So I spent the six hours or so at the Mayo’s emergency room yesterday. Wheezing. I’ve never wheezed before in my life.
Besides being flicking miserable, it was an interesting experience.
The place was absolutely mobbed. People come from all over the Valley, largely, I expect, because so many local hospitals are not all that great and because the Mayo is one of the very few in the state that rank among the top clinically and in terms of safety. I met people who had schlepped to their ER all the way from Mesa, and I spent most of the six hours with a pair of elderly Michiganders who had driven in from Apache Junction, where they spend the winters in their RV.
Because of the overcrowding, once they let us in to see doctors, there were no rooms for us, so the old guy from Michigan and I were stuck on gurneys in the hallway. This, of course, allowed each to hear in detail what was ailing the other.
He was really a sweet old guy, never complaining and always good-natured despite what must have been a great deal of suffering. As it developed, he had come down with diabetes in his old age, shortly after a botched knee replacement. He ended up with chronic painful, itchy swelling in his lower legs, which were covered with chronic sores that refused to heal. One wound had been open for 18 months. His wife had dragged him in to the Mayo because he wasn’t getting adequate care (he was being treated by a PA—hadn’t seen a doctor more than once or twice!) and she figured he could get better attention there.
When the doctor came around, she was visibly horrified to learn the quality of care he was receiving, though she tried to hide it when she was face-to-face with him.
Part of what ailed the old fellow was impaired circulation in his legs. This, she pointed out, was caused by his pack-a-day smoking habit. She suggested that if he quit smoking, he might have less pain.
If he lost about 60 or 80 pounds, too, he certainly would have less pain. Both he and the missus were pretty overweight. She could have done without 40 to 50 pounds and he, upwards of 60. Even if losing some avoirdupois didn’t help the diabetes (as it might), it would at least take some of the pressure off the poor old guy’s legs.
I thought about the old man, driving home at the end of the day. It made me feel terrible that such a nice old fellow was suffering like that.
He had no intention of knocking off the cigarettes, and said so.
The people who manufacture those things are murderers, plain and simple. They know they’re putting out an addictive product that kills, and they do it anyway. That makes them killers, and it makes the legislators who facilitate their drug business murderers, too.
But that’s neither here nor there.
The question is, let’s say you’re an old person. Let’s say a doctor gives you a choice: do without something that gives you pleasure and relaxation in your daily life and live several years longer, or keep enjoying that something and take those years off your life. Which would you pick?
The answer, to my mind, is not as obvious as it looks.
At a certain age, you realize you’re going to die sooner or later. And you realize you may or may not go through a period of intense suffering before that happens. Maybe forgoing a pleasure that relieves your boredom and distracts you from discomfort today isn’t worth a few extra months or years on the other end: extended life that may be full of pain and misery.
At 20, it’s obviously worth picking and choosing your vices: stay off the fatty foods, stay off the booze, stay off the tobacco, and stay off your fanny. With any luck, you’ll reach old age and old age will be tolerable.
But if you’re already there, or even halfway there? Hm.
What’s your choice? Longer life with asceticism, or shorter life with pleasurable bad habits?
Considering my worst habit is chocolate, I’ll take the shorter life 😉 At any rate, I would rather live a little, even if it’s for a shorter time, than live longer. It’s all about how you perceive your quality of life.
I think as you get older it has to be a mix. My grandma died at the age of 95. Toward the end, she was on a low sodium diet and the assisted living center she was at wouldn’t even give her ketchup until a cousin of mine intervened and pointed out that by that point, the salt in that ketchup wasn’t going to make a difference. In the case of your new friend, he should take the same approach. Maybe it’s unrealistic for him to have the desire to quit smoking entirely, but any bit he cuts out of his life will only serve to lessen the effects on his diabetes, so could he cut down to half a pack a day? I guess that’s really only for him to decide.
Interesting post and I am not sure I have answer, but I often wonder the same exact thing. Like why the hell does type 2 diabetes even exist? The doc says lose 100 pounds and you won’t loose an F’in knee – why would anyone continue to live the way they do? I don’t get it.
Problem is that you don’t know what will happen! My father in law continues to smoke at 93. My father stopped smoking 30 years before he died of a cerebral aneurysm at age 80.
Seeing the extreme issues with weight in the USA is disquieting–and we’re all paying for it.
Type 2 diabetes has been around for a long time, long before our so-called “obesity epidemic” (i.e., the current fad hype). My great-grandmother, who raised my mother in upstate New York, could hardly have been overweight: they lived on a subsistence farm and ate only what they could grow and process themselves. McDonald’s, Twinkies, and potato chips were as yet unknown. Exercise? Ever tried to supply ALL your food out of a garden and barnyard? Or keep a house clean without a vacuum cleaner? Or do a load of laundry without a wash machine?
But she died of type 2 diabetes, long before insulin was discovered.
Hm. As for abandoning our little comforts…it’s hard to stay judgmental as you get older. For years, after watching my mother die hideously through the machinations of the nicotine peddlers, I thought anyone who would so much as touch a cigarette, cigar, pipe, or chaw was a slavering idiot. And I still think anyone who starts today, knowing what we know now, is none too bright.
However. Life is short. Time is long. When you get closer to the end of your brief flight through the torch-lit room, you have fewer and fewer comforts and so are more and more disinclined to give them up. And who’s to say, from that perspective — as the window out into the night comes into view — what’s a right choice and what wrong?
Ketchup. For godsake.
“Yes, Mrs. Dingbat, I’m afraid your 98-year-old mother died from consuming a squirt of ketchup on her dry-roasted turkeyburger.”
“Oh, Doctor, if only we’d known!” [sobs]
Mrs. Dingbat Senior sits on high, chuckling.
I’ll take quality of life.
We’ll have to disagree on tobacco companies. You could extend that reasoning to any company which makes *any* product with inherent risk, including beer and alcohol companies, makers of sugary snacks and sodas, car and truck manufacturers, and peddlers of high-fructose corn syrup — the latter in and of itself probably the greatest contributing factor to type II diabetes.
Life’s full of risks. But with our big brains, humans should know better.
By the way, count me in as one who’s none too bright. I quite like my whiskey and cigars, less in the winter and summer, more in the spring and fall (nicer weather to be out on the patio).
Nice article, by the way. I like the way you write.
@ Centavos: Thanks for the compliment. 🙂
After you’ve watched your mom die the way I watched mine go, you may change your mind.
There’s a difference between selling something that’s nonaddictive and selling a drug that has been shown to be as addictive as heroin–possibly more so. There’s a difference between selling candy and beer and selling a product proven to cause cancer, strokes, and heart disease. There’s a difference between deliberately spiking a poisonous product with a high-test version of that addictive drug and selling snacks. Fat is not the same as cancer. Sugar and salt are not the same as nicotine. And while for some people alcohol is addictive, it’s not in the same class as nicotine.
On the other hand, there’s something to be said for risk-takers. People who smoke are often more interesting human beings than those of us who refrain, apparently because they’re more inclined to take on risks in pursuit of pleasure and adventure.
As an almost old person, I’m strongly on team QOL. Having faced down major illnesses a couple of times and gone through treatments that definitely reduced my QOL for over a year, I’m opting from now on for the best life possible, however one personally defines that. For some that could mean doing whatever it takes to prolong it, but I’m more for enjoying things.