Of smoke and fire

This week we began enforcing a new county law that bans smoking within 100 feet of hospitals. I recall when hospitals used to allow smoking within their walls, decades ago.

It was a different time. Smoking was common in hospitals among patients, among hospital staff, and even among doctors. You could see doctors puffing on cigarettes as they made notes in patient charts.

Hospitals (and society in general) treated social smoking almost as if it were a civil right. A doctor's order was needed to keep a patient from smoking.

I smoked. I sat at my hospital desk and puffed away, oblivious to the smoke in the work environment. I remember bumming a cigarette from my boss.

At hospital board meetings each place setting had its own ash tray. Those meetings were filled with cigarettes glowing and pipes flaring.

When the first patients' rights regulation came from Albany, it included the right to a smoke-free room. Imagine that.

When Community General restricted smoking in its cafeteria to a designated area, it was a major upheaval. It was common to hear grousing about smoker discrimination.

Community General was the first Syracuse hospital to ban smoking among patients, and I recall the event that prompted it: a patient set fire to herself.

It was about 6:00 a.m. one morning. A confused patient decided she wanted to smoke. She had no matches because the nurses had taken them in compliance with the doctor's no-smoking order. The patient removed the cannula from her nose and placed it on a blanket, creating an oxygen-rich pocket.

The patient borrowed a cigarette lighter from her roommate, and when she used the lighter, her bed clothes burst into flame. The patient screamed. The nurses responded promptly. They sounded the alarm, and they rescued the patient, using blankets to smother flames that shot from the bed and scorched the wall, all the way to the ceiling.

Hospital engineers in the fire brigade arrived quickly, making sure the fire was out and evacuating smoke from the room and hallway. The fire department complimented our nurses and engineers on their work that day. Their prompt and correct actions saved the patient and prevented harm to others.

That single episode clarified what was at stake --the increased risk of fire that smoking posed for patients and for all of us in hospital buildings.

Since then, of course, there has been broad recognition of the dangers of smoking. More than fire, those risks include ambient smoke.

Thanks to the new county law, smoking has now been pushed farther from hospital walkways and entrances. There are, however, still far too many smokers, including health care workers, and the evidence of that is just 100 feet down the sidewalk.

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I used some of the information above in a somewhat different form in a letter to employees on October 4, 2003.