Lighting Up

by Margaret McNellis

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When I see people light up a cigarette, I wonder if they really know where it will take them. Sure, everyone knows that cigarettes increase your risk of getting lung cancer, that they’re linked to 80-90% of lung cancers. But how many people who smoke really know what that looks like? When my father was diagnosed, he had Stage IV non-small cell lung cancer. Two and a half months before that, he felt great. He was working, traveling, and we have a picture of him at my sister’s birthday dinner looking happy and healthy. Two and a half months.

He didn’t have a single tumor. When one of his doctors showed my mother and I his CT scan, it looked more like static on a television, like a blizzard. All the white stuff floating around in his lungs was cancer.

The cancer would have been a quick death. Less than two weeks after his diagnosis, it would have killed him if he didn’t go on emergency chemotherapy. I remember walking through the ICU, I saw another patient whose face looked like it was skin stretched over his skull. His cheeks were hollow, his eyes sunken, and his lips pulled tight. He was having trouble breathing. As scary as it was having a parent in the ICU, at least my dad still looked healthy.

The monitors told a different story. His heart rate was hanging out in the 150s even though he was resting, because he couldn’t get enough oxygen. His heart was working overtime to feed his brain and other organs. We had the “get your family here” talk with his pulmonologist.

My father wanted chemotherapy. He wanted to live as long as he could, fight as long as he could, but I think he knew before he started that he was on borrowed time. The rest of us realized that over the next three months, but what none of us knew was how sick the chemotherapy would make him, how fast he’d drop eighty pounds and begin the starvation process that would rob him of the ability to move around, to think clearly, to live. The chemo made it painful to eat, so despite our attempts to find foods he could handle, he ate less and less.

A lack of oxygen made it difficult too, and the more his stomach shrunk, the more even the tiniest of appetizers made it harder for him to try to fill his lungs with air. He got skinnier and skinnier until his collarbone protruded so much that were it not for the absence of any bruising or complaint, I might have thought it was broken. I could see his ribs through his shirt. He started to look like that man I saw in the ICU, that man who wasn’t my father and I hoped my father would never become.

My father used to smoke cigarettes. I don’t blame him for it; he did so at a time when the population believed they were healthy. Hell, doctors used to prescribe smoking, after all. Just because someone is addicted to cigarettes doesn’t mean they deserve lung cancer or chemo. All the same, whenever I see someone light up, it takes every ounce of control for me to not rip the damn thing out of their mouth and stamp it out on the ground. It takes every ounce of control for me not to hop up on a soapbox and ask them if they want their children to watch them starve, for food, for air, for just one more month or week or day. I want to ask them if they know what it looks like and feels like when someone actually fights that fight until the bitter end.

I’ve never smoked a cigarette. The smell has always bothered me. I don’t know if they taste good or not, but after watching my father fight lung cancer—which eventually metastasized to his lymphatic system, bones, and maybe even his brain—I know this: the end is always bitter.

There’s never enough time at the end, no matter how much time the chemotherapy bought. I always wanted one more day, one more hour, even after my father slipped into a coma. The hospice nurse told us that was the final stage before death, evidence the body was finally shutting down. The morning that he died, on Friday, September 6, 2016, I told my father it was okay to go. I wasn’t okay with it, really, and I never will be. But I said those words, because he needed to hear them, because it was time.

Someone my age or younger once apologized for lighting up as we walked down a sidewalk. “It’s okay,” I said.