Jon Doe. 135 pack years. 135. That’s 3 packs per day since the age of 16. Does that not sound ridiculous? 20 to 24 cigarettes per pack so 60-72 cigarettes per day… who knows if they were king size… gotta pack in that extra 20% where you can. Did he not get the memo? I guess it’s too late now.
The classic 9-5 work day has historically been divided into 4 segments. An hour for lunch at noon and two 15 minute breaks; one for splitting up the morning and the other for the afternoon. I heard somewhere that when they designed the cigarette they were shooting for an average burn time of 7 minutes. Seven minutes so you could squeeze two of them into your 15 minute work break.
Who knows if that was mere serendipity, but it fit nicely so they rolled with it. No pun intended.
Best case scenario he smoked 20 packs. That’s 20 cigarettes X 7 minutes a pop = 420 minutes per day. That’s 7 hours per day with a cigarette sparked, dangling from his lips. When do you find time to breath, brother? Or is that a sensitive subject?
My ol’ granpappy drank a handle of quadruple x whiskey every day with a pound of bacon, extra salt and n’er layed down the pipe. He could lift a locomotive with one hand, run the mile under 3 minutes flat …. And he had polio to boot…. Yeah we’ve all heard it before. “It’ll never happen to me”. Conspiracy theories, physician/pharmaceutical/tobacco companies’ brainchild to milk me for every cent to my name on my way through, and on my way out of this world.
I’d like to think in this day and age people have come to terms with the fact that if you’re a chronic smoker then there’s a pretty decent chance you’ll get a hot date with Davey Jone’s locker sooner than the abstainers. And in fact we have seen a significant decline in smoking rates in young people… which is something we should be proud of. But Jon Doe with 135 pack years under his belt has good company in his cohort. He’s part of a club where the damage is pretty much done.
Too many itches. Too many flashes of flint bathing a stream of sublimating butane, igniting in a perfect one inch flame to be cradled from the wind as a pair of pursed weathered lips suspends a cylinder of relief in the dancing flicker. His cheeks pulse like bellows drawing the flame towards the cylinder’s end with a force unseen. His eyes illuminate as the tip ignites in glowing embers reflecting off his hands onto his focused face. His hands slink to his sides, slipping the lighter into his front pocket in one, cool, well rehearsed motion. Inhaling deeply, his chest expands and the first tingling sensation of his actions begin to lurk. Quickly, he reaches up to his face and snares the cigarette between his index and middle finger, pulling it from his lips in one fell swoop. He arcs his neck backwards expelling a plume of smog into the crisp night air. The nicotine is flowing now. An intricate network of pipes, membranes and chambers lead to a familiar home. In fact the only home that matters when all is said and done. The muse for which all this effort attempts to appease. The pleasure center of the brain, the nucleus accumbens.
Now bathing in nicotine it rewards its obedient young cadet with a fleeting sprinkle of dopamine.
He turns chuckling to his neighbor the caudate nucleus with a menacing grin, “he’ll be back”.
A host of comorbidities to say the least. 6, 8, 10 life threatening conditions all tracing back to a common thread. Smoking. Emphysema, bronchitis, coronary artery disease, atherosclerosis, peripheral vascular disease, stroke, renal failure, macular degeneration and periodontitis to name a few. And now… a cerebral aneurysm.
Ex-heroine addicts who travel the country regaling gymnasiums full of malleable high-schoolers on smart life choices… shamefully admit that there’s one crutch they haven’t been able to kick. Now free of alcohol, marijuana, cocaine, ecstasy, coffee, gluten, red meat, GMO’s, doing yoga six times a day and buying into any and every overnight health craze any twat has tweeted in the last decade, his dark passenger still clings on tight. A voice from the crowd in that gymnasium timidly asked in the question and answer session (why): “if you have come this far, why do you think you still need cigarettes”. He didn’t have an answer for us. I feel like him and Jon Doe had at least that in common.
We got a pulse back. I snapped at least 3 ribs on my first compression. Enough force to dislodge the bag from the endotracheal tube; wisps of off-white sputum puffing upwards in the expiring air. 3 bouts of atropine and finally a shockable rhythm etched across the monitor. Clear! Stepping back his body tensed and lifted a half second before slumping back to a puddle of least effort. Blip, Blip, blip, 77 BPM.
Walking back upstairs to the resident’s lounge the door was barely closed before “code blue ICU” was repeated over the loudspeaker.
Deja vu. A series of compressions, stimulants and electrical pulsations brought the vehicle up to speed again but we knew this was only momentum and could only fight the resistance of a strong headwind for so long.
“Daddy I love you” sobbed a 20 something girl as a pack of scared and downtrodden siblings encircled the bed, lower eyelids welling in tears as the staff members respectfully shuffled out.
“Daddy I love you so much”. The pack doesn’t look so different in age from my siblings and I.
Who knows if Jon Doe would have succumbed Monday December 8 2014 at the age of 61 if his ‘friend’ hadn’t offered him that first butt behind the bleachers in high school. I’ll never know and nor is it my place to pass judgement. This is one thing, and one thing only. A crippling loss in a young family which cannot be undone. Our condolences offer no comfort. Fond recollections are mere lip service. Deepest sympathies fail to fill the void. And sullen hearts cannot escape the pain.
In lieu of flowers… plant a seed. Not a seed that can grow into leaves to be harvested, cured, shredded and rolled, but a seed of knowledge. To ensure this generation will be the last to see loved ones fall at the hand of tobacco. Expunging its flame forever.
more by BEN COOKE
photograph by F Romero