Cigarette Butts: The Dark Cloud Over My Late Wife’s Health

Note: I wrote the first version of this a month after my wife passed away in 2005. I have kept it close to the original, because the grief in it is real and I do not want to polish that away.

Have you ever tried to talk rationally with a smoker about the effects of smoking? Smokers will listen, nod, sometimes say they can or will quit someday, and then they do not change. You will hear “it’s my body and I’ll do what I want with it” and “my smoking doesn’t hurt anyone else, so leave me alone.” Yes, it is their body, and what they are doing is killing it slowly over many years. As for hurting someone else, here is my story. You decide who else was hurt.

How cigarettes harmed my wife Claudia

My wife, Claudia, was a smoker her entire adult life. I watched her destroy her body for twelve and a half years and stood by her through all of it. I cried many times while she was alive, trying to help her quit, listening to her promises, only to find she was still smoking in spite of everything.

She said she began smoking because her mother smoked while she was in the womb. In her mind, this made it acceptable. It was not her fault, she said, it was an addiction and her mother’s responsibility. What she said was not rational, but she believed it completely.

When we married, I was not thrilled about the smoking, but she had so many other good qualities that I decided one flaw could be tolerated. I had known drug users and alcoholics in my life. How could smoking compare to those? It seemed like a minor thing at the time. If only I had known.

A few months after we were married, Claudia called me in a panic. She was having trouble breathing and wanted me to bring her to the doctor. I rushed home, scooped her up, and drove her to the clinic as fast as I could. The doctor took one look, said “asthma,” and gave her a shot of adrenaline. Her body shook violently and her heart rate went through the roof, but her breathing cleared within seconds. The doctor, a kindly older lady, told Claudia she must quit smoking. Claudia nodded and said she would. Tomorrow. Tomorrow came and she forgot the promise.

Over the next year we visited that doctor regularly, and each time Claudia received a shot of adrenaline and breathing treatments. Each time, I rushed home from work, loaded her into the car, and drove like a maniac to the office. The rational thing to do was to stop smoking. Reason has nothing to do with smoking. I learned there is nothing worse than the reaction you get from telling a smoker she has to quit. I still wear the emotional scars from those conversations.

As time went by we switched doctors, bought a nebulizer, and collected prescriptions for a growing number of breathing drugs. The most significant was Prednisone, a steroid with so many side effects it would be labeled a poison if it were not so useful. During one nasty attack a doctor prescribed a massive dose, and Claudia became a different person for two weeks. She took her aggression out on one of our cats, a gentle creature named Baby, and one day, enraged, she tried to kick him, missed, kicked the wall, and broke most of the toes on one foot. She hated that poor cat until the day I came home from the vet and told her Baby had asthma too. That gave them something in common, and the two became constant companions.

Test after test made it clear that cigarette smoke was the cause. A pattern also emerged: when Claudia got emotional, upset, or grieved, a severe asthma attack almost always followed. I felt more and more like I was walking on eggshells. There was one exception. Anger causes a surge of adrenaline, so when she had an attack and no medication was near, I would get her angry, and the surge settled the asthma down. One night at urgent care, a doctor told her she was faking it. Her face turned red, her asthma vanished, and the doctor ran from the room and had a nurse finish up. I never saw him again.

Over the next nine years I became far too familiar with the side effects of steroids. Claudia, who weighed less than a hundred pounds when we married, eventually gained over two hundred pounds of water locked into her tissues. One day she could barely walk down the stairs. She checked into the hospital and, over three days, lost twenty-one liters of fluid. I remember stepping into her room and seeing jugs of liquid lined across the floor. Our doctor was making a point: this was the result of her refusal to quit.

She seemed to understand. On a visit, I wheeled her outside so we could talk, and she pulled out a cigarette she had smuggled past the nurses, exceedingly pleased with herself, and swore, as she smoked it, that this was the last time. We repeated that scene half a dozen times, six trips to be drained of fluid, until one day she fell into a coma for four days. A lung specialist told her plainly that her asthma was now chronic lung disease, COPD, and that she had to stop smoking to live. Again she swore she would.

Her tissues began to leak. Small holes opened around her ankles and water dripped out. Her skin turned brittle and sores developed, and we added a wound care specialist and twice-daily dressing changes to the routine. Then a two-liter bottle rolled out of the refrigerator and hit her leg, raising a three-inch bruise the specialist popped open to prevent infection. It became infected anyway, with MRSA, and I will never forget the panic on that doctor’s face. Three separate times her cuts became infected, and three times a home nurse delivered antibiotics through an IV I hooked up each morning and night.

This was my life for several years: change the dressings twice a day, check the wounds, check her temperature and blood sugar, another gift of the steroids was diabetes, and take her blood pressure. At one checkup our regular doctor told Claudia she looked much better, asked gently if she was smoking, and she said no. Once she was out of earshot he told me, “She’s still smoking.” It was not a question. I asked what I should do. He said something I will remember as long as I live: “You cannot live your life being the cigarette police. I would suggest you buy her a good life insurance policy.” He was not joking. No company would insure her, and his meaning was clear. Unless she quit, she would die.

The worst month of my life came after another coma. Claudia could not breathe, the steroids stopped working, and even emergency adrenaline did nothing. I called 911. She spent the better part of a month in a coma while the doctors fought to keep her alive, and it was often unclear whether she would survive. She pulled through, barely, and I watched a woman who had just cheated death demand a cigarette from her hospital bed. She fought and cried and screamed at me for days until, for my own sanity, I agreed to let her smoke one cigarette a day.

She recovered some strength, though never near normal. I bought a dozen HEPA filters, special bedding, an oxygen machine, a commode with handles because she could not stand from the toilet, a bench for the shower, and I arranged a nurse’s aide twice a week. By December I started to relax. It looked like she would slowly recover.

In the middle of January 2005 she took a sudden turn. Her breathing worsened, her tissues filled with water, and blisters formed on her feet, all of it fast. On Monday, January 31st, I was at work when she called, in pain and struggling to breathe. I rushed home, tried everything, and called 911 for the third time in our marriage. I watched the paramedics carry her downstairs and wondered how long she would be in the hospital this time. It never crossed my mind that our long, sad story was ending.

My wife, my best friend and soul mate, passed away the next day, February 1st, 2005, at 10:37 in the morning. The cause was sepsis, a blood infection, probably from the wounds on her feet. I had signed the form saying she was not to be resuscitated, something she had asked of me years before, and so as her body failed, they let her go. I walked into the room and looked at her for the last time, and our whole life together flashed through my mind. Our journey was over.

After she passed, I cleaned our apartment from the back room forward. It was a cleansing. I threw out two full trash cans of pill bottles, equipment, and papers. The most infuriating discovery was several hundred empty cigarette packs stuffed into every possible hiding place in the back room. She had been getting far more smoke into her lungs than I ever knew, begging cigarettes from friends and walking, in pain, to the corner store whenever she could find a few dollars.

Now when I see someone smoking, I have to suppress what I feel. I feel the loss of Claudia. I feel anger at the stupidity that killed her. I feel sorrow at her inability to stop. When a smoker says “it’s my body and it hurts no one else,” I have to leave the room, because I know from experience that it hurts everyone around them.

Life goes on, and I have moved forward. I am at peace with the choices I made. I don’t drink, don’t smoke, don’t take anything but what a doctor prescribes, and I try to live to a high ethical standard. I hope these words are of use to someone. Perhaps a dose of the truth might shock one smoker into quitting. If it does, then telling this was worth it.