March 8, 2008
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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 has outlawed smoking completely. And
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 have 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.
