Can we talk?

Smokers

    I have taken my former mother-in-law to the doctor numerous times, not because we are fond of each other, but because she has no one else. There is need on her part, and a feeling of obligation on my part. I can't let an elderly person who's almost helpless be abandoned. And I feel like I'm helping my ex, out of pity, not obligation, certainly not because there is any hope of a renewed relationship
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She's a smoker. She has COPD. She had quit by necessity during recovery from brain tumor surgery. She had to stay in the nursing home until she could care for herself again. Once home she didn't start smoking right away. She blames her son, my ex for tempting her, since he smokes,and she would smoke the end of his cigs, or steel a few from his pack. She takes no responsibility for starting up again. It's his fault.

Her pulmonary doctor has been begging her to stop. She's on oxygen and takes a lot of medicine for breathing throughout the day. Her lungs are getting worse despite her ritual of medication, and the 24 hour a day oxygen. He has told her that her lungs are like bubble paper with all the bubbles popped. He has shown her pictures and explained relentlessly what she's doing to her lungs. She tells him its her dirty house--she's very neat and straight, but won't allow dusting or vacuuming due to her problems--or second hand smoke.

Now the doctor has reacted strongly to that last one. It's the biggest fraud the US government has imposed on us. Second hand smoke according to him is not as bad as they would have us believe. Babies and young children should not be exposed, of course, but in normal settings, second hand smoke doesn't hurt us. Bars and other heavily smoke-filled places are not good for us. But if you already smoke, second hand smoke doesn't count in any situation.

I go into the exam room with her because she can't remember what the doctor says when she gets home, and she gets confused about some things. She then panics and makes it even worse and has little tantrums. It's hard to draw the line between dementia and just a bad personality. (I told you there are no warm feelings between us.) So I see how hard the doctor is trying to communicate with her. She has an argument or a "Yeah, but..." for everything he tells her. The last visit when he told her it was the cigarettes taking her breath away and making it so much harder for her, not the first time he's done so, and she looked him right in the eye and said, "You really think so?" After a long pause, he shot me a glance and then said he's done arguing. He'll never mention it again.

This woman needs cataract surgery but can't have it because her lungs are too weak. She can't walk out to the driveway without huffing and puffing. She's very small, she's 77 and still flexible for her age. Her heart is strong. Her mind and her lungs are going fast. I believe that even without the early signs of dementia she wouldn't get it about her lungs and cigarettes. She knows cigs are bad. She knows she should quit. She is responsible for her own decisions, but will never admit that. She knows that she's suffering from emphysema, but won't take the most important step to cut down her suffering. Unlike the doctor, I gave up a long time ago. If she wants cigs, I'll stop at the store on the way home from the doctor and let her buy them.

I didn't really mean to write about her. I think she is an example of most smokers, or other addicted people, for that matter. (We all have some vices, some which really hurt us, like food, or laziness, or shopping, etc.) The addicted person doesn't want to be forced to quit or change. He'll do it when he wants (and he doesn't want to right now). He blames other people or other causes, taking no personal authority or responsibility, thereby, telling himself he has no power in his own life. He diverts attention elsewhere, like second hand smoke, or another person's problem. He makes excuses for not changing. And he feels at least a little fear, like filling the void when the bad habit is gone, like finding a new crutch. And there's that rebelliousness, whether a teenager or a 77-year-old: you can't make me change if I don't want to.