Letter to a Young Smoker From an Oncologist

Craig R. Hildreth, MD

My Dear Patient,

It was a pleasure meeting you and your fiance today. I know you were scared when you saw the words “Cancer Care” on my office door, especially since you were referred to me for a minor irregularity in your CBC test. Don’t feel too bad-you’re not the first patient I’ve encountered who stared at me as if I was a hanging judge in a hurry. Recall that my initial words were “Don’t panic-oncologists also see people with simple blood problems.” Weren’t you relieved when I told you that your low white blood cell count was just leftover from a viral infection? You really didn’t think you had cancer, did you? C’mon-you’re going to live to be an old man!

Then again you may not. Although we just met, I am concerned about your future, and if there is one person in this world that you do not want to be worried about your health, it’s a medical oncologist. You know what I’m talking about. Did you think I wasn’t going to bring it up? What kind of a doctor would I be if I ignored the fact that you are shortening your time left on Earth, time to be spent with your beloved, because of an unsafe habit? I appreciate the fact that you answered honestly, but even if you lied to me the smell of your breath would have given you away.

So without being judgmental I tried to give you a friendly bit of counseling on how to abandon the only legal product that, when used as directed, kills 443,000 of us a year, the product that makes you 23 times more likely to get lung cancer. Thank you for your time. I pray that the tips you received today will inspire you to quit.

Remember, I never want to see you in my office again. If you continue though, you may end up someday joining a particularly sorrowful club, whose members I have the dubious honor of ministering to as they travel on a funereal journey. There is no age restriction on membership. You may be asked to join when you are only 45 years old, feel fine, in fact never felt better and can’t understand why just 14 months after having an early-stage lung cancer removed you now have liver metastases, or how about…

…when you’re 55, in the process of mastering your golf game on weekends, and your nagging cough turns out to be due to a large mediastinal mass from small-cell lung cancer, or

…when you’re 65, newly retired and ready to attend your many grandchildren’s sporting events, and you find yourself in the emergency room after suffering a seizure from previously undiscovered brain metastases, or

…when, at age 75, your children ask me privately if you will live long enough to celebrate your 50th wedding anniversary party, and I answer, “I doubt it.”

I see these tragedies unfold so often it has become routine for me now, yet don’t think that your life was less precious, that your death is less grievous, just because you killed yourself with cigarettes. It is not too late to change your future-listen to me! Please don’t become yet another one of the countless husbands, fathers, uncles, brothers in this country who, if they only hadn’t started, would still be alive today. You don’t have to do this alone, but you have to want to quit. We will get you the best help available to help you kick the habit, but you have to want to quit. True, no one can see what fate has planned for them, but if you return to me someday as a cancer patient, I will get to see what fate did to you-and it is a dreadful sight.