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.