| Donya stepped outside the trauma center where she worked and lit the first cigarette she had had in three hours. She was still a bit winded from the exertion of dealing with the last case and as she held the smoke deep in her lungs she felt a massive cough welling up. After a minute or so of hacking, her lungs finally calmed down and she took another deep drag and held it. “With a cough like that, I’d expect something to come up” said one of the other nurses who had come outside for a smoke. “Not with all the crap in my lungs” Donya replied. The other nurse asked how much she smoked and Donya told her around three packs a day. “You should sign up for the hospital’s study” the other nurse told her. They’re looking for women in their 30’s who smoke more than two packs a day. They want to see if there is a way to accurately determin severity of addiction” The next day Donya signed up. “What the hell?” She thought, “I know I’m addicted and my lungs are fucked. Might as well find out how bad it is.” The technition took her history–started when she was 12, was smoking a pack a day by the time she was 14, up to two packs a day when she was 15, three or more packs a day since she was 16. She asked about her overall health and Donya explained that she felt good. Did she have a persistant cough? Yes. Was it productive? Sometimes in the morning or when she had a cold. Did she get colds often? About twice a year, often turning into bronchitus. Was she easily winded? Yes. Could she remember the last time her chest had not been somewhat congested? No. Did she think she would have a hard time quitting if she tried? Yes. Did she have any desire to quit? No. The technition did a chest x-ray and a lung scan. Then she put Donya through a series of spirometer tests after which Donya coughed harder than she had in a long time. It had been at least an hour and a half since her last cigarette and her hands were shaking as she stepped onto the tredmill. The technition said “Given your numbers, I’m going to set this slower than usual. When the monitor says your breathing and pulse have reached the point where it will take more than two minutes to return to normal, I’ll shut it off. Then we’ll check how long it really takes.” Donya felt her pulse quicken almost as soon as it started. After a minute and a half she was wheesing and gasping and the technition turned it off. Five minutes later the technition said “I guess you’re breathing well enough now to have a cigarette. I’m sure you want on. I know I do” They went outside and Donya sucked the smoke as far into her lungs as she could and held it until her chest ached. The technition told her “I’ve got to be honest with you. Even though you seem to be in decent shape for a heavy smoker, your lungs are shot. We’ll look at the films and scans when we go back in, but it’s not going to be good.” “I know” Donya said, “I know” When they went back inside and looked at the films and scans the technition pointed to the top three fourths of Donya’s lungs and said the capacity here is less than half of what it should be. For an average smoker your age I’d expect it to be around 80%. Ypu’re at 30%” Donya pointed to the lower quarter of her lungs and asked “What about here?” “That section is in better shape, but your lungs arn’t strong enough to get air down that far, so you aren’t really using that part of your lungs. At this point, I’m afraid most of the damage is permanent.” Donya thought about what she was seeing and hearing. She knew smoking was bad for her. She knew she smoked more than she should and that even if she quit the next day, her lungs would never really recover. She also knew she didn’t care. She loved smoking and didn’t want to quit. She took a deep breath and felt the crap shift in her lungs and erupted with a rough cough. “That sounds like the cough of a smoker who really ought to quit, but isn’t going to” “I don’t know” said Donya “I’ll probably quit when I die”. The two health care professionals laughed and went outside for a cigarette. |
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