21 Cigarettes

This is a story about smoking. But it’s also about bursitis. And marriage. …You’ll see.

I was recently diagnosed with bursitis. If you don’t know what that is, then you’re just like I was before I visited a doctor to ask about a painful, tiny bump in my left elbow that felt like a hybrid cyst-scar-pimple. I’d actually had this lump for over a decade, but it was only painful when I put my elbow on an arm rest at a particular angle, so I wasn’t planning on ever looking into it.

Sadly, I’m married to a woman who (as YouTube has popularized) loves picking at dermal blemishes. But before I elaborate: Yes, this is gross. No, I don’t like talking about this in public. But also, well, it’s a thing. Some women people love that kind of stuff. Ick.

So one night, while seated together on the couch to watch TV, my wife leaned over and started playing with my elbow, noticed the lump, and excitedly said, “Oh! Can I pop this?”

I asked her not to, but I’ve also asked her not to leave the lights and fans on when she leaves the house, so I was not surprised when five seconds later I felt intense pain shooting out of my elbow as she attacked my blemish like Gallagher with a watermelon, squeezing with all her might.

A minute later, frowning, she said, “I’ve gotten something out, but it’s not puss.”

Wearing my patented quasi-ambivalent frown, I said, “Let’s stop here and cut our losses,” and then, a miracle occurred: She released my arm, and an hour later I was asleep without a second thought.

But when I woke the next day, I was baffled! The lump was not only smaller, but I felt no pain! Naturally, I didn’t admit this to Dr. Frankenstein, lest I become her personal Edward Scissor Hands, but I don’t like to lie, so when she asked about it, I said, “Actually, it’s better. Thanks.”

Famous last words.

Two days later, the bump was back, only two times larger than before, and now it was very painful, even to the touch (whereas before I had to press on it to experience pain).

Wifey-poo was thrilled at a chance for “follow up surgery,” but Mean Husband (me) Harry S. Truman-ed that idea and passed the buck to a doctor who specializes in dermatology. Alas, she said it was not dermal, but rather a sub-wegfisgsegfser issue (technical terms are my forte), so she referred me to someone who specializes in sub-wegfisgsegfsers.

The new doctor was my age, and cool, so when he told me that it was called “bursitis,” I nodded my head to indicate that I too am a learned man with profound knowledge who feels solidarity with medical professionals, but also to encourage him to explain just what, exactly, is bursitis.

My plan worked and I didn’t have to out myself as an ignoramus. “Yeah,” he continued. “It’s a weird condition. Everyone has fluid in their joints, but sometimes that gets inflamed and you get bursitis. It’s common in hips and elbows, but can also appear in any joint, even the shoulder.”

“Wow. So how did I get it? Was it something I did? And also, what can I do about it?”

The brilliant doctor smirked (always a good sign), then replied, “You’ll probably never know, but it can occur from any one event, or repeated stress. However, very few people figure it out. Some people even get it just from sleeping wrong. It’s sort of a medical mystery.” He paused in case I wanted to interrupt, but I kept my dumb food hole shut, so he said, “There’s only three options at this point. The first is to have me pop it, suck out the fluids, then give you a steroid shot. The second is to ignore it and live with it, and the third is to have surgery to remove it.”

“Wow. So when my wife was picking at it, she had the right idea?”

“What? No!” he scoffed. “She could have caused you serious harm. You’re lucky you didn’t get a staph infection. You need to do that in a sterilized environment, and the steroids are essential.”

“Right,” I said, grinning ear to ear. Talk about music to a husband’s ears! I couldn’t wait to tell my beloved how she’d almost killed me. I figured, at the very least, I could trade her attempted murder for one Sunday of watching football alone while she took our kids...anywhere but home.

“So what do you think I should do?” I asked the marriage counselor doctor.

“Well, it’s pretty easy to pop it and try the steroid.” He looked at his watch. “We can do it now.”

“Will it work?”

He grimaced. “It’s fifty-fifty. Like flipping a coin.”

“And what about the surgery? Like, are we talking major surgery, or just a quick procedure?”

“Oh, it’s really serious. In fact, I rarely do it and I would not recommend it. The problem is that we have to put you under because of the pain, and then you have to keep it stretched in one position for 6 weeks, which means no exercise, and a pretty serious, restrictive brace.”

“Wow. OK. Well, what kind of restrictions will the steroids put on my exercise?” I asked, hoping to convince him I’m one of those rare, healthy Americans (because I need doctors to like me?).

“Oh, you can do anything that doesn’t hurt it. But like I said, You could have gotten it from sleeping.”

I love gambling, so it was a no-brainer. “Hit me!” I exclaimed.

“Huh?”

“It was a black jack joke. Let’s try the steroids.”

Minutes later, I was in my car, calling my wife to explain how a doctor had just said she almost killed me. Then, as an afterthought, I told her about the steroids and asked her to wish me luck.

Overcome with optimism and a pep in my step, I hit the gym the next morning to lift weights, do yoga, and ride a bike, doubling down on my dedication to live healthy as I crest into year 45.

That night, my wife left to meet friends for dinner, so after bathing my hellions and ushering them to bed, I fixed myself a martini and sat on the couch, excited to play solitaire on my iPhone while listening to a podcast (if you’re not married with kids, this is what you’re missing).

Alas, when I put my elbow down, a searing, shooting pain, worse than any previous one, hit me like a ton of bricks. Luckily, if nothing else, I’m a model of responsibility, so I shrugged off the pain, gulped down the rest of the martini, made myself a second one, and an hour later I was asleep, though I must admit I had the weirdest dreams that night: I kept imagining that my elbow was pulsing with pain and swelling so badly that it was painful to the touch.

I should note here that I’m a moron (and then some), because that will justify why, when I woke the next day with an awful hangover and a bright red, burning hot elbow that had swelled to the size of a softball, I knew it was my fault and easily accepted my fate. I was going to die.

I told my wife I needed to go to the ER, and she advised I wait and see if the swelling reduced. I didn’t like her lack of concern for her dying husband, but I also sort of saw her point. However, four hours later, when the lump was redder, bigger, hotter, and even more painful, I headed to urgent care where a nurse practitioner said I was not going to die, but I did need to take anti-inflammatory pills while keeping it elevated and icing it 5-7 times a day, for at least two weeks.

The silver lining was she said I should repeat all the exercises I’d done before it swelled, as any motion that hurt would tell me what caused it, so I could never repeat that mistake again.

The next two weeks were infuriating. Despite a zealous adherence to her instructions, my hot-to-the-touch gas-giant stayed the same size, and as an added bonus, the pills made me nauseous and tired. But the worst part (because I’m vain and narcissistic) was that I looked like a total freak!

My wife said I was exaggerating and paranoid, and no one cared, so I took a picture of it and sent it to my 20 closest friends, all of whom said something to the effect of, “That’s literally the most disgusting thing I’ve ever seen, and I did not give you permission to send me that. NSFW, dude.”

For those of you keeping track at home, my wife was now 0-3 at playing doctor, but in her defense, I’m a blithering idiot who ignored bursitis for a decade and thinks a perfect night is being alone, listening to a podcast while playing solitaire.

The title of this essay is “21 Cigarettes.” I mention this because if you remembered that and got this far, you’re probably exasperated, as this tale doesn’t have anything to do with that. Right?

Wrong!

I have a great memory, and I’m a decent problem solver, so for every wrong turn I made in this long saga of sadness and swelling, I did do one thing really well: I hunted and wracked my brain for any and all clues as to what originally gave me bursitis 10+ years ago, and I’m proud to say that I figured it out, and my doctor even agreed that my theory is “very likely” correct.

But the best part of my discovery is that it proves three things to me that I don’t want to admit to, but also mustacknowledge. 1. Karma works in mysterious ways. 2. I totally caused my bursitis, (and the reason is embarrassing). and 3. It totally has to do with “21” and “cigarettes.”

***

The first time I noticed my “elbow pimple” was on a road trip in my late twenties. I was a smoker back then, so my go to move was to unroll the window a crack and hold my lit cigarette in the corner so the wind would suck the smoke out, and when I exhaled, I’d carefully blow smoke in a thin stream into the slit, because I didn’t want my car to smell like an ashtray.

If you think I’m full of it, tell that to the two dealerships who bought cars I smoked in and didn’t raise an eyebrow when I checked the box that said “I’ve never smoked in this car.”

At any rate, all these years later, I realized I gave myself bursitis by pressing my elbow into the arm rest to keep the cigarette poised by the window, and the doctor agrees with me because that is the only place and motion that caused me any pain before my wife “played” with it.

I’m all about accountability, so I want to take full responsibility, but part of me wants to blame the dumb foreign man who worked at “21,” a mini-mart in Berkeley, California when I was eleven.

However, lest you get your “I’m offended” undergarments in a ruffle, I want to be clear that both details are important because if it wasn’t for how dumb this man was and the fact that he clearly didn’t speak any English or know anythingabout America or its laws, there is no way in hell that he would have sold me cigarettes when I was eleven, with a pre-pubescent voice and body.

But he did. And the reason I know he was doing it because he was dumb (as opposed to being immoral, greedy, or indifferent to my health), is because I bought cigarettes from him every Friday, at the same time, for over a year, and never, not once, did he remember me or seem to notice that I sounded like Baby Elmo when I said, “5 packs of Winston Reds, please.”

And I know he didn’t speak English because he’d stare at me, wide-eyed, until I eventually played charades, pretending to smoke, until he got an “aha” look, at which point he’d slowly run his finger along every pack until I screamed, “YES!” when he got to mine.

I was happy with this arrangement until one fateful day when I started to order a pack and a short, angry, older man ran to the counter, screaming Mandarin at my nicotine dealer.

I wasn’t alarmed until he spun around and pointed at me, yelling, “He is just a kid!” He then barked more nefarious-sounding phonemes at the guy while I stood there, paralyzed, hopeless, and hopelessly addicted (they’re not the same). I said, “Can I get one pack? It took an hour to get here.”

“NO! Now GO! And don’t ever come back, or I’ll call the cops!”

But I need one last fix, I thought as I left, devastated by my bad luck (Note: Now that I’m older, I find it ironic that I thought I was unlucky, as any mature human would say luck was very much on my side. Because it’s not lucky to smoke 5 packs a week when you’re 11, and since this was literally the only place I could buy packs from, this event made it much, much harder for me to smoke until I turned 18, which I’m certain prevented me from becoming a lifelong smoker).

***

My bursitis finally went away, but it took two months, and I still must be vigilant to not push it into anything. Which is harder than you’d think, as most of us regularly use our elbows to close doors, raise ourselves from a couch, or even just to balance our arm as we type on a laptop.

But my story isn’t all bad! For example, I discovered what caused the severe inflammation (puppy pose in yoga), and my wife is now banned from scanning my body for dermal flaws!

But the best part of this story is that now, if I ever catch my kids smoking (or vaping), I get to tell them something no other parent would: “Are you crazy? Smoking is bad! It smells awful, it ruins your teeth, it causes cancer, and worst of all? It’s a leading cause of elbow bursitis!”

---

---

This week on Coffin Talk: Crystal Cunningham is a retired humanitarian surgeon who has been published in physics, chemistry, and surgery texts, and she is now fulfilling her dream of writing poetry. Listen or watch by clicking HERE!