For Smokers, Habit Permeates Life

"Memories, imagination, old sentiments, and associations are more readily reached through the sense of smell than through any other channel."

- Oliver Wendell Holmes

Before I enter the exam room to meet a new patient, I often spot their CT scan jacket sitting outside the door. If there is time, I take the envelope down the hall to review the films on the x-ray view box. This allows me a few moments to digest the information that the films provide and to begin preparing my treatment plan even before I have seen the person behind the door.

Occasionally, as soon as I pick up the film jacket, I am startled by how it reeks of cigarette smoke. As I reach inside to pull out each sheet, another wave of stale smoke odor washes over me.

I examine the films and re-assemble the anatomy of the cancer in my mind - where it began, where it spread, and what we will probably recommend for treatment. As each sheet of scans is mounted on the view box, the smoke odor reappears and dissipates.

An hour later, as I am finishing up the office visit with the new patient, I comment on the smell that had saturated the scans. Usually, the patient tells me that they had picked up the films from the hospital a couple of days before and had kept them in the car until the appointment. Now they have come to the clinic, looking expectantly for our team to rid them of this cancer.

My experience - and my nose - tells me that the smoke that permeates their x-rays also permeates their car, their clothes, their body, their life, their home, their hobbies, their free time, their lifestyle, and their entire identity.

Convincing them that they must quit smoking to optimize their cancer recovery will be a tough sell, although not impossible. But I knew that the moment I picked up their film jacket.

Bruce H. Campbell, MD, FACS
Professor of Otolaryngology and Communication Sciences
Chief, Division of Head and Neck Oncology
Interim Director, The Medical College of Wisconsin Cancer Center

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