An Indelible Stain
The Inuit are native people who have lived for more than a thousand years in the frozen tundra of the Canadian Arctic. When necessary, they have to be flown to Montreal for advanced medical care, approximately a 1,300-mile flight. I remember my first encounter with an Inuit man who was referred for aortic valve replacement surgery. Although he lived as a seal hunter in a remote settlement, far from anywhere, his first request upon arrival in the big city was to find someone to deliver his government-issued smoking allowance, a carton of cigarettes. One look at his tobacco-stained fingers said it all. Tobacco wreaks havoc everywhere. It leaves an indelible stain—on hands, in mouths, lungs, hearts, arteries and even in joints. But sometimes, when it destroys credibility, its stain is invisible.
Simon M. Helfgott, MD, is associate professor of medicine in the Division of Rheumatology, Immunology and Allergy at Harvard Medical School in Boston.
References
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