Doctors giving you a hard time about smoking

As many will correctly presume, I am on Mash's side.

What you may not realize is that, many things are occurring during an interaction with a doctor; many more things than you are aware of. They are assessing risks, doing statistical calculation, assessing what complications can be expected, what information should be gathered up front to make decision making easier/better/quicker when the possible complication does occur etc. But, also deciding what counselling to do at that time. Anesthesiologists can be pretty busy; many times their current interaction with you may be the last conscious/competent interaction you have with them (they will probably talk to you after you wake up, but amazingly most people completely forget this interaction). So, they have to guage what the chances are that you are "falling through the cracks" with getting appropriate counselling from other sources. And, with all doctors getting more and more pressured to work faster, alot IS falling through the cracks. Any time a doctor doesn't give you a hard time about smoking, might not be because they think it is fine, or they understand the APPARENT differences between cigarettes and cigars. It is probably as likely they just "can't be bothered" either because they are too busy, they don't think it is likely to result in you changing etc. Since they have limitted time and think they may never see you again, "scare tactics" might just be a way to make the greatest impact with the hopes that this impact continues. While this has not been proven effective, docs are human too and will jump at these options just like any other person who feels they have to get the "point across right here, right now" (how many times have parents here found themselves being more stern with their children just to get the point across eg:"child wanders away from parent at mall, but comes back when parent is starting to call out in a panic", "child steps out onto road of an otherwise vacant street but then gets heavily scolded" etc). If the doc didn't care, you wouldn't have gotten any grief at all.

But, I don't think they called you any names. "Leave it to some holier than thou delicate genius"; that's just simply an ad hominim attack for no good purpose.

Lastly, you probably won't find many doctors versed in the risks of cigars and how they differ from the risk of cigarettes. The only "specialists" of tobacco subtypes in the physician world are those docs that do have the occassional cigar and have gone out seeking the information in order to justify that its not going to harm them more than they are willing to accept. The rest of the physician population will be "generalists" in that information. Thus, they will know the risks of cigarettes, by far the MOST common form of tobacco consumption. Erring on the side of caution, they will lump cigars in with cigarettes. It seems the more reasonable/ less dangerous approach for the generalist.

Imagine a generalist deciding whether you need surgery for your prostate cancer, or whether it is safe just to "wait and watch" that cancer....you would probably want them to err on the side of caution and send you to the specialist who could cut it out.

But, I just got done a 24 hour shift and need to sleep. If the above rant seems meandering and deluded....just imagine how my last patient felt like 2 hours ago.

Finally; "manufactured, mind-altering, legal but arguably lethal substances,"...the way you use it is nothing more than scare tactics as well. So now who's taking the hypocritic oath? Of course you realize that the use of those substances is to allow the surgeon to do what could never be done without those drugs...cut deep into your body, alter the anatomy in a controlled and skillful fashion and then get out without putting you through easily the worst pain in your life. Of course these drugs can kill you, that's why the anesthesiologist has to decide which exact concoction to use for you, control it every step of the way, know how long (to the minute sometimes) each drug will take effect, know what subtle signs your body gives that things are going wrong, and how to pull you from the brink of death if they do go wrong. That's whay it takes 9 years to become a fully trained (yet still green at that point!) anesthesiologist.

There is nothing delicate about a 36 hour shift either.


Cheers

Please take my comments with a grain of salt. I sound aggressive in digital, but I assure you I would smile and shake your hand even after this exchange


Cyanide (I know, ain't it just a deliciously ironic monicer)