As far as I can remember, I smoked my first cigarette when I was 14 years old. I'm not precisely sure on the date — I remember where I was (my friend's house), and I'm fairly sure I was in late middle school/early high school.
Whenever it occurred, it was among the dumbest things that I've ever done. I knew it at the time, and I know it now.
That didn't stop me from periodically trying it again for several years, until by college I was a full-time smoker. I was addicted, of course, and like so very many others who wrestle with addiction, it wasn't just the physical dependence — the irritation that started as a vague sense and grew exponentially with every stressor or hour that came between me and my smokes — it was the overwhelming psychological dependence as well.
This isn't a particularly astute observation on my part, but I mention it because I recall so clearly how much I needed to smoke when I was stressed, or scared, or heartbroken. I believed it, even while knowing that need wasn't the best word to use. This cognitive dissonance defined my relationship with cigarettes for over a decade, until I finally quit during my first year of medical school.
As I take stock of a world now six months or so into the Covid-19 pandemic, I'm very grateful to have been able to quit smoking seven years ago and, with one or two relapses along the way, managed to stay quit. The current times are overwhelmingly stressful, and I know that they are causing immense challenges for some of my patients who struggle with substances such as cigarettes, alcohol, or various illegal or illicit drugs.
We live in a world in which the social networks that so many of us depend upon for strength and encouragement are crippled by social distancing measures. Now, please don't take this as an endorsement on my part to do away with those social distancing measures because I believe with my whole heart that they are keeping us from being so much worse off. Instead, I mention them more as an acknowledgement of the "collateral damage" of the pandemic. I worry about my patients who wrestle with addictions much more serious than I ever had, and ask myself how I can best help them.
Just to be clear, I am in no way saying that my struggles with cigarettes equate to the other ones listed here — but every little shared experience gives me something to draw upon, something from which to build a relationship.
One way, I think, is to simply remember to offer support. I try to do this in my office, to let patients know that I'm there to listen and offer resources where I can. For example, I try to tell them that Alcoholics Anonymous and other similar 12-step programs are working diligently to offer virtual meetings and make sure sponsors and those they sponsor stay connected.
These acts on my part don't require specialized medical training. They require a moment's compassion to see someone suffering and try to help in some small measure. I don't always succeed in embracing that compassion.
But I am trying.
I hope that if any of you know anyone who may be struggling with addiction during the pandemic, you might find a quiet moment to offer encouragement, to ask if there's anything you can do to help. Sometimes that's all it takes to get someone headed in the right direction. Yes, sometimes it gets met instead with anger, or resentment. It's not an easy path to navigate, I know that, but if you come to it, I hope there's a way for you to help.
And if you're someone struggling right now, I hope you have someone in your life you can ask for help if you need it. Your family physician, your internist, your priest or rabbi, your best friend or spouse. Don't forget that there are meetings, and places like Stony Brook Eastern Long Island Hospital and Quannacut Outpatient Services in Riverhead, among so many others, where you can find resources.
Most of all, don't give up.