“I don’t want to quit smoking,” my patient says with her face firmly set. I’m taken aback.
“I don’t think that’s true,” I say,” you just told me you quit, then you started again because your brother and grandson died in the past few months and you’re struggling with the loss. I don’t think it’s that you don’t want to quit, it’s just that quitting while you’re coping with emotional trauma probably seems too tall an order.” She becomes tearful and wipes her eyes with a tissue.
I can’t fix any of this for her. I can’t bring her family members back, I can’t take the rest of her stressors away, I can’t cure her of the multiple diseases that rack up such high medical bills, and I can’t even offer her a very effective tobacco cessation treatment. She is already on antidepressants with a long history of depression, she has tried, and didn’t find too helpful, the various tobacco cessation aids, the ones that didn’t give her nightmares or cause her to consider killing herself, that is. Perhaps the least I can offer is compassion and attempt not to be another person she sees the need to defend herself against.