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Meaning of Christmas and My Mother In-law

Christmas is here. Unfortunately, it is difficult to look back at 2001 and say anything nice.

Not long ago, we thought that the world was shrinking. “It’s a small world,” was one of the most commonly used phrases. I haven’t heard this sentence recently. Now even the U.S. feels distant! Travel across the border is not taken for granted.

Worldwide, there is news of death and destruction, of fear, terror and revenge.

Human differences have never been so much verbalised or written about. Are my fears different than yours? Is my God different than my neighbour’s? Are these differences important when millions of people are dying from illness, civil wars, starvation, terrorism and other wars? Is their God different than yours or mine?

Closer to home, many families lost their loved ones due to sickness or accident. Medical and nursing staff of Palliser Health Authority lost three of their finest: Dr. Ivan Witt, Dr. Keith Clugston and Nurse Wendy Smith. A big loss not only to their families but also to their colleagues and patients. What is more painful is that they were taken away from us so suddenly. What did their God have in mind?

Then there are people in hospitals or at home who are chronically ill and incapacitated. They are waiting to die because they are in pain. They are suffering. One such person is my 88-year-old mother-in-law who lives in Vancouver. For several weeks now she has been close to death. But continues to live. Her end is near. But we don’t know when. The family waits and flies in and out of Vancouver not knowing what to do.

If there was a case for euthanasia, then here is one. Her body is small and frail. All the body fat has disappeared. The joints are stiff and painful. The bedsores are hard to see. The muscles are wasting away. She is unable to eat or drink. She is literally starving to death.

Morphine helps relieve pain. Her dutiful son, who has looked after her for so many years, waits and watches in helpless despair. “What can I do to make it easy for my mother without prolonging her sufferings?” he keeps asking. The best thing is to keep her pain free and comfortable. But it is painful to watch. He wants to be at the bedside until the end.

I wonder what his God is thinking about?

But we know life isn’t fair. Whether it is your God or mine, He has His game plan. And there isn’t much we can do except learn to be descent human beings. Share and enjoy what we have with those who are struggling in life. I think the God of the Christians, Jews, Muslims, Hindus, Buddhists, and others teach the same thing – be nice and help others.

Time and again we have learnt that life is too short. But greed and exploitation continues. Yesterday’s friends are enemies today. And yesterday’s enemies are friends today. It is no secret that ruthless exploiters (I wonder if their God is different than yours or mine) take full advantage of the majority of the people who are honest, descent, and God-fearing individuals.

The message of Christmas transcends all religions and human beings. It is one religious festival that has no defined boundaries. So let me wish you all a very merry Christmas, Ho! Ho! Ho!

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Laughter

“Laughter is the closest thing to the grace of God,” says Karl Bath (1886-1968).

We all agree that laughter is good medicine. But our life is a race against time. And we are looking for instant results and gratification. There isn’t much time to stop and laugh.

Physicians are no exception to the rule. In fact, physicians have to deal with sickness, disease and death all the time. So, do they find time for laughter?

Many patients have excellent sense of humour. These patients have a positive outlook in life. They generally do quite well with whatever illness they have. They make our lives very easy and comfortable. They show us that we, as physicians, should lighten up and look at the funny side of medicine.

Physicians are lucky that they have a magazine completely devoted to making them laugh. Every physician in Canada receives a magazine called “STITCHES – The Journal of Medical Humour.” It has 160 pages. Almost every page has a cartoon or two. Physicians write most of the humorous articles.

In the February issue of the STICHES, there is an article by Simon Hally: “Where there is a smoke – A modest proposal for discouraging tobacco use.” He says that for some smokers –like teenagers- the risks of smoking are too remote to be effective deterrent. Hally says the real key to an effective anti-smoking program is to make the risks more compelling and immediate. He suggests the following plan:

1. Tobacco manufacturers must be required by law to insert a small explosive charge at random into every, say, 100th or 200th cigarette they produce. The explosive shouldn’t be powerful enough to be dangerous – the objective here is to protect people’s health, not harm it – but it should be loud and smoky and very startling. This would bring a nasty surprise and embarrassment to the smoker. If the smoker happens to be a teenager then the effect of embarrassment would be immediate.

2. These explosives should be booby trapped with greenish, gooey substance. When the teenager smokes, the substance would explode on his face and on his designer clothings.

3. Some of these explosives should be booby-trapped with foul smelling gas, dye that will stain teeth, or substance which will give the smoker 48 hours of horrible breath.

Do you think this will stop people smoking? Especially teenagers?

***

Here is a doctor joke from Dr. Howard J. Bennett, a paediatrician in Washington, D.C. who has written books on medical humour. In one of his articles in the STITCHES, he relates the following joke:

A doctor died and went to heaven, where he found a long line at St. Peter’s gate. As was his custom, the doctor rushed to the front, but St. Peter told him to go back and wait in line like everyone else. Muttering and looking at his watch, the doctor stood at the end of the line.

Moments later, a white-haired man carrying stethoscope and black bag rushed to the front of the line, waved to St. Peter and was immediately admitted through the pearly gates.

“Hey!” the doctor said angrily, “How come you let him through without waiting?”

“Oh,” said St. Peter, “that’s God. Sometimes he likes to play doctor.”

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How To Quit Smoking

“Getting kids to butt out” was the topic of my column last week. We also discussed Medicine Hat School District No 76’s “Tobacco-free Environment” Policy A-38. Today, we will take the subject little further.

We know that no one starts smoking after the age of 20. Most smokers start smoking in their teens. We know that 91 percent of youth believe smoking is addictive. We know the two reasons why teens start smoking are: peer pressure (“be cool, man!”), and curiosity.

So, how can we stop teenagers from picking up this habit? And help smoking teenagers kick the habit?

Prevention programs depend on creating public awareness of the serious health consequences of tobacco use. But the Alberta Cancer Board says: “It is now recognized that awareness alone is not enough to alter behaviours. For example, it is ineffective to teach children that smoking is bad for you if the students then go home to parents who smoke, or go to the mall or other public places and see widespread social acceptance of tobacco use.”

To encourage and help people become and remain tobacco free, it is also necessary to create a supportive social environment, says the Cancer Board. Does our school system have such supportive social environment?

Ninety percent of everything we do is habit, says Kurt Hanks in “Motivating People”. Much of motivation involves changing someone’s habits. People are usually quite comfortable with their established patterns and routines. So how can we change them?

To change someone’s habit pattern, you have to substitute a better habit pattern. We have to show them that their time and money can be spent on better and healthier things. Besides that, personal motivation plays a big role.

Personal motivation is the single most important factor that determines a person’s success or failure in quitting cigarettes, says Dr. Edward Beattie, Jr., M.D. in “Toward the Conquest of Cancer.”

The man or woman who is highly motivated to stop smoking – for whatever reason – will be successful while those with weak or moderate motivation often do not succeed, says Dr. Beattie. Personal motivation also determines whether a smoker who has quit will backslide into smoking again.

The teenager does not fear cancer or other illness that may strike him in 20 to 30 years. But he does fear being “uncool”, not knowing how to handle a cigarette, and not being an “in” member of his social group, says Dr. Beattie.

It is never too late to quit smoking. The risk of death decreases soon after quitting and continues to do so for at least 10-15 years. After that, the overall risk is nearly the same level as for never-smokers.

Therefore, it is very important for schools to have programs that focus on prevention and elimination of smoking in and around schools. This should involve parents, teachers and students. We should also create a supportive social environment for teenagers to keep them away from this deadly disease.

The task is not easy. But the parents and teachers should get together and organize some serious preventative measures that we can all try and make it work. Does anybody talk to the kids who stand across from their schools and smoke? Do their parents know they smoke?

Finally, let us remember that cigarette smoking is the largest single preventable cause of cancer. It is also the largest single preventable cause of illness and premature death in Canada. Smoking accounts for almost 30 percent of all cancer deaths and kills almost 3,500 Albertans and 45,000 Canadians each year – more people than killed by heroin, cocaine, alcohol, AIDS, fires, murders, suicides and car crashes combined.

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Teenage Smoking

Each morning, if you are driving by one of the junior or senior high schools, or dropping off your child at one of these schools, you will notice a group of students hanging out and smoking across the street. Many parents, who do not want their children to pick up this deadly habit, find this very disturbing. It is a scary sight –especially at eight o’clock in the morning.

Come to think of it, five or ten students seen smoking outside their schools represent a very small minority. I know there are many more students who smoke, but are not seen “showing off” first thing in the morning. Perhaps there are few teachers at each school who smoke. But my impression is that the vast majority of teachers and students abhor smoking. But is that enough?

Medicine Hat School District No. 76 has a “Tobacco-free Environment” policy A-38 which says: “Effective August 31,1994, the use of tobacco products in the buildings of the Medicine Hat School District No. 76 is prohibited. The senior high school principles will designate a smoking area on the school grounds for senior high students.”

The Superitendant of the Medicine Hat School District No. 76, Dr. Dave Beresh, says that this policy applies to students, teachers and other staff members as well. This prevents students and teachers going in the neighbourhood back alleys to smoke.

Some parents look at this differently. They say this policy encourages smokers to continue to smoke and slowly poison the beautiful work of nature, personally and environmentally, and eventually cripple the cardiac and respiratory systems. As the smoker develops chronic illnesses, he not only becomes a burden to his own family but to taxpayers in general by extensively draining the already drowning health care system.

Smoking is extremely addictive. Perhaps the “tobacco-free environment” policy does not want to drive the smokers underground by banning smoking completely. We face this sort of dilemma in life all the time. How to strike a right balance between achieving results and not upsetting any segment of society. But one has to do what is best for the majority of the people.

What do smoking parents tell their children about smoking? What do smoking teachers tell their students about smoking? What do health professionals tell their patients about smoking? One can only guess!

In a 1999 survey, Health Canada noted the following:

-27 percent of Albertans aged 15 years and older were smokers – two percent higher than the national average.

-27 percent of Alberta male and 28 percent of Alberta females were smokers – the same as the national average for males, but five percent higher than the national average for females.

-25 percent of youth aged 15-19 years are currently smokers.

-91 percent of the youth believe that smoking is addictive.

-54 percent of Canadian Aboriginal teens smoke

Why do teens start smoking?

Mainly two reasons: peer pressure and curiosity. But almost no one starts smoking after age 20. So, can we make teenagers understand the dangers of smoking and prevent them from taking up the bad habit? How can we help teenagers who are already smoking? What do you think of the of School District No. 76’s “Tobacco-free Environment” policy?

Let me know. We will discuss this further next week.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!