Big Frank and I go back about 10 years or so. When we first met he said his golfing buddies affectionately gave him that nickname, probably because he stood six-four and was overweight, to put it politely. He had moved to the Coast from the Midwest where he was general manager of a plant that made gloves and employed about 80 people. He had retired, at an early age actually, and he and his wife decided to move to the Coast to be closer to his only son and daughter-in-law who at the time had started a new business, and was also talking about starting a family. Well, a few years after Frank relocated they gave him his first grandchild, a girl, and Frank and his wife looked forward to their new status as “babysitters,” if you know what I mean.
Anyway, aside from having high blood pressure and high cholesterol, Big Frank was overweight and also smoked. It took about a year to convince him to take cholesterol medication because he had read on the Internet where it could “ruin your liver.” Somehow he was unable to appreciate the well-known evidence that as a group, people with 290 cholesterols have high rates of heart, stroke, and blood vessel diseases – not to mention premature deaths – and that the benefits of cholesterol medicine was far and away greater than the very infrequent side-effects. To him the benefit of running around with an untreated 290 cholesterol was better than taking what he misperceived to be evil medication. Like the rest of us, he liked and needed his liver. But eventually, with the help of his wife, who was well-versed in logic and persuasion, being a retired paralegal, he finally consented to taking the medicine. While Big Frank continued to enjoy golfing, commanding a handicap of six no less, he also continued to enjoy control over his high blood pressure and cholesterol, both of which were normal for several years. However, his weight was a continuing problem, no thanks to the Coast’s many fine restaurants and its diverse culinary traditions. He would also come in for various other things, maybe three or four times a year, and at every visit I would bring up his weight, his need to exercise and walk more (like most golfers he always rode the cart) and his smoking. I would explain, at each visit, how smoking accelerates arterial blockage, regardless of your cholesterol level, but especially so if it is high, and that if he never lost a pound that compared to stopping the cigarettes he would be in much better health. My repetitive advice for him to quit smoking, along with his lack of response in having deaf ears to this advice, became so expected from both of us that it devolved into something almost comical. During each visit and exam he’d have his Marlboro pack defiantly snuggled into his top shirt pocket, as if to be reminding me, “I’m in control here.” After listening to his heart and lung sounds, I would thump the pack with my finger and say “have you heard these things are bad for you?” He’d come back, “Yeah, that’s what I hear.” And we would both smile. I always thought I was wasting my breath on Frank in actually vocalizing the advice to quit smoking, which it turned out I was, but I did so anyway since surveys continue to show that smokers have a higher quitting rate if they actually hear their doctor tell them to quit. Strange psychology it is. But when it came to Big Frank, he wasn’t on this side of these stats. So this lame charade went on for several years. Until one day when he came in for an unrelated problem and voluntarily announced he had quit smoking. At first I thought he was pulling my leg. But he looked and talked serious. I told him that that was great, shook his hand, and then asked him how he’d done it. I’m always curious to know what motivates people to make changes for the better. Expecting him to say the cost of a pack had gotten too high, he instead related a different reason – and one I had heard before. He said one evening, a couple of months earlier, he was sitting in his easy chair, reading the newspaper, when his son and daughter-in-law, and their daughter, seven year old Amy, came to visit. After the usual greetings, Amy climbed in his lap and they would, during visits like these, read a few comic strips together, with Frank helping her with some of the big words. But on this occasion, after a few minutes, the second-grader paused, turned her big brown eyes to him and asked, “Paw Paw why do you take them drugs?” Frank told her he didn’t take drugs, never took drugs, and what in the world was she talking about? She said, “Well we learned at school that cigarettes is a drug and when you take drugs that it makes you sick and you can die. And I don’t want you to die.” Frank said he was at a loss for words. How do you rationalize your smoking habit to a seven year old? “Why do you smoke drugs, Paw Paw?” His only lame response was he had done it for years and since he’d been doing it for years and that it hadn’t made him sick, and that he would be okay and for her not to worry. But he knew this explanation would not suffice for this learned second-grader. Later that night when Frank shared the encounter with his wife, she gently reminded him that he needed to realize that, possibilities being what they are with smokers, that it was possible that things might happen such that he might not live to see Amy graduate from high school -- or get married -- or have a family -- or that he might not even get to see additional grandchildren. Frank said he put them down the next day – and hadn’t had the urge to smoke since. Well, so much for the doctor beating his head against the wall trying to make some men quit smoking. Leave it up to cute skinny little grandkids with big brown eyes to get the job done. I just hope whatever they’re teaching them in school about health issues – that they’ll continue to do so. Because whatever they’re doing -- I think is working.
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