One of my favorite charity patients is in ICU this week. She is finally losing her battle with chronic obstructive pulmonary disease. She cannot even turn over in bed, she cannot even have the nurse turn her over without immense agony. She has smoked all her life and is only 48 years old. She has already been dragging an oxygen tank around with her for years. Why do I like her? Why do I care? Because I believe that if she would have believed there were deathly results from smoking, she would have chosen differently. She despises herself for it. She has a huge family and she mostly hangs on for them because she is the center of it, and she is the one with the spirit and drive. They are an extremely poor and under-privileged group of people, but she is not so dumb that she can't analyze and assess what is going on. I like her, she has a great sense of humor which comes across between gasps for air and uncontrollable wheezes, and she will talk to me about more than just her health. When a skeleton passing for a woman talks about world events, or local happenings, while picking up 10 inhalers to help her breathe, well, I pay attention. It hurts me so much to see her struggle for air...a weird feeling comes over me like I want to scream at her BREATHE NORMALLY, DAMN YOU. Like I want to follow her outside and slap the cigarette from her hand and grind it into nothing beneath my heel. Like I want to hold her grandson up to her, shove him in her face, yell at her for being so stupid as to cheat him out of a grandmother. But it is too late. Much too late. Instead, I care about her and I tell you, because I care about you. And you know what I am really saying here. It all comes down to what you mean to yourself, whether or not you care enough about yourself to quit. We smokers do not quit for anyone else, for any other reason than we finally believe we must quit--to save our own lives. If there is ever a single reason I must give as to why my job at the hospital means so much to me, it is because I owe my own smoking cessation to the glimpses I had into the lives-known-as-living-death. I am a witness to Living Death. It's a constant reminder of why I quit, and the constant reaffirmation to stay quit. I don't know a sane person who would choose extended smothering as a "good" way to die. They say it feels like being smothered and it just doesn't stop, on and on it goes. You see, it takes awhile for all of the cells in the lungs to die, cuz there are millions. There is no cure and no going back. And as long as a little air squeezes into those sacs, then you live, in spite of yourself. Friends don't let friends smoke to death and say nothing, do nothing.