Physician detective is on the case of the ‘smoking’ gun
Douglas Corwin, MD, of St. Luke’s Pulmonary & Critical Care Associates, considers himself a detective when diagnosing a patient with lung disease or helping someone stop smoking.
By getting to know his patients - their lifestyles, habits, histories and priorities - he gathers clues that lead him to that “aha moment,” so he can guide them on the best path forward.
When it comes to smoking, patients know the health risks, but that is not enough to get them to quit, he said. Smoking increases the risk of cancer and damages nearly every organ in the body, including the lungs, heart, blood vessels, reproductive organs, mouth, skin, eyes and bones.
A smoker’s life expectancy is 5-10 years less than a nonsmoker.
Dr. Corwin is never accusatory but works with patients to determine what motivates them.
Some patients quit to reduce their loved ones’ exposure to secondhand smoke, others because of its negative example for their children.
“I tell them you can quit smoking,” he said. “I can appreciate being frustrated or angry, but at no point should you give up. Even when you think you’ve run out of options, there’s always somehow, someway we can help you quit.”
The effects of smoking
Smoking affects everyone differently. Dr. Corwin has 35-year-old patients with the lungs of 90-year-olds and 90-year-old patients who smoke two packs a day with healthy lungs.
“Most people who gamble on smoking lose - meaning loss of independence, being on an inhaler or oxygen, having hospitalizations and more frequent infections,” he said. “Losing doesn’t only mean death; it also means your quality of life.”
Dr. Corwin finds ways to motivate his patients. For example, a grandmother enjoyed taking her grandkids to McDonalds. She’d buy them a Happy Meal and let them play on the playground. But then, she couldn’t afford it.
“I called her out and said you can spend $10 on a pack of cigarettes, but you can’t spend $4 on a Happy Meal,” he said. “She broke down in tears in the office because I had said you’re choosing your cigarettes over your grandkids. That struck home for her. It wasn’t a cancer diagnosis or a health effect, but it was the fact that the cigarettes blocked her from doing something she truly enjoyed.”
Smoking a pack a day at $10 a pack amounts to $3,600 a year. That’s a vacation, several car payments or monthly dinners where everyone orders whatever they want.
Each patient teaches Dr. Corwin something to help him be a better doctor.
He treated a smoker in the intensive care unit whose dying request of his daughter was her promise to stop smoking. Over the next year and a half, Dr. Corwin supported her until she succeeded.
“Her determination to see it through, her honesty about the struggles, has helped my understanding of the smoker’s path,” he said. “Seeing how hard she worked, and her ups and downs shaped how I counsel other people.”
Smoking is a robotic, almost subconscious behavior for many smokers. He encourages patients to try something different. If they light up when they get in the car, turn left rather than right out of the driveway.
If they smoke with coffee, drink tea instead, anything to break the connection.
Dr. Corwin treats patients with many lung conditions, including miners. He is certified in treating black lung disease. He uses the same detective approach when diagnosing and treating all patients.
He joined St. Luke’s five years ago, attracted by interviews with amazing partners; the ability to teach medical students, residents and fellows; and the ability to do research. He has never questioned his decision to be a pulmonologist.
“There’s no other organ that’s exposed to everything in your environment,” he said. All the blood goes through your lungs. Everything you breathe and everything in your environment affects your lungs. You get to be a detective in figuring out the cause of the disease. Is it something inside your body or outside? Is it something you’re around now or the asbestos you were exposed to 65 years ago? I enjoy figuring out the smoking gun.”
Dr. Corwin sees patients in Lehighton, Coaldale, Bethlehem and Easton. To make an appointment, call 484-526-3890.