None for the Road?

Automobiles kill 37,000 Americans every year, and until now, cutting this rate has been largely left to the law. Now doctors are beginning to take responsibility for preventing auto deaths. Reason: excessive drinking is a cause of an estimated 50% of car fatalities, and the use and abuse of alcohol are in medicine's province. Last week in Pittsburgh, the U.S. Public Health Service convened a national conference on traffic safety focused solely on the part played by alcohol.

A clear distinction, said California's Dr. Ira H. Cisin at Pittsburgh, must be made among three types of drinking drivers. Two of them are obviously serious medical problems: the alcoholic driver, whose problem is primarily alcoholism, and the psychopathic drunken driver, whose problem is his character defect. Dr. Cisin lands hard on the third type, who is a more subtle medical problem: the "normal drinker" who is a "normal driver" when sober, but sometimes does his driving too soon after drinking. Most drunken drivers, when arrested, are heading away from a bar or a party to their homes--or to another party.

To Dr. Cisin, the party is the villain: "The proper guest cooperates in making it easy for the host to play his defined role of pressing drinks upon the guests. The correct host stages a kind of alcoholic potlatch, making sure that everyone has a glass and that no glass is permitted to remain empty . . . Thus, from the parties and from the bars, pour the drunken drivers." They are driven by psychological forces as potent as their car engines, and even more difficult to control. Said Dr. Cisin: "We ought to know by now that a campaign built around a 'don't' slogan is doomed to failure."

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