April 16, 2006

• Freedom of Choice

  Maybe it’s because I see life and death every day that I get bored watching T.V. shows these days. Maybe it’s because I see people without any real choices in life other than to accept that they have a terminal disease that makes me scoff when I listen to people complaining about the U.S. government taking away their freedom to smoke pot or to go above 45 in a 20 mph school zone. Maybe it’s because a lot of the patients who end up in my hospital have diseases that are fully preventable, by their own choice of what they’ve done in life.

  And every day, I attempt to fix the results of poor choices. That is the price we pay for freedom — poor choices.

  I still remember when I was just a medical student, a man came in who had serious liver cirrhosis (from drinking) and COPD (from smoking). As I was taught, I counseled this man (old enough to be my grandfather) about the hazards of continuing to smoke. I offered him two options — the patch or the gum. He wanted neither. Only oxygen by nasal cannula was what he wanted and needed to stay alive (for the meantime).

  He was discharged from the hospital in stable condition, but we sent him to a veterans facility because 1) he was homeless and 2) he probably had liver cancer and would need further evaluation and treatment.

  While he was in the hospital, he was visited a total of 1 time, by his sister. When he was discharged from the hospital, she paged me, and then asked to talk to me. The entire conversation consisted of her yelling at me for not making him stop smoking. I explained to her that I discussed the dangers of smoking and offered him smoking cessation aids, which he refused. “You didn’t do enough,” she yelled. And proceeded to emit a series of foul words which I will not repeat on this site.

  I was quite livid at the time, but looking back on it, it was easy to see why she was angry. First, she was probably feeling guilty that her brother was in the hospital. Alone. After all, he’d been homeless for who knows how many months. Even he didn’t know how many months. She had to find someone to blame for the fact that her brother was not well. Nevermind that before his hospitalization, I had never even met the man, and she had known him for nearly all his life (which is maybe why he chose to be homeless rather than to live with her).

  Secondly, control freaks like her are the reason Singapore* is considering outlawing smoking completely. They’ve outlawed chewing gum, as well. I’m happy to say that America is still a free country, and that as much as I deplore the effects smoking has on my patients who started this absurd habit of inhaling partially combusted material. . . I’m not fascist enough to tie a man down to a bed and force him to use a nicotine patch.

  Nor am I schizophrenic enough to go blaming health professionals for refusing to force a man to accept elective medication.

  Next thing you know, this lady will be lobbying in the Senate to impose nicotine patches on people against their will. “Chew that nicotine gum! Chew it! NOW, I SAY!“

  Control freaks. They know how you must live your life, and they will force you to live a “good” life, even if it means making it a law.

  

  * Singaporean politicians outlaw everything, including not flushing the toilet after use.  In spite of people’s claims that Singapore is ”safer” that the U.S., my roommate from Singapore remembers that one of her classmates was murdered while jogging in one of Singapore’s parks.  Safer?  Hardly!  You can’t legislate crazy people, people.

   

   

  • 9:23 am
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