The Smoking Issue We Can't Ignore

My mother was a life-time smoker. She started when she was about 15 and was probably completed addicted by the age of 18, so much so that she lit up in her parents' house without even thinking about it when she visited them after being out on her own for some time. This freaked her out so much that she jumped up and ran outside to put it out.

As far as I know, the only times in her life that my mother stopped smoking were during the periods when she was pregnant with me and my brothers (thanks Mom). We used to tease her that she would die with a cigarette between her fingers, and that is very close to what happened.

She was heavily addicted. She had bypass surgery in 1995 and came to live with me during her recovery period, which was, well, hairy. "Hairy' is a word I have heard soldiers use in movies about Vietnam, when they want you to understand that death may be imminent but you really shouldn't panic. She had to be taken back to the hospital three times in the first two weeks, once by ambulance when her blood sugar dropped so precipitously that it was obvious, in retrospect, that the nurse practitioner who called for the ambulance was not convinced she would survive the ambulance ride. He realized he had been too calm with me in his description of the problem, bless his heart, when I said I could drive her and he said, well, yes you could, but I really think she needs oxygen and someone to administer it. Oh, I said. So, its kind of serious. Yes, he said, it is.

During the time she lived with me following her surgery, she acquired a staph infection that required Vancomycin, a serious anti-biotic that at the time was the drug of last resort. There was nothing else available. The drug was given to her via IV, and we won't get into a healthcare debate here by drudging up the fight I had with the Medicaid folks who wanted me, a writer, NOT a nurse, NOT a doctor, NOT even a technician, to administer the IV. In any event, the Medicaid folks relented (after I refused). At the time, I lived in a house where the only bathroom was on the 2nd floor, and since she couldn't make that trip (she slept on the couch on the 1st floor), we had to have a portable toilet brought in for her. The Vanco killed the staph but along with it pretty much all the good bacteria in her intestinal tract. Needless to say, the stench was almost unbearable, and we, my now ex-husband and I, had to take that toilet upstairs and dump it every day.

I also had to cleanse her wound. I will never forget, as long as I live, putting on the sterile apparel, standing in the shower with her, she naked, cleansing her wound, toweling her off, and re-bandaging (using sterile techniques), all while my two-year-old son howled outside the bathroom door. The wound was so infectious, I had to lock him out of the bathroom for his own safety.

During this time, I was also battling a tenacious case of head lice on my seven-year-old daughter's head (and eventually, of course, on my two-year-old as well). I spent mornings taking care of my very ill mother and evenings wearing out my already-bad eyesight with hours of nit picking. Literally. That year was one of the worst the CDC had ever seen for resistant lice infections. The school kept sending her home, and I kept insisting there was nothing I could do. I read the literature. I read a lot of the literature. I knew more than the school knew, including that while lice are disgusting, they do not carry disease, but in the long run, the only course of action was to simply cut her hair off very short. She lucked out (i.e., she got to keep some of her hair). Her brother got a head shave. To this day I can still hear him telling people "the bugs got my hair."

So, visualize all this, and imagine my consternation when, in the middle of it all, just as I had re-entered the workforce part-time, and only three months after her near-fatal surgery (her lungs collapsed twice during recovery), I discovered her smoking on my back porch. Her lungs had collapsed because the doctors did not completely comprehend the extent of her habit. They preferred to believe her (oh, I dont even smoke a full pack a day) over me (uh, more like almost three packs a day). That was the last time I allowed doctors to not to listen to me.

So she resumed smoking. She had been a non-smoker for three months. She had almost lost her life. She had survived withdrawal. She had placed a burden on me for her caregiving that was threatening my marriage and my very health. And here she was smoking again. I called my brother that day and told him to come pick her up. I couldn't do it anymore. I didn't speak to her for months.

Smoking did eventually kill her. The average survival rate for bypass patients at the time of her surgery was five years, and with good medicine, great doctors, and extremely supportive children who made sure she took her meds and got to the doctor, she made that milestone plus two more. She was a fighter and a tough old broad. She had a great will to live. If she had not resumed smoking, she might be alive today. She has missed so much in the last seven years.

This is all coming back to me today because in the next two weeks I have a decision to make, as do all St. Louis County voters who actually vote. On the November 3 ballot is a question about smoking in public places. Should we allow smokers to continue to smoke in restaurants where it is allowed by the owners, or should we take the decision out of the owners' hands and make it unlawful everywhere with just a few exceptions (casinos, bars where 75% of the revenue is not from the sale of food, tobacco shops, etc.).

This is a very hard question for me. I believe completely in personal freedom. If you want to smoke yourself into an early grave, I believe it is your prerogative, as long as you don't take me with you. I believe restaurant owners should make the decisions for their restaurants. Same for bar owners.

On the other hand, I have had meals ruined by smoke. The older I get, the less I find that I can tolerate smoke. Maybe it was all those years of living with two smoking parents, but today I find that I am as sensitive to cigarette smoke as I am to heavy cologne. They both make me sneeze and make it hard for me to breathe.

And then there is my mom. I saw cigarettes take her life away. In the end, she didn't care if she had food in the house, as long as she had cigarettes. My loving, gregarious mother became so demented by her habit that she once called me on the phone and left a voice message, after discovering that I had paid her bills and left her not enough money to buy a full carton of cigarettes, that said "You lying, thieving bitch. You better give me my money back." She thought I had stolen her money. She sounded the way I imagine a crack addict might sound. To this day, the memory is fresh and brutal.

So how am I to make this decision? How am I supposed to separate my personal family experience from the broader cultural issue? The personal and the political have never been closer for me. I just wish it would go away. For the first time in my life, I feel the burden of my responsibility as a citizen as if it were a knife in my gut. I have about a week to make a decision, and I'm not sure that I can. I'm not sure it's enough time.