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As I watched smoke curl around my grandfather’s chapped hands, I often wondered if the burning red tip of the cigarette kept him warm in the cold prairie winter. It was a ritual for him; plucking a thin stem from his coat pocket, flicking open the lighter, holding the flame close to his face. It was a normal habit for him as long as I could remember. But he only smoked outside, working on the farm. Never indoors, and never too close to me. Cigarettes became just an item Grandpa stashed in his shirt pockets, along with my favorite peppermint candies. Cigarettes were bad for you, he'd say, yet he continued the ritual every workday. Adults always told us they were bad for your health. But nobody told Grandpa he shouldn’t smoke. Bad health habits became a touchy subject for me.

As a child I loved chocolate, of course, and sweets. But too many sweets were bad for you, my health-conscious mother told me. But she never said anything about her father’s habit. That was just something Grandpa did, and only he could stop it. I first began to realize the impact on his health when I was a teenager. As he neared retirement, my grandfather was still smoking regularly. I had several aunts and uncles who smoked growing up. And now a couple of my cousins had taken up smoking, much to the chagrin of their parents. But no one said anything. It was clearly an issue, but it was swept under the rug. And it wasn’t just smoking. Anytime there was a health scare or injury, it was downplayed. When Grandpa’s arthritic hands started bothering him, he soldiered on. When his lungs worsened, he waved off concern. He didn’t tell anyone about the pain he was feeling. I found this was a common ailment when I began volunteering at a long-term care home. I’d always enjoyed talking with seniors, and I met so many diverse personalities. But there were many, like my grandfather, who simply ignored their pain, or didn’t see the need to talk about it. I couldn’t understand why so many people didn’t even want to address the problem, let alone seek a solution for it.

When my grandfather was diagnosed with lung cancer, there was no surprise from the family. It was to be expected, given his many years of smoking. My mother had remarked many times that it was difficult for people to quit nicotine, but I wondered why they were fighting the addiction alone. Their family members ignored the problem, so the patient ignored there was a problem.

I moved from the seniors’ care home to shadowing at a family medicine practice in [City]. I was excited to see how doctors could help people, and how family medicine might bridge the gaps in communication my family seemed to suffer from. It amazed me to hear, from the third patient I met, how no doctor before had simply listened to her and taken the time to understand her pain. She suffered from chronic headaches, and after years of struggling, she’d finally seen a doctor, despite her family’s assurances that her symptoms were common and normal. After the first two doctors she’d seen hadn’t found anything wrong with her, she arrived at the clinic where I was working. Dr. [Name], who I was shadowing, took the time simply to talk with her and understand her struggles. It affirmed for me my belief that open communication could do so much to help others. The expression of relief on the patient’s face when someone acknowledged her problem for the first time has stayed with me.

I never talked to my grandpa about his daily habit. I’m not convinced that talking with him would have changed the outcome, but I regret not taking the chance. There are too many people suffering in silence, fighting their problems alone, thinking that they don’t need to seek help because their problem isn’t really a problem. But I have been privileged to see how the empathy of healthcare practitioners can provide room to discuss health. I want to become a doctor so I can help patients like my grandfather know they are listened to, and someone cares.

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