Frederick Montgomery's perspective on addiction as a young physician did not differ much from the stereotype. In medical school he had done biopsies on alcoholics' livers, and he saw these individuals as representing a subculture completely foreign to him.
One of the young patients during Montgomery's residency was a parole officer who had been experiencing serious personal problems. It was not until the patient contacted him a couple of years later that Montgomery learned the man was an alcoholic. But the two had connected, and now that the former patient had gone into recovery and was working at Sundown M Ranch, he was calling to offer Montgomery a job.
Montgomery knew little about chemical dependency when he was hired as a psychiatric consultant in 1973, but by 1975 his inquisitiveness and his effectiveness with patients had landed him the medical director's post. Even with today's bureaucratic demands on treatment administrators, Montgomery says nearly all of his time is still spent on patient issues.
“I try to determine their psychiatric status,” he says. “I see how they relate to me, and I explore their personality style and how it should be dealt with.”
The work is a cooperative venture with treatment staff, who he believes have much to teach him about work with alcoholics. In the meantime, he is primarily responsible for managing client medical issues ranging from chemical withdrawal to dementia to co-occurring mental illness.
Sundown M Ranch is a highly 12-Step oriented facility, currently not using medication treatments except for withdrawal. Yet Montgomery is keenly interested in all strategies that enhance the goal of client sobriety, and says he has the authority to research the newest interventions for their appropriateness to his facility's work.
He is particularly proud of how he has helped open other generalist physicians' eyes to the human suffering of the addict. “When a medical student actually sits next to alcoholics for three days, and sees that they've got families, jobs and educations, that's what changes attitudes,” Montgomery says.
Position: Medical director
Organization: Sundown M Ranch, Yakima, Washington
Quote: “We approach things here in a very basic way that is wonderful. We don't deal with the thinking that says, ‘I drink because my wife hates me, or because I have an eating disorder.’ We're cognizant of all the other issues, but our approach is, ‘You drink because you're an alcoholic. You have a genetic difference, and you've got to stop drinking.’”
Comment from nominator: “Early on Dr. Montgomery realized the value in medical students gaining an understanding of alcoholism and the treatment offered at programs like Sundown M Ranch,” writes facility executive director Scott Munson. “Beginning in the mid-'70s he invited medical students from the University of Washington to Sundown for a practicum. This program continues today with each of the residents in the local family practice program doing a rotation at Sundown during their second year.”
Photographer: Mike Burke
Addiction Professional 2009 January-February;7(1):11