The 7-Yr Old Kentucky Smokers

I've never been wined and dined by a drug rep before, but FD has, and it's generally an opportunity for me to watch TV or blog uninterrupted. He comes home and tells me what he's had to eat, I tell him I missed him not at all.

Remember, I went through medical school, internship, and residency years with him falling asleep in his soup. Independence is my middle name. (And you thought I was so in love).

The last time he went out to an elegant dinner with drug reps and other doctors, he listened to the lecture, ate better than he would have here, and came home rather late. He put his hands on my shoulders (I was staring at the computer screen, reading something or another), and said, "Dr. E's wife came with him."

"WHAT?!?!"

"Yup, I guess you can bring your spouse if you want."

"Really."

See, now it's crunch time. Would I rather stay home and blog and watch mindless television, perhaps cook for Friday night or bake some cookies. . .or go out for dinner at Shallots?

"Are you saying you want me to join you next time?"

"I am."

FD is by far the more social of the two of us. I talk a good game, but would rather not have to hold any conversations at the end of the day. Face it, I do active listening as a professional, and there's just so much active a person can listen.

"Well, okay."

So tonight I joined the group. You have to understand. When I'm out socially I can try not to be a therapist, but being a therapist is so much more entertaining to people than not being a therapist that I'll usually start off saying something about a person's profession that intimates that indeed, I am onto them.

Tonight I was less than subtle. The leader of the presenters introduced herself to me, a sincerely lovely blond with lots of zip and personality, yet very sensitive and intelligent. I loved her immediately. I said something profound like, "Oh, man, I treat drug reps. YOU GUYS WORK SO, SO HARD! HOW DO YOU DO IT?"

"We all need therapy," she said.

"I can imagine."

Soon it was just another girl's night out, because Dr. Z, a female family practitioner in the hood dropped in and sat next to me. We talked about dating, sex (I always end up talking about sex, I don't know why, mainly about how it should be the last thing people do together in a relationship, yet it seems to be number one on the dating list of things to do.)

The women talked books and television (of course I'm the only one who watches, or admits to watching) and FD and the guys were talking politics and a discussion of restless leg, one of the symptoms that Boehringer Ingelheim's (our host) pramipexole (Mirapexin®/Sifrol®) apparently controls quite nicely, "with 15% less nausea." It's good for your bi-polar patients, too," one of the drug reps said.

"I can't even suggest a drug to a patient," I reply kindly. "Malpractice. I can suggest an evaluation, but not a drug."

Saying that, Dr. Z and I relax and compare bike rides to work.

Then I heard the following from E., a drug rep at the other end of the table. It blew my mind.

The average kid in Kentucky begins smoking tobacco at 7 years old.

I asked her to repeat that 3 times. I couldn't believe it. I thought maybe I heard it wrong. I didn't want to believe it.

When I got home I looked it up. See, it helps to look things up, to think critically. A story from NewsMax.com Wires,Tuesday, July 19, 2005

LOUISVILLE, Ky. -- Kentucky ranks among the unhealthiest states - a plight that's largely self-inflicted due to smoking, eating fatty foods and not exercising enough, The Courier-Journal reported in a special section published Sunday.

Chronic poor health threatens lives and hits all Kentuckians in the pocketbook through taxes and insurance premiums, according to the Louisville newspaper's special report.

On almost every health measure, Kentuckians fare poorly - second worst nationally for cancer deaths, fifth worst for cardiovascular deaths and seventh worst for obesity, according to the paper, which published a special eight-page section on the state's poor health.

Kentuckians die at a rate of 18 percent above the national average, the newspaper reported. Its report said residents of all income levels are disabled and killed by cardiovascular disease, cancer and diabetes _ chronic illnesses that are linked to smoking, poor eating habits and sedentary lifestyles.

"We don't have to worry about foreign aggressors," said Dr. Baretta Casey, a Hazard physician and University of Kentucky professor. "We are killing ourselves off."

Poverty is at the center of the problem. . .

Where is the word 7-year old? Nowhere.

Next story, a story on 5-7 year olds with ADHD who also have sleep disordered breathing (SDB) in Pediatrics concludes with the following:

We present additional confirmatory evidence that symptoms of SDB are frequent in 5- to 7-year-old children and that the risk increases when parents snore or smoke cigarettes. In children with significant symptoms of ADHD, REM sleep disturbances are more frequent and may contribute mildly yet significantly to neurobehavioral function

I suggest that these two stories, the one about Kentucky's populace having the worst health in the nation and the one from the pediatric journal on parental smoking and SDB blended to create this marvelous new urban myth.

But you heard it here first, folks. It really is an urban myth. (If I'm wrong, please show me the research.) Kids in Kentucky don't light up. They probably do, however, breathe in more secondary smoke than the rest of us.

Now that makes sense.

Thanks for dinner, Boehringer Ingelheim. And sure, I'll be happy to do it again.

Copyright 2007, therapydoc