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.

But it turned out there was something seriously troubling her. About a month before, her younger sister (by about 15 years) had died suddenly back home in Albania. She’d had a sudden heart attack, and that was it. Marsela and her sister were very close, despite the age difference, and Marsela was crushed. She had actually increased her smoking over the past month, and I was at a loss for words. How could I suggest she cut back on her smoking when such a terrible thing happened, and smoking was her way of coping?

But I truly felt that somehow that was my task for the visit. After listening to Marsela talk about her grief and expressing my interest in her relationship with her sister, I tried to direct that relationship into the issue of smoking. I told Marsela that just as she cared so much for her sister, I imagined that her sister had cared just as much for her. If she could direct her grieving energy into the effort of quitting smoking, that would be the best way to showcase the importance of their relationship.

After the visit and before seeing the next patient, I called Marsela’s daughter and repeated the details of the encounter. Her daughter echoed my worries and said she had been trying for years to get her mother to quit, even taking her for hypnosis. We both hoped that something would change.

The following week, I was called over in the waiting room by Alexandra, a 40-something-year-old patient of mine, also from Albania. She showed me her phone, and I could see that FaceTime was on. I didn’t recognize the young woman on the other end of the call, but soon Marsela came into view! The young woman on Alexandra’s phone was Marsela’s daughter, and Alexandra explained that Marsela was her aunt. Marsela’s daughter came back on and said her mother had cut back on her smoking! Marsela then came back into view on Alexandra’s phone—with a big smile on her face.

Ashrei Bayewitz
Teaneck, New Jersey


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