Disturbing new research reveals that one in six doctors has been hooked on alcohol or drugs. How has this happened - and what are the implications?
The patients were waiting dutifully. But their young female doctor seemed reluctant to attend to their ailments at morning surgery. As the minutes ticked by, her door remained firmly shut.
The reason for her absence soon became apparent. When staff finally went to investigate, Emily Heinzman was found slumped unconscious over her desk at Oulton Medical Centre, near Leeds. The room reeked of alcohol; the dishevelled doctor was snoring loudly and oblivious to the world.
Clearly, Heinzman had not been taking her medicine properly. For this bright, intelligent 31-year-old usually tried to ensure she wouldn't suffer any ill-effects from the previous night's drinking - by taking a cocktail of drugs.
Using all the pharmaceutical skills she had learned during an expensive university education, Heinzman would mix herself 'magic elixirs' to deal with the raging headaches and trembling hands that always followed when she had too much to drink - an occurrence which, as the years went by, had become a nightly event.
At her upmarket docklands apartment in Leeds, she kept thousands of tablets in dozens of bottles. There was codeine, temazepam, diazepam and co-codamol - all highly addictive substances that are often used as a temporary treatment for drug addicts.
And there was another problem: the drugs had been stolen. Heinzman had obtained them by writing fake prescriptions for non-existent patients.
Although she claimed she drank and took drugs to ease the pain of a break-up, Heinzman also liked getting high - and she was in the perfect position to exploit a never- ending supply of pharmaceuticals.
But prescription drugs weren't her only addictions. She was also a heavy cocaine user. And she was handing out stolen drugs to her friends and holding late-night parties at her flat in Leeds,where drink and narcotics flowed.
Indeed, when the law finally caught up with her, cocaine - along with countless other substances - was found to be coursing through her veins.
Finally arrested and brought to court last year, it transpired that she'd been living this secret lifestyle for several years, treating patients at the same time as she was bingeing on drugs and alcohol.
Heinzman was given an eight-month jail term - suspended for 18 months - and ordered to carry out 100 hours' Community Service after she admitted 16 charges of fraud relating to her fake prescriptions. Not surprisingly, she also feared losing her job.
But this month, three years after her drug-taking spiralled out of control, Heinzman was cleared to resume her medical career after serving a 12-month suspension imposed by the General Medical Council hearing into her potentially life-threatening behaviour.
Before she was cleared to return to work - on condition she remained 'clean' - Peter Atherton, a lawyer for the General Medical Council, outlined the full scale of her abuse of the system, revealing that she had used a number of cunning schemes to ensure her supply of drugs.
'She used many different names, and multiple addresses for the same patient,' he said. 'Prescriptions have been presented in many different large pharmacies, where staff were less likely to remember her. The efforts and preparation appear to have been a way of covering her tracks.'
But, in truth, the only really surprising thing about this sordid tale of abuse is how commonplace it has become in the medical profession.
According to shocking new figures, up to one in six doctors will have been addicted to drink or drugs - or both - at some stage in their medical career, raising the horrifying prospect that these highly-paid carers may have your life in their trembling hands.
And that's not all. Surveys of hospital trusts also found that a third of male junior doctors and almost one in five of their female peers have used cannabis, ecstasy, cocaine and other hallucinogenic drugs.
'The problems will become more acute in future, as drug and alcohol dependency is becoming more common in the population as a whole,' say the authors of Invisible Patients, a government-funded study into the scale of the crisis.
'It may be easy to spot a health professional who is obviously under the influence of drugs or alcohol, but persistent and long-term substance misuse can be harder to pick up and the consequences for quality and safety of care harder to predict.
'Working while under the influence of drugs or alcohol increases the chances that healthcare workers will make mistakes and communicate poorly with colleagues and patients,' say the authors, revealing that more than 15,000 British doctors suffer from drink and drug addictions.
In other words, while medical staff are dealing with the growing carnage caused by drunks in chaotic Accident and Emergency wards, these same professionals are themselves increasingly intoxicated.
That was certainly the case for Dr Michael Wilks, a general practitioner who was downing a bottle of whisky a day between examining patients.
'I was in a bit of a mess after several years of denial about the scale of the problem,' he told me. 'I thought I could handle it because I was a doctor. I don't think I was a good doctor, but I don't think I was a dangerous doctor.
'I was certainly deeply unhappy. I finally realised I couldn't go on drinking, but I also knew that I couldn't stop. I approached a patient I'd helped with an alcohol problem 15 years earlier and asked him for help. He told me what he'd done to get sober and for the first time in my life I listened.'
Now sober for 20 years and deputy chairman of the Sick Doctors Trust, a charity established to help medics addicted to booze and drugs, Dr Wilks says the medical profession is in deep denial about the scale of its alcohol problem.
'Doctors are taught to be decisive and they are treated with respect,' he says. 'So to ask for help, you have to climb down off your pedestal and admit you have a problem. Doctors don't want to reach out for that help - because they don't understand that a real alcoholic cannot help themselves.'
Such is the stigma among alcoholic doctors that few are willing to be named. But many interviewed by the Mail, on conditions of anonymity, revealed harrowing details of how their drink-sodden lives as medical students did not stop when they became full-time professional medics.
Incredibly, doctors told me how they hook themselves up to saline drips before going to bed to combat the effects of alcohol, and how they and their friends self-prescribe drugs to ease their symptoms. One even said his recollections of carrying out medical procedures after drinking were 'vague'.
The most striking example of this growing scourge emerged last year when it was revealed that one doctor drank three bottles of vodka a day, and was often so drunk on duty that he didn't know his own name, let alone how to carry out correct medical procedures.
Dr Ramasankerpersad Jairam, who worked at Coventry's Walsgrave Hospital, left his hospital accommodation in such a squalid state that the bedding and curtains had to be burned and the carpets steam cleaned.
For more than a year, other staff covered up his drink problem, with hospital security helping him to bed most nights. He was even seen propped up against a hospital wall, clearly drunk.
Concerned colleagues took a blood sample from Dr Jairam when he fell unconscious. Fearing he may die of acute alcohol poisoning, it transpired he was almost five times over the drink- drive limit when dealing with patients.
Disturbingly, however, a General Medical Council disciplinary inquiry heard from fellow medical specialists that there was no evidence that his drinking had caused 'any direct harm' to patients.
In fact, as well as the obvious risk posed to patients, this superior attitude to drink and drug abuse is also killing doctors. Studies have shown they are three times more likely to die as a result of alcoholrelated cirrhosis of the liver.
But many are in denial, believing the normal rules don't apply to them. Indeed, surveys have shown that even school pupils know more about safe drinking levels than medical students.
This is a problem for doctors - but it also has profound implications for patients. One doctor, who asked to remain anonymous, revealed that he drank himself senseless at least four nights a week - with what he called 'definite health implications' for himself and his patients when he was on duty.
Describing the medical profession as 'hypocritical' in its attitudes to alcohol, the doctor added: 'This dependence on alcohol for social interaction and relaxation should be worrying to all medical students and perhaps we should strive to live by example.'
Yet, astonishingly, there are no country-wide rules preventing doctors from drinking. Nor is there a policy of random blood tests for drink and drugs - something that many other professions, including bus and train drivers, must submit to.
Indeed, there are huge disparities between the policies of individual NHS trusts - some doctors are even allowed to drink while on call.
Yet some doctors insist the scale of the problem is exaggerated.
Prizzi Zarsadias, a trainee doctor and editor of the British Medical Journal's magazine for students, said: 'I've heard of people using saline drips to rehydrate themselves while they sleep off the drink - but as far as I'm concerned, it's an urban myth.'
She also dismissed suggestions that, as doctors, she and her colleagues believe they are impervious to the problems faced by 'ordinary' people.
'It's got nothing to do with feeling superior,' she said. 'My view is that it's down to the long hours that doctors have to put in - the sheer volume of work. They just use their free time to the max.
'The types of people who become doctors are often extrovert and when they celebrate, they really go for it. We know what's on the line if we fail - there' s a lot of stress and that makes certain people drink more as a release.'
Yet many older doctors scoff at the 'stress' argument, pointing out that doctors' hours have never been shorter and the rewards greater.
But as alcohol claims 40,000 lives a year in the UK, doctors are falling prey to Britain's binge- drinking culture.
Hannah Barton, a first-year medical student at Barts and The London School of Medicine, blames student unions offering cut-price drinks and tequila shots for £1 a pop.
'I remember being told when I began my degree that gone were the days when I could take the chance of getting on a bus or train without paying; these were the sorts of seemingly innocuous transgressions that would damage my reputation and possibly my future career.
'But excessive drinking is still promoted. We are all aware of the health risks and downsides of excessive drinking - not least the morning after - but for many of us, it is part of our student social life.
'Undoubtedly, alcohol will continue to be one of the most important public health problems of our time. But that won't stop many people, including me, from going down the pub tonight.'
But with so many doctors drinking themselves silly, while being charged with advising others against alcohol abuse, it seems that in alcohol-soaked Britain, it's now very much a case of the blind leading the blind.