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Here is the good news: you are going to be discharged shortly.
Even if you’re 17, the doctors won’t call your parents—doing so would be illegal—so you will be free to put your shoes on (assuming you still have them) and take yourself home. The consequences aren’t immediately real. You survived, you didn’t know what was happening and you’re not in high school anymore. It’s a normal Sunday morning, and you are hungover as fuck.
Do you really want to know what you did last night?
Whether you chose microbrew or Banker's, you drugged yourself at first sip. Alcohol is a vicious stimulant, which, according to Max Kelz, an assistant professor of anesthesiology and critical care at Penn Med, is also highly promiscuous. That’s a laughable but scientifically–approved way of saying that, as opposed to drugs like morphine and heroin, which target a small number of specific receptors, alcohol floods a much wider array of targets. From neurons to enzymes and lipids, it permeates the signaling systems in your brain to make you “black out.” Hard drugs are picky, while alcohol is a neurological slut.
Under your hair, scalp and skull, your brain is composed of neurons, which conduct electrical and chemical communication; glial cells, which protect the neurons; and blood vessels, which transport blood. While you walk and talk and breathe, your central nervous system works to synchronize the voluntary and involuntary actions responsible for the state we know as “alive.” Within this system, neurotransmitters, like the one known as gamma–aminobutyric acid (GABA) function by inhibiting receptors, making them less likely to transmit information from one neuron to another. This action—or inaction—is a neurobiological signal.
To a certain extent, this kind of in–brain inhibition is normal. As Dr. Kelz explains it, communication between neurons in the brain is like a phone call made from one friend to another. If your friend picks up on the other line, you will get one message. If she doesn’t, you’ll get another.
When you black out, however, your brain reaches a critical mass of inhibitory effects and normally transitive impulses like daily thought and awareness are cut off. Whether you like it or not, your brain is dialing desperately, you’re just so drunk that you’re screening its calls. In addition, memory is obliterated. A story told to you that night at 10:30 will be purged by 10:32.
Everyone knows that NSO is marketed as blackout initiation. “I remember my first time,” you’ll say senior year. In between August 25 and September 5 of 2012, 30 students were hospitalized for blacking out or something close to it. It happens a lot, and when you’re underage, with little perception of your limits and high expectations for the contents of solo cups, it might not be totally your fault. Three years later, it kind of is.
At a mixer on Spruce Street two weekends ago, a junior in costume has planned to black out. The party isn’t packed, but the music is good and bottles are open at the bar. Some kids—mostly older ones—are upstairs smoking joints or doing lines, hanging out and playing video games until the party reaches its peak and becomes fun enough to attend. They’ve been drunk for a while. It was a day of beer pong outside and a boozy dinner at Tap House. Girls are arriving ,and Friday is welcome after a week of work or sports practices or social anxiety. Handle pulls are in order.
“I have a wide–developed blackout personality,” the junior fraternity member explains. A few drinks deep, his cheeks are already rosy. “I feel like I’m experienced. I think experienced people who blackout are not just going to blackout immediately—they can sort of hold their blackout for a long period of time and generally just not puke, because puking… ruins it. It puts you right to bed.”
There is a concept Urban Dictionary calls the “Morality hangover.” It is defined as “the sickening feeling you wake up with when you have partied too hard the night before. Regretting the crazy thing[s] you did last night and feeling very bad about yourself.”
If he has outgrown puking, has regret faded, too? Or, head pounding, does he ever wake up sorry?
“All the time,” he says. “The worst is when you don’t wake up in your house and you don’t know where you are.”
The idea that physiological blackouts are a cultural derivative of generation Y’s fixation on college partying is a myth. Dr. Charles O’Brien, Penn’s Vice Chair of Psychiatry and the director of the Center for Studies in Addiction, says so. “Since the very first early human being realized that wine—fermented grapes—tasted good and it made them feel a little bit of a buzz they were already having blackouts," he explains.
Dr. O’Brien is one of the leading researchers of drug addiction and advocates for its implementation in medical school curricula. After returning from Vietnam, spurred by scenes of rampant substance abuse, he found his way to Penn. Now, he is helping Penn’s Office of Alcohol and Drug Program Initiatives in its year–long exploration of alcohol and memory, or, as its organizers put it on their posters, “Alcohol: it’s a science.”
Of course, Dr. O’Brien’s historical reference does not negate his opinion that blacking out is a problem. He’s just saying we didn’t start it. What we have started, though, is a sort of topping–off process. When Penn’s administration began to proactively address its student body’s drinking culture in the 1990s, heavy drinking meant ingesting five drinks in one sitting. Now, the standard is 10 or 12, which is way more than it takes the average 18– to 22–year–old to black out. Our hangovers and hospitalizations, therefore, are exacerbated not only by our desire to escape by way of blackout, but by our propensity for impulsive risk–taking, too.
If you think everyone is doing it, you’re lying to yourself.
In a ’70s style conference room in Chestnut Hall, a group of doctors (including Dr. O’Brien), post–docs, fellows and members of Penn’s alcohol–and–other–drugs bureaucracy have gathered to hear University of Maryland's Dr. Amelia Arria give a talk on unnecessary consumption: our problem. Dr. Arria’s Powerpoint, entitled “Substance Abuse: Academic Outcomes,” is the result of an attempt to track collegiate heavy drinkers into their thirties.
A graph appears on the projection screen: it’s a list of reasons students have cited for their poor academic performances, for the drops in GPAs that are endemic as year one turns into two and so on in a four–year college experience. Stress appears. So does anxiety, cold, flu and internet use.
Alcohol—anything in the family of alcohol—is absent.
The morning after a senior society initiation, a group of six girls—five of whom were accepted early decision to Penn four years ago—are splayed in one’s room, a few on the bed, some on the floor with an almost–killed six–pack of 9.5% ABV beers. Three of them had blacked out the night before—they remember nothing, even when prompted to do so. It’s not their first rodeo: food’s been ordered, epic tales of nude awakenings have been told, Blowfish (a condensed form of caffeine and aspirin you dissolve a la alka seltzer) has been taken from a stockpile downstairs. There’s school tomorrow. Work will get done, but obviously not right now.
“I cannot handle peer pressure.” “I’m an opportunist.” “FOMO—it’s drinking with my friends.” “It’s definitely a social thing.” “I would never ever drink alone.”
“Honestly, I think it’s a problem with our parents’ generation that they like to blame everything on us. It’s like—you raised us,” someone says.
Everyone laughs. “You are so fucked up,” someone responds.
Nationally, graduation rates are just about 50%. This isn’t the case at Penn, but it’s also a convenient metric for overestimating our success. Goal attenuation—a major theme in Dr. Arria’s presentation—is a better one. It’s the idea that, while you might graduate, you won’t toss your hat on College Green having accomplished what you came here to do.
Possible courses of action following goal–setting are generally quadrisected. We tend to follow through, develop or attenuate—to reduce the force or value of our goals, making it easier to digest that we’ve come up short. The final option is diffusion, complete goal abandonment.
The students at Penn who blackout—and not all of them do—will attenuate. “Over time, the [neurobiological] rewards of academic achievement can be replaced with the temporary rewards of intoxication,” a May 2013 report from Maryland’s Center on Young Adult Health and Development reads. Our self–identified rationales have confirmed our denial—in blacking out, in poisoning the brain cells created 20 years ago in love or lust or opportunity, we create black holes in the world, too. We have replaced the straight–A butterflies with the dependability of lowered expectations—don’t shoot so high and you’ll miss less often.
Dr. Arria and others are determined to correct our impotency. “I guess that’s your job, to connect the dots for them,” Dr. Arria says to the members of the Office of Alcohol and Other Drugs, who nod slowly, as if handed the stone tablets of intervention, a quest now validated by authority. On the far side of the room, a woman who will later suggest a campus–wide ban on alcohol chortles.
The bowels of HUP’s emergency department are not a place you want to be sober. It’s hard to find a paramedic—they’re tied up with trauma, carrying igloos full of blood, checking the vital signs of a young helmeted motorcyclist who was struck by a car.
In the middle of the night, when limp Penn students are delivered to them via stretcher, these paramedics aren’t any freer. Still, they’re taken off the job to, as Jimmy Pisaturo, a veteran of the Emergency Department says, “babysit DPSs”—ER lingo for Drunk Penn Students. Sometimes they go as far as to intubate them in an effort to save their lives.
“They poop, pee, mess themselves up,” Jimmy explains, “then they ask for different clothes. We tell them, ‘Too Bad. You did this to yourself.’”
Outside, a younger paramedic climbs down from his ambulance. No longer on the night shift, he’s resting in between calls. “You wanna be nice to them,” he recalls, “but they’re treating you like shit and puking all over your ambulance.” (Penn's Division of Public Safety declined to provide data on the number of alcohol related transports per year).
His coworker hears and joins in. “Other colleges in the city don’t do this. For every ten calls we get from Penn we get Drexel once. That’s basically all our job has become is a fuckin’ liability mom for society.”
It’s a suitable analogy with a fatal catch: when you leave the hospital, the medics and your blackout far away, you are back in charge.
Key in the door, vomit–stained clothes off, shower scorching: you’re home. Van Pelt won’t feel good, but you’re going—you have to get it done. At a third floor carrel, Sunday afternoon turns into Sunday evening. You’ll write 1,500 words, or maybe just 1,300 until you turn in, take a melatonin and fall asleep, promising you’ll do better in the morning.
Nina Wolpow is a senior studying English from Boston, MA. She is the Editor-in-Chief of 34th Street Magazine.
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