This is the prelude on this chapter as found in the Big Book Study guide.

This “Doctor’s Opinion” was written by William D. Silkworth, M.D. To many recovered alcoholics, this section of the Big Book is considered to be the most important as it describes alcoholism inin terms that make sense to the real alcoholic. From the description, the alcoholic learns the exact nature of the disease of alcoholism and how hopeless this condition of mind and body seems to be. We are told why we are unable to control the amount we drink once we hae taken the first few drinks. But more important, we are told why it is that we cannont manage our decision to not take the first drink once we hae made a firm decision, pledge, vow, promise, etc. to never drink again.

He also expresses his beliefe, based on his obserations, in the effectiveness of the Program of Alcoholics Anonymous as a method of assuring the essential entire psychic change which he believed to be the only solution for the seemingly hopeless state of mind and body.

Dr. Silkworth was trained in Neurology and lost his practice as the result of the stock market “crash” of 1929. He met Charlie Townes who was in search of the physician to direct his hospital, Townes Hospital, which specialized in the treatment of alcoholics and drug addicts. Dr. Silkworth accepted the position for a stipend of $40.00 a week. His plans were to re-enter priate practice when he could afford to do so, but the time neer came. He deoted his entire career to a practice of helping alcoholics. Many thousands of alcoholics were directed to Alcoholics Anonymous because of his faith in our way of life.

Without Dr. Silkworth’s opinion of alcoholism, Alcoholics Anonymous would not hae happened. It is only when we clearly understand a problem that we may be able to find a solution. Bill W. understood the hopelessness of his alcoholism from Dr. Silkworth’s opinion. Dr. Bob understood the hopelessness of his alcoholism after Bill W. explained Dr. Silkworth’s opinion to him.

If an alcoholic really wants to stop drinking for good and all, he must fully concede to his innermost self that he has a hopeless condition of mind, body and spirit. This is the first step in recoery and the “Doctor’s Opinion” gives us the knowledge necessary to surrender to that truth.

ery simply, from this section of the Big Book, we learn why it is that the real alcoholic has a body that can neer get enough alcohol and a mind that will not let the alcoholic leave it alone.