Up until today, I didn't give much consideration to how I, as an orthopaedic surgeon, could contribute to the discussion of how much is safe with regards to safe quantities of alcohol consumption. The op-ed piece entitled "Drinking by Numbers," by Bonnie Tsui, published today in the New York Times Sunday Review section, changed that.
I found Ms. Tsui's article to be incredibly insightful and thought-provoking and it immediately sparked me to examine my clinical practice and how I counsel my patients with regards to alcohol consumption. As an orthopaedic surgeon, I have an inherent vested interest in my patients' bone health and I frequently advise my patients to engage in weekly or biweekly impact exercise to maximize bone density and strength (for an excellent general article on the topic of the importance of high-impact exercise, click here). Counseling regarding alcohol consumption is relevant in my practice because alcohol can (and frequently does) lead to impaired balance, compromised decision-making, and incredibly entertaining but risky dance moves, among other things. These, in turn, lead to orthopaedic injuries such as shoulder fractures and broken hips. Instead of yet another scientific article that merely facilitates further confusion as to whether or not alcohol consumption is healthy or unhealthy, Ms. Tsui's nuanced article examines the motivations behind alcohol consumption and provides an extremely useful suggestion as to how one can determine a safe number of alcoholic beverages to consume:
"Nothing is as important as something. Nothing is the reference point from which we can judge all else. The numerical middle is different for everyone, but perhaps that’s the point. Because my number is two and yours may be one and his might be five, the most relevant number to us all is zero.Maybe the only way to think about drinking by numbers is not to obsess over how much is too much, but to be acquainted with what zero feels like — that is, to come back to zero often enough to understand the relative value of our numbers. The reset helps us see those numbers for what they are."
This advice recognizes that everyone's tolerance is different and does not attempt to give a hard and fast number for a "safe" quantity of alcohol. Instead, it advocates awareness and thoughtfulness, as well as moderation. I wholeheartedly agree.