Over-psychologized

Palomar · 2004-05-29 07:25:33

*I just did a report of a man who's trying to quit smoking completely. However, he can't give up the morning cigarette with coffee and the sports page prior to reporting for work, nor the after-work cigarette prior to showering and relaxing for the evening. Obviously he enjoys the comfort of a cigarette during the two most pivotal times in his day. Just 2 cigarettes the entire day.

The doctor diagnosed him with "tobacco use disorder."

--Cindy

Shaun Barrett · 2004-05-30 06:19:50

"Tobacco use disorder" ... ?!!
Wow! I know cigarettes aren't good for you but 2 a day is a disorder??

I have a confession to make. I used to smoke from the age of 19 until I turned 30. I rarely smoked more than half a dozen cigarettes a day and, if I did smoke more than that on one particular day, I probably wouldn't smoke at all for a day or two after that.
But, Cindy, if the guy you mentioned has been diagnosed with a "disorder", I must have had a full-blown, certifiable, sociopathic psychosis!! :laugh:

Cigarettes are poison, I know, but I think it's possible to take worrying about personal longevity just a little too far. I remember asking a doctor friend of mine how much damage I was doing to myself in smoking 6 or 7 cigarettes a day. He said he didn't know of any statistics that covered such a low consumption rate. (In fairness, I should report that he, too, after we'd had a few beers, had been known to light up! He probably didn't smoke much more than 6 cigarettes in a whole year, though.)

There are a few of my favourite sayings which cover this sort of thing. They're only common sense, really:-
'Moderation in all things'
'Beyond a wholesome discipline, be gentle with yourself' - Desiderata.
'A little of what you fancy does you good' - my grandmother (! ).
Almost everything in life we enjoy carries a risk. Driving, skiing, cycling ... some of the big ones, like scuba-diving, sky-diving, mountain-climbing, etc. Even enjoying food a little too much carries the risk of obesity and the diseases associated with that. I've heard that the people who enjoy living in Denver, Colorado risk higher rates of cancer because of the altitude. And the Apollo astronauts who went to the Moon have been calculated to have a significantly greater chance of developing cancer, too.

Where does the "disorder" of smoking 2 cigarettes a day fit into this picture?

DonPanic · 2004-05-30 11:50:21

LO
I'm amazed with the very selective reactions from non smokers,
they are campaining against others' cigarette smoke as a threat for themselves, and when our national health survey agency warns that automobile pollution kills more than tobacco use, they keep silent.
As drivers, they don't admit being slow killers of their citizen fellows and being responsible for their own lungs cancer.
I guess it's quite the same in other countries.

Josh Cryer · 2004-05-30 17:14:41

My mom smokes a pack, sometimes two packs, a day. Now that's a disorder. The amazing thing is that she doesn't have any major breathing problems as of yet (while my father, at her age of smoking was in far far worse shape). Can't get that lady to quit smoking for the life of me.

But that is a thing about biology, things affect people differently, there is no magical "exactly 10 cigarettes a day will cause you to have cancer" rule. Some people can be super heavy smokers, while others could be light smokers.

Shaun's post gets to the real meat of the matter. Moderation is important. Without moderation even water can kill people.

Palomar · 2004-05-30 21:26:06

'A little of what you fancy does you good' - my grandmother (! ).

*Hey guys. Shaun, I like the quote of your grandmother. Once a year I crave menthol cigarettes; I buy a pack (cheap brand), smoke 6 or 8 of them, toss the rest. You and Josh are right about moderation.

DonPanic, I once worked with a group of ladies who insisted on having bottled water (purified water, of course) available in the office. They were willing to help pay for the expense of the bottled water. Their reasoning was, of course, that purified bottled water had none of the additives found in city tap water, and were concerned for their health. That's commendable, I suppose, but what was next -- portable oxygen tanks and face masks in the office?

To be blunt (I've been a medical transcriptionist for roughly 16 years now), some of this is, IMO, simple manipulation tactics on the part of less ethical doctors. You know, scare people and keep them coming back ($$). And I'm sure such a thing would be no surprise to most folks here.

At one clinic I worked at (about 14 years ago), I suspected a physician in the group of attempting to manipulate patients' anxieties. For instance, one of her patients had cholesterol and triglycerides screening; the patient's cholesterol was 201. The desired level is 200. Obviously just 1 point over the desired level. What did this doctor do? She dictated a long letter to the patient, asked that literature (information about diet and cholesterol-lowering drugs) be included with the letter, and urged the patient to return in 4 months for another test!

Of course, it was impossible to know for certain if this physician -- just recently graduated from med school -- was simply ridiculously overly cautious or eager to get her schooling paid off more quickly.

But I see this trend increasing, i.e. any even *slight* variation from what is considered "a norm" gets some psychological label slapped onto it. It's like a weird version of Puritanism.

I was surprised, though, at the doctor labeling that patient with "tobacco use DISORDER" (despite my years in this career). Any medical report is a legal document, and that was of course a diagnosis.

--Cindy

Mad Grad Student · 2004-05-30 21:32:08

Earlier this year I got into an interesting discussion with a classmate about the risks of cancer and the like. Now, neither of us are scientists, but we're both well-versed in a variety of scientific topics (We once got into a heated debate about string theory, not a common site for high school freshmen). Our eventual conclusion was that the greatest contributor to your risk of cancer was being alive. No matter what, you're constantly exposing yourself to what will eventually be certain death. With every breath you suck in millions of probably pathenogenic bacteria. Even when you're sitting indoors you're constantly being bombarded by cosmic- and gamma-rays, boosting your cancer risk. It seems as though our bodies are designed to rip themselves apart, eating creates free radicals that bashes cells apart, and even breathing exposes them to oxygen that wears cells away over time. The best way to protect yourself from cancer, aparently, is to not be alive.

Now, I'm not sure how smoking fits into all of this. Being a teenager, I am constantly bombarded by all of these anti-smoking, anti-alcohol, anti-drugs, anti-sex, anti-being-alive campaigns, so it's hard for me to get an unbiased view. However, I have no doubt that smoking anything more than a few cigs a week is an increadibly stupid, destructive thing to do to your body. Let's think about it. Okay, eating, breathing, and commuting to/from work everday are extremely destructive/risky things to do, but there's no way around that. The rewards profoundly outweigh the risks. However, you don't really get that much of a payoff from smoking (Compared to breathing and eating, I assume), and it comes at a BIG risk increase. It just doesn't make economic sense. Also, it seems like you can't walk five feet without hearing about some new study about how smoking adds great cancer risks when combined with drinking, obesity, contraceptives, etc. (I feel that I should clarify something, I'm not anti-birth control at all, but I have read of studies that say that smoking does raise the negligable risks of contraceptives by a pretty big margin. Again, birth control by itself has incentives that outweigh the risks, but with smoking it's harder to say).

So, the enevitable conclusion is that we're all screwed. Turns out there's probably no good way to beat the reaper, it kinda sucks, but that's life. IMHO, what we need to realize is that, yes, everything we do brings us that mcuh closer to our deaths, but use that make every bit of life sweeeter (Extra e for emphesis ). Live with it man, let's live life.

Shaun Barrett · 2004-05-31 00:31:30

Yes, Cindy, I have no doubt that unscrupulous doctors exist. They come from the same gene pool as the rest of us flawed creatures, so there's no reason to think they're all squeaky-clean! A certain percentage of humanity will do almost anything for a dollar, so why shouldn't a similar percentage of MDs be in the same boat? An unpleasant thought, but probably realistic.
[On a more optimistic note, perhaps there is a slightly lesser percentage of crooks among MDs if you subscribe to the idea that at least some people still enter medicine for altruistic reasons rather than for money(?). ??? ]

You make a very good point, Mad Grad, about weighing up the risks and at least eliminating the most damaging activities in your life. I do agree with you that smoking is a disproportionately large risk when you consider the 'benefits' - the relaxation aspect and the gratification of a relatively benign addiction. (I say benign because it's not the nicotine that kills you; it's the delivery system! ) But obviously, the benefits and pleasure one gains from driving a car are very much greater, which makes the risk worth it.
That's why I stopped smoking 18 years ago but still drive a car, even though getting into my car and heading off into traffic is probably an individually more dangerous act than lighting up one cigarette instead. You're quite right that it's all a matter of 'playing the odds'.

But I happen to believe strongly that the human mind has a powerful and profound influence on the body. This is borne out by research which shows that a happy person's immune system functions far better than that of a depressed person. I believe you can bring on cancer, and other ailments, in your own body simply by being unhappy or overstressed. And I don't think this is totally unsubstantiated 'voodoo medicine' either; holistic medicine has been based on this premise for centuries and it seems to make sense, at least to me.
Getting back to the man Cindy mentioned, who was diagnosed with a tobacco use disorder, I think my grandmother's simplistic summary of holistic medicine is very apt in this case. A pivotal and very pleasurable part of that man's life, involves a cigarette in the morning with coffee and another at the end of his working day. The regularity and predictability of those two little islands of peace and tranquillity in his workaday world give him great pleasure and satisfaction and, importantly, something to look forward to! And I'd be inclined to think they do him vastly more good than harm because they promote a feeling of well-being, which boosts his immune system and thus his general health. 'A little of what you fancy does you good'!

Just as an aside, I know we're all wound up in our own health and happiness and worried half to death about trying to live a few years longer. (Spot the paradox! ) But I can remember a different time, when I was a child, when people still smoked pipes. I remember spending vacation time at my grandparents home in Worthing on the south coast of England when I was about 11 years old, and being sent to the corner store for a few groceries and 2 ounces of 'Condor' pipe tobacco. The tobacco was in small, compressed, solid blocks and my grandfather had to break it up and rub it between his fingers, which gave it the shredded consistency necessary for smoking. Those small blocks of tobacco would, when shredded, fill his tobacco pouch and keep him happy for days! The raw tobacco smelled great as I'd watch him tamping a pinch of it into his old wooden pipe. And, as he lit it and puffed repeatedly to get it burning properly, I remember him wreathed in richly aromatic, sweet-smelling smoke.
The above scene is about as politically incorrect as you're ever likely to witness: smoking is regarded as bad enough on its own but to subject a child to second-hand smoke is looked upon as unforgivable. But I loved it and such scenes form some of the happiest memories of my childhood!
Smoking that old pipe brought my white-haired grandfather such pleasure that I can't, in my mind, separate the images of him smoking it from the images of him smiling and laughing. Glorious pictures in my head of such a happy gentle man!
Did the pipe do him any harm? Much less than it did him good, if you ask me. He died when he was 84.

DonPanic · 2004-05-31 02:25:39

LO
Ancient Chineses were quite wise : they paid the doctor as long as they were healthy, so the doctors rushed to take care of them when they happened to be ill.

New Mars Forums

Announcement

#1 2004-05-29 07:25:33

Re: Over-psychologized

#2 2004-05-30 06:19:50

Re: Over-psychologized

#3 2004-05-30 11:50:21

Re: Over-psychologized

#4 2004-05-30 17:14:41

Re: Over-psychologized

#5 2004-05-30 21:26:06

Re: Over-psychologized

#6 2004-05-30 21:32:08

Re: Over-psychologized

#7 2004-05-31 00:31:30

Re: Over-psychologized

#8 2004-05-31 02:25:39

Re: Over-psychologized

Board footer