Dying smoker left out in the cold

Suzanne Penny, 58, smokes outside Toronto Grace Hospital. Penny, who suffers from terminal cancer, says smoking is a coping mechanism and one of the few pleasures left in her life, but because of the Ontario smoking ban, she must go outside in the cold to light up.
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Dying smoker left out in the cold - Toronto Star
No room under new rules for indoor smoking areas in hospitals

December 21, 2006

Jack Lakey
Staff Reporter

Suzanne Penny, 58, smokes outside Toronto Grace Hospital. Penny, who suffers from terminal cancer, says smoking is a coping mechanism and one of the few pleasures left in her life, but because of the Ontario smoking ban, she must go outside in the cold to light up. "It is a decision that is sure to give me pneumonia," she says of the ban.

As Suzanne Penny prepares for death, one of the few remaining pleasures in life is her cigarettes. They are the cause of the cancer that ravages her, but also a soothing source of comfort. They helped Penny cope with the terror of diagnosis, brain surgery, radiation treatment and knowing she will die soon, and likely alone.

Cigarettes will be her partner on this final journey; there isn't anyone else. They are her friends. To indulge her habit, Penny must leave the Salvation Army Grace Hospital, at Church and Bloor Sts. She bundles up, rides the elevator six floors down and pushes her walker out to the smoking area, near the parking lot and next to an industrial garbage dumpster.

It's the law. There is no protection from wind, rain or cold, only a bench and a receptacle for butts. "It is quite delightful when it's dark and raining," said 58-year-old Penny, a trace of sarcasm tingeing her prim English accent.

Penny and many others in hospitals, chronic care facilities, nursing homes and seniors residences are on the wrong side of the Smoke-Free Ontario Act, which bans smoking in workplaces and public places. It took effect June 1.

The legislation is intended to reduce workers' exposure to second-hand smoke and make it harder for people to light up. But it left no wiggle room for hospitals, some of which had an indoor smoking area for gravely ill people before, but are no longer allowed.

Major Dennis Brown, CEO of Grace Hospital, said he sympathizes with smokers and understands the hardships caused by the new rules, but can't help them.

"When it was legal for us to have a smoking room, we felt that it made sense for people in their final days to have an area where they could continue to smoke and not be faced with symptoms and cravings," said Brown.

Before the province's rules kicked in, the city's smoking bylaw called for a specially ventilated room. Brown says a bylaw inspector told the hospital a year ago its smoking room didn't comply and to stop using it within 30 days, or face large fines.

To a patient with a long-nourished nicotine habit, facing a life-threatening illness without cigarettes may seem like a good idea to non-smokers, but is out of the question to them.

Just stand near the doors of any hospital and observe the procession of patients with jackets over gowns, sometimes in wheelchairs or with intravenous carts in tow, puffing away.

In the daily emails and calls to The Fixer, we occasionally get one that jumps out from the usual fare of tripping hazards and burned-out streetlights.

Penny's began by saying: "I am dying in the palliative care unit at the Grace Hospital. I would like to do so with a reasonable amount of grace and dignity, but that has been taken from me. I am a smoker.

"Forbidding smoking can't – won't – stop me from smoking, but I must go outside to do it. It is a decision that seems sure to give me pneumonia.

"I cannot stop smoking. Someone else's decision gives me no dignity and no choices. I feel sad and angry. Where is the mercy? Where is the humanity? Where are the exceptions?"

Her plea is especially ironic, given that both the University of Toronto and York University recently created rooms for professors who smoke marijuana for medical reasons, but didn't want to sneak around outside to do it.

Outside the front doors of the Grace, a red line has been painted across the pavement. No smoking is allowed inside the line, to comply with the rule that forbids smoking within nine metres of the entrance to a health care facility.

Rather than go to the designated smoking area, patients using wheelchairs and walkers often hover just outside the line, trying to escape the wind while puffing on cigarettes.

One man, outfitted in a shiny, chrome-coloured helmet, sits on the small seat of a walker and smokes while greeting visitors.

"He was always falling down and banging his head, so they gave him a helmet," Penny explained. "Some of the people down here don't have any money for cigarettes, so they beg for them from people going by. It's terribly sad."

Before she was diagnosed with terminal lung and brain cancer, Penny lived in Etobicoke and worked for the province's Office of the Public Trustee and Guardian. Her job was to find family members of people who died without a will, often to give them money they didn't know was coming.

For 40 years, she's smoked at least a pack a day, and says it was closer to two in the old days, when people still smoked at their desks.

"It's not the nicotine that's so hard to give up, it's the habit, the socializing. I always enjoyed it." She's been on her own since the infamous morning of 9/11, when her husband died of a heart ailment a couple of hours before planes started slamming into towers.

Her only family in Canada is her 24-year-old daughter Ashley, who has a small child and lives with her husband in Victoria, B.C. She's here for Christmas but has to go home Jan. 9. After that, Penny is on her own.

She's been a patient at the Grace for about six weeks, after a stay at St. Michael's Hospital, where she underwent brain surgery in October.

The long, fresh scar from where they went in climbs up the back of her head. It's easy to see; she has no hair.

Other than a few friends, she must deal with her impending descent entirely on her own. It is no wonder that she is driven to leave her bed and go out into the cold for a smoke, every hour or so.

She'd settle for a small bit of shelter somewhere closer to her room. Through a sliding glass door on one side of the lounge for palliative care patients is the Roof Garden, used for social events in good weather.

It's an open area but has a roof over it. To Penny, it looks a lot better than standing next to the garbage dumpster, but the new rules don't allow it to be used for smoking.

Greg Flood, a spokesman for the Ministry of Health Promotion, which is responsible for the legislation, said circumstances such as Penny's were taken into account when it was drafted, but it was decided that it was more important to protect others from second-hand smoke.

"When that bill was being enacted, we actually did consult with the ministry, specifically about our palliative care unit," said Brown. "We were told very clearly that there would be no exemptions for palliative care units."

Patients can always avail themselves of smoking cessation aids, adds Brown, including nicotine patches and chewing gum. It pains us to say there is no fix here.

Comments

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