A very nice patient of mine died this summer. This former teamster spent most of his life enjoying his "golden brew" though he had had to cut back in recent years after recurrent episodes of alcohol related pancreatitis (inflammation of the pancreas). These episodes had damaged his pancreas (the organ that makes insulin) enough to give him diabetes by the time that he was 45 years old, though that never stopped him from enjoying his meals despite what it did to his sugars (which he declined to follow). He did stop the alcohol without any medical support or counseling.
His wife was concerned that he would eventually die of lung cancer from his heavy smoking, as had his father and grandfather before him. She asked that I do my best to catch it early so that he could have the chance to survive that they never had. After all, he was the breadwinner for her and their large family.
We were quite lucky that the past three decades have been accompanied by advances in science. While his regular chest x-ray was still normal, we found a cancer on a CT scan (computerized tomography) while it was still "small", though surgically it did not turn out to be totally "curable" as it was wrapped around an artery. With surgery, followed by radiation he did fine over the next six years with pain only in the area of the surgical scar. The pain was sufficient to overcome his addiction to smoking: "I always said I'd quit smoking when I got cancer". He was quite proud that he had done this without any medicine support.
He never complained about having the cancer, the surgery, or even the need for oxygen as it became necessary due to the long-term smoking, the surgery, and the radiation. The insulin injections, however, did bother him and he continued to decline to check his own blood sugars. His wife became quite good at "keeping the sugar score" though he always made it a bit more challenging by eating just what he wanted, when he wanted and declined to let her do the checking. As his kidneys and eyesight began to fail (from the diabetes), and his heart caused problems (a function of smoking, diabetes and kidney disease) recurrent hospitalizations became the norm. Between hospitalizations, he never complained knowing the causes of his problems and accepting their consequences. After several years of ill health and a brief period of hemodialysis ("being attached to machines" in his words), he succumbed- to the consequences.
I see his widow, children and grandchildren from time to time. Sometimes we talk about how they would have liked to have him around longer. The next time that you take a health risk, please think of ALL of the consequences.