Children have never been very good at listening to their elders, but they have never failed to imitate them.
-James Baldwin
I calculated backwards and figured that her granddaughter must have been about 10-years-old when my patient first developed cancer. Few of my patients have had such a difficult run.
Nothing has come easily. Her cancer was difficult to control and she required radiation and then extensive surgery and more radiation. The side effects led to additional treatments, a feeding tube, and expensive pain medications. She had battles with both her employer and her insurance company. She cannot gain weight. I suspect she has lost friends because of her difficulty with communication. Many of her old friends no longer spend time with her since she quit smoking and does not like to be around smoke.
Of course, to hear her tell the story, she is doing fine. She feels well and has adjusted reasonably well. She celebrates her freedom from cancer every single day.
I was worried, therefore, when she arrived for a follow-up visit. She looked distracted. I moved into position to perform the examination.
“What’s this?” I blurted out. “Have you started smoking again?”
“Oh, no!” She was adamant. “Quitting was the best thing I ever did!” She looked quizzically and then realized that I had smelled tobacco smoke on her clothing. “Doctor, my family still smokes in front of me. They know how I feel but they smoke anyway.”
She paused.
“Even my 17-year-old granddaughter! She just started smoking. Despite growing up watching what I have been through, she smokes.”
My patient sat silently and shook her head.
“Doctor, it is just absolutely unbelievable.”
Of course, raising kids is tough. When my own children were very small and my oldest son was acting up, a favorite teacher once told me, “Remember: your sons will wreck your cars, but your daughters will break your heart.” My teacher’s half-joking comment came to mind again as my patient struggled to land on an argument that would induce her granddaughter to see what smoking could potentially mean for her own future. Was there something that the girl had somehow missed watching her grandmother’s ordeal over that last seven years? We came to no conclusions and both suspected that getting through to the girl would be neither quick nor easy.
The following is feedback received for this blog:
My husband was forced to give up smoking in late Nov 2006 because of a severe sore throat. Some 7 weeks later when it had practically improved, he'd "gone off" smoking, much to my delight. Recently, I've discovered that he's taken it back up again. He tells me that it's only 1 a day, but I know it's more ... Sadly there is just no telling some folk. And even more sadly, nothing we can do to stop them.
- Jabulani
