Rock Bottom
III.III.III
ROCK BOTTOM
I know I won’t particularly enjoy writing this. Mostly because I have to mention a lot of my failures in excruciating detail. Also because it’s probably gonna sound like I’m giving a lecture or something.
I want to reiterate that I’m no psychiatrist nor a motivational speaker – I’m writing solely from personal experience. That, and the fact that I don’t have an agenda here. I’m not gonna use the med student or doctor card to influence anyone into changing their lifestyle. I know I’m in a position where I should promote health, but as someone who’s been alienated and entrenched in a hedonistic and masochistic lifestyle for the better part of my life, I know how condescending it is to be told to just up and change everything that grounds you. It doesn’t work. I’ve seen it in practice, especially during my psych rotation where I was faced with all kinds of addictions. And it takes an addict to understand another.
Take smoking for example. I know the deleterious effects a single cigarette can have on your body, on those around you, and on the environment in general. You don’t have to be a med student to know that. Everyone knows that. And if you don’t, all it takes is looking at the ad on the front of a packet of cigarettes. But speaking for myself, I was never deterred by those pictures, regardless of how grueling they may seem. Hell, I’d be on my respiratory medicine rotation seeing people die of lung cancer in front of my very eyes and I’d still be itching for a cigarette.
Despite knowing all about it, I kept on smoking. Why? Because addiction works on both the biological and psychological level. Nicotine is addictive. Stop smoking, and after a few days, when the nicotine’s been expelled out of your system, you’ll still have cravings. Maybe not as bad, but still pretty bad. The pathways of the mesolimbic system in the brain have already been rewired. But if there’s something the human brain’s known for, it’s plasticity. With time, these pathways can be re-rewired to function the way they used to before the very first cigarette touched your lips.
For some people that’s easy. For others – the undersigned included – it’s still hell on earth trying to give up those cancer sticks. The psychological hold depends on who you are as a person. I’ve been taught there’s no such thing as an addictive personality. That might be the case, but I beg to differ, at least when it comes to my own personality. If I know I can feel this good, I know I’ll be chasing that feeling for the rest of my life. That’s why I started smoking in the first place. And that’s precisely why I don’t do drugs. I know I’d be chasing that kind of high forever. So I don’t even trust myself to try anything that could get me there.
For me, the entire process of smoking was something I not only enjoyed, but cherished. From rolling the cigarette to lighting it, taking a drag, exhaling, and putting it out. It was almost spiritual. Cigarettes kept me company in the best and worst times of my life. Nothing complimented misery or bliss better than a cigarette. Whether it was a breakup or a nice view, a really good song or a heart-to-heart with a stranger, a cigarette always made everything better. Cigarettes were always there for me.
I know I’m overly romanticising them. I get it now, but that’s what I used to think. Close friends would lecture me over and over, but much like those ads, it was no use. “You’re smart! You study medicine! You know better!” they’d tell me. Of course they were right. Of course I knew better. I also used to agree with them. But the way I saw it back then was that I would’ve gladly sacrificed ten or twenty years of my life to cancer if it meant I could enjoy a few minutes with a cigarette.
Irrational though it might have been, it made sense to me. I know smoking kills. But I also know stress kills. Smoking decreases my stress. Therefore, smoking decreases my chances of dying.
Plus, I could get run over by a truck tomorrow. Ask McDreamy – he’ll confirm. Actually he can’t, cause he got run over by a truck. He could’ve enjoyed as many cigarettes as he wanted and he still wouldn’t have died because of smoking. Oh, and what about pollution? With the amount of contaminants in the air, everyone might as well be smoking. That’s how an addict thinks. As an addict you start rationalising every single thing. You fool yourself into believing something you know isn’t true. And apparently it’s not just me that does this. It’s a whole thing, and it’s called rational addiction. Immediate pleasure over long-term pain.
Hedonism in all its glory. And for that I used to hate myself. I used to hate myself because as much as I claimed to be happy and to know what I wanted in life, I was being self-destructive. Maybe medicine being my whole life was BS after all. For starters, I was willing to sacrifice time I could be spending in an operating room performing surgery for time spent undergoing surgery myself. Second, how could someone aspiring to be a doctor have so little respect for life?
If that weren’t enough to convince me to stop, I also had something else, something more in my face.
It wasn’t growing up with the stench of my parents’ smoking or watching my father die from cancer. It was the side effects I used to get from smoking. A lot of people never stop because the idea of getting cancer or cardiovascular disease in the future isn’t scary enough. A lot can happen until then, and when something does happen, it suddenly feels too late so they might as well continue. The hedonist prevails until that touch of cancer is detected incidentally on an X-ray or they start coughing inexplicably or feeling chest pain after fifty steps.
But me? Oh boy am I different. Screw the average Joe. Throughout my seven years (by the time of writing) as a smoker, I used to suffer from palpitations, tremors, and anxiety. I’d get a dry mouth, acid reflux, and a chronic cough that would inevitably climax in a sore throat and laryngitis on a monthly basis. Add to the list my stamina level being next to zero and my fingers having nicotine stains – a smoker’s own medal of honour.
Despite all these symptoms I didn’t stop smoking. Whenever I felt my throat starting to get inflamed, I’d pop an ibuprofen. Ibuprofen, like all other NSAIDs, should only be used with caution and for a short duration – having tons of side effects in and of themselves, including the fact that they worsen acid reflux. When I started feeling a gnawing, dull pain in my stomach, I knew I had taken way too many and gotten myself a stomach ulcer. I didn’t stop smoking. I started taking antacids to help the reflux. For months I kept on adjusting my self-prescribed meds to balance my sore throat with my ulcer. A twenty-three-year-old with two self-induced, chronic conditions, taking two regular medications. Medications I needed only so I wouldn’t have to give up smoking.
It’s pathetic, embarrassing, shameful. And the worst part? I still didn’t want to stop. I never did, not until that night in Hungary anyway. And even then it wasn’t something I wanted. Nothing had changed. The errors of my ways weren’t pointed out to me all anew by someone else. I didn’t see someone collapsing in the middle of the road gasping for air because their lungs crapped out on them. It was like a reflex. My body had had enough. I needed a change. I needed to not be anxious all the time. I needed to not feel like an old and diseased person anymore. I needed to not be controlled by an inanimate object and a greedy industry. I had hit my rock bottom.