Do read Part I first for backstory. (Photo is not my mother, but this is how she held her hand when she smoked.)

I tried cigarettes perhaps three or four times in high school. The first time I inhaled, I had a coughing fit, of course, and the smoke hurt my lungs so badly; I thought “Why in the world would anyone keep this up long enough to become addicted?” I’ve heard people say it’s relaxing, but that’s because one is taking a deep breath. And we teenagers were “treated” to a movie about lung cancer in health class, full of gross pictures of the insides of actual lungs with actual cancer, which confirmed that I was never gonna be a tobacco smoker.

In my late twenties, after repeated bouts with bronchitis, my doctor asked if I’d ever smoked; I told him only a little pot. He asked if my parents smoked and then told me that my bronchioles were damaged from that level of secondhand smoke (two packs a day for Mom for twenty years, plus Dad’s  for seven years).

In my thirties, I temporarily worked for a game and puzzle factory. It was mostly a fun place to work, and when I moved up from the factory to the office, I found myself in a circle of gals who went out to lunch on Fridays and smoked Sherman cigarettes. So, I would have one, but only puff, not inhale, to be… well, cool. I did like the taste of the licorice paper encasing the tobacco.

I smoked marijuana from the time I was nineteen until about age forty (I’m 77 now), mostly in my youth, especially in art college. But I never had more than one to four inhalations to get the mild high I enjoyed. (And yes, I had to get past the initial coughing, but you hold it in your lungs for a few seconds, and the marijuana itself seems to relax the coughing reflex.) But you can’t get lung cancer from that level of marijuana smoke. Last week I read that people in their sixties who smoke pot or use gummies have at least a 25% higher risk of heart disease, so, there’s that.

I lived most of my adult life at least three hours’ drive away from my mother. Around 1990 I had a phone conversation with her about her health. She had had a severe chest cough for years. She mentioned she’d been to a doctor and they’d done a procedure where they “put a tube down her throat” and they had found a spot on her lung. I asked her what the spot was, and she said, “Probably something from when I had pneumonia as a kid.”

“What about smoking?”

“I decided I should quit.” This abruptly, after fifty-seven years of two packs a day. My stepfather said she had told him she didn’t miss it. She still held her hand cocked to the side when she had a cup of coffee.

(And that constant 90-degree position? She had gotten carpal tunnel syndrome, had to have surgery on her hands, and couldn’t imagine what had caused it. It had been immediately obvious to me, knowing that the same position at a computer causes carpal tunnel, but I held my tongue.)

I asked her doctor’s name, called him and said, “It sounds like my mother had a bronchoscopy. I know what that is and why it’s done. Does my mother have lung cancer?”

“Yes, she does. Hasn’t she told you? She should tell her family about this. I advised her not to stop smoking at this point because it would be too stressful for her.”

“Is she going to do chemo?”

“I also advised against that because of her age [81], but she wants to do it anyway.”

“Well, the alternative is to die of lung cancer, and I don’t think she wants to do that.”

“Well, yes.”

I called my sister to let her know; she lived less than an hour from Mother. No, Mom hadn’t told her either.

In another phone call my mother said, “This time the chemo made me really sick.”

“Did you take your anti-nausea pills?”

“I took two; they usually have me take six but I only had two left.”

“Mom, you have to tell them when you need a refill. They are not keeping track of that for you. You don’t have to get sick like that. Call them and tell them what happened and that you’re out of your medication.”

“Oh, okay.”

Mom never had medical insurance until she was eligible for Medicare, and paid for every doctor visit prior to that from her housecleaning income.

She did the chemo for nearly three years until she fell and broke her back and wound up at home in bed, and no one thought to look into whether they could bring the chemo to her while her back healed. I did go and see her at Christmas, when she was quite debilitated in bed, but she and my stepfather didn’t tell me she’d stopped her chemo. They were not proactive about their health care; they just did whatever the doctors said to do. Apparently, she didn’t show up for chemo, and no one called to ask why.

A scant few months later, Mom went into the hospital on a Wednesday. I was a tax accountant; it was February 1993 and I was working six days a week, at least ten hours a day. I planned to drive over and see her on the following Sunday. I called her on Thursday to see how she was doing. She said, “I’m in a lot of pain.”

“Aren’t they giving you pain medication?”

“I don’t know.”

“Is there a call button at the end of a cord there so you can call a nurse?”

“Yes.”

“Mom, you press that call button and don’t let go of it until a nurse comes in, and tell her you are in too much pain, okay? And I’ll see you on Sunday.”

“Okay. I’m gonna go now.” Click. No goodbye, no “I love you,” no “I’ll see you Sunday,” so I knew she was really not her normal self.

I called on Friday and she was sleeping. Saturday I worked all day and then went out with my new boyfriend for the evening (he became my husband eventually).

Sunday morning, I had showered and was preparing to make the three-hour drive over to the Central Valley, when I got a call from my stepfather to let me know that my mother had just passed from lung cancer. He was shaken, as was I; I called a friend to ride over with me. It did not seem like an appropriate request to make of a new boyfriend.

My sister told me she’d been there on Friday and Saturday. I was really angry with myself for not going over a day or two earlier; palpable guilt. My kind sister told me that Mother had been in what seemed to be a coma and would not have known I was there anyway, so not to beat myself up about it. (I now know that Mom would have been aware I was there and could have heard my voice, since hearing is the sense which holds on the longest when death is near.)

At least I had been the one to initiate easing her suffering with the drugs that had put her in a torpid state.

I know my mother was afraid to die. I believe she thought she might not “go to heaven” because she smoked and drank coffee against her church’s doctrines; I have always thought if there were a hell for her, it would have been for beating her children and being judgmental of others, not for her meager vices. She may have just feared the process itself; I don’t want to die, either, but this was almost pathological, a fear of riding in a car for long distances and of driving past cemeteries. I know she would have preferred to live, even though it seemed her only joys were holding hands with my stepfather, watching television at top volume, and drinking coffee.

None of us cheats death, but we all must weigh the risks of our behavior against whether our actions are really that pleasurable.

Whatever takes me, it won’t be because I smoked. At least not on purpose.