I've been following a 54 y/o male for many years. He has the "usual" assortment of diagnoses frequently encountered in the primary care setting. He also smokes 1-2 packs a day.
I had previously tried many different approaches to get him to quit smoking.
No idea why on this particular day, a routine follow-up appointment, I decided to ask, "are your wife and other family members prepared to meet your needs after you've had a heart attack or a stroke due to your smoking?"
He smiled, then laughed and said "yes they are...good try doc."
I'm pretty sure I then smiled as well.
He wasn't ready to quit.
We spent some time talking about the trip he was about to make up north to see other family members.
Unfortunately, I received a phone call message about a week later. He was still away on vacation.
"Tell Doc he was right. I had a heart attack and a stroke and am still in the hospital. My heart is OK but I don't have a lot of movement on my left side."
I've seen him since.
He's quit smoking. He still has left sided weakness. His family is helping to meet his needs.
I'm still a little freaked out about the whole thing.
Weird as it may seem, however, I think the patient thinks I'm smarter than I actually am, just because I was able to predict his future.
It hasn't changed my desire to get folks to quit smoking, just the phraseology I use with other patients.