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The memoir of a doctor whose addiction derailed his career offers flashes of illumination amid clouds of defensiveness and denial.

If there really is a textbook case of a delusional addict, the narrative perspective here could provide that textbook. Early on, Grinspoon admits that “the problem at this point was that I was still blaming everyone and everything else for what I was going through: Work was so stressful, H. was such an unforgiving bitch, and it was exhausting being a parent to two small children.” What he was going through was a felony arrest for writing false prescriptions for narcotics to feed his addiction. Work was his role as a primary care physician, one in which he showed little empathy and seemed to receive less satisfaction: “It’s not human nature to be that caring all day long.” H. is, of course, his wife, and his attitude toward her (and hers toward him) seems harsher as the narrative progresses, though he occasionally admits that being married to a lying, self-sabotaging addict was no walk in the park. Their children ultimately provide more than exhaustion, though being caught between two parents who couldn’t stand each other couldn’t be much fun for them. Grinspoon never developed much appreciation for the lawyer who navigated his way through rehab, suspension, and a return to the practice of medicine; felt unfairly targeted by drug tests that he knew he couldn’t fail but did; and never showed anything but contempt for 12-step programs (“I didn’t want anything more to do with AA for the next thousand lifestyles”). The author resents the judgment passed by alcoholics who think they are somehow morally superior to drug addicts, yet he passes judgment on practically everyone the narrative encompasses. His recovery from addiction seems to end on a positive note, but every addict knows that a positive test is just one slip away.

Grinspoon’s story is instructive, with readers potentially learning more than the author has.