A Most Noxious Weed


People who smoke don’t look like that, at least not for long. Smoking is the greatest source of preventable death in the world.

I despise cigarettes. Cigarettes cause heart disease and lung cancer, among a great many other vile things. Heart disease is not my problem. If somebody shows up at my clinic having an active heart attack they get a swift trip to the local Emergency Department. Lung cancer, by contrast, belongs to me.

Cigarettes are horrible, ghastly things. If you smoke you need to quit
like your life depends upon it. Photo by Nikita2706.

Whistle While You Work

I’m a pretty happy guy. I’ve got Jesus in my heart and a wife who loves me. Sometimes that manifests in silly little ways. There was a time in my life when I did a fair amount of whistling.

I realized it was annoying, so I eventually disciplined myself to stop. However, I would still frequently whistle to myself around the clinic. Hymns, Christmas Carols, or classic 1970’s rock and roll — whistling softly just seemed to help the day pass faster.

The patient was in her early fifties and had smoked a pack a day since her teens. She presented with a dry nagging cough. All adult smokers have such an ailment, but hers was getting worse. I ordered a chest X-ray and moved on to my next patient. As I came around the corner within sight of the X-ray box I saw it.

Lung cancer on a chest x-ray has a characteristic appearance. It looks a bit like cotton balls. The bottom half of one lung was just eaten up with it. I said a little prayer and got my wits together. I was going to have to tell her about this, and I wanted to get it right.

I knocked on the exam room door and pushed inside to find the woman already softly weeping. I was genuinely surprised as we hadn’t discussed anything about her chest films. When I asked what was the matter she responded, “You stopped whistling.”

Lung cancer most typically has a characteristic appearance. I once diagnosed
lung cancer on the strength of a shoulder X-ray. It was one of my proudest days.

It’s Always Somebody Else

Another patient was 47 years old, and this was the fourth time I had seen her. We were by now on a first-name basis. The first time I saw her I had smelled cigarettes on her clothes and castigated her about her smoking. However, I only fuss once. These people are grownups. I treat them accordingly.

It was three days before Christmas, and I remember her clearly because she was so obnoxious. She had pictures of this little four-month-old granddaughter on her phone that she was showing to anybody she could catch. She was so excited to be a first-time grandmother.

She told me she didn’t have time to be sick. She had a houseful of company and this new grandbaby, and now she also had a head cold. She wanted a shot and she wanted to get out of there so she could go home and cook. I get that around the holidays all the time.

I put my stethoscope on her back down low on the right and heard some crackles. I was concerned she might have pneumonia. That wouldn’t do. It was three days before Christmas, and she had a brand new grandbaby. I ordered a chest X-ray to make sure her chest was clear.

Hers was on the right just where I had heard it. The largest bit was about the size of a golf ball. There’s really little else that looks like that.

I had to waltz back into that room three days before Christmas and explain her terrifying chest X-ray. In an instant it was all gone. She had walked into the clinic a human being and walked out a cancer patient. There was no putting that back in the box. I didn’t sleep well for a week thinking about it.


Cigarettes kill 478,000 Americans a year. That’s about the same number as we lost to COVID in its first full year. 41,000 of those 478,000 are non-smokers.

We shut the economy of the entire planet down over COVID. The government screams about mask mandates and fires those who won’t take their vaccinations. At the same time, roughly the same number of folks die from cigarettes, and nobody cares.

If you smoke, for the love of God quit. Statistically every single cigarette subtracts twelve minutes from a normal lifespan. You do that a couple times when you’re fifteen and you’ll never miss it. You do that ten to twenty times a day for a couple decades and you’re screwed. The way to fix lung cancer is not to break it. Quit smoking like your life depends upon it, because it really, really does.

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