“Why Would An Oncologist Discourage Smoking?” : A Conversation Over Coffee

Public speaking allows me to meet diverse groups of people, many of whom I would not otherwise get a chance to interact with. A common topic I am asked to speak about is “Cancer Awareness”. Typically, my talk has three segments:

  1. Causes of cancer (does the listener know that almost half of all cancers occur because of the use of tobacco?!)
  2. Signs and symptoms of cancer.
  3. Advances in cancer treatment and improving outcomes.

One day, after speaking to an audience of software professionals, a man in his mid-twenties came up to me and handed me a cup of coffee. I was stirring in the sugar when he said, “Why do you talk so much about smoking?”

Before I could start with the statistics, he went on, “I mean, how does it help you?”

“What do you mean?” I asked.

“You are an oncologist. You make your career by treating people with cancer. If you encourage people to quit smoking, won’t you have fewer clients/patients?”

He continued, “I have been thinking all evening – how can you possibly benefit if people stop smoking? I am just not able to come up with anything.”

His candidness amazed me, not to mention his cynicism!

“See, I am a skeptic. No offense to you personally, but I believe every so-called ‘good deed’ has an underlying selfish motive. Now, by giving this talk today, you gain some popularity which may fetch you some new patients/clients. If you talk about symptoms of cancer, or how you treat cancer successfully, I can understand. But almost half of your talk harped on the dangers of smoking – why would you waste your time on that?”

The young man seemed earnest – he was not simply trying to pick an argument. It was his perspective, after all, and I appreciated his candor.

I thought for some time. “Well, it is difficult to fault your logic. Yes, by getting people to quit tobacco, oncologists may run out of clients. By the same token, finding a complete cure for cancer will make our jobs redundant. But that is what we strive for. Our duty is to act solely for our patient’s benefit, putting their interest before our own. In legal parlance, this term is called ‘fiduciary relationship’. In medicine, we go one step beyond fiduciary duty – we even look out for the interest of those who are not our patients, and hope they will never become our patients.”

“Maybe for me as an individual, cancer prevention will deprive me of my livelihood. But it is a huge gain for society. And what are we, if not part of a society, part of a larger good?”

The man smiled – I was not sure if it was a cynical smile. Sometimes, we are not eloquent enough to convey what we believe in. But, it is our duty to put in an effort – be it to inspire someone to give up smoking, or to convince someone that not all deeds are born out of selfishness.

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