How Much Do We Care?

Abstract

She could not have been more than 14 years old, sitting there with her family, bored, waiting to get on the airplane. She was very pretty with lightly tanned smooth skin and lank, shiny sun-bleached hair tossed carelessly away from her face. She bent down to the tote bag at her feet, pulled out a pack of cigarettes, took one, lit up, and inhaled deeply, then slowly exhaled. For me, her beauty, innocence, freshness, and future vanished.
Watching her from behind my magazine, I thought of the patients I had cared for in the past few months. I had noticed a recent, remarkable increase in the number of individuals whose medical conditions were attributable to a lifetime of tobacco use.
A month ago five of the 20 patients on my service had lung cancer that had spread to the brain or had invaded the vertebral column. The rapid, relentless growth