about physicians."
In 1997, Lackner concluded he couldn't afford to continue his time- and labor-intensive approach to medicine. In a 10-page letter announcing his decision to close his practice, he told patients: "I am now certain that my style of caring for patients and the current system of financing medical care are intrinsically incompatible."
When he left, one patient said, "it was like Calcutta losing Mother Teresa." Within months, Lackner's patients and other supportersincluding physicians who referred patients to himhad pooled their resources and reopened his office as a nonprofit treatment center. The Silkworth Memorial Fund & Clinic for the Advanced Study, Training & Treatment of Addictive Disorders is named for the first physician to support AA. The goal, says Amy, is to generate enough revenue to pay a salary to Lackner and a staff, and to attract other physicians to work at the clinic and undergo training in the kind of care he provides.
"We'll be sitting in a board meeting, and he'll get six or seven calls on his pager in one hour," says Amy, who serves as the board's president. "We all understand that what he's doing is a lot bigger than a board meeting."
Helen Lippman. Doctors Who Go the Extra Mile: Helping the addicted. Medical Economics 2001;4:85.