Respiratory Therapy by Farzad Refahi

As I sit down with patients and discuss smoking cessation, I actively try to stay open and to hold back any judgment. I hope for an honest discussion on their part as well. I share with my patients that everyone’s journey is different and there is validity in their struggle. Smoking has a physical, social and psychological aspect to it.
I am not a smoker and have never been addicted to nicotine. Could I truly be empathetic to a smoker? Sure! I believe we all can be more empathetic without going through the same experience by listening to people.
Coffee is my addiction.
I have been drinking coffee since my first year of undergrad. It began as a necessity to allow me to read through pages of Kinesiology and Psychology notes at York University. Drinking coffee continued even post-graduation. Again, it became my crutch while studying respiratory therapy at school, during my clinical rotations and while working as a staff RT at an acute care hospital. Even when I stopped working in the acute care setting, every day I drank a total of two medium Tim Horton’s cups of coffee.
As a self-awareness and reflective process, I decided to limit my caffeine.
For the past three weeks, my caffeine intake has been limited to decaffeinated coffee. Even within the first three days, I experienced some expected changes. I felt more tired in the afternoons. My heart rate was lower and didn’t have the sensation of beating at the “top” of my chest. My ongoing general and social anxiety has reduced to almost non-existent, and I urinate less frequently.
I have also experienced two elements that I did not predict or expect. First, I expected to have some irritability or withdrawals but experienced none. This may be due to my daily consumption of decaffeinated coffee as it contains a small amount of caffeine.
Second and unanticipated to me, I began to have more dreams! In the past, I would wake up once or maybe twice a week knowing that I had dreamt. Now I wake up every morning, knowing that I have! It is my guesstimate that with a medium size coffee in the morning and one in the afternoon, caffeine’s six-hour half-life never had a chance to clear my system in time to allow me a restful sleep.
Literature and studies go back and forth on the benefits of coffee, and this post will not attempt to cover that information. The goal of this post is not to change your drinking habits (unless you experience general anxiety associated with an increase in heart rate and have a pattern of low quality sleep).
What did I learn from this “experiment”? In this self-awareness exercise, I had the assumption that greatly reducing my caffeine after 15 years would be very difficult. Also, that it would lead to severe withdrawals over the first few days. Luckily that was not the case.
I did not decide to suddenly stop drinking coffee and instead, settled for decaf because I really enjoy the smell and taste of coffee! Sometimes it is hard to change the social, lifestyle and behavioural patterns and routines.
Did this experience lead to a groundbreaking insight and further deepen my empathy with my patients who smoke? The truthful answer is not really. I felt that I already had a supportive mindset toward my patients. While this exercise did not necessarily make me a better clinician, I do enjoy the personal benefits of limited caffeine consumption. I still occasionally drink regular coffee but almost all my coffee and tea is decaffeinated. The reduced heart rate and associated lower anxiety symptoms and increased dreams are great benefits.
I encourage you to identify and challenge some of your held beliefs and routines. If you are on the right path, then it will re-confirm your choices. If not, you can explore new possibilities.
Through self-development, hurdles, struggles, and victories you can be more aware of the processes involved in change. Sometimes awareness itself can make one more empathetic.