Not confronting a smoker


On the edge of a change, on the brink,

I might bring a person to think

About why they’re broke,

Or continue to smoke,

If into the cold they must slink

Synopsis: I’m a family practitioner from Sioux City, Iowa. I danced back from the brink of burnout in 2010, and, honoring a one-year non-compete clause, went for adventures working in out-of-the-way locations. After jobs in Alaska, New Zealand, Iowa, and Nebraska, I returned home and took a part-time position with a Community Health Center, where I worked for 3 years.  I left last month because of a troubled relationship with the Electronic Medical Record (EMR) system.  Now I’m back from a road trip, working a bit with one of the rural docs, and getting ready for another job in Alaska.

On my way into a drug store to pick up melatonin for my upcoming trip, I saw a young, depressed-looking woman leaning against the brick wall of the adjoining building, smoking a cigarette next to the employee entrance of a health care establishment, and I faced a dilemma.

I could something or I could say nothing.

If I said something, I could say any of the things she’s already heard, but, as her continued tobacco use showed, those things hadn’t dissuaded her.  I could point out that the lungs of a smoker beat every other place on earth for radioactivity (including the hospital basement in Chernobyl where the radioactive clothes were dumped and where they remain) except a nuclear power plant; she probably hadn’t heard that.  Or I could whip out my calculator and point out how much money she burns a year.

I briefly considered saying nothing, but only briefly.  Not speaking out would go against my very identity.  Tobacco killed too many members of my family.

Whatever I would say I would have to use a minimum number of words.

I didn’t try to show her the wrongness of her actions.  I didn’t ask her, on a scale of one to ten, how ready was she to quit.

I exited the car.  “So, how’s that smoking thing working out for you?” I asked.

Her joyless face blossomed into a sardonic smile.  “It’s OK,” she said.

I said nothing more.  I can hope I made her think about the problem, I can hope I made a difference, I can hope I did the right thing.  But I cannot know.

I can regard the irony of a health care worker smoking, and I can wonder about the drama.

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