Carson’s death serves as a grim awakening

Carson's death serves as a grim awakening by David Lias Those of us old enough to be aware of Johnny Carson's work know that calling him the king of late night television is no exaggeration.

Many people are talking about Johnny these days since his death last weekend. Most of the time, the talk is about the Midwesterner's impact on showbiz, television and popular culture.

Not many people are talking about how he died.

One would hope someone as beloved as Carson would quickly and painlessly move on from this world to the next, in no more time than it would take Carnac the Magnificent to stumble on stage.

Carson, however, died of emphysema. It's the kind of death you wouldn't wish on a nemesis, let alone a beloved guest who entered your living room through the magic of television five nights a week.

John Kass, a columnist with the Chicago Tribune (and a smoker) decided to learn more about the disease.

He contacted a doctor whose primary interest has been the study of what killed Carson.

His name is Dr. Nicholas Gross, 70, a former president of the Chicago Thoracic Society and currently a professor at Stritch School of Medicine at Loyola University.

The disease starts slowly. Patients don't know they have it. Unaware, they reduce their physical activity so as not to get short of breath. The body degenerates, and still they grab that smoke.

Dr. Gross has seen people on oxygen, on the tubes, burning cigarettes. "You think, my God, don't they understand?"

Kass asked about Carson and the science of what happened to him.

"He was a heavy smoker," Dr. Gross said. "I read somewhere in the papers that in his last 15 years or so, he sat home and smoked."

Kass and the doctor talked about how addictive cigarettes are, and how difficult it is to kick the habit.

"But you can quit. I did. It's not easy. But you can do it," the doctor said.

I wanted to get back on the science, to listen to him explain it in precise terms, to concentrate on something terrible, Kass writes.

"One of the most striking things about the disease is the loss of skeletal muscle," Dr. Gross said. "They lose it in the voluntary muscles in the arms, legs, shoulder. They atrophy. They lose body strength, muscle bulk. Most people with emphysema die of cardiac disease or malignancy, which are the two leading causes of death."

What about respiratory failure?

"They don't have enough functioning lung to pull them through. That's when you really do have a problem with oxygen, and getting rid of the carbon dioxide in the bloodstream. Blood gas goes haywire, the kidneys, the wheels start falling off the wagon, things go downhill pretty rapidly," he said.

Kass suggested that such respiratory failure must involve a general physical decline, then at the end a casual drifting off, a lightness of the brain without the oxygen.

"It's not as if someone put a pillow over the person's head at the end?" he asked the doctor.

"Well, no, not exactly," Dr. Gross said. "It is a gradual slowing down, and at the end, the very end, for the last matter of days, it is the pillow over the head."

Carson's death could have been due to pneumonia, to infection, or it could have been respiratory failure. Either way it was private, and ugly.

Kass wrote that he thought of Carson suffering amidst tubes. It's an image that's been active in my mind these days, too.

You can call up pictures of Carson on the Internet during his hey-day. In the 1960s, the black and white days when he was young and had dark hair, he smoked on the air.

Everybody smoked on the air.

In the last decade or so of his rule of late night, one could easily have gotten the impression that he kicked the habit. There was no ashtray on the desk, no puffs of smoke as he interviewed a guest.

Now and then, however, people who were glued to the tube when Carson was on would occasionally see the cameras catching him as he finished one last drag after a commercial break, waving away the wafting smoke when the director cut back to him.

Carson, apparently, could not throw his cigarettes away. If you are smoker, you too, may think it's hopeless.

It's not.

Mary Merrigan, public relations director at Sioux Valley Vermillion Medical Center, said the local health care provider has packets of information available describing nicotine addiction and some of the best ways to stop using tobacco.

The hospital also directs smokers to the South Dakota Quit Line.

Tobacco-cessation telephone counseling has helped the South Dakota Quit Line users reach a 26 percent rate of success. A quit attempt is considered successful once 12 months have passed without tobacco use.

In comparison, only about 5 percent of people who quit on their own are still abstinent a year later. Between January 2002, when the state launched the quit line, and November 2003, over 18,000 South Dakotans called the telephone counseling service.

"Twenty-six percent is a phenomenal success rate. It's gratifying to know that so many tobacco users who wanted to quit were able to find the help they needed at the Quit Line and that they've succeeded in their attempt," said Doneen Hollingsworth, secretary of health.�

Tobacco users who call

1-866-SD-QUITS (1-866-737-8487) receive over-the- phone counseling from trained professionals as well as discounted cessation products.

Counselors schedule regular follow-up calls over several weeks to offer support during the individual's quit attempt.�

The quit line is a partnership with the American Cancer Society, which operates similar counseling lines in other states.

South Dakota was the first state to provide a program that combined quit-smoking medication and telephone counseling services statewide.�

Twenty-two percent of adult South Dakotans are smokers, and tobacco use is the leading cause of preventable death in the United States.

Secondhand smoke results in serious illness for nonsmokers, including an increased risk of respiratory infections and asthma in children.�

Are you a smoker? Do you wish you could quit? Do you feel there's a good chance your life could end in misery because of your habit?

Emphysema, heart disease and lung cancer don't have to be in your future.

Call Sioux Valley Vermillion Hospital. Call the South Dakota Quit Line. Call the state health department's Tobacco Control Program at 1-800-738-2301. Call the American Lung Association at 312-243-2000.

Do it today. As Dr. Gross repeatedly told Kass, "You can quit. You can have a life. You can quit."

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