Ricochet is the best place on the internet to discuss the issues of the day, either through commenting on posts or writing your own for our active and dynamic community in a fully moderated environment. In addition, the Ricochet Audio Network offers over 50 original podcasts with new episodes released every day.
In Lieu of Flowers, Please Stop Smoking
I learned something interesting earlier this month. If you want to donate your body to medical research, there’s usually a minimum weight requirement. If you’re an adult, you need to weigh at least a hundred pounds. If you’re too emaciated, for example, from a long illness, they won’t take you.
I discovered this because I spent the latter half of January helping to take care of a terminal cancer patient. One day she could walk down the stairs. The next day she needed help. The day after that, she lost all feeling below the waist.
At that point, there’s no point in doing scans to figure out what’s wrong. Everyone involved understood that the end was fast approaching. The cancer had either spread to her spine or her brain. Either way, it wouldn’t be long, so a call was made to hospice.
That’s where I come into the story. By the time I arrived, the patient already had a hospital bed. After eight months of cancer treatment, she had no hair left. The last time she’d been weighed, she was down to 94 pounds.
It took two weeks, but she finally passed, early one morning. At that point, there was no pain. I was administering generous doses of liquid morphine using an oral syringe, the kind without a needle that you use to administer meds to a child.
She was unresponsive by then, and we had called the hospice on-call nurse to see if there was anything else we could do. Other than tell me to stop suctioning when she’d start foaming at the mouth, and ordering more morphine to make sure we didn’t run out, there wasn’t anything more to be done.
I’d read about it, of course, but I’d never seen the process of death before. I’d never seen what happens when a person’s kidneys shut down. I’d never seen someone’s color change. I’d never seen someone start foaming at the mouth because her lungs were filling with fluid. I never realized, until it was gone, how much flesh a woman has on her skull, including at the temples. And I’d never seen someone draw her last breath.
As some of you reading this already know, the cancer patient I’m talking about is my mother.
Look, I’m the last person to tell someone how to live his life. If you want to shoot heroin into your eyelids before you attend the weekly orgy at your lesbian coven, I really don’t care. But what happened to my mother was not an accident. It was not random. It was not fate. It was not chance. My mother chain smoked for 45 years. She kept smoking even after being diagnosed with small cell carcinoma. She was literally chain smoking on her deathbed. The only thing that made her quit was the oxygen tubes she had up her nose to allow her to continue breathing.
We were lucky with my mother. They found her lung cancer early enough that we were all able to get in a full cycle of holidays together: Mother’s Day, her birthday, Thanksgiving, Christmas. Contrast that with Walt Disney, who died of lung cancer six weeks after it was revealed on an x-ray.
If you’re a smoker, I realize quitting is a difficult thing. But it’s going to catch up with you. Think about how your children will have to watch you die. Think about your son having to suction the foam out of your mouth as you drown in your own lungs.
Think about the future and think about the waste of life. My mother wasn’t old. She was 62 when she died. It doesn’t need to be that way. You have a choice in the matter.
This post was originally published on Feb. 15, 2016.
Published in General, Healthcare
Friends, I realize some of you want to express condolences to me. (And many of you already have.) While I appreciate it, that’s not the point of this piece. (In fact, I’d prefer you not express condolences in the comments here.) Instead, please either take the message to heart if you’re a smoker, or share it with someone who it might help.
That will mean far more to me than any words of condolence.
Smoked Camel unfiltered for 55 years and stopped cold turkey. Been off them 2 years three months and 12 days. Miss them frequently. They provided a quiet time to stop, regroup and think. Could start again in a heartbeat just like a drunk. Nasty habit and very expensive in Texas at 72 dollars a carton. Glad to be free. Can taste food again, sinuses cleared up. Lots more pluses than minuses.
Thank you for sharing this story. I hope it helps some people to make the right decision.
This was great, Fred. Thanks for sharing. My grandfather died 25 years ago from smoking as well. It was a long, drawn out death with a COPD diagnosis and portable O2 before progressing to lung cancer. He was a wonderful man, and it’s sad that I never really got to know him (I was 7 when he died).
It is quite a thing to see your mother die. I know.
Thanks for the lesson, Fred.
Sounds like the theoreticals of libertarianism ran right smack into the realities of conservatism.
Well, I care. Fred, you are railing against second-party destruction of the self, in part based on its harmful effects upon third parties (the children!) And who is to say that such a son (as in your theoretical example) might not be better off, in a strictly libertarian way, with a callus parent gone? Well. Better not to think of that.
I like the idea that a society without drugs is objectively better than one with, and that as a society we have the ability to outlaw some things based on the larger effects. Not all rights are absolute; not all are even on the same footing. We already have a negotiated settlement with the line drawn at alcohol and tobacco, and halfway across marijuana. Now which way would a competent society move that line? Can any still argue that smoking etc is of no impact to society? “My life, my body” uber alles?
My heart goes out to you, and I know your pain, or a version of it. The reason I bring this up now is not to be argumentative, but to capitalize on a teachable moment. Is this not your intent?
Dear Mr. Cole,
Upon reading the headline of your piece I was just about to jump on my soapbox about nanny-staters inserting themselves where uninvited, until I read further, and realized it was the plea of man who has just lost his mother. It also stated that this was not the space for condolences, yet I feel obliged to do so anyways. My own mother is not long for this world as we speak and the sorrow you must feel is creeping upon me with each passing day, it is truly a burden, though seen aforehand, I cannot fathom how to be borne.
Really, truly, my heart goes out to you and may she rest in peace. As I am typing this I am tearing up in anticipation of what is to come.
That said, I am reminded of a quarrel I have often had with those that preach a “healthy life-style” for the sake of longevity. To deprive oneself now, so that one can deprive oneself longer. To be honest about it, I fail to see the merit of this argument. To be fair, I have to recognize that this is being said from the vantage point of a past life-style of derring-doo & utter recklessness. I have cheated death so often that you would think I would be a habitual lottery player, funny thing that, when it comes to money, my conservative colors show.
My only bone to pick here is the age old question, quality of life or, quantity?
Would one rather live a vegan/low salt/gluten free/non-alcoholic/sans nicotine life in a padded cell so as to not hurt oneself and live to the ripe old age of one hundred and whatever? Which brings to mind Winston’s warning of whom never to trust, or to live ones life in full whilst one can, because it’s duration is never certain.
I myself have been a pretty much pack a day smoker since the age of 9 when we lived in Cartagena Columbia. If there were laws against such a thing at the time I was to young to be aware of it, and enforcement was non-existent as with much else in third world countries.
To be sure, the affect upon my health is most definitely noticeable, I most certainly can never match running a mile in under 7 minutes as was the case when I served and my professional wardrobe consisted entirely of camouflage and dress greens. Nonetheless, as a 50y.o. construction foreman I regularly have to let go millennial eco-health-weenies who can’t keep pace, go figure.
This is not to say that your warnings Mr. Cole should go unheeded but, should be taken with a grain of salt.
One note I should add, and I unashamedly put forth a gratis plug, having switched to organic completely chemical free American Spirits has made a tremendous difference.
And again, Mr. Cole, my condolences.
I myself quit smoking for the last time several years ago. I had been back and forth several times before that, and oddly enough, one of the times I broad-jumped right off the wagon was when my own father was on his deathbed.
I will always be grateful to the nurses at St Mary’s in Evansville, Indiana, who made the process a human endeavor for family, rather than a struggle against the system.
Technical note: Because my father was on a LOT of oxygen at the time, this provided an opportunity to finesse the timeline of what was obviously underway. After a family meeting, the nurses took him off oxygen at midnight, and right when they said, he went through a process at about six in the morning, including a period of lucidity followed by an agitated state, and finally a settling calm.
Fred, I am sure that you have been a pillar strength for your family in real-time, as well as now that the new normal must somehow settle into place.
Good article Fred. I hope you are at peace now and we get a few more occasionally.
That is a great opening line. Fred has been accused of many things at Ricochet, but nanny-stater – not so much.
Thanks for posting Fred. I consider myself lucky I was never particularly tempted in my teenage years, and therefor never had the extraordinarily difficult task of quitting a lifetime habit. I will forward this piece to two friends in particular.
Got a son who smokes. A young man finishing up his tour in the Army. Rebellious, guitar playing when teen, but drawn to macho life of Army and guns, and a bit ‘edgy’ about something emotionally (otherwise a really swell person), so … smoking. His grandfather had COPD and the big E, his parents disapprove, but, well you know the way these things work… Life goes on.
Maybe quality of life wins out over quantity to some degree. Here’s hoping.
Having been bedside at the death of four loved ones over the years I know painfully well what you’ve experienced, Fred.
Peace to all.
Fred,
I wholeheartedly support your plea to stop smoking. Sitting at the bedside of someone you love who is dying is taxing. Not that I haven’t been glad I did it, but it is draining.
If I might be so bold as to hop on my soapbox and take this in a slightly tangential direction.
Here’s the problem, the call for palliative care should have been made either at the time of diagnosis or when her symptom burden from the disease or chemo began interfering with her ability to do the tasks that were important to her. Lung cancer has a terribly high level of unpleasant symptoms, and while I am glad that hospice was there for you, there were clinicians available to walk alongside your mom and you far earlier in the process.
If you receive a serious diagnosis, please ask your treatment team for a palliative care consult. It doesn’t preclude you from receiving treatment and it can make a difficult thing somewhat less difficult.
PM me if you ever have questions.
Thanks for letting me do this Fred.
It is indeed.
I was holding myself to three packs a day, five sometimes on the weekends in 1982. My father had died of COPD in 1974 and I could see my future. I had tried quitting many times. This sounds crazy but I flipped my mind from trying to quit to not starting again. I just refused to pick up another cigarette. It wasn’t easy. I chewed gum, sucked on stirrers, life savers. I also pumped up my running. I trained for a marathon in 1984 and 85. I am absolutely positive that I would not be writing this if I had continued to smoke. Believe me if I can quit anyone can. Remember you are not quitting you are not starting. It’s a new life.
I helped hospice an aged relative who’d been a lifelong smoker. She hadn’t been a chain-smoker – her habit was more moderate than that – but it was not something she was willing to give up, especially to prolong her life.
The truth is, once she became a widow, her reason to live a long time disappeared. Sure, she had grown kids and a few grandkids, but she just wasn’t into growing old, especially without her husband. She had her bourbon and smokes, and wasn’t about to stop when informed they would soon kill her.
After a hospitalization or two, she was ready to call it quits, and opted for home-hospice. She had been avoiding regular medical care for years, despite having conditions that called for it. The hospice nurses did their best to try to persuade her to use nasal oxygen, but she hated the tubes so much that she just couldn’t keep them on, even with tape. Besides, she knew oxygen and smoking didn’t mix, and for her, choosing between a life-prolonging discomfort and a life-shortening comfort was easy.
That she had been avoiding medical care for a long time, rather than fighting strenuously against cancer without giving up its likely cause, undoubtedly made her choices less agonizing on us: we weren’t exactly getting mixed signals on whether she wanted to live or die.
Thank you.
My 77 year old mom has smoked non filter cigarettes since she was 14. While she is cancer free she has COPD and has atherosclerosis in her gut that has turned in her into a 85 lb. skeleton. I am sorry to say that I will eventually belong to your club. My mother worked like a dog her whole life, married to an abusive man with an abusive family. While I’d love to boss her around she had a lifetime of that. And I am her kid, after all. What does a 47 year old know that she doesn’t? Sigh.
For anyone interested, I replied to these specific comments here:
http://ricochet.com/on-conservatives-libertarians-tobacco-use/
There is a world of difference between one man making a case in the public sphere and using government for force his desires into existence. But you knew that.
There are so many comorbidities brought on by smoking, never mind the cancer. Caring for patients in the past year has made me really, really hate what smoking does to people. That along with drugs (including the legal kind), inactivity, overeating and alcohol. The anguish people end up being in and the anguish family members go through just cannot be worth that momentary high or decrease in anxiety. Please, please, please consider healthy ways to decrease stress and find enjoyment. Your body is a gift and can be such a tool for blessing people. Then again, if y’all didn’t get sick, I wouldn’t have anything fun to do…
Indeed. I lost two aunts to smoking last summer, within 3 weeks of each other.
The first was my mother’s sister. By the time she was diagnosed, she was already in the hospital with a collapsed lung from what was thought to be pneumonia – she lasted a week beyond that mis-diagnosis. She was a lifelong smoker, but never a heavy smoker, and cancer got her anyway. Age of 69, and she had retired at last only 1 month prior. Same age as my father is, who finally quit smoking 3 years prior (with the help of e-cigs).
My other aunt, by contrast, continued smoking right up until emphysema put her in the hospital for the last time. She had been on oxygen for 10 years, and still wouldn’t quit (fire hazard anyone?). Somehow she made it to 89.
Cigarettes are playing Russian Roulette with your lungs. Not every smoker gets lung cancer, I know. But many do. My best friend’s mother still (age 64 and in terrible health) refuses to quit, even as her smoking is hurting her in so many other ways.
Thanks Fred, I lost my older sister to lung cancer on December 7th of last year. She too smoked. While the rest of the world will think of the 7th as Pearl Harbor day I’ll think of it as the day that I lost someone very special to me. She was 14 when I was born so by the time I got to elementary school she was a grown woman out on her own. She became my second mother. Someone who was young enough to participate in the silliness of a small boy and old enough to provide gentle wisdom to a young mind. She passed away much as your mother did.
I’m sorry for your loss and understand your message: Stop smoking. Let the example of others, both positive and negative, be your guide.
((((Fred)))) :'(
Goodness, Fred! Your mother was so young! (I say this because I am only 2-3 years younger than her. I am sorry you lost her so early.
My 38-yr-old daughter smokes and I am concerned about that, but she is an alcoholic in recovery and is also dealing with bipolar disorder (and doing very well I am happy to say). I figure that it’s helpful for recovering alcoholics to have a smoke. I hope that in the future my daughter will be able to do without that as well.
I know you don’t want condolences, Fred, but you have mine anyway. I quit some thirty years ago and a few years later convinced my wife to. I think both sons have quit and that leaves one nephew to convince. Blessings and may 2017 be a better year for you and your family.
Ned
My husband was a smoker when we married. But when our first child was a few months old, he tossed his pack into the fireplace one night saying he didn’t want to teach his kids to smoke. He’d watched his dad as a kid. Weird thing about it though, I was so unnerved by his change in routine. He was supposed to light up after dinner, and after sex, and first thing in the morning! …and…and. I can’t imagine how hard it must be for the actual smoker to quit! I was so accustomed to his habit that I felt nervous. But, he made it, and I’m always grateful he stopped. It is tough to watch loved ones suffer, like you did. Hugs.
You are so right. I lost my best friend to smoking. He only had a little bit of functioning lung left the last year or so. He had smoked since he was a pre-teen, with his mother’s enthusiastic encouragement. (On her deathbed, of course, she DID tell him to stop, but, uh, to little, too late… ). He didn’t develop an operable lung tumor, though one doctor mentioned he did seem to have mesothelioma. But heart failure, COPD–those are enough, they’ll serve. This generous, charismatic man, who would always do ANYTHING to help anyone, who was one of that special breed who play Santa every year, found himself with no energy; couldn’t even stand up without exhausting himself.
oh, he did stop smoking eventually, when it became obvious that even one more cigarette might kill him on the spot. Lived a few years after that. Died a few months after his 70th birthday (not really very old these days.) Totally gratuitous.
Let’s think about the way smoking has been handled as a public health issue. First, I think THE most powerful message our govt sends about cigarettes is: they’re for sale! In shiny colorful packaging right next to the candy bars, the toothpaste, etc. Cigarettes thus send the message:”I’m OK, really, or I wouldn’t be here, now would I?”
And my personal fave: taxation. While spending billions on useless measures like “butthead” billboards, our governments at state and fed levels rake in billions of dollars in taxes on tobacco. Do they really want to eradicate it? I don’t think so! Remember that when the states got payouts from the tobacco lawsuit a few years ago, they spent the money on fixing highways, NOT on smoking cessation.
Hypocrisy, deceit, greed. And your mom and my best friend are among the many, many victims.
You ask us not to offer you condolences, so I won’t–
but I think of my friend every day, more than once a day. I will take all the sympathy I can get.
I know you aren’t looking for condolences Fred, but you gave your mom the best of you. My dad died of lung cancer at age 74 – he was diagnosed with an inoperable tumor on lung 5 years before he passed. He had some success with radiation, no chemo – he refused it – it bought time, but……he continued to smoke the entire time. He started out at age 11 with camels and Marlboros. He had a smoker’s cough like, forever. My sister and I used to hide his cigarettes and ash trays. But he continued. I don’t know why – he even had to have a nicotine patch while in hospice.
We have alcoholism in our families, past drug use – we can’t change how people choose to live. I hear you. It is the best message for 2017 resolution. God bless you and your family.
PS – I’ll add that an old neighbor went for general check up this year, PSA count was up (again) – doc said will check again in 6 mo. His wife said NO! Do a biopsy! It was stage 4 prostate cancer. He has had great success with treatment at MD Anderson in Houston – no chemo. All tests now ok. Just a heads up to keep up with your yearly visits and if question results.