I Don’t Want to Quit Smoking

It started out innocently enough is the cliché, but it’s really true in this case. The irony is that I never smoked a puff until my first month of medical school, at 21 yrs of age. I was living in a craphole on the Southside, near the last remnants of Little Italy in Chicago. At the time the area was largely populated by poor, black people, many of whom I think were homeless or living in the projects. And they would have no qualms with smoking a bowl or crackpipe on the porch of their palatial estate.

I walked past the projects and went into a 7/11-type store to buy my first pack of cigs. I asked the clerk, an obese black woman with a kind and gold-plated smile, “What brand do most people buy?”

“Here, most people get these.” And she handed me a pack of Newport Menthols, the 100 variety (extra long). I didn’t even know the stereotype that mostly poor, black people smoked these but I didn’t know anything about cigarettes, not even how to hold one without looking like a total asshole. But I learned quickly and went through phases from Marlboro lights, to Turkish Blends to Camel lights and occasionally Djarums or Dunhills. So many cigarettes smoked in those 4 yrs of med school. Aaaaahhhh.

When I moved to Texas for residency, I was pleasantly surprised to find that the $7 Camel lights I bought in Chicago were now $2.80 in San Antonio. There was no way I was quitting at that price. I never tried the patch or nicotine gum. I did take Wellbutrin/Zyban and I guess it kind of worked. I stopped smoking for like a month. Then one day I was thinking, “Boy, it’d be really nice to have a cigarette now”. So I did.

I know a chief sign of chemical dependence is denial. I have never experienced nicotine withdrawal, as far as I know. I just really wanted to have a smoke. It’d be like if one day someone said, “You can never have milk again.” Eventually you’d want milk or something made with milk (chocolate, baked goods, etc). That’s my explanation of it all. As I sit here, I feel fine and it’s been about 4 days since I had a smoke. But eventually I know I will feel like having a cold, white, glass of nicotine. And it’s going to taste good. Because what it all comes down to at the end of the day; I don’t want to stain my teeth or have my hair and clothes smell like an ashtray. I don’t want to reduce my exercise capacity or increase my odds of stroke and heart attack. And I certainly don’t want to get lung cancer and I don’t want to die. But I don’t want to quit smoking, either.

I'm Big Boned

Along with my newfound health kick has come a healthy respect for, well, health. Most WHO data and leading medical authorities agree that America is much fatter now than in past times. Well I am 29 yrs old and I can tell you from experience: the kids in grade school now are huge fat asses compared to when I was in school in the 80’s. It’s one of the more interesting social flips. Like in the 40-50’s there was that one kid who was the nerd with the glasses; four eyes. Now days EVERY kid has glasses or contacts and there’s one kid without the glasses; two eyes (and he would be mocked if I had my way). Similarly in my 2nd grade class there were a few fat kids in the 3 homerooms. The fattest of all being Julia Meyerhoff who was this Miss Piggyesque (even wearing pink barrettes or bows in her hair) little kid who, regrettably, I was very cruel toward. Now days the whole class is full of Meyerhoffs, and there’s like 1 or 2 kids who are thin.

I don’t know if it’s video games, or McDonalds or whatever reason; kids today are fat slobs. I don’t even remember being that active. Heck, Nintendo came out when I was in grade school and my parents basically spoiled me with a slew of NES games. Still I was always really skinny as were most of my friends. From grades 3-5 I ate PB&J sandwiches for lunch EVERY day usually with a HoHo, Twinkie or DingDong and 2% chocolate milk. That cannot be good for a growing kid. And kids today ARE fatter.

So it shouldn’t be a big surprise that most young adults are fat, too. But this is the point that eludes me. Unless you have some longstanding debilitation, why are you fat? And you’re NOT big boned. Lest you’re in the extreme minority with hypothyroidism or another hormonal imbalance, it isn’t in your genes no matter how fat your parents have gotten over the years. It’s math. I know in high school algebra/geometry/calculus you always thought; heck, I’ll never use math! But this is very easy math:
(calories you eat) –(calories you burn at rest) – (calories you burn while active)= caloric deficit (CD)

If CD is positive, you’re gaining weight even if it’s slow. In order to lose weight this must be a negative number. That’s the big secret to losing weight. Stop eating and get on a treadmill. Or eat smaller meals and go for a walk after dinner. I figure most people are too lazy, they don’t care/are indifferent to their health or how they look or finally they really are that dumb and don’t realize the above equation. Most are too lazy or just don’t give a damn, I suspect.

A woman I knew since grade school had bariatric surgery a few years ago and she’s lost a lot of weight. I saw her at a mutual friend’s wedding and she looked great. It’s too bad that she had to resort to life-changing surgery but she did something about a kinda serious problem and I think it’s affected her very positively. So good for her. I only hope that wherever she is, Julia Meyerhoff has made a similar change. And that she forgives me, eventually.

The Incredible Shrinking Boy

I have officially been dieting and exercising for 6 weeks now. The initial results are:I'm 17-18lb lighter, 2inches off my waist and I quit smoking (I did smoke liberally when I was in the city this past week). I feel great though. And I ran nearly 15 miles near the end of last week. I haven’t run that far since I was in high school, so that’s impressive for me, even if it was slow.
Now that kind of weight loss may seem really extreme (3lb/week) but honestly, it wasn’t that crazy and my diet has been pretty consistent. I am largely dependent on my family for food, and that is the kicker because no one here eats as much as an apple unless it’s covered in fat and sautéed in butter. Unless you count the caramel apples my Dad bought for Halloween, which I don’t. I make most of my own food and much of meals consist of:
1.Some veggie, usually corn, peas or beans or a small salad w/ a vinaigrette
2.Carbs, usually pasta in olive oil, brown rice or a baked potato
3.Meat, almost always grilled chicken breast but 1-2/wk I have steak, salmon or trout

4.Drink NOTHING but water or diet soda. That means no milk, no juice and most sadly no beer.

A few times a week I’ll have a mini-Reeses’s peanut butter cup or half a Twix bar. A snack is usually a small bit of rice/pasta and 2 egg whites, tuna or a protein shake. Sounds bland, but it’s actually quite good. The diet part has been easier than I imagined. The running and weight lifting has been tough. I’ve regressed into such a pussy that I am weaker now than I was in 11th grade gym class. Ugh. Not good for a guy turning 30 this year.

To top it off I am sidelined with a right lateral knee injury which I suspect is illiotibial band syndrome. Basically this group of muscle and connective tissue on the outside part of the leg wasn’t warmed up or stretched right and it’s inflamed now, especially at the point of insertion on Gerdy’s tubercle at the top of my tibia. Sorry for the doctor talk, but all the training kinda hard wires a person. I don’t know when I can return to running, but I will undoubtedly lose progress. I’m on a steady diet of ice and piroxicam, with little relief unless my leg is totally numb.

On the positive, I do feel outstanding and I’m getting stronger every week. My clothes fit great too. I’m basically the same waist size I was in high school, and I know this because some of the clothes I wear are from high school (yet another indignity I must endure). It’s kinda sad when I have a bunch of shirts from “Structure” and I’m pretty sure that Structure closed all their stores some time around 2001. This is starting to get wordy and I bet most people aren’t too interested in the idiosyncrasies of my workout routine so I’ll stop now. But this moderate life change has made me reconsider a few things which I’ll touch on in a few days. Do you recognize the child actor from above? Ah, the classics.

Breaking up the band...

A bum. I never would've guessed it but I am a 29 year old bum. After spending the past 11 years in college, medical school and residency it all cumulates in me mastering Guitar Hero on my friend's leather couch at 4am fueled only by White Castles, Pabst Blue Ribbon and my own gray determination to avoid productivity in this world. I won't try to explain why I'm here or the course that has delivered me. But I'm trying to get things back in order. More structured and more 'normal'. People often say to not worry about being normal and to just be yourself. And while being "me" has proven virtuosity at the use of a plastic, faux guitar I need to grow up.

I know many who swear that they'll never grow up. I commend them on their efforts but eventually it'd be nice to own a home. Or go on a vacation to Europe. Kids don't do shit like that, at least not without their parents money; and at 29 it's way past starting to sound pathetic. For the sake of redundancy; I do need to grow up.

It's not original to state the distinction between maturation and growing up, but just for the taste of it: I like cartoons. I eat Lucky Charms and Count Chocula. I wear a mitt to baseball games. I like "toilet humor" and will laugh if someone farts. I play video games, but not obsessively (aside from Guitar Hero, as noted above). I like the movie "The Goonies".

These proclivities are not likely to change. But I do need to start being more responsible. So this is largely cathartic for me. I need to put down this stupid, black guitar with the multi-colored buttons and complete the paper work for my medical license. I used to be a really good doctor, it hasn't even been a year. And I'm still a good doctor, only now I can play "Welcome to the Jungle" on Expert mode and absolutely crush the solo.