If her fight were against breast cancer, then her son's well-being wouldn't seem like such a good excuse.

But the woman I met recently when I was in Boston for a speech isn't battling cancer. No, her adversary is the hideous illness called alcoholism. And she isn't ready to allow the desperation of her situation to stop her from being a mother, even though her drinking already is widening the gulf between her desire and her son's needs.

"I was a fully functioning alcoholic for many years, even after watching both of my parents die from this disease," she told me. "Then I adopted my beautiful son, and I truly went over the edge with the pressure I felt to be a better mother than the mother I had. I can stop drinking for short periods, but that insatiable craving returns, and I can't stop myself for a glass of wine before I put my son to bed, a bottle of wine when he's asleep. I know I can't do this alone. But neither can I imagine leaving my son while I go off and get help."

She asked that I not use her name at all because her first name is unusual, and people certainly would know who she is. That could embarrass her and perhaps even jeopardize custody of her son, age 5.

I understand her sentiment. Shame is a potent higher power in the sick minds of alcoholics who know they are in trouble but fear asking for help. Stigma is a harsh judge of those who do ask for help by admitting their addictions to alcohol or other drugs. So too many people like her fear what will happen if they do seek help. Instead, they try to overcome their illnesses by themselves, often with disastrous results.

That night, I asked her what she would do if her illness were breast cancer. She mulled it over for a moment, trying to find the words to justify her perspective. "I know what you're hinting at," she replied. It was easy for me to know how to finish her thought: "You'd get help in a flash, even if that meant leaving your son in the care of somebody else for a while."

She protested that she had no family, no trusted friends, nobody to leave her son with while she helped herself. "But you would find someone if you had cancer," I responded, and her only answer was a sad nod. This truth hurt.

Unfairly, addicted women with children often face the added hurdle of how to let go of their motherly obligations in order to get help. However, there are residential programs that allow mothers to bring their kids to treatment with them, such as New Directions for Women (www.NewDirectionsForWomen.org) and Seabrook House (www.SeabrookHouse.org). Many outpatient programs also give women the flexibility to receive treatment while the kids are at school during the day or at night, when a father or another family member or caregiver can do double duty.

But too often, women use the "excuse" of motherhood in the same way that men cite their professions and students use their scholarly pursuits to avoid the reality that help is not only available but also imperative. In truth, the mind of an addict or alcoholic is hardly a birthplace for sound reasoning or a pillar of the call to duty, for if an addict does not get help, addiction always crushes conviction, obligation and desire.

A few days after I met her, the woman sent me an e-mail: "I feel pretty fragile right now — been talking to God a lot (I think he would like to have a mute button for me) and have managed not to drink since I heard you the other night. I know it's only four days, but today I was on the edge. And I don't think it will ease up much with the silly season upon us. I also have the anniversaries of my parents' deaths. (The only thing they did without a lawyer involved was to die a year apart.) Both died of alcoholism. I don't want to continue the cycle and orphan my son again."

Sadly, that cycle still looms.

William C. Moyers is the vice president of external affairs for the Hazelden Foundation and the author of "Broken," a best-selling memoir. The paperback edition was released in August 2007. Please send your questions to William Moyers at [email protected]. To find out more about William Moyers and read his past columns, visit the Creators Syndicate Web page at www.creators.com.