No Deeper Commitment to a Patient
Few conditions demand more of patients and their physicans than the journey, the odyssey, to becoming a former smoker.
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August 2021
Command Performance
The reasons not to go to Mary’s wedding seemed overwhelming.
She was neither a family member nor even a close friend: She had, in fact, been my psychotherapy patient several years back. The very notion of attending her wedding raised the issue of professional boundaries: Wasn’t it inappropriate for me to see a patient outside of the office setting?
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Addiction
Hello. My name is Sharon and I am an addict. My drug was tobacco. Exposed early, by smoking parents, I tried tobacco in high school and was quickly dependent. It calmed me. It gave me something to do with my hands. I smoked out my window at home and, when I could, other places. I was not alone. This was 1964.
Smoking Is Glamorous
In the mid-1970s, as a preschooler, I used to stare at a poster in the waiting room of my pediatrician’s office. This poster depicted a disorderly person, dark hair unshorn, snarling and puffing on a cigarette. The poster’s caption: Smoking Is Very Glamorous.
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The Wizard and I
He’s wearing a Yankees T-shirt, an EpiPen holstered to his belt like a lightsaber. We’re old friends. Trevor has been my patient for four years—more than half his life.
This will be our last visit: After forty years, I’m retiring.
Echoes of a “Yes”
Several months ago, I was in an appointment with “Richard.” Richard was a 45-year-old Italian-American construction worker, a father of three (four if you counted Gerald, his family’s new labradoodle puppy—which I did), and a devoted husband to his wife, Sherri, his high-school sweetheart. Unfortunately, none of these descriptors explained why he and I were in the same exam room. That was because I am a medical oncology scribe. I write notes for an oncologist. Richard was our patient: a former smoker receiving treatment for Stage IV lung cancer.
Who Am I?
“I’ll see you soon, Dadai,” I enunciated for the third time on the video chat.
He still can’t hear me.
Before I could repeat myself, tears swelled up in my grandfather’s cavernous eyes as he peered at me through the tiny screen. The screen that was somehow meant to bridge the immense distance between myself and my grandpa in Kolkata, India. I sighed, my heart wrenching at the sight.
The Doctor Said It Was Okay
When I was a third-year medical student in 1972, the young attending physician on my cardiology rotation said smoking was okay. Actually, he said that he had wanted to do something to manage the stress of his work and had looked carefully into the options that were available at that time. He told us that smoking a pipe seemed like the safest option, so that is what he did.
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Sisters
I was looking forward to seeing her in my clinic that morning. Marsela was a 60-something-year-old Albanian grandmother whom I had been following for her chronic anemia. At first, the visit went as I expected. Her bloodcounts were stable, and she had no new symptoms.
Frustrated Smoker
Buzzzzz! I looked up from charting temperatures and checked the call board. It was Mr. Anderson again. Geez, I thought, this is the fourth time he’s rung his bell, and it’s only 4:20! We have a long way to go till it’s 11:00.
When I walked into his room, he was sitting straight up in bed with his legs on top of the covers. His face was drawn up in a tight scowl.
“What can I do for you, Mr. Anderson?” I asked.