Life Choices

“The person I miss most is the one I could have been.”
–G. B. Shaw

The little boy ran circles around his mother as she stood outside of the restaurant smoking a cigarette. The young woman and a friend were engaged in an animated discussion and the smoke rolled from their mouths and drifted past their faces. Suddenly, the toddler stopped running and squeezed his mother’s hand. Once her gaze had focused on him, he smiled broadly. She grinned back at him and he resumed running laps. She took a drag on her cigarette and resumed her conversation. I remember being charmed by the interaction but disturbed by the tobacco.

A few days later, I stood at the bedside with a family of a delightful woman in her mid-fifties. Her smoking-related cancer had required removal of her voice box and a course of radiation therapy. Months later, her cancer had recurred and all of her treatment options had now been exhausted. She was at peace, slipping in and out of wakefulness, and very near to death.

The whole family had tried to prepare for this day and her adult children gathered in a semicircle around the bed. One of her boys sat dejectedly in a chair gripping her hand. As I watched, she slowly opened her eyes. He brightened visibly and wordlessly returned her gaze. She closed her eyes, but they both continued to smile. This, too, was a powerful yet disturbing moment. They knew that her death at such a young age had been preventable.

I was struck that the two scenes were essentially from the same drama, with the second following inexorably from the first. Within a few days, I had witnessed two points along the same arc.

"Reflections" is a collection of essays by the health professionals of the Medical College of Wisconsin.