On Sunday I took my son Leo to his school to play on the playground. During school the playground is separated by grade - the kindergartners have a separate playground, one for first and second graders, and one for 3rd through 6th graders. Since Leo is at the end of second grade (two more days left), he has wanted to play on the "big kids" playground since he was a kindergartner. As we were walking up, he made some negative remark about girls. I told him that he would change in mind about girls and would most likely marry one. He immediately said no, that he was going to marry a boy. I smiled to myself, thinking that he was imitating his own family. And chances are he is heterosexual and will marry a woman. When I mentioned this to my husband David, he said that I shouldn't dismiss Leo's statement so quickly. David said that at Leo's age, 7, that David knew that he was interested in other boys, but without role models in either his life or the media he didn't have an understanding or vocabulary to express it. I guess that is possible, but nothing about Leo has set off my "gaydar." I am curious though - of the people who read this who are gay or lesbian, did you know at age 7 that you were attracted to people of the same sex?
One of my nicest patients died last week. She always asked about Leo and how he was doing. She smoked for many years, and last year had an episode of blood in her urine. The workup showed cancer of her ureter, the tube from the kidney to the bladder. She had to have the ureter and kidney removed, then had lots of complications, including a wound infection, sepsis (the infection spread to her blood and all over her body.) She was able to be discharged and went home for a while, but she was too weak to take care of herself so went into a nursing home. Then she developed pneumonia. She did not want to be intubated (put on a ventilator), so she died of the pneumonia. But it was the tobacco induced cancer that caused her death. Some patients have been surprised that smoking can cause bladder or ureteral cancer, but some of the toxins from tobacco end up in the urine, and the ureter and bladder are constantly exposed to the toxins, and cancer is the result.
Another patient was brought in last week for a change in her personality, inability to sit still with near constant twitching, and muttering. I thought that she might have a movement disorder and sent her to a neurologist. The workup showed two masses in her brain that were likely metastatic cancer from somewhere else. Further scans showed a lung mass, so it is likely lung cancer from her smoking. The patient is now very confused and can barely get out of bed, so I suspect that she won't live much longer.
How much longer is this going to continue? Tobacco is a known carcinogen, as is second and third hand smoke. (Second hand is what others breathe in while someone is smoking, third hand is the residual left that others breathe in later - yes, that "tobacco smell" is cancer causing.) So why does our and nearly every other government let tobacco sales continue? In this country it is the tobacco lobby paying off our elected officials to continue this corporate murder. If I am every made ruler of the world, tobacco will be gone very quickly (but after equal rights for gays, lesbians, transgendered and women are written into law.)