"Lung Painters"

Sick in the ICU, my patient's heart was beating so fast that her heart, stiff from years of untreated high blood pressure, couldn't keep up.  Her kidneys were starting to fail because the heart couldn't get enough blood to them.  Her lungs were struggling mightily both from emphysema and the fluid building up from her heart.  Wanting to comfort her as well as she could, the nurse, entering the room, asked, "Can I get you anything?"  Without a moments hesitation, my patient responded, "Yeah, get me my cigarette."

My patient did not lack for knowledge in regards to the dangers of smoking.  She knew full well that it was the cause of her emphysema and was the main contributer to her high blood pressure.  The addiction is so powerful, it did not matter to her.  I have spent my career educating my patients to the dangers of smoking and encouraging them to quit.  I am the eternal optimist and will never quite trying.  I am pleased to say that a 95 year old patient of mine decided to quit with my prodding.  I understand, though, that the knowledge of the dangers of smoking will only take people so far.  They need a cheerleader.  They need support at home.  Children are some of my best co-conspirators.  If one of my smoking patients comes in with a child, I will look the child in the eye and commit them to be my partner.  I ask them to hide the cigarettes and watch out for Mom or Dad.  My daughter drew the "Lung Painters" picture as a nine year old.  I have it framed and hung in an exam room.  Many patients have looked at its simple message and given the decision to quit another look.  Who wants to have a "gurntee" to have your lungs turned black?

I'll have to say that my biggest ally in helping people quit smoking has been the government.  I can talk till I'm blue in the face or get on my knees and beg (which I'll happily do if it would work!) but I've noticed that the willingness to quit has increased in direct proportion to how much it costs to buy them.  The cigarette tax works.  I can now tell patients, "It is too expensive to smoke anymore, you need to save your money for gas."  Restricting smoking in public places has also helped.  "I might as well quit," I've heard, "I can't smoke anywhere, anyways."

What is the best way to quit smoking?  The best way is whatever works for you.  There are medications that now directly attack nicotine receptors and work well.  I have seen people do well with hypnosis, with electrical current placed on an ear lobe.  Support groups are good.  The nicotine patches and gum work well. The word is not yet out on the "electronic cigarette" but I say if you want to try it-do it.  Almost anything is better than smoking.  Some can just out and out quit on their own.  My own grandfather had a hard time quitting.  He tried over and over again.  He probably felt as did one of my patients who said, "quitting smoking is easy, I do it every week!"  One of those weeks, he was out plowing his potato field on the tractor.  He took his cigarettes, crumpled them up and threw them in the dirt.  By the time he reached the end of the row he started wanting a cigarette.  Turning around he started scanning for his discarded pack.  When he returned to the area where he had thrown down his cigarettes, he jumped down off the tractor and started digging through the dirt.  Something about a grown man on his hands and knees, digging through the dirt was so ridiculous that he started to laugh at himself.  "How pathetic", he said.  From that moment on he let them lie in the dirt, where they belong.