Monday 9 February 2015


I've been on a bit of a rampage about measles, vaccines, and the antivax movement for the past week or so, so I think it's time to take a break from that and get back to the smoking update I meant to post last week before I got sidetracked.  So without further ado . . .

I was looking through my posts for the past few months, and I realised I haven't railed on cigarettes lately.  I apologise for this obvious oversight.  If you are a smoker, you may want to change the channel now, because you aren't going to like this one bit.  I'm sure you smokers think you know what I'm about to say already:

Oh isn't this just great!  Doc's going to get all self-righteous and tell me exactly what I already hear a million goddamned times a day, that smoking fucking kills.  He's going to say that it causes lung cancer and COPD and heart disease and strokes and oesophageal cancer and stomach cancer.  He's going to say that smoking is stupid and should be illegal because it's so fucking stupid.  YEAH, I KNOW!  I ALREADY FUCKING KNOW, DOC!
No you don't, smarty pants.  It seems smoking also causes presumptuousness.  Because that wasn't what I was going to say at all.  Ok, maybe it was just a little.  But that's not what this story is about.  Mostly.

Yes, we all know that smoking kills (sorry, I know I said I wasn't going to say it, but I changed my damned mind).  Non-smokers know it.  Smokers know it.  Children know it.  Cats and gerbils know it.  EVERYONE knows it.  And we all know how smoking kills (see the partial list of Ways Smoking Can Potentially Kill You above).  Until recently I thought I knew all the various ways that cigarettes can kill you.

And then I met Howie (not his real name©), who taught me 1) there's always more to learn, and 2) there are always more ways that smoking can kill.

When I see "Other" on my pager, it's one of the mysteries of trauma that always gives my Inner Sleuth a bit of a thrill.  I see more than my fill of car accidents, falls, pedestrians struck, assaults, stabbings, and shootings, but "other" is often quite interesting.  My Inner Sleuth likes to guess if I'll be getting someone kicked by a horse or run over by a snowmobile or in a parasailing accident.  However, when I see "other" at 1 AM, my Inner Sleuth is almost impossible to wake up.  It's all fine and dandy at noon to guess if I'll be getting a lawnmower accident or a table saw accident or a guy who was hit by a falling piano, but in the middle of the night my Inner Sleuth is a lazy little fuck, and he actively refuses to participate.

And so it was that I found myself trudging down to the trauma bay at 1 AM wishing my pager had just said "MVC".  I wasn't particularly interested in solving any mysteries just then.  I just wanted to fix a problem and get back to bed.  Howie, an average, everyday 40-ish year old dude, was brought to me that Saturday night with a bandage wrapped around his entire face.  He had no signs of injuries below the neck, so despite his usual nighttime sluggishness, my Inner Sleuth began ticking off possibilities:

Ooh, maybe his ceiling fan exploded and sent shrapnel into his ear!  No no, he was hit in the nose by a speeding goose.  Oh wait no, he walked into a post and impaled his eyeball!  Oh oh oh I got it, Pop Rocks and Coke made his face explode!

My Inner Sleuth can be an annoying twit at times, and he's usually wrong.  Since we were talking about cigarettes earlier, you've obviously deduced that this was a smoking-related injury.  Well done indeed, Mr. Holmes.

Howie had been drinking with his buddies when he decided he needed a cigarette break.  His wife doesn't let him smoke in the house, so she forced him to go outside.  He went to his back porch to light up, and as soon as his cigarette was lit, a dog jumped out of nowhere and latched onto his face, severely lacerating his eyebrow and ripping off the entire tip of his nose.

The damage to his nasal cartilage was extensive, so I asked the plastic reconstructive surgeon on call to take a look at it.  He's had one procedure so far with (most likely) several more to go.

So the moral of the story is this: if he hadn't been a smoker, he would never have gone outside while that killer dog was lying in wait, and this never would have happened.  I think we can now safely and appropriately add "dog bite" onto the ever-growing list of Ways Smoking Can Potentially Kill You.

Even dogs know that smoking is stupid.


  1. My sister once dropped a cigarette while driving. Went to pick it up and rear ended some one.

  2. Much as I agree with your stance on smoking Doc' I can't help thinking that the counter-argument would be:

    If his wife wasn't such an intolerant bi@ch about him smoking in the house then he wouldn't have had to go outside etc.

    So sadly the moral could equally be that condemning people for smoking makes you a spouse-killer.

    Hummm... I think I like your moral better.

    1. Anyone who thinks that not letting go someone smoke in the house is intolerant is a stupid jackass anyways. It damages the house, smells awful, and is harmful for anyone else who happens to have to share the air.

    2. Agreed, I smoke (gasp), as do my parents (double gasp), but they've never smoked in the house. I've been living on my own for 5 years now and I still don't smoke in the house. Even if my fiance was a smoker, I would still take it outside. It also drives me absolutely insane when people throw their butts down wherever they're standing. Come on, a little courtesy goes a long way. Not everyone smokes and not everyone wants it around them.

    3. Dogs have much more sensitive nose than we have! Maybe the dog was sick and tired of it!? My neighbor goes outside and smokes and it comes RIGHT into my flippin' house! No matter if the windows are closed it finds a way. If I were a dog I would bite his face off also. People don't realize WHERE their stupid smoke goes. They should lock themselves up in their cars and smoke there. Or just not smoke.
      The poor dog probably HAD it! "Oh no this guy smoking again and blowing smoke at my doghouse damn it, I'm going to show him"!
      Can't blame him one bit.

  3. Then we must blame the butterfly for beating its wings

  4. "He somehow lit his beard on fire with the lighter, didn't he?"

    "Oh. That was... well. That was completely unexpected."

  5. Somewhere out there is another idiot insisting that their dog would never, ever bite.

    1. Thank you for your comment. I've had a chunk of my leg (not so surgically) ripped out, and I hear this comment on a regular basis while delivering mail. It drives me insane.

    2. Every time I hear and owner insisting their dog doesn't bite, I immediately assume it will for two reasons:

      1. The owner is complacent with their dog and won't be watching them closely.

      2. Owners that fall into number 1 rarely know how to properly train their dogs in the first place, and usually over indulge their dog which leads to aggression.

      I assume the same of children when parents say their child would never do X, and for the same reasons.

    3. my dog has never given me cause to expect her to bite; however, she has been known to poke people in the eye with her nose.

      but no, she is trained and socialized, including my best effort at teaching her that physical contact is not appropriate behavior. of course, this is somewhat handicapped by mrs brazen teaching her that licking faces is an appropriate way to show affection.

    4. Shark,
      This is why I tell people "He's not bitten anyone yet. However, he is a dog, and therefore is capable of biting." So far (4 years) he has been great with 99% of people he has encountered. The only ones he wasn't good with where actively being aggressive to me.

      My dog hasn't given me cause to expect a bite either. However, he is a dog. He can't tell people "get away, you're making me uncomfortable" he can growl and he can bite. He is trained and socialized, but all the training in the world doesn't stop dogs from biting the children who are allowed to harass (hug, pull, jump on, etc) them. What other owners (like you?) don't seem to understand is that dogs are not people, they don't think like people, they don't act like people, and thus, to us, they can be "unpredictable".

  6. Your blog posts give me incredibly firm erections doc, just saying

    1. I've read many strange comments on here but yours takes the biscuit for most disturbing.

    2. Long ago in a nursing unit far, far away a patient wanted a smoke in the middle of the night. This patient was on O2 by cannula. She removed the cannula from her nose and placed it mid forehead with the O2 blowing toward the top of her head.

      Mrs. X received two soot marks on her forehead. And an embarrassed son. He was a doctor.


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