Case #4: Juanita Carlos(Adapted from Morrison, 1995) One of Juanita Carlos's earliest memories was of when she was four years old, sitting on her grandfather's lap. She would rest her head against his soft old cotton sweater. He would wrap his arms securely around her, and she would cling to his neck. Also clinging to him was a particular smell that she always associated with her grandfather. It wasn't until she was a teenager that she realized what it was: beer. By the time Juanita was 10, she had watched in horror as by degrees the old man died of cirrhosis. When she was a teenager, she saw her father's drinking wreck her parents' marriage. In college, when she discovered that two glasses of wine would ease her chronic sense of tension, she promised herself that she would use alcohol and never let it use her. Accordingly, she had evolved a set of rules to limit her consumption. She allowed herself only one drink before dinner, and never more than three in a day (except on weekends and vacations, when she could have four). From her father's unfortunate example, she had learned; Regardless of the occasion, never drink during work and never allow "extras." Even the day of her 22nd birthday, when she married Quentin, the young salesman in her father's office, she had only four glasses of champagne - just enough to maintain her customary, comfortable glow. Despite her control, Juanita had had two lapses. The first had occurred 12 months earlier, when she became pregnant for the first and only time. Although she wanted a child, she took the precaution of having and amniocentesis. When it revealed that she was carrying a Down's syndrome baby, she gulped several extra drinks and drove around while deciding what to do. A Breathalyzer-measured her blood alcohol level at 1.2, landing her in traffic court just one week after the abortion. Her second arrest for driving while intoxicated had occurred six months later, when she lost her self-control once again after her mother died of Alzheimer's disease. The day Quentin entered treatment was therefore only the third time he had ever known his wife to be drunk. Juanita accompanied her husband to his clinic appointment. She had been worried about Quentin for several months, and when his agitation kept them both awake most of the night, she had gone down to the kitchen and poured them each a drink. When he refused his, she drank it for him. Then she lost count and had a couple more. "Anything was besher - was better than what he was going through,"Juanita told the clinician that morning. After correcting herself, she spoke slowly and deliberately. On the spur of the moment Juanita had decided that she should accompany Quentin to his appointment, to be sure he didn't get into trouble. They had taken her car, and she had insisted on driving. Quentin hadn't dared remind her what had happened on the other occasions she had driven after drinking. Fortunately, traffic was light, and her only difficulty was that she needed two extra tries when parking in an unusually long space at the curb. As Juanita entered the clinic building, however, she stumbled and might have fallen had someone not grabbed her elbow and steadied her as she wobbled into the waiting room. She fumbled with the large buttons of her coat until her husband undid them for her. She then slumped into a chair where, with her coat thrown over her, she appeared to doze until they were called into the clinician's office.