Sitting quietly while the nurse inflates the blood pressure cuff on his arm, he keeps a straight face and listens to the music. He hates this tune: it’s agitating, like the loud rap that young kids blare from their rolled down car windows. Beside him, his wife reads a magazine, turned away as one would be to give someone privacy as he changes his clothes. They are a quiet couple and a satisfied one, having spent thirty-eight years of their lives together and having brought to life three beautiful children. It’ll be another seven months before the family reunites for Christmas, but by then, his first grandchild will be born. He secretly hopes it will be a boy.
The tune picks up again, and he shifts in his seat as the nurse makes her exit, promising that the cardiologist will be in to see him soon. He’s not too worried about anything he’ll say: he’s fit, well-built, and feeling as good as he could expect for his age. He’s never felt the panic and anxiety preceding a heart attack. And yet, there is a heaviness in his chest as he waits. Tight-lipped, he pulls in a thin stream of air, and blows out as though whistling, half-expecting some relief. A few minutes later, the cardiologist arrives, followed by another white coat. The cardiologist introduces the medical student, who greets him with a smile and shakes his hand. He doesn’t smile, but gives a polite nod of acknowledgment.
The cardiologist reviews his records: everything looks good. His LDL and triglycerides are down, his HDL is low but improving. The doctor then moves on to the question he was anticipating: “Are you still smoking?” “Yes.” The doctor says, “Hmm,” evaluating this disturbing detail. The man’s face remains expressionless. The cardiologist takes out his stethoscope, unbuttons the man’s top shirt button, and places his stethoscope over four points on his heart. He then listens to the carotid arteries in the man’s neck. “I’m going to listen to your lungs.” The doctor places the stethoscope on his back, and he breathes in deeply. “Ah, come here and listen to this,” the doctor says to the medical student.
The medical student fumbles with the stethoscope for a moment. As soon as he breathes in again, the student says quite suddenly, “Wow. I’ve always wondered why rhonchi are described as musical.” The cardiologist asks the man, “Do you want to listen?”, offering him the stethoscope. The man immediately says, a little darkly, “No, I can hear it already.” The cardiologist and the medical student sit down, and the doctor says, “Your heart’s fine. The problem is with your lungs. They’re going to quit on you, unless you quit. You really need to stop smoking.”
“I know,” the man says, noting his wife looking intently at him from the corner of his eye. The doctor asks if he’s tried using a patch or another smoking cessation treatment. “No, that’s not for me. If I’m going to stop, it’s going to be with the power of my own will.” He’s worked hard all of his life and never asked for sympathy, favoritism or crutches; he’s made a life for himself with his own hands. He’s not about to start now. The doctor says, with a note of skepticism in his voice, “It’s your choice on how you do it. But you need to stop smoking. Let’s set this as the goal for the next visit in six months.”
As the doctor and the medical student make their departure, the man and his wife stand up to leave. He knows what’s coming, and the tune rising from his chest is only the first sign of things to come. As he takes his wife by the hand, he feels her squeeze it a little more tightly than usual, and he feels a little more resolved. He’s no quitter: he’s not giving up this fight yet, his eyes tell her. But the music keeps playing, the same tune over and over again, like the song of the sirens drawing him closer, and closer, and closer.