Crusade by Lawrence Martin

Doctor Miller will try anything to get his patient to quit smoking, but who is more determined? By Lawrence Martin.

Dr. Lewis Miller always struggled to get his smoking patients to quit. He cajoled, he pontificated, he pointed out facts. When all that failed, he used his funeral home gambit.

"Mable," he would say to his patient, when her smoking habit came up, "What funeral home do you do business with?"

This question would, of course, get Mabel's attention. After her "why-the-heck-are-you-asking me-that?" response, he would go into his the-cigarettes-are-killing-you-quick spiel. He tried some variation of this question with most of his addicted patients. Sometimes it worked, but most often not. Still, he kept trying.

And if one of his smokers was admitted to the hospital, for whatever reason, he would, in the middle of examining the patient, ask where they stashed the cigarettes.

"My cigarettes?"

"Yes, the ones you brought with you."

Outed, the patient would invariably reveal the hiding place, usually a purse or the bedside drawer.

"May I have them, please?" the doctor would ask, ever so politely. "You won't be smoking in the hospital." And usually, without a fuss, the patient would turn them over. Like his other methods, though, this gambit seldom worked to break their habit. Still, he felt it a duty to always try something, and he liked inventing new ways.

Which brings us to the case of Amanda Wiggins, a middle-aged woman with chronic lung disease whose chief complaint was always some variation of "I am short-winded." She had gone through several hospitalizations for chronic lung disease, yet continued to smoke even when in the hospital, this being an era when "smoking rooms" were available for tobacco-addicted patients.

Neither fear of funeral homes, emergency rooms, artificial breathing machines, lung cancer, nor skin wrinkles - all warnings offered by Dr. Miller - had made any dent in Ms. Wiggins' smoking addiction. She was incorrigible. She continued to smoke in her hospital room, even though that was forbidden, and when reminded of the ban, she got out of bed and walked to the ward's one small area that allowed the stinking habit.

Now you might think there is something wrong with the mind of a patient who continues to abuse the very thing making her sick, and you would be correct. There was a history of depression and a chaotic home life, and she had seen a psychiatrist on occasion, though she was no longer taking prescribed anti-depressant medication. As for Dr. Miller, he practiced pulmonology and did not feel daunted by her psychological problems. He would find a way.

He had come to learn that Ms. Wiggins' anchor in life was the Bible and fundamentalist religion, facts heretofore not mined in his no-smoking crusade. And so, on her second day of yet another hospitalization for chronic lung disease, Dr. Miller made his move. Ms. Wiggins was in bed, reading her Bible. He arranged for her nurse, Emily, to come join him. He needed a witness in case Ms. Wiggins really did quit smoking, someone to testify to his no-smoking creativity. While he stood to the left of the bed, he had Emily stand on the other side, making it easy to observe her reaction as he focused on their patient.

"I want to discuss something with you," he said to Ms. Wiggins.

She put down the book. "Yes?"

"It's about your smoking, Amanda. We can't get you better if you continue to smoke."

There was a short pause, then she said, "I'll quit," in a manner which conveyed just the opposite intention.

"You've got to quit."

"I'll quit. I want to get better."

"You're gonna die!"

"Don't say that, Dr. Miller. If I quit will I get better?"

"How are you going to quit? You've promised me a hundred times, and you always go back to smoking."

"Well, I'll quit now."

"Can I have your cigarettes?" He knew her supply was endless; taking them would be like trying to cut off the flow of cocaine with a single arrest. Still, he figured it would be a step in the right direction.

"Take 'em, Dr. Miller," she said, confidently, pointing to her nightstand. "They're in here."

He opened the drawer and took out two unopened packs of Camel cigarettes.

"Can I have the others?" he asked.

"I don't have any more. That's all I have."

He knew there would be others, easy to obtain.

"Now you've got to swear you'll quit smoking."

"I'll swear," she said, showing no emotion.

He raised his brow slightly to catch Emily's eyes, then returned his gaze to Ms. Wiggins.

"Then swear," he repeated, raising his voice slightly.

"I swear." Still no emotion from his patient. Dr. Miller reached over and picked up her Bible from the bed.

"Swear on this," he commanded.

"Why do I have to swear on the Bible?" Now her voice was rising. "I said I wouldn't smoke. Don't you believe me?"

Dr. Miller knew the power of religion, especially her fundamentalist brand. Unless he could get her to swear on the Bible she would never take her promise seriously.

"Ms. Wiggins you've got to swear on the Bible. Otherwise God won't believe you're sincere."

She hesitated and her body began to shake. She looked at Dr. Miller, then at Emily, then at her Bible. She seemed lost in thought. Then, after a few seconds, she looked up again at the doctor.

"Dr. Miller," she said, this time with indignation, her voice trembling a little, "that's the word of the Lord! You want me to swear on the Bible?"

"Swear!" He paused, counted the seconds: one-two-three. "SWEAR!"

"I can't do that!"

"Then you don't intend to quit. You lied to me." He looked again at Emily, wondering if she found his method unprofessional, but she remained an impassive observer.

"But I will quit, Dr. Miller. I promise!"

"Then SWEAR ON THE BIBLE!"

Slowly, with hesitation, she placed her right hand on the holy book. Now he felt the flush of victory for his crusade. He had reached the pinnacle of no-smoking creativity: a unique message tailored to a unique patient.

"Repeat after me," he said. "I, Amanda Wiggins..."

She hesitated and looked again at Emily, who merely nodded her head, affirming Dr. Miller's command. Then Ms. Wiggins looked back at him, and their eyes met. Evangelist and true believer. She repeated his preamble.

"I, Amanda Wiggins..."

"Do swear before God in Heaven..."

"Do swear before God in Heaven..."

"That I will never touch or smoke cigarettes again."

"Oh, Dr. Miller!"

He repeated the command with raised voice, this time a deep baritone. "THAT I WILL NEVER TOUCH OR SMOKE CIGARETTES AGAIN. SWEAR, AMANDA!"

"That I will never touch or smoke cigarettes again," she echoed.

"SO HELP ME GOD!" he bellowed, hoping no one from the hallway would hear him, enter the room and break the spell he was so carefully crafting.

"So help me God," she whispered. With the last word her whole body shook, and she began crying. He checked her pulse and listened to her lungs. No acute problem. She was not having an asthma attack, just a religious experience.

"She's okay," he told Emily. "I think we can go now. She'll be fine, but please check on her in a half hour or so." The two professionals left the room, with Ms. Wiggins sobbing quietly in her bed.

Feeling quite smug about his effort, Dr. Miller went to see other patients. He thought: to get a patient to quit smoking you must learn to communicate on their level, to search out that part of their psyche that will obey the doctor. Why aren't all physicians this creative with their advice?

A half hour later Emily called him to return to the ward. "Check out the smoking room," she said. "You won't believe this." The tone in her voice was like a sharp needle to his inflated balloon. He ran up to the ward.

There, in a chair next to a card table, sat Ms. Wiggins, smoking a cigarette. He noticed only two items on the table, an ashtray and a pack of opened cigarettes. He saw no Bible. Relaxed and calm, she looked up at her physician with not the least hint of anxiety.

"What happened?" he asked, feigning a hurt incredulity. "You PROMISED me you would quit. You promised GOD! You swore on the Bible!"

"I just had to have a cigarette," she said, flashing an innocent smile. "And besides, I had my fingers crossed."

Never again did Dr. Miller try religion to break a patient's habit.

5 comments:

  1. A nice light-hearted tale. Too bad for Ms. Wiggins.

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  2. at the end of the day everybody needs their vice whatever the potential cost. An enjoyable and revealing story.
    MMc

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  3. Quick and entertaining. Frustrating work for a doctor when people don't want to help themselves.

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  4. Funny story! Sure glad I don't smoke. My vice is dry cereal.

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  5. I agree that it is a fun little story, but with a touch of sadness. Unfortunately, there is no hope for Mrs. Wiggins. I just hope the doctor keeps trying with her and his other patients. Thank you for the great story.

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