Sunday, 18 April 2010

He'll ask how much I smoke

Tomorrow is the date of my annual visit to the GP for a dodgy-ticker assessment. There can only be three outcomes, the same pills, different pills or an appointment with the undertaker. It's always rather a fun thing. My GP is one of the sensible ones who knows which patients will react to nagging with either a raised eyebrow or a clenched fist.

I have been off the sauce for a few days to ensure my blood pressure will be lower than normal. There is no intention to mislead. Visiting someone who will measure your blood pressure causes a rise in blood pressure, so mine should be at about its normal level when he measures it. An unnecessary increase in the daily dosage of Amlodipine or Ramipril can then be avoided. The beta-blocker will always remain at the same dose as will aspirin and the statin, it is the blood pressure pills they twiddle. Having checked with chums in the medical world it is not normal practice to second-guess the blood pressure meter, so my breakfast and bedtime pill intake should remain the same as a result of a few days of painful abstinence.

One question he will ask is how much I smoke. He might or might not ask how much exercise I take or the general construct of my weekly diet but he will ask how much I smoke. For years I have told him that I buy one packet of cigarettes a day, I used to say a packet of ten now I say one packet because my consumption has crept up. It is a lie, then again it is not a lie because my medical chums tell me the usual practice is to either double or increase by half the level of smoking admitted to by the patient and my daily usage is usually between 30 and 40 little vitamin sticks (as I like to think of them).

What I never say or, indeed, lie about is how much I smoke. I only lie to him about how many I buy because I have absolutely no idea how many I smoke. The question "how many cigarettes do you smoke?" is really quite meaningless because there is no unit by which it can be measured. Some people are assiduous smokers, the ciggy is in the hand from the moment it is lit until the moment the last possible shred of tobacco has burned and puff furiously between those times. Others take an occasional drag and leave a long stub. Or you could puff furiously but leave a long stub. Or take regular but not incessant drags and leave any length of stub. Or the bus could come, requiring you to discard whatever is left of your heavily taxed sinful pleasure. Or or or. In each case a cigarette has been smoked to some degree or another.

The person who smokes every possible morsel of his little treat cannot smoke more than one cigarette for each cigarette he ignites. The person who takes one drag and then leaves it in the ashtray until it is burnt to the filter has also consumed one cigarette, although he has taken into his black lungs only a small fraction of the supposedly noxious fumes emitted by his conflagratory companion. If each of these chaps buys forty ciggies a day and treats each one in the way I have described how should they answer their doctor when asked "how many cigarettes do you smoke?" It would be accurate for them each to say "forty", yet that would tell the doctor absolutely nothing other than that his patient takes some tobacco smoke into his system forty times a day. How much he takes cannot be ascertained without further questioning, which rarely if ever happens.

Were such additional questioning to happen I wonder what the answers could tell the medical people? "I smoke forty a day and suck every last dribble of first hand smoke", "I smoke forty a day but only have one puff every ten minutes and don't inhale deeply", "I smoke forty a day, sometimes take a lot of the ciggy and sometimes take a puff or two and the rest drops as ash into my keyboard", "I smoke forty a day and have no idea how much of each ciggy I consume and how much burns gently in the wind" ... they are all forty-a-day smokers yet three out of the four probably inhale less tobacco smoke than a ten-a-day dedicated deep inhaler. There is no way in the world of any medical person being able to fine-tune treatment on hearing that someone "smokes" forty-a-day rather than ten or twenty.

Since my GP is not in a position to draw any clear conclusion, or to determine the appropriate treatment for my dodgy-ticker, from me saying I smoke ten, twenty, thirty, forty or more ciggies, I prefer to tell him the truth dressed in a lie. I will tell him I buy one pack of twenty every day (actually it's nineteen, not twenty but that just confuses things). He will note down that I buy/smoke thirty or forty and we will both be happy. His note will be correct, I know his interpretation of what I say will result in his note being correct, he won't waste time with advice on ways to give up smoking because he knows me better than to waste his breath like that, I will leave with a prescription for my pills for the next three months and life will go on. And neither he nor I will know how much I really smoke, nor will we really care.


wonderfulforhisage said...

I had an American boss in the sixties who used to light up everytime he did something different. Thus if he were smoking when the phone rang and his current fag was burning away in the ash tray, he'd light another one after about five seconds on the phone. His underlings found this very amusing and on a few occasions witnessed three on the go at once. We were always on the lookout for a 'foursome' but never witnessed one.

Apropos of dodgy tickers, nine years ago when I was a smoker I had a heart attack at about five in the morning. Amulance and all the trimmings and at about eight o'clock I was lying in my hospital bed wired up to God knows what and with an oxygen mask over my face. I suddenly realised that I didn't smoke. It wasn't that I was going to give up smoking or anything similar, it was a knowledge that I was a non-smoker.

And I haven't had a fag since, nor have I had the slightest inclination to do so. So different from the agony of giving up that I'd experienced several times previously.

Given that I was smoking about thirty a day at the time, say £7 a day or £2000+ per year, I reckon that my heart attack has saved me around £20k. Also when I came to retire I got about £3k a year more from the annuity company because I was such a 'good' risk, in their terms, with my ticker problems.

So all in all my heart attack could well net me £50k plus by the time I eventually turn up my toes.

And the moral of this story is: smoking can be good for you.

Stan said...

I've only ever been asked how many I smoke by a doctor once. She was a locum who told me I smelt like a smoker (at the time I worked in an office full of smokers).

I thought this was a bit rich coming from a woman who seemed to have bathed that morning in some sickly perfume so I told her that she smelt like a whore's boudoir, but I wouldn't dream of implying that she was a prostitute.

Andrew W said...

Are you still using those e-cigarettes? How do you find them? It looks like they'll not be sold in this country as getting them past the health Nazi's is too big a hurdle.

Clive said...

I haven't seen a GP in years, so I've never had the opportunity to try this line:

GP: "How many cigarettes a day?"
me: "Sixty-five"
GP: "."
me: "... thousand. Sixty-five thousand."
GP: "!"
me: "Oh, hang on -- you've got one of those new-fangled 32-bit computers. Better make it four billion."

Charon QC said...

Excellent post! Inspiring!

Keep at it..... I shall join you.

H.R. said...

FB, when you eventually pass into the great beyond make sure your GP records it as a suicide. (He might also make a note that you were in no particular hurry to carry out the act.)

TheFatBigot said...

Mr Andrew, I managed to burn-out the last of the little electrical widgets in my e-ciggy a few months ago. Keep meaning to buy some replacements.

Mr Charon, I thought you'd like this one. Oh for the days I could give a tutorial on the finer points of anticipatory breach of contract while filling the room with cigar smoke. It all seems so very long ago now. Probably because it was.

Blogger said...

After doing some research online, I've ordered my first e-cig kit on Vaporfi.