Let’s call her Doris (though that was not her real name). She was as lovely as could be last winter. She had been up on the fifth floor for weeks, but just couldn’t wean herself off less than 8 liters oxygen to go home. She made no excuses; her lifetime of smoking had left her lungs both restricted and obstructed. On rounds, we started to discuss the likelihood of her going to a facility, rather than seeing her new grandbaby, a choice she understandably can’t fathom.
Her situation hit me hard. I’m all too familiar with cigarette smoking. It runs up both sides of my family tree. Lung metastases took my grandfather when I was in high school. They left one of the sweetest women on this Earth, my 82-year-old grandmother, bound to a nebulizer to start and end her days, with innumerable inhalers in between. They were a different generation, bamboozled by the tobacco industry, and the damage was done long ago.
But my dad’s almost 40-year pack history continues to this day and scares me to death. He’s the greatest man I’ve ever known, my biggest supporter, and smoking is his only vice. He’s had a stressful job and has tried to quit multiple times, so I can’t be angry. But I’m afraid now that I know too much. I’m the only person in my family in medicine, and I know entirely too well the havoc cigarettes wreak.
With the risks ever heavy in my mind, I oscillate between optimism and pessimism as I wait to see what time and biology will dictate. I harass my dad and my grandmother to get regular screening imaging and aerobic exercise, but in the end I’m powerless. I cross my fingers that they won’t be another statistic, as I turn my efforts to youth prevention. And I loathe the sound of a lighter.
Greenville, South Carolina