Guilty as Charged: the Stigma that Remains

As someone who spends quite a bit of time evangelizing about the need to re-imagine the lung cancer narrative and remove the stigma associated with that range of diseases, I did not expect to admonish myself for making the same judgments I often condemn. Such is the nature of these entrenched ideas that they affect even those who recognize them for what they are. Some might say, old habits die hard. But this just means we need to double down on our advocacy and strive harder. Even then, I suppose it is important to recognize our own fallibility and work from there.

Frustrating behaviors

I have an acquaintance who has a long history of health issues. She is a bit older than me, more or less retired, and as far as I can tell, more or less able to live a productive and responsible life. I like her, but I also have issues with the fact that she refuses to take better care of herself. In the years that I have known her, I have watched as she underwent various health struggles. The outcomes should have left her happy and more confident with her life: she overcame obesity, she healed from surgeries and illnesses, she turned the tide on diabetes, she always "beat" whatever issue she faced. But she also always behaved like it was the last act, each time. And she refused, utterly refused, to change some detrimental habits.

Like smoking.

She chain smokes. As a lung cancer patient, it is difficult for me to be around her. Knowing what she has struggled with, and having spoken at length about my lung cancer, I always expected her to quit. Smoking has caused or contributed to a number of her health problems already and her doctors told her long ago that she must stop. Yet, after developing some breathing problems recently, she still had three cigarettes while waiting for her PET scan. That did not surprise me, but it did make me angry.

Let's choose compassion over judgment

And when news came back that she had three masses in her lungs, I shook my head and said I was not surprised. I was sad for her, of course, because I know that this news is difficult to process and if it turns out to be cancerous, I am all too familiar with the bumps on the road ahead. There is still a chance that these masses are the result of infection, of course; it is too early to know with certainty what they are until a biopsy has been done. But such knowledge did not prevent me from having that primary thought: she smokes like a chimney, it is probably cancer. Right there, I laid the blame at her feet without even waiting for a proper diagnosis. I did not put my compassion first. I did not stop to think that, even if it is lung cancer, smoking might not be the direct cause.

It is an unhealthy habit, and it is so widely known to be unhealthy that nobody should be doing it, but smoking is still part of life for many people, for many reasons. I am angry when I see people deliberately doing things that are highly likely to cause themselves suffering when there is every reason they should know better. The guy who delivers my cancer medicine each month makes me bristle from the stench of cigarettes that billows about him and I want to scream each time I have to sign for the package -- it is hard not to feel a personal affront, tempered only slightly by the irony.

Setting a better example & stopping the stigma

Still, I want to be a better example. I want the stigma of smoking -- more importantly, of victim blaming -- to be removed from the narrative of lung cancer. But it is impossible to remove a proven cause from the discussion of prevention, and as such tobacco use remains an intrinsic part of the story. The challenge remains, even for the ardent advocates among us, to keep the subject of prevention separate from the notions of guilt or blame.

Nobody asks for lung cancer. Nobody deserves lung cancer. That needs to be clear, and it is really all most of us need to know when it comes to the whys and wherefores of an individual's diagnosis. Nobody asks. Nobody deserves.

Editor’s Note: We are extremely saddened to say that on October 21, 2018, Jeffrey Poehlmann passed away. Jeffrey’s advocacy efforts and writing continue to reach many. He will be deeply missed.