Smoke and Mirrors: Reflecting on ICU Trauma During a Cigarette Break

On Independence Day, I found myself alone, drunk, and crying. Every other person at the small party had adjourned to the parking lot to smoke.

I have always had a problem with smoking. The first fight my husband, Jonny, and I ever had was when I found out that he was smoking at a party. I may sound a bit self-righteous here, but I have always been vocal and unapologetic about how much I dislike the habit.

Before my cousin died of lung cancer and my mom was diagnosed with IPF, I would bemoan the interruptions caused by smoking breaks at an otherwise fun gathering. I would wonder aloud how many minutes of my life I’d spent freezing my butt off in some parking lot waiting for Jonny to have one last smoke. I hated smoking for how it affected my life, but also because of its risks. I didn’t want Jonny to get cancer, and I told him so often.

My complaints never helped Jonny end his smoking habit. Pleading that I didn’t want to be a widow because of cigarettes didn’t magically make them less appealing to him. Trying to be more understanding and supportive didn’t extinguish the flame of nicotine dependence, either. It made me sad, tired, and frustrated.

I sat in the warm evening glow thinking about the situation. It wasn’t just that I hated the smell or that the party was being interrupted. I’d just gotten back from a six-month stay in San Francisco, caring for my mom before and after her double-lung transplant.

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I know that nicotine addiction has a loud voice, but as a person who’s never had an addiction, I don’t actually understand how it feels. It seems like a choice even though I know that, to a large degree, it isn’t. Usually, I can bite my tongue because of that fact, but in my boozy, self-centered universe, I took it personally. I sat on the couch having a pity party.

Visions of my mom hooked up to the ventilator swam through my mind. I remembered watching her endure suction — when a small tube is inserted through the tracheostomy to suck sputum out of the lungs — just to get one mediocre breath. I thought about the numbers on the monitor when she was in the ICU: O2 saturation at 80 percent, respirations three times faster than they should’ve been, heart rate erratic and unreadable.

I never again want to see someone I care about go through that. I felt defeated, but I thought of how lucky we were that my mom survived. My mind turned to the people who weren’t so lucky. I thought of departed Pulmonary Fibrosis News columnist Kim Fredrickson. I imagined hundreds of people in ICUs all over the world who were not four beers deep and getting ready to watch fireworks.

My family survived the ICU. Mom is doing great six months after her transplant. I was at a Fourth of July party 1,000 miles away, no longer worried about her lungs. I had lost no one in this ordeal, and yet I felt sick with guilt.

The alcohol had loosened my brain up enough to feel all the fear and sadness I had pushed away while my mom was in the ICU. I was projecting it onto imagined strangers in the ICU, feeling fear and sadness for them, but for my mom, too. Most of the time, I feel grateful and in awe of my mom’s transplant journey, but the difficult feelings come in bursts and probably will for a very long time.

I dried myself up and went outside to watch the sunset. When everyone came back from their cigarette break, we resumed our conversations, fired up the grill, and watched fireworks explode all around Fort Lewis. I didn’t think about the hospital at all for the rest of the night.

As for Jonny’s smoking habit, I told him that it hit me in a new way because of the events of the past year. After years of voicing my disapproval, I didn’t expect it to make a dent in the addiction. He’s wanted to quit, but past attempts were short-lived. However, after all the support he’s shown me, he went the extra mile. He tried a new approach, and after years of on-and-off smoking, he has finally quit — dare I say it, for good.

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