Addiction

When taking a medical history, we ask about cigarettes and alcohol. Sometimes, if the nicotine stains are obvious, we also ask about tobacco chewing. That doesn’t mean these are the only addictions that you should be concerned about in yourself and your loved ones. These are usually the most damaging. 

Recreational drug use is also fast becoming common place these days, and some day, future doctors in India will start asking about cannabis, cocaine and LSD. I used to have to do that when I worked abroad. Didn’t think I’d have to restart doing that here in India. 

Anyway, I’m rambling. I’m writing this to talk about cigarettes and alcohol, mainly, but what I say will apply to all sorts of addictive substances that are used these days. It applies to all addictions because I’m not going to talk about specific damage done by each substance. There are pages and pages of technical information about each individual poison that is available for free. You all know what’s written in those pages too. In spite of that knowledge you continue to destroy your own health. 

So, it’s not a lack of Knowledge, that is causing you to destroy yourself. What is it then? 

1. You think you’re indestructible

This seems to be the main reasoning I see among my patients. You know you’re not. But you’re good at self deception, so you convince yourself, that you are. Somehow. You’re good at it. 

2. It won’t happen to me. 

This is a variant of the above. This is the gambler mentality. You do realise that you’re gambling with your life, and the well-being of your family (in case you kick the bucket) I don’t know about you, but that’s not something worth gambling with. 

3.  “Life without _____ isn’t worth living “

Most of my friends are fed up of my constant nagging and have now shifted to this camp. They tell me, that they understand the risks. They tell me that they know that they’re damaging themselves, but, they persist because they’re ok with damaging themselves in return for the pleasure they recieve from their addiction. Can’t really argue with that, except, asking them to consider their family, especially their children. I find it difficult to believe that they’d rather die for a few (thousand) cigarettes, than watch their children grow. How can one accept that sort of a fate? I don’t understand it. It doesn’t make sense. It won’t make sense to the addicts either, if they were really honest with themselves. 

The other thing I’d like to tell this camp is that, I’ve seen people dying slowly and painfully for 15 years now. None of them tell me that they’re happy they smoked, in the past, while they’re gasping for breath, even on 100% oxygen through a face mask. Maybe that’s because they don’t have the breath to speak. 

4. “We’re all going to die anyway” 

There are many kinds of deaths. I’d like a good one. Painless, living my life to the full, and slipping away in my sleep, not even knowing that I’m about to die, sounds very good. 

I’ll tell you what sounds bad. 

COPD – not able to breathe, not able to sleep, dragging on for years before finally dying in an ICU, your lungs drowning in the stuff they make themselves, antibiotics and ventilator just prolonging the agony. 

Cancer is easy (relatively) you go quick. You only suffer a few years. 

Cardio vascular disease

-strokes can leave you a vegetable unable to wash yourself after soiling your clothes and bed sheets. 

-liver disease – you go quick, but it’s a nasty way to die. Swollen abdomen, endless needles, your mind gone, limbs weak. 

It doesn’t make sense. The only reason that would make me accept the risk of a death like that, is, if my destructive lifestyle was absolutely essential to making my children’s life better. I wouldn’t do it for cigarettes, alcohol or designer drugs. 

This is just an emotional appeal. The guilt of living while thinking that I could have saved someone by being a bit more forceful in my advice, is awful. 

I’ve lost some friends before I got to do all the things I wanted to do with them. Call me selfish. There’s one guy who haunts me everyday. He was so full of life. Someone I wanted to emulate. Someone who inspired me and everyone around him. If it sounds like a “Bromance” I’d say, yes it was. I kept quiet because I didn’t want to risk him avoiding me, with  my constant nagging on cigarettes. A few months after I nagged him for the last time, where he politely let me know that I risked losing his friendship, he was gone. Dead from his first (and massive) heart attack. Far away from home. In a strange place surrounded by strangers. It broke my heart. And if this is the way I feel about losing a friend who I’ve interacted with face to face for only a few dozen hours, Can you imagine what his family has gone through?

Is that cigarette worth it? 

I kept quiet so that I wouldn’t lose him, and fate took him away. 

This incident shook me up quite a bit and it is this incident that shapes my present behaviour towards the people I care about. 

It will hurt, if you avoid me because I’m nagging you about your cigarettes, but it won’t hurt me as bad as feeling that I should have done more to stop you.