Sunday, March 1, 2015

21 mg Transdermal

Dear Friends,

It takes an astute doctor to distinguish a touch of the winter doldrums from a case of the winter blahs. Both cause mopeyness, that draggy feeling, and episodes of down-in-the-dumps. Whichever you have, the treatment of choice is the latest Hard Taco song, “Surfing Instructor from the 1960s.” This drop of concentrated sunshine will alleviate all but the most intractable eruptions of the winter ho hums.

Biographies of Vice, Part A:Trysts with Tobacco

A recent study suggested that the human nose can distinguish one trillion odors. If we took a moment to arrange these smells from most pleasant to least pleasant, cigarette smoke would fall towards the bottom of the list.
  • (998 billion smells....)
  • Primordial cesspools
  • Infected glands
  • What it would smell like if an egg farted
  • Cigarette smoke
  • Cigar smoke
  • Cat poo that makes you run outside and scream because you smelled it
  • When you find a hiker who has been dead for a month and light her hair on fire
Context is important, though, because olfaction is tied to the emotional centers in our brains. If there was a large cash prize for finding burning hiker corpses, you may begin to enjoy the smell. This partially explains the fact that I once had a Pavlovian attraction to clothes that reeked of cigarette smoke. My first three high school girlfriends were smokers.

Okay, fine, Memoir Police. Maybe I didn’t have three girlfriends in high school. The person I’m counting as number two portrayed my girlfriend in a play. She smoked, and I’m counting it.
Anyway, Smoker GF#1 enjoyed the fact that I was the last tobacco-naive person in our friend group. Before high school graduation, she hatched the following plan: She would spread a rumor that I was planning to smoke my very first cigarette at a friend’s graduation party. Then, the day before, she would teach me how to smoke, first with a twig, and then with a genuine secret practice cigarette. I would show up at the party, casually burn through my alleged first cigarette without coughing, everyone would be amused and impressed, the girlfriend and I would never fight, and we would go to college together and/or elope.

And what a plan it was! Seamlessly it worked, up to and including the “without coughing” part.

Smoker GF#3 was the real deal. Not as a girlfriend, but as a smoker. Her brand was Marlboro Reds.

We were both summer camp counselors. Most Friday nights, after the kids were asleep, we would go down to the storage area with one her friends. The three of us would sit on an overturned rowboat, and I would watch the two of them smoke. Sometimes (but no more than once a week), I would take a single slow drag and tell them how high I was. I was being funny, and they appreciated that, but this is one of those things that was funny because it was true. To someone accustomed to nicotine-celibacy, a Marlboro Red might as well be speed.

“They’re funded by the KKK, you know,” she told me one night, pointing to the red chevrons on the Marlboro box. Sure enough, they looked like the letter K, and if you rotated the box, there were three of them.

"It's true," said the friend.

I was skeptical. I didn’t know much about the Klan or their 501c3 status, but I suspected that they were primarily donor-funded. It just didn’t seem fiscally responsible to funnel their limited assets into subliminal advertising on cigarette boxes. Plus, smokers were not really the KKK’s target demographic... the masks didn’t even have mouth holes.

“And check this out,” she said, “If you turn the Marlboro logo upside-down, see what it says?”

I didn’t.

“It spells out OROBLJeW. It’s HORRIBLE JEW without the H.”

"It's true," said the friend.

Holy cow, they were right. Orrobl Jew! There’s absolutely no way that could be a coincidence. “Then why do you still smoke them?”

Both of them just rolled her eyes at me. “I’m addicted, you idiot.”

Oh, my poor summer fling. I knew I would be out of the picture during her (yet inevitable) battle with lung disease, but it was still sad. What made it worse was that the CEO of Philip-Morris was apparently some kind of cockney bigot, who took pleasure in the infirmity of my people. He probably had a giant projection TV in his office that would cycle through a morbid slideshow of my cancer-stricken ex-girlfriend and her co-counselor. I imagined him prancing back and forth in front of the screen, pointing and howling with delight.

‘Orrible Jew! ‘Orrible Jew!

A few years later, I had my last memorable cigarette-related incident, and it didn’t involve tobacco. I was a first year medical student, and we had a lecture about how to discuss smoking cessation with patients. The speaker brought a sample box of nicotine patches, and passed them out for us to look at. I decided to try on a 21 mg patch, the highest available dose.

Real smokers know that 21 milligrams of transdermal nicotine confers absolutely no benefit. I have since seen patients with a patch on each limb running out of the hospital, dragging iv lines behind them, so they could get back to their smokes.

That was not my experience. By the 1-minute mark, I was frankly lightheaded. By 5 minutes, I felt like there was a wind tunnel running between my eyes and my throat. I started pacing. I started grabbing my classmates' wrists and telling them that they were my best friends and that I really meant it. When I would turn my head, the their faces had vapor trails. By 7 minutes I was kneeling in front of the toilet.

That was my last nicotine high, and I haven't missed it at all. By then, I was dating the love of my life, and coffee breath had replaced smoky sweatshirts as my olfactory turn-on.

With warmest regards,