Meet the Northern Ireland doctor who became addicted to his own medicine... and how he endured the horrors of going 'cold turkey' just so he could get clean again
Former Crossmaglen GP Liam Farrell ended up in court for stealing morphine from his practice partner and writes movingly about his fall from grace in a new book. Linda Stewart reports
It's a beautiful summer day, the sun is shining in a deep blue sky and everyone's out in shorts and T-shirts. A father walks along the road, holding his child by the hand.
But inside the house, Dr Liam Farrell is willing away the next 48 hours. He's shivering and sweating, his eyes are running and his body is wracked with abdominal cramps and diarrhoea.
He can't go to bed because he thrashes and turns in damp, sweaty sheets. He can't sit for a moment without getting up. Adrenaline is surging round his body and his skin prickles and burns.
"Forty-eight hours, I tell myself, only forty-eight hours to get through, then things will get easier and I'll know the worst is over, but only a few hours have gone, the time drags, the seconds inch along," he says.
"I dread the night. Darkness was my friend, but now the hours stretch ahead of me, there will be no relief, no oasis, just a long darkness.
"But, I promise to myself, this is the last time. This is definitely the last time. I won't put myself through this ordeal again; this time I'll stay clean. I promise."
The first chapter of Dr Farrell's debut book is a searing, brutal account, first of the lovingly vivid details of the administration of the very last ampoule of morphine, and then of the horrors of the cold turkey that followed inevitably in its wake.
It's hard to believe that this is the opening salvo of what is largely a book of humorous writings opening a window into life as a Crossmaglen GP - and yet that stark honesty ends up being one of the most positive things of all - and the knowledge that he has been through that dark night, beaten his morphine addiction and has been clean for 10 years now.
"The book is essentially humour. I do rail against Brexit and against Trump occasionally, and I defend the NHS. But the first chapter does put the humour in the book into perspective," he says.
Unlike the other writings in the book - a selection of the most memorable of the hundreds of columns he has written over the years - the first chapter was written in a heady outpouring.
"I wrote 4,000 words in one sitting, usually the columns are crafted over a week or 10 days," he explains.
"But it was a warning. You hear talk about 'heroin chic' and there is this fatal glamour associated with it.
"But there's nothing glamorous about it.
"It's just a horrible, squalid, venal, selfish vice. It's horrible. But you can get better."
Controversially as ever, the title of the book is Are You The F**king Doctor? Tales From The Bleeding Edge Of Medicine. Dr Farrell writes like a dream, and this book really brings that talent to the fore.
At times you find yourself giggling out loud: the bit about how you can tell when an Army patrol is concealed in a ditch because the curious cows line up to have a nosy, the warning about the cardiac dangers of taking to the wedding dancefloor when Abba's Dancing Queen comes on, the smouldering encounter with the drug rep.
At a time when even fewer voices were heard from the border region than today, his offbeat writing was catapulted into the big time, first appearing in the prestigious British Medical Journal during the editorship of Dr Phil Hammond and then proliferating into all sorts of other media, including this newspaper.
Now 61, married to Brid and with three grown-up children, he is retired from general practice and is concentrating on writing full-time. He still lives in Rostrevor, his home for most of his life.
"Rostrevor was a relatively secure place during the Troubles," he says. "I do remember going to school in Newry in the mornings, certainly in the early Seventies, and the troops would regularly get on to the bus and search the bus, but nothing too dramatic in my experience. I feel very fortunate."
He studied at Abbey Christian Brothers Grammar School and University College Dublin.
"At the time there were three or four of us who went down to do medicine. It would have been during the Troubles, which as one reason why Queen's didn't appeal to us very much at that time. It was 1976, so the Troubles were at their height," he explains.
"UCD was terrific. Dublin was a very cosmopolitan city with people from all over the world studying there."
After a series of locum jobs Dr Farrell joined a practice in Crossmaglen, which had a fairly fearsome reputation as the heart of "bandit country".
"The people were very generous and kind and supportive. They were very stoical. There was no major industry and they lived on the border so they had to live on their wits. I'm very fond of Crossmaglen," he says: "It was a huge responsibility - very good people, very strong family networks. They all look out for each other and it was very fulfilling."
It was in 1994 that the British Medical Journal held a competition to find a new columnist. A voracious reader since childhood, Dr Farrell decided to give it a shot.
"I wrote a piece on the back of being called to a mortar bomb, when the Army base was mortar-bombed, a piece about being called out to that.
"You were always restricted (as a doctor).
"You can't write anything that may be identifiable, so to a certain extent all the stories were an amalgamation of different instances.
"I think it was just so alien to the judges in London that a family doctor in the NHS could be doing this sort of stuff and I won it.
"Suddenly I was a columnist. Writing for the BMJ was so prestigious that it opened up many doors to me.
"It's been a great experience; it's a huge readership of hundreds of thousands across the world and it opened many, many doors for me."
Everything Dr Farrell writes is either funny, or moving, or sobering, or infuriatin. It never fails to evoke an emotional response.
Witness the furore when he became the first writer to drop the 'F' bomb in the BMJ, writing a scathing line on how wrong it would be to ration treatment for conditions brought about by smoking - "The F**k You School Of Health Promotion".
"To my knowledge it was the first time the F-word had ever been used in the BMJ," he explains. "So I was walking down the street one day and I saw a billboard: 'F word doctor has no regrets'. One of the Sunday papers had picked it up.
"It was entirely in context, but you would think from the title of the book that all I do is swear like a trooper, but I like to think I actually have a refined vocabulary.
"So that was picked up and there it was on a billboard. I think I asked for a copy of the billboard, it's around the house somewhere."
And there was the time when he provoked pet lovers with an offhand joke about running over a cat, and ended up with the Army at his door.
"I was writing one day about euthanasia and the difficulty of it. It's always talked about in abstract terms, but to be the doctor that does it is a huge task," he says.
"I was talking about coming home from a house call and driving over a fox.
"What actually happened is that I thought it was injured very badly and it was lying in the middle of the road, so I took the jack to hit him on the head. But somehow it had made its escape and I didn't have to do it."
However, he took the incident and used a little poetic licence to illustrate how challenging euthanasia would be for the doctor at the coalface.
"My columns are always disposed to be slightly offbeat and I wrote that I ran it over because I thought it was a cat. It was an offhand joke," he explains.
"But the reaction was incredible.
"I got hate mail from across the world. I was reported to the cops. I had the cops coming round to visit me and when the cops came down they have to have Army support. And the Army come down they have to have a helicopter in the area.
"So an Army regiment descended on the health centre one day to interview me about something I'd totally made up."
The BMJ printed a rebuttal a week or so later and that Christmas the journal presented Dr Farrell with the inaugural Black Cat Award.
It is now presented every year for the article that has managed to elicit the most complaints.
The moment he first tried morphine is lost in the mists of memory.
"At the time I was working very hard, I was on duty every second night. It was quite a busy period. I was also writing columns for two or three newspapers and journals. I'd even started a brief medical journal called Ulster Medicine. But none of this excused me, because other doctors had workloads that were worse," he says.
"I tried it to see what it was like, I've no memory of exactly when.
"I did it very infrequently but at some stage I began to take it more regularly and suddenly realised I was addicted. So I went for rehab and I was clean for about 10 years. I had a minor relapse, but it was enough to confirm the seriousness of my addiction and shortly after that I retired as a GP in 2010.
"I actually don't know why (I first did it). I cannot remember my thought processes. I don't remember the when, the where, the why.
"Curiosity killed the cat and it's such an addictive substance, and it's one of the ultimate transgressions if you're a doctor."
Doctors are given responsibility for what is a hugely important and powerful substance, he says, describing morphine as a miracle drug that can free patients from agonising pain.
"To see somebody in terrible pain and to give them morphine and see them released from that trap, it's such an important drug that we have, but along with that miraculous power comes responsibility not to abuse."
The addiction brought him to the point that he ended up in court in 2008 for stealing diamorphine and cyclimorph from a colleague's bag in the Crossmaglen surgery. He was given two suspended sentences of three and six months.
"It's a very insidious problem. You take one, you think nobody will notice. You think if you take another, nobody will notice. But they do notice, because these things are very closely watched now.
"Addicted doctors are comparatively rare - there aren't many of us around because morphine is so carefully watched. The number of doctors with alcohol problems probably far outweighs the number of doctors who are addicts."
But the positive message is that there is a high recovery rate for addicted doctors.
"It's 95%, which is a message of hope. You can get better," Dr Farrell says.
He managed it with support from Narcotics Anonymous and a variety of other support groups.
"I had support from family and friends and colleague. My colleague Dr Pat Fee was a tower of strength to me."
He says that now when he mentions the addiction in his writing, it's like dropping a bomb into an article, "it mutes everything into silence".
"But I wake up every morning and I say: 'I am going to stay clean today'. And every night before I go to sleep I say: 'At least I stayed clean today'.
"It doesn't define me. I am a husband, a father, I have friends, I love football.
"Addicts aren't just addicts, they are people with roles to fulfil. Labels are very dangerous.
"The longer I practised medicine, the more I realised that 'patient' is too small a word. Patient is just a role. Outside the surgery, they are husbands, they are wives, they have children, they have jobs, they have passions and interests, they are lovers.
"I am an addict and it doesn't define me, and it does not define any addict."
Dr Farrell says he is fortunate to have had his writing career to step back into. He's also very active on social media, curating the IrishMed tweetchat, which has expanded into a global phenomenon.
As for the future. "I'll wait to see how the book goes. It might be time I broke into trying to write a novel," he says.
"But it's fine doing a 400-word column. When you write 80,000 words knowing you may never get any money, it's different. I will have to really gird my loins."
Are You The F**king Doctor? Tales From The Bleeding Edge Of Medicine is published by Dalzell Press, £13