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

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by Christie Patient |

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pollutants and IPF

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.


Note: Pulmonary Fibrosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Fibrosis News or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to pulmonary fibrosis.


Sara Everett avatar

Sara Everett

Christie, I can imagine how happy you are that your husband quit smoking. I hope it’s for good. Everyone in my family quit smoking, some after being chain-smokers for 30 to 40 years. I never thought I would see it happen. My sister had success with nicotine patches. In a few weeks, she was smoke-free. I understand how you feel about the ICU. My husband had IPF. He went to the hospital by ambulance in July 2018. He was immediately put on a ventilator. For the first few days, I actually thought he would come home. Then things started going wrong and they started talking about DNR orders. I agree to the DNR as I didn’t want him to suffer trauma and broken ribs. Then they told me they didn’t think he would make it. I found out they were giving him paralytic drugs because he was “fighting” the ventilator. One day the doctors told me he would never get better but they would keep doing everything the could for him. During all of this, my husband was heavily sedated on Fentanyl and other high-powered drugs and couldn’t communicate at all. When the doctor said his numbers were falling and he would have to paralyze him again, I said, “Let’s don’t”. My husband slipped away peacefully a few hours later. I had sat there for eighteen days, watching the man I love hooked up to who knows what and looking at the numbers on the monitors. Every time his oxygen dropped even slightly, I panicked. Every time his heart rate went high and his blood pressure dropped, I panicked. Those 18 days were a nightmare! I truly believe I have PTSD from the whole experience. I will not even ride by that hospital now and I don’t want to go in any hospital ever again. I understand your feelings about ICU. I’m ashamed to whine about my experience because my husband’s experience was so much worse. He’s the one who experienced all that only to leave the hospital in a hearse. Please forgive my ramblings, but I think it may help me to get this out. I hope your Mom continues to do well and you never have to go in an ICU again.

Christie Patient avatar

Christie Patient

Hi Sara,
First of all I want to say thank you for sharing your story. It takes a lot of courage to talk about these things, and I really appreciate that you are here talking about it with me. You never need to apologize for sharing your pain, or feel ashamed about your feelings. You have been through a terrible trauma and you have every right to feel horrible about it.
I'm so sorry that your husband died under those circumstances. It sounds like a lot went wrong quickly and you probably didn't have time to process or say goodbye in a way that gave you closure. The week when my mom was on fentanyl and other heavy drugs was the worst time (for me) of her 6 months in hospital, and that was after the transplant, when everything should've been fine. I can't imagine how hard it must've been to see him in that state for so long, and not be able to talk with him. Eighteen days in the ICU feels both like 18 years and 18 seconds, and it's so hard to process what happens in there.
You're welcome to express yourself in my column anytime, and I'm happy to listen. I'd also like to suggest checking out our forums** if find yourself wanting more support. There are a lot of caregivers in there who have gone through similar experiences and it might be a comfort to talk to others who understand. Thank you again for sharing your story.
All the hugs,


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