Thursday 18 April 2013

Smoking kills faster

Ok, I'll resist my usual temptation to rant and rave about how stupid smoking is and how it kills people in approximately 8,472 different ways.  Everyone knows that it smells horrible, it's expensive, it looks stupid, oh and did I mention it KILLS YOU?  Sorry, sorry, sorry.  I'm done, I promise.  So now you must be left wondering, "What the hell does he mean that smoking kills faster?"

Don't I always explain myself eventually?

Dr. K (not her real name), an emergency physician in the United States, wrote to me to about a woman who was brought to her ER complaining of shortness of breath and chest pain.  Now I know what you're thinking -

"BOOORING!  I'm going to go find some cat videos on YouTube."

Whoa, hold on there cowboy, stay with me here.  It gets more interesting, I promise.  I admit this is a very common pair of complaints, and any doctor (or anyone else, for that matter) who knows anything about medicine would immediately think of a heart attack.  But what made it less common (and therefore more interesting - see, I told you!) is that she was only 29 years old.  This beautiful young woman had a long history of multiple bouts of pneumonia spanning back several years, and she had undergone a mini-biopsy of her lungs a few years ago which showed something called bronchiolitis obliterans with organising pneumonia, otherwise known as BOOP.  This is a relatively rare condition where the lung becomes chronically inflamed and the air sacs fill with connective tissue, inhibiting their ability to exchange carbon dioxide for oxygen.  She had undergone a further workup a short while later (including a formal lung biopsy) and was also diagnosed with respiratory bronchiolitis-associated interstitial lung disease (which is also bad) and idiopathic pulmonary fibrosis, which is extremely bad and has a median survival after diagnosis of 3-4 years.

Sounds pretty damned serious, right?  And anyone in their right mind who carries these diagnoses wouldn't dare go near a cigarette because that only makes lungs worse, right?

Come on now!  Didn't you read the title?

Dr. K (still not her real name) noticed the characteristic yellow staining on her fingernails (no, she was not a yellow clay sculptor or a turmeric harvester), not to mention the unmistakable stench of cigarette smoke all over her clothes.  Despite the overwhelming evidence, the woman denied smoking (of course).  But her husband spilled the beans and told Dr. K that she was indeed still smoking.  The worst part about all this is that this is not an uneducated woman who just doesn't know the damage cigarettes can do (then again, these days who doesn't know how stupid smoking is?) - she has a PhD in biology and is a university professor.

"People are not educated.  Ok, it's all over the place that smoking kills, but I'll give most people the benefit of the doubt and say that they just don't know better.  NOT THIS GIRL.  Do you ever feel like sometimes we set nature back?  Survival of the fittest...what happened to that?"   - Dr. K

I'm not sure what Darwin would say about survival of the fittest when it comes to human behaviour.  I've seen some damned stupid people survive some damned stupid injuries.  But now you know what I mean by "smoking kills faster".  If this woman does eventually succumb to her many pulmonary ailments, I think Dr. K should submit her for consideration of a Darwin Award.


  1. I know some people that have always said if they had a terminal illness and knew they were going to die in a few months or years that would start smoking again because they enjoyed it and they only stopped for health reasons. Maybe it's similar for her. She knows, barring someone finding a cure for her disease, that she will die, so she doesn't see the point in quitting. Just a possibility.

  2. Today in my chemistry class, my professor mentioned that the smog in my city is so bad that people raised here have decreased lung function. I looked out the window and saw a girl puffing away on a cigarette.

  3. Hello , I don't like smoking, some of my friend are a chain smoker and all time a have said that plz you have to remove this bad behave . But they don't

  4. People are such idiots these days.

  5. For some reason Kayla's comment wouldn't go through. Blogger is giving her difficulties, so she emailed me this:

    Hi Doc Bastard,

    I found your blog after following many of your debates on FML; I come from a family of RNs and we all find your blog fascinating.

    I was trying to comment on two different posts, but the mobile site kept cutting me off. I thought there was a character limit until it only allowed me four characters on the second post. (And you were complaining about a 140 character limit? Tsk tsk! =D) I've attached one comment below (no, I don't expect you to post it for me... Unless you feel like it! Lol).

    Post on "Smoking Kills Faster":

    I will never understand smokers and their health. My fiance's grandmother fought stage 3 lung cancer for over four years. She changed her diet, began to exercise, faithfully took her medications, and did everything her doctor told her to, except for one thing. Can you guess? She refused to quit smoking. In fact, she even refused to cut down her TWO PACK A DAY habit. She kept saying she wanted to live but she didn't seem to realize she was feeding the cancer inside her with her own habit!

    My fiance's mother is almost worse, in my opinion. She tended her mother (the grandmother mentioned above) for those four years. She watched her mother move back and forth between her home and hospital, and finally the hospice where she lasted a full eight months. My fiance's mother is a complete "health-nut" because of those four years, but she also refuses to stop smoking! She claims smoking had nothing to do with the lung cancer because her friend developed lung cancer without ever smoking. She also claims it's the treatments that actually kill you, not the cancer. She finally bought an electronic cigarette when she became a grandmother - and only at her son's insistence. I will never understand smokers.

  6. This comment has been removed by a blog administrator.

    1. Obvious advert was deleted. If only I could delete the user from google too.


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