My thanks to Dr. Jay Joshi, who first published my story at The Daily Remedy. I have cut and pasted it below as it appears on his site.
Link is here, so please visit his website and podcast for great content on healthcare.

Daddy Quits Smoking

Daddy Quits Smoking

He struggled, his chest forcing air out in squeaking wheezes. ‘Daddy, it…it’s happenin’ again. I…need…to go to the…doctor.’ Daddy looked at him, realizing he was right. The breathing machine helped; but seldom enough. Daddy knew the truth, and he stubbed it out in the ash-tray made from the empty artillery shell his own papa had brought back from Vietnam. ‘Well junior, let’s saddle up and go down to the hospital.’ He loved the cool feeling in his lungs, and leaned over to inhale a bit more before the smoke faded away; even as it drifted lightly, slightly, towards his little boy. He loved the boy more than the burning paper and tobacco. Still, his last puff eased the fear he felt every time they left for the hospital.

Sometimes the smoke was all he had. It rose and lifted his pains away, and sometimes he felt that it almost hypnotized him, the way the wisps curled in the slow- moving air of his small house. It was cigarettes that comforted him when his wife, the boy’s mother, left him; it happened the year the boy was five. Lung cancer had taken his own father, and his mother lived far enough away to be of little comfort.

‘OK, Daddy, I’m…ready.’ He broke into his father’s thoughts, but the keys were in his hand, next to his lighter. And the pack he had not opened, but which he held for his own comfort.

His son’s expiration was long and hard; his little chest already widened by only seven years of fighting for air. The man, who worked as a logger, reached down with his great, bear-paw hands and scooped his son up in his arms, carrying him on broad, aching shoulders to their old F-150. He tried to make this a game for his son; but it was a dangerous game, and he knew it. Still, it had happened before, and odds were it would happen again.

They drove with the windows cracked, and the radio played a sermon by Adrian Rogers, a preacher the man loved to hear for the comfort it gave him on dark, lonely nights when his son was with the mother and her new husband. The cool, autumn air smelled of different smoke, the kind from brush fires and early fire-places; homes where old neighbors lived, whose bones felt winter from far away. They had driven this road over and over. As the miles ticked away, his boy’s breathing became faster and more shallow, but he was awake. He could not speak, but pointed out the window at the yellow arches, bright against the dark sky, as if to say, ‘Daddy, if I go home later, can we have a snack?’ He nodded and smiled, knowing that any smile, every smile, was a bit of hope for his sick child. Even the hope of over-salted French fries seemed to relax him a bit. He would buy him any amount of French fries if it would help. And with that thought, they pulled into the parking lot and he turned the engine off and pushed the headlight knob to off.

‘Well, let’s…go…in so we can get…some…fries.’ Daddy carried him on his shoulders again, and took a wide swing around clusters of night-shift nurses and doctors, puffing their own cigarettes and laughing with one another.

At the entrance, a nurse asked, ‘what’s the matter with this little guy?’ ‘He can’t breathe too well, ma’am. He has asthma, and it’s been worse here lately. Tonight, it was a lot worse. He needs some help.’

‘Well, let’s get him checked in,’ she said. ‘What’s your name?’

‘Jer…Jeremi..ah.’ She put a probe on his finger and brushed the hair out of his eyes. At the same time, she asked a sideways question, soft but pointed: ‘does anyone smoke around him?’ The boy shook his head to lie and say ‘no,’ but the man hung his head down as he interjected. ‘Well, yeah I do. And his mom and I separated, but she does too a bit.’

The nurse’s look pierced. ‘You know, it’s very bad for him.’

‘Yes ma’am, I know, and I want to quit. I’m trying.’ God knows I’m trying, he said to himself, and looked at his yellow nails.

The boy coughed, a long, hard cough that seemed to force all the air out of him. Then he inhaled again, with the high pitch he had emitted at home. Aryn was the nurse’s name, and she pulled a wheelchair into the room and eased the slight little boy across; he smiled again, wishing like every boy that he had one of these at home. Despite his struggle, he still felt excited about the prospects of a chair with wheels.

They hurried, not too fast, not too slow, to a room larger and brighter. The boy breathed oxygen and breathing treatments. And he held his Daddy’s hand, even more tightly, when an IV pierced his small hand. In all the rush, a young, blustering doctor rushed in and pushed his way to the boy.

Listening intently with his stethoscope, he gave orders in a language Daddy couldn’t understand; not foreign, but as good as foreign, for the length and complexity of the names for drugs and tests. He appeared worried, but Daddy had met him before. He always looked worried; he always looked in a hurry.

The young doctor looked back at Daddy. ‘Nice work; hope you enjoyed those cigarettes. Don’t you know any better? For God’s sake, I just don’t get it…’ The boy looked up, clear eyed from the oxygen that almost lifted his little face, ‘I love you Daddy, I’m fine.’

The man received the love, the gift, the reassurance it was his own job to offer to the child, and turned away with his eyes red. The sting from the clean men and women in scrub-suits and lab-coats, that was all fine. The love, so spontaneous, so undeserved, was too much to bear for a moment.

Ironically, he wanted a cigarette so badly he could barely keep his hand off the lighter. He was deterred by propriety, irony, and that he knew that oxygen was flammable. So, standing in the open doorway, by a blue curtain, he fingered the pack of smokes and dreamed of the way the white cloud rose.

The doctor rushed to his computer; they all had computers. Daddy wondered if anyone ever worked without one; of course he did, as a welder. No computer could connect steel; this was his secret joy, that he made something.

The doctor punched keys and drank coffee from a large mug with the name of some foreign drug on the side. Daddy heard every word the doctor spoke ‘Could someone please make some fresh coffee? I’m dying here! My kids kept me up half the evening. I mean, you’d think Carol would cut me a break and DO something at home, wouldn’t you? I am a doctor, God’s sake!’

Daddy looked at his son, who was breathing easier, and thought how much he would love to have the boy’s mother at home, and how he would do anything for her. How he missed her smell, her touch, even her tirades.

The boy was soon holding a small thing he called ‘the pipe.’ Through it flowed medicine, cool, bubbling medicine that opened Jeremiah’s little airways. His deep breathing, which had grown horribly silent (his father knew it meant danger), was now loud, wheezy, the noise of water through pipes or air through an organ. And the medicine as he exhaled it rose like smoke to the bright hospital lights on the ceiling of the clean, perfect room.

‘Do you feel better?’ A new nurse walked in, sat down and stroked the boy’s forehead. ‘I’m Erica. Can you breathe better?’

Daddy felt a little more at ease. She seemed kind, but he knew he should get it over with. ‘If you’re curious, I smoke around the boy. He’s got bad asthma, and I’m trying to quit. I feel awful about it.’ He touched the pack of cigarettes again, and leaned close to his son on the opposite side of the stretcher, breathing in the rising cloud of medicine the way he did at home when his boy took treatments. So unlike smoke, but so cool.

‘Well, I’m not going to judge you. I can’t wait for my break. This night has just sucked. It’s hard to quit, sir. Hard to quit.’

The boy looked up, took the plastic piece from his mouth and said, ‘see Daddy! It’s not…just…you.’

‘Put that back in and take your treatment, son! And yeah, I know it’s not just me. Thanks, ma’am. When you bring a child in like this, they all kind of jump on you.’ ‘Please, you don’t need to tell me. They all have this high and mighty thing going. But let me tell you a few things.’

She walked up to Daddy in her purple scrubs, her hair pulled back. He could smell perfume, but more beautiful, the faint scent of her last cigarette.

‘I’m going to pretend to be explaining your son’s care to you, and I’m going to point out some things about the folks here, OK? The thing is, I’m quitting. I’m going to be a travel nurse, so it doesn’t matter what I say tonight, kay?’

‘Sure…I guess.’

They stepped away from the boy, whose eyes were lit with mischief; a sure sign of his improvement.

‘You see that guy over there? He’s an x-ray tech. He’s on wife four. He works out and runs and eats nuts and berries and crap. He doesn’t smoke, but he’s as addicted to new women as any man ever was to Marlboroughs. He’s a boob man, and if a young girl comes in here to work and she’s built, he will be on her like white on rice.’
Daddy was uncomfortable, but intrigued. For once since he arrived, Nurse Erica had distracted him so that he did not desire a smoke.

‘You see that nervous old bat over there? Bossiest one nurse on God’s earth. I have never seen her without a $3.50 cup of mochachinofrappalatte over-priced coffee in her bony hand. She doesn’t smoke either, but I’ll gauran-damn-tee she spends five times more on coffee than you (what one pack a day?) or I do.’

‘Well, one and a half.’

‘Well anyway, she’s as addicted as you or me.’

‘Now, in the corner over there, going over papers, she’s the nursing supervisor. See how the chair is about to collapse? She is one serious chocoholic. Girlfriend eats candy like tomorrow will be the rapture and heaven is sugar free. But Lord, she hates to see anyone smoke! All high and mighty about me whenever she sees smoke in my purse. Of course, her purse is filled with Dove Bars.’

Erica looked over at the boy, tapped his breathing treatment. ‘Are you feeling OK, honey? Do you feel better?’
‘Yes…ma’am,’ he said, with more strength and clarity than before. His little neck muscles no longer strained for air.
‘Good boy, now you watch the television. I need to talk to your Daddy a minute more.’

‘Mister, I can tell you love this boy and he loves you. And everyone has a thing. You get it? Everyone has a pack of cigarettes that they won’t throw away. My momma called them pet sins. It may be smoking or girls, boys or drugs, food or television or something else. You are not one bit worse than any of them. Tell me you understand that, do you?’

‘Yes, I do. I think so, at least. And his eyes filled a little.’

She leaned over and handed him a tissue. ‘Sorry, it’s just I hate for people to be cruel when somebody’s already afraid. Now, I can tell you that your boy is better and he’s going home tonight with you. And I can promise that smart-ass doctor is going to give you a hard time. But I’ll tell you about him. He’s addicted to himself. He thinks he knows everything and stands in judgment on everyone. His little girl calls and he tells her he doesn’t have time.

His wife stops by and he tells her he’s too busy to talk. He is a grade-A, 100% jerk. So you smile and listen and ignore him. And if your boy wheezes, that’s a problem. But I can tell from his eyes that he is inhaling love with smoke, and we could all do worse than that. So be good now, and you smile at these folks as you leave.’

The boy looked up. ‘She’s…cute Daddy!’

‘Hush up. Quit wasting your medicine. We’ll go home in a few minutes.’

Minutes turned to hours in the busy hospital, but at 2 am, the angry, busy doctor swept in with his cup of coffee.

‘Well, he did alright this time. But I would think that if a man loved his child, he’d know better than to smoke around him. Do you understand me, mister? Do you love this child?’

‘More than you know, doctor.’

‘Well good. Now take him home. Here is a prescription for some steroids. Have his pediatrician see him next week, alright? And next time I see you, I hope you’ve thrown away your cigarettes.’

As he said it, he took a drink of his coffee. Simultaneously, in the background, a young man flirted with a new nurse, an old nurse wolfed down a chocolate bar; Daddy smiled to himself. The doctor rushed out as fast as he had come in. The discharge papers were handed to Daddy by a thin woman, with a cup of expensive expresso in her thin hands, who looked down her nose and talked, again, about the dangers of smoking.

‘Yes ma’am,’ he said yet again.

In the parking lot, in the cool night air, they walked to the truck. Daddy took out his cigarettes.

‘You want me to get in the truck while you smoke one, Daddy?’ The boy’s voice was clear and strong now.

The cigarette in his father’s hand was approaching his lighter when he turned and said, ‘I’ll be right there.’ He tossed the pack in a trash can, knowing he might buy another in the morning. But also feeling the cool comfort of love and truth that filled his lungs that night, lit by street-lamps and kindness.

‘Let’s get some fries. I think they’re open 24 hours now!’

‘Yes!’ He jumped up and hugged his father around the neck. ‘You smell good, Daddy.’

The boy scooted next to his teary father and dozed as they drove, his breath clear at last.

Edwin Leap

Edwin Leap

Edwin Leap, MD, is an emergency physician and writer. He was born and grew up in West Virginia, where his mother was a nurse and his father a pastor. He met his wife Jan during his undergraduate work at Marshall University. He graduated from the West Virginia University School of Medicine and then completed his emergency medicine residency at Methodist Hospital of Indiana in Indianapolis. He has lived and worked for most of his career in South Carolina, where he and Jan raised four children. After 20 years in a private emergency medicine group, he embarked on locums work and has worked in many small, rural hospitals over the last ten years. Dr. Leap is especially passionate about the plight of those underserved facilities and their struggling populations. Beginning college as a journalism major, he changed directions to enter the medical profession. However, he rediscovered his passion for writing and has been a columnist for assorted publications since submitting his first op-ed to the Greenville News in 1995; a publication where he had a regular column for decades. Along the way he has also written for Emergency Medicine News, MedPage Today, the Huffington Post blog, Physician Magazine, the SC Baptist Courier, the Atlantic and others. He continues to practice emergency medicine for West Virginia University Hospitals in Princeton, WV and hopes to one day write a novel of staggering brilliance which will change the literary landscape. Or at least sell a hundred or so copies, whichever comes first.

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