As she has made painfully clear, moderation did not serve Kishline so well. Last March, at the tail end of a binge-drinking episode, Kishline, who is a housewife and mother, got into her pickup truck, headed the wrong way down an interstate freeway in central Washington and smashed head-on into a car, killing a 38-year-old electrician named Danny Davis and his daughter, LaSchell, who had just celebrated her 12th birthday. According to prosecutors, her blood-alcohol level was three times the legal limit. When she woke up in a hospital trauma unit, Kishline said, she could barely remember getting into the truck.

The moral here is fairly clear: Moderation for alcoholics is a very dicey idea, and Kishline will no doubt go down in history as the best evidence against her own theory, the woman who single-handedly, spectacularly, caused it to crash and burn. The line between problem drinking and full-fledged alcoholism may be blurry and difficult to discern -- certainly it's difficult for the drinker to accept -- but once you've passed a certain point in your abuse, moderation simply ceases to be an option, a fact Kishline's critics have long understood. The very concept of moderation is oxymoronic in the world of alcoholism, and in abstinence-based circles like AA, her approach seemed not only deluded but dangerous, a form of codified denial that offered little more than false hope.

The hope, of course, is powerful: Most of us -- alcoholic and non-alcoholic -- want moderation to work. We want there to be an alternative to complete abstinence, which sounds like such a desert of self-abegnation and deprivation. This prospect -- no drinking, no alcohol-laced relief, never again -- ultimately turns out to be the great benefit of recovery, the gateway to the rediscovered self, but it's terrifying when you're still clinging to booze, and it's what keeps so many of us grasping for other options, desperate to believe that "normal" drinking is a possibility.

I don't know one recovering alcoholic who didn't struggle to control his or her drinking, who didn't make rules and then break them, who didn't set limits and make promises and deploy strategies to cut back, anything to avoid doing what the true alcoholic is so thoroughly loath to do: learn to live without alcohol. In the years before I quit, I tried drinking only after 8 p.m., I tried limiting myself to two glasses a night (which invariably turned into two glasses the size of buckets), I tried swearing off hard liquor and sticking to wine. The trials rarely lasted for more than a few days and they never worked; the nagging doubt -- "I cannot do this, I have a real problem" -- festered and grew. This is what makes Kishline's story so classic: Alcoholics are by definition failures of moderation, walking case studies in its impossibility.

Five years ago, Kishline's movement began to gain a certain amount of cachet, with full-spread coverage in Self magazine, Newsweek and the New York Times. (Self headlined it a "radical new approach" to alcohol treatment.) I was just about a year sober at the time, and still stunned by the vastness of what it meant to live without liquor, and I wrote a not-very-eloquent column about the movement, calling it, among other things, "moronic" and "bullshit." Today, far from feeling smug or vindicated by Kishline's very public fall, I feel humbled, and sobered, very much the way I feel when someone stumbles into an AA meeting after a relapse. This is a hideous story, one whose horror will only be compounded if we fail to learn from it.

And it has plenty to teach. There are obvious lessons about the dangers of moderation as an approach -- and they're important, timely ones, particularly in the age of medical cost containment, when insurers and healthcare providers are desperate to find quick and measurable fixes for complex and elusive problems. (In a bizarre twist of timing, just days after Kishline's guilty plea, a feud erupted at New York's prestigious Smithers Addiction Treatment and Research Center, when the director decided to steer the clinic toward a moderation-based approach.)

But there are also lessons in Kishline's story about the profound complexity of alcoholism, and the insidiousness of its grip, and the enormous challenges of treatment. Few of us can know what Kishline's past few years have been like, although we can certainly speculate about the horrors. Apparently, she'd given up the moderate approach prior to her drinking spree, and had tried unsuccessfully to stay sober through AA. Following her guilty plea, she went public about that, reversing her stance on the movement she helped found and stating through her lawyer that Moderation Management involves a lot of "alcoholics covering up their problem." She also talked, again through her lawyer, about the shame and humiliation of relapse, and about her profound remorse at causing the deaths of two innocent people.

You don't have to read too carefully between the lines to see how deeply and tragically alcoholic this narrative is. It's all there: the desperate struggle to find a way to hold onto alcohol, the failure first of moderation and then of denial, the horror -- and horrific consequences -- of relapse. Kishline will be sentenced on Aug. 11. Prosecutors are seeking a four-and-a-half-year term, although the maximum penalty is life. Judging her, of course, is the easy part. Learning from her is far harder, but the instruction is vital.

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