An Attack of the Vapers… Er… Vapors?

Unless you have been a shut-in with a phobia of all forms of media, you will be aware of an up-ticking trend in nicotine use. It involves the use of the electronic cigarettes. There has been recently and increase in the debate concerning regulation and health concerns regarding the use of these alternatives to combustible tobacco use. Warning, dear readers, this may get “sciency”. I’m not going to apologize. In this particular issue, science is a significant player in the regulation debate. So, with the disclaimer out of the way, on with the show…

What Are Electronic Cigarettes?

The first electronic cigarette, vaporizer, or nicotine delivery system was patented in 1963 (Gilbert, 1965). The devices work by using an electric heating source to heat a solution to vapor state by which it can be inhaled (Czogala, et al., 2013). The liquid solution or “e-juice” is usually a mixture of propylene glycol (PG), vegetable glycerine (VG), and or polyethylene glycol (PEG). These chemicals are mixed with flavors and nicotine. These days, there are a wide variety of flavors. Additionally, not everyone is keen on PG and PEG to which many are allergic and/or it exacerbates asthmatic conditions. So, there are 100% VG versions that do not contain any PG or PEG. The solution of nicotine is also variable these days, generally from 24 mg down to 0 mg of nicotine. The user breathes in the vaporized solution, and exhales mostly water vapor. Unlike other smokeless nicotine delivery systems (gum or patch), the electronic cigarette more closely resembles the feeling of the physical and behavioral aspects of smoking.

With the expansion of non-smoking laws and limitations, the popularity of non-combustible tobacco options grew. There are a wide variety of electronic cigarettes that closely resemble traditional cigarettes. Some brands also have a glowing tip that mimics the fire of traditional cigarettes. There are disposable options. Other options have disposable cartridges that attach to rechargeable power sources. With the increasing popularity of the vaporizing trend, there are a wide variety of power sources (batteries) with varying power charge and time. More advanced options include ability to adjust power and delivery. With these new power options there are detachable tanks that run the gamut from disposable tanks to artisan crafted hand-blown reusable options.

As the number of electronic cigarette users increased, the language also expanded to incorporate new vocabulary associated with the trend. Because the mechanism is vaporizing the solution, the behavior has been labeled “vaping.” The devices have been called e-cigs, e-fags (U.K. primarily), e-hookahs, or hookah pens (Richtel, 2014; The Time Out London blog, 2014).

Why Are More People Vaping?

So, why the up-tick in the vaping trend? In four years, from 2008-2012, the number of e-cigarette sales increased by nearly 7000%. It seems that while the mere restriction on smoking in public places may have pushed traditional smokers to the non-combustible alternatives, this may not be the only reason for the increase in number of vapers. So what are the leading reasons for people to choose e-cigarettes?

  • Avoidance of smoke-free laws (Koch, 2012)
  • Convenience (Noguchi, 2014)
  • Smoking cessation (Pokhrel, et al., 2013)
  • Health concerns (Farsalinos & Polosa, 2014; Koch, 2012)
  • Financial (Koch, 2012)

The concern for environmental factors and second-hand smoke made more and more indoor environments become non-smoking. Smoking sections in restaurants, airplanes, hotels, and other facilities became a thing of the past. Smokers were relegated to outdoor designated areas. Complaints about non-smokers entering buildings through a cloud of second hand smoke, prompted building owners and businesses to post boundaries and zoning to bar smokers from proximity of the doors. However, more and more organizations, companies, etc. are moving towards the smoke-free environment entirely. The push has been for users to choose smoking cessation options, such as nicotine gum or the patch. However, the new prevalence of e-cig options have made vaping a more convenient option. Vapers can remain at their desks (in places where vaping indoors has not yet been banned) rather than being pushed into the weather for their break (Noguchi, 2014).

Some people saw the e-cigarette as an alternative to smoking cessation (Koch, 2012; Pokhrel, et al., 2013; Richtel, 2014). While there is a significant lack of evidence to support the efficacy of e-cigarettes as a smoking cessation intervention; people still believe that vaping is a viable alternative to nicotine gum, the patch, or other pharmaceutical options.

Even for those who do not desire abstinence from nicotine, there are aspects of vaping that have smokers switching in hopes of improving their health (Farasalinos & Polosa, 2014; Koch, 2012). Detractors have argued that there are still dangers and volatile chemicals associated with the vaping process that endanger the health of humans (Koch, 2012; Reasons Supporting Regulation of E-Cigarettes, n.d.). Additionally, nicotine is still a poison and can be dangerous to anyone inhaling, ingesting, or absorbing transdermally (Glatter, 2014). Nicotine toxicity is a concern for those handling the nicotine infused e-juices. Additionally, the risk to children who might mistakenly consider the intriguing smells and colors to be something edible supports the push for child-proof closures on e-juice containers. The detractors also are concerned with the second hand vapor expelled into the environment. However, much to the chagrin of those who want to claim harmful effects of vaping as being as dangerous as combustible tobacco, what little research is out there has shown that the negative effects of vaping on the primary user and the innocent bystander from second hand exposure are a fraction of what would be experienced with traditional smoking (McAuley, Hopke, Zhao, & Babaian, 2012; Noguchi, 2014). Studies have shown that there is still some nicotine expelled in the vapor resulting from e-cig use, but that it is ten times less than the amount found in traditional combustible cigarette smoke making it less harmful to those exposed second hand (Czogala, 2013). Additionally, there is none of the “side smoke” (fumes from the burning tip) that occurs with puffing a traditional cigarette. Goniewicz, et al. found in 2013 the levels of other toxicants to which vapers are exposed were 9-450 time lower than by traditional cigarette smoking. Most sources acknowledge that the research is just very limited at this time and more time and studies are needed to examine the long term effects.

There are many anecdotal accounts by former smokers who have reported that vaping has improved their own perceived health (Koch, 2012). Vapers indicate that the traditional “smokers’ cough” disappears after a short period. An unexpected development for some former smokers switching to vaping is a return of their olfactory sense. One former smoker/new vaper stated, “I went outside to sit and vape and smelled something. I couldn’t identify what it was, but it didn’t seem very pleasant. After looking around, it finally dawned on me… I was smelling the ash tray [that was still sitting on a table for smoking guests].” Because the oral behavior and nicotine are present, many report that they have not seen the weight gain that accompanies other types of nicotine replacement systems, and even though there is no current research supporting vaping as an effective smoking cessation method, the ability to step down the e-juice nicotine to zero might provide options for those who wish to break their nicotine addiction (especially for those to whom the “ritual” of smoking is as important as the actual chemical addiction).

One of the other major foci of the people against vaping has been the aspect of vaping as a gateway for young people and the behavioral aspects of the trend. Several outspoken antagonists of the vaping trend say that the “candy” flavors and colorful packaging target the young (Richtel, 2014). Additionally, the non-smoker rights movement have viewed the vaping trend as setting back smoke-free society by decades by “making smoking seem acceptable” again (Reasons Supporting Regulation of E-Cigarettes, n.d.). The argument is that the “mimic behavior” of vaping is just going to draw more people to the smoking behaviors, and nicotine addiction will keep them there. The lack of federal regulation leads detractors to fear the marketing of these items to teens and children.

Finally, the last reason on this list is the financial perspective. E-cigarettes present options that are far less expensive than smoking (Koch, 2012). With the cost of cigarettes and “sin tax” making the price of combustible tobacco rise astronomically, vaping provides a significantly less expensive alternative. Even with the cost of starting (purchase of power source, tanks, and e-juice), most vapers find that the choice to vape instead of smoke significantly decreases the amount of cash expenditure monthly. Let’s look at an example of an average user:

Assuming a moderate smoker as a pack of cigarettes per day use, this averages approximately a carton of cigarettes per week. Obviously, the cost of cigarettes varies significantly from state to state, but for this exercise, we will use the prices from Tennessee. Cartons of cigarettes vary in price. The range is somewhere between $36-70 depending on brand. Taking the cheapest option as the choice, a carton of cigarettes per week gives us about $156 per month or $1872 annually. This does not include accessory costs (lighters, lighter fluid, flints, etc.); or incidental costs of accidental burns in clothing or upholstery, smokers deposits (some rental agreements), and cleaning costs of ash and smoke in clothing and environment. For this case, we will calculate cost based on one of the mid-range electronic cigarettes known as the “hookah pen.” This particular model includes a battery with removable tank that charges using a USB connector. The basic start-up kit at the local vapor emporium includes one power source, charging adaptor, one disposable tank, and one 10 ml bottle of e-juice; all for $30. Disposable tanks cost $5 a piece and last between 10 and 30 days depending on intensity of use. However, there are alternatives. There are also rebuild tanks that cost $5 new and have replaceable coils for $2. Coils last about the same time as disposable tanks. The e-juice is the primary consumable in this process. From speaking with vendors and vapers, a 15 ml bottle of e-juice is the approximate equivalent of a carton of cigarettes. This amount varies person to person according to reports. Factors that impact usage are nicotine load in the e-juice, prior smoking rate before switching, and behavioral differences in drawing vapor/smoke. In general, the cost of e-juice runs $8-10 per 15 ml bottle. Right there, you have a comparison: One carton of cigarettes, $36; the equivalent amount of e-juice, $8. To take it a bit further, let’s follow our new vaper/former smoker for a year. At the end of a year, assuming the pattern above, the smoker would spend approximately $2000. For the equivalent vaper, the annual spend would be (including start-up, additional tank purchase, and coil replacement) $473. That is a difference of $1527.

Would it be an even greater savings to quit smoking or vaping all together? Of course it would. However, for those who do not want to stop the “ritual” or abstain from nicotine, vaping provides a fiscal alternative that is far less offensive to the bank account. Now, keep in mind, these things are not currently federally regulated or taxed. Some states are imposing their own taxes, and sales tax is definitely applicable (Koch, 2012). If regulations are implemented, it is possible that the cost of vaping may increase, especially if those already lobbying against vaping succeed in their efforts. The inexpensiveness is another point they make in the risk to teens and young people for whom the cost of cigarettes has exceeded their lack of adult income.

To Vape or Not To Vape… What Was the Question?

So, what is the conclusion? There is no doubt that more research is needed. The long term effects of vaping are, as yet, unknown. There may be health impacts that we have not seen. It is still not recommended to expose children or pregnant women to electronic cigarette vapors, actively or passively. Nicotine is still a poison, and unless you are using the zero nicotine e-juice, you are still inhaling this chemical. Additionally, the danger to anyone ingesting or transdermally absorbing the nicotine solution can be significant. E-juice should be kept away from children, and vapers should always wash their hands after filling tanks to prevent accidental overdose exposure. However, as noted in the studies mentioned here, the levels of carcinogens and harmful toxicants are significantly less for e-cigarette use than for combustible tobacco. The second hand risks and impact to the environment are also decreased. Financially, at least for now, vaping is less expensive than smoking. The trendiness of vaping, along with the flavor and color associated may draw younger people. However, as with all trends, the potential for long term use may be less as the newness wears off. Since it is possible to vape without any nicotine in the e-juice, those choosing to vape initially as opposed to switching from traditional cigarettes do not face addiction risk in the same way. Also, with the capability of stepping nicotine down, it is possible for former smokers to break their own addiction to nicotine while still participating in the behavioral “ritual” of smoking. The biggest deterrent for anyone considering vaping is that there really is just not enough research to indicate what the risks and benefits might be.

Bottom line is that for those who do not smoke, vaping is an unnecessary habit to form. For those who smoke, weigh the pros and cons and do your research (there are articles listed in the references as well as links for organizations that have more scientific research to offer). Think about your reasons for switching. If it is for health reasons, set yourself a timeframe and think about the step down process. Keep a calendar and stick to it. Remember that nicotine is a poison. Keep e-juice out of reach of children and pets. For those who are looking at the financials, watch the news and be aware that regulations may decrease the fiscal benefits of vaping. Also, watch out for the “shiny” aspects. There are a lot of toys, gizmos, accessories, and flavors of e-juices that go with vaping. You aren’t saving if you are buying all the latest “shiny” new things.

Examining all the various arguments for and against as well as observing the phenomenon first hand, my own leaning is that vaping is positive option for smokers. It can save money. Vapers smell better (both the individuals and their own olfactory sense). Until research proves otherwise, I believe that this new trend is a better option for those who are forced or would like to avoid combustible tobacco but aren’t ready to let go of the “ritual.” For those who do not need the “ritual” but want to quit, there are viable options in the form of gum, patches, and pharmaceuticals. And for those who are just fine with their tobacco in fiery form, enjoy while you can as the non-smoker rights advocates chase you from pillar to post.

I know that this has been a very long post, but I hope that it has presented useful information that will help any of those teetering on the brink of decision.


Czogala, J., Goniewicz, M., Fidelus, B., Zielinska-Danch, W., Travers, M., & Sobczak, A. (2013). Secondhand exposure to vapors from electronic cigarettes. Oxford Journals: Nicotine & Tobacco Research, doi: 10.1093/ntr/ntt203

Farsalinos, K., & Polosa, R. (2014). Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review. Therapeutic Advances in Drug Safety, 5(2), 67-86.

Gilbert, H. (August, 1965). Smokeless non-tobacco cigarette US Patent 3200819 A. Gilbert Herbert A. Retrieved from

Glatter, R. (2014). The real dangers of liquid nicotine. Forbes (online). Retrieved from

Goniewicz, M., Knysak, J., Gawron, M., Kosmider, L., Sobczak, A., Kurek, J., Prokopowicz, A., Jablonska-Czapla, M., Rosik-Dulewska, C., Havel, C., Jacob, P., & Benowitz, N. (ABSTRACT, 2013). Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tobacco Control, doi: 10.1136/tobaccocontrol-2012-050859 Retrieved from

E-cigarettes and coffee at London’s Vape Bar. (March, 2014). The Time Out London blog: your daily guide to city life, news and culture. Retrieved from

Koch, W. (September, 2012). E-cigarettes: No smoke, but fiery debate over safety. USA Today. Retrieved from

McAuley, T., Hopke, P., Zhao, J., & Babaian, S. (2012). Comparison of the effects of e-cigarette vapor and cigarette smoke on indoor air quality. Inhalation Toxicology, 24(1), 850-857.

Noguchi, Y. (March, 2014). Ok to vape in the office? Cities, feds and firms still deciding. NPR Shots. Retrieved from

Pokhrel, P., Fagan, P., Little, M., Kawamoto, C., & Herzog, T. (2013). Smokers who try e-cigarettes to quit smoking: Findings from a multiethnic study in Hawaii. American Journal of Public Health, 103(9), e57-e62.

Reasons Supporting Regulation of E-Cigarettes (n.d.) Retrieved from

Richtel, M. (March, 2014). E-cigarettes, by other names, lure young and worry experts. The New York Times (online). Retrieved from

More Resources

Scientific and Medical Information on Electronic Cigarettes, National Vapers Club –

Smoke-Free Alternatives Trade Association (SFATA)

Careful, Girl! Your “Old” is Showin’

No one ever expects it. Rather the opposite, we all assume that we will never say and do the things we observed in our parents, grandparents, elders of whatever relation. It was as obvious to me as I am certain it is (or was) to all of you that, unlike those we observed, we would be more likely to perish of terminal coolness and hipness and general with-it-ness than fall into the bear trap of cliché and caricature from which the likes of Walter Matthau and Maxine derive their entertainment value.

I have blithely progressed through my life, certain that I would never lose touch with the modern set. I would be able to understand and connect with people of all ages using understanding and open-mindedness (something I was absolutely certain my parents and other forebears never obtained). And then… something changed. I don’t know exactly what it was. It was as if an alien entity entered my very being and I awoke to hearing a horrific cacophony from my own brain, “Hey you kids! Get off my @#$% lawn!” Ok. Maybe not literally, but it might as well have been. I found myself saying things like, “What has happened to…?” and “When I was starting out…”

I was horrified. I seemed to have no control of it. The vile ramblings would spew forth as if from an octogenarian fount of crotchetiness. Where in the name of all that I hold holy did this awful despair of the human race come from?!? Sadly, I have become that which I never expected… I’m an old codger. Oh, the humanity!

We’ve become a very casual society. I’m not entirely sure what did it. It might be the fast pace. It might be that as a society we have become more interested in the inside of the person than the superficial appearance of geniality. It might be that in the age of widespread technology and decreased privacy, there are no secrets and therefore no need to put on airs and facades. It might be any or all of these… or it might be something else entirely; something that we have lost through the passage of time and lack of patience, something that has lost any importance and meaning lost to history, like a relic or the Antikythera mechanism.

I am talking about manners and self-concept and, yes, even to a certain extent fashion. I can almost hear the clicks of people shutting down this browser window. I can hear the arguments brewing and desperately wanting to talk over the words on the screen. “We don’t need some antediluvian set of social conformity rules to guide our behavior! Go back to your cave, you old crone!” However, I will just say that I become nostalgic for some of the finer interactions of days gone by. I miss the days when people waited for their turn to speak and listened when someone else was speaking. I miss having dinner or any meal or serious conversation without someone checking their phone in the middle of it. I miss having events or social engagements where it was expected that you would wear something other than jeans and a t-shirt. I miss the days when people actually felt some remorse for hurting the feelings of others, instead of the entitlement of those who live by “YOLO” and the value of not caring about what people think… or feel.

I find myself falling in with the pattern of society and failing to observe what might be considered just common good manners, but then again, good manners appear to be about as common as common sense… in other words, not so much. As much as I abhor the lack of good grace by which we all seem to live in these modern times, I cannot deny that I am easily as much at fault in my own manners. My language inclusive of way too many slang words and too few apologies. I catch myself paying more attention to my electronics than the breathing beings around me. While I am actively trying to be mindful, I catch myself speaking over others or interrupting them because I feel too rushed to take the time to just listen. I am culpable. And I don’t like it. I do not want to join the crowds of “me” generation who don’t care about the feelings of others. I want to remember and experience what it is like to engage in pleasant social interaction with people who value the companionship chosen, not merely as an audience for a game of “Look how clever am I”.

It is not that I fear change (hush up all of you who know me and will contradict this statement emphatically…). Ok, so maybe it is. I didn’t used to be. What happened? I really can remember a time when I would dive in head first to the unknown. And… that is stretching the truth as well. Now, I’m getting depressed. Was I always so reserved and hesitant? Perhaps, that is the sad truth. Perhaps I was raised by someone who believed that good manners were not a luxury. Perhaps I was encouraged to engage in the niceties because they are not just superficial, they are a sign of respect for yourself and for your companion. Perhaps, these weren’t such worthless lessons to absorb. Are some of the trappings of society superficial? Of course they are. However, they represent something that we seem to have lost. They are small ceremonies of respect that we show the people who fill our daily lives. When we fail to engage in those small ceremonies of respect for those around us, those around us may fail to show us the same respect. When no one respects each other, we may start to absorb that disrespect and lose respect for ourselves, no matter how entitled we feel.

I guess that may make me old fashioned. I would like to continue interacting with the people around me with respect, for them and for myself.

Ah, but watch out girl! Your ‘old’ is showin’.

Is it? I can live with that.

The Breakfast Club

I apologize to my loyal few for the delay. I will only say that I have experienced some internal resistance recently. I will warn you that this entry departs strongly from my usual style. It may also feel a bit more intense than my usual entries.

Walking into the waiting room, it was subdued, more than usual. It was not that the day was gray and sullen, though it was. It was not that it was early, but it was. There was a difference in the mood. It was the same room where I had been spending mornings periodically with varying frequency for going on half a decade. The room was familiar as was almost every face. But today, something was different.

I signed in and took my seat. Occasionally, the loud clear announcement from the phlebotomist would request the presence of one of the occupants of the room to provide their blood sacrifice into the plethora of vials and tubes that would be delivered to the lab for quantifying and assessing. One of the volunteers came through the room stopping and asking “How are you doing today…?” to all in passing. Occasionally, she would spend a bit more time with this person or that because she had some knowledge of their personal life. However, the question seemed on this day less of true interest and more the mechanics of habit.

I lifted my eyes to scan the room. Closest to me, a frail, fragile lady with immaculate white hair and bones so visible that they appeared to almost cut through the skin sat next to what appeared to be her daughter. The daughter kept up a whispered commentary, but her delicate companion fidgeted with an antique gold and diamond ring too large for her right hand with the left hand which sported a tiny engagement and wedding set, the kind that was favored in the days when a tiny chip of a diamond would have been the equivalent of a crown jewel. I could only imagine that the giver of these treasures had long since passed. Beyond this pair was another lady, skin bruised and slack on the frame of her bones. A cane balanced against her knees indicated the possible source of all the purple patches marring the skin of her extremities, but it could also be the result of intravenous punctures for any variety of causes.

Across the room, a new couple sat close together. By their physical behaviors, it was evident the wife was the patient. She appeared resigned, holding her records, but next to her, the husband hovered protectively and uncomfortable, in truth unable to protect her in this instance from her attacker. The door opened to admit two ladies. In my head, I’ve always called them “Dorothy and Rose”. The one is tall, almost masculine but stylish. Her build would have once been athletic. Her friend is of a more petite stature, with curves and more femininity. It is “Rose” who is the patient, but “Dorothy” always accompanies her, and they always bring their coffee, purchased from an expensive franchise. While it is possible that neither lady would miss the cost of a latte, it is also likely that this is the weekly carrot that rewards the acceptance of the stick of treatment.

An elderly gentleman, who has a volume control issue, wears overalls and an engineer’s cap. He is back for his third round of our shared experience. We are all aware, as he is not shy about sharing, but we are all also aware that this is likely his last chance. His attitude is always positive, and his loud voice is never raised with complaints, though I know how often pain is his companion, as much as the younger man seated on his left.

Resuming my scan of the room, I mark an absence from our morning gather: An elderly gentleman who had been present every Wednesday since my initiation to the club. He was always cheerful, despite evident discomfort and occasional shortness of breath. He was usually accompanied by his daughter, and they always sat in the same seats. We all did. It was if by general consent we had assigned seats. Their seats were empty, and no one sat there. Even new people avoided the chairs as if there was an invisible barrier preventing it. Perhaps he just recovered, I told myself. I understood now the change in the atmosphere. I had seen it before. None of us asked the question, but we all knew what the absence meant. The subdued tones of the staff confirmed our suspicions. We all just sat quietly and waited.

Loudly, startling everyone in the room, my name is called. I walk back to be installed my recliner. The room is always so cold. Scattered about the room, others have taken their places. One elderly man dozes under a blanket while the IV monitor continues to pump the toxins that are meant to prolong his life. I patiently await my own turn. The nurse comes to my side and goes through the ritual of verification. I prepare myself for the sting and pinch as vehicle of administration is inserted into the crook of my arm and the bags of pharmaceuticals hang to pump into my body. I can feel my arm going cold and slightly numb. The feeling of fatigue and nausea begin, and I attempt to distract myself with reading or social media on my phone. Across from me, the fragile lady sits in her own recliner waiting for her own treatment. She sips on a cup of some fluid and begins to choke as the liquid, due to her weakened physical state and damaged swallow reflex, attempts to enter the wrong pipe. Her daughter attempts to assist her. Staff quickly assemble equipment to help with the oxygen deprivation. The woman meets my eyes, and I see her panic like that of a drowning victim. I forget about the discomfort in my arm and disorienting feelings caused by the chemicals. I can only see the terror in those eyes as she struggles to cease the spasms in her throat and get enough oxygen to her body.

What makes it all worse is looking around to others who, like me, want desperately to help, but we cannot move, tied to our own seats by the tubes and needles that connect to the bags of chemical assault upon the diseases that have overtaken our bodies. So, instead, we sit impotent and weak and watch the struggle.

How selfish and self-centered am I? Having my private pity-party with my discomfort and anger. I watch as the woman clutches at the breathing mask and tries desperately to get the spasms to quiet and oxygen to her system. Slowly, the terror recedes to exhaustion and slight embarrassment at being the center of so much attention. The activity returns to normal, and conversations start up around the room, softly at first and then increasing to normal volume. They talk about travel and family and hobbies. No one talks about the nausea and the night sweats and the hair that comes out in greater amounts with each passing treatment. We all know. It isn’t important.

Life is what is important to these few. The people they love. The people who love them. The daughter now carefully watching her frail mother breathing more comfortably now, and the son who sits quietly beside his dozing father. The friend who crochets a newborn’s skullcap while her friend slips in and out of consciousness to the ticking and drip of the IV. And the solitary woman who sits quietly and observes. Is it better to struggle against futility to extend the hours of life upon the earth merely for the sake of existence, or might it not be better to spend the time more wisely in the pursuit of a worthwhile goal though it shorten the span of time? For these, the choice is made. Every extended moment with those they love is worth the fight. And with that, I find that it is remarkably easy to let go of a lot of things that take more energy than I have to give. I find that there is only so much room in my life for the petty and self-important. I have enough drains on the energy that sustains me, and I feel that my time and activities are spent better with those who fill that void rather than further drain it.

The following is not my own creation, but I found it to be extraordinarily poignant, appropriate, and wish to share it with all of you:

She let go.
She let go. Without a thought or a word, she let go.
She let go of the fear.
She let go of the judgments.
She let go of the confluence of opinions swarming around her head.
She let go of the committee of indecision within her.
She let go of all the ‘right’ reasons.
Wholly and completely, without hesitation or worry, she just let go.
She didn’t ask anyone for advice.
She didn’t read a book on how to let go.
She didn’t search the scriptures.
She just let go.
She let go of all of the memories that held her back.
She let go of all of the anxiety that kept her from moving forward.
She let go of the planning and all of the calculations about how to do it just right.
She didn’t promise to let go.
She didn’t journal about it.
She didn’t write the projected date in her Day-Timer.
She made no public announcement and put no ad in the paper.
She didn’t check the weather report or read her daily horoscope.
She just let go.
She didn’t analyze whether she should let go.
She didn’t call her friends to discuss the matter.
She didn’t do a five-step Spiritual Mind Treatment.
She didn’t call the prayer line.
She didn’t utter one word.
She just let go.
No one was around when it happened.
There was no applause or congratulations.
No one thanked her or praised her.
No one noticed a thing.
Like a leaf falling from a tree, she just let go.
There was no effort.
There was no struggle.
It wasn’t good and it wasn’t bad.
It was what it was, and it is just that.
In the space of letting go, she let it all be.
A small smile came over her face.
A light breeze blew through her. And the sun and the moon shone forevermore…

~ Rev Safire Rose
via Devi Moksha

Diagnostic Evaluation of ‘But First’ Disorder: The Epidemic

It was a joke between my father and me. It was a collection of observations we made over the years. Many of our family members actually praised the organizational skills of my father. My mother frequently noted wistfully how much more disciplined I am that she. Dad and I knew what it was. It was the ‘but first’ disease.

The ‘But First’ disease is a remarkably prevalent disorder in the general human population. There are acute and chronic versions. It is a degenerative disorder and can become more chronic and severe with age. Here is a general case study of the criteria for this common disorder as described by an anonymous sufferer and disseminated to the internet in the early BBS days:

“I call it ‘But First’ Syndrome.  You know.  It’s when you decide to do the laundry.  So you start down the stairs with the laundry, but then see the newspapers on the table.  OK, you’ll do the laundry.

BUT FIRST you decide to put the newspapers away.  So on your way in to put the newspapers away, you notice the mail on the table.  OK, you’ll put the newspapers away.

BUT FIRST you’ll pay that bill that needs to be paid.  So you look for the checkbook.  Oops…there’s the baby’s bottle from yesterday on the floor. OK, you’ll pay the bill.

BUT FIRST you need to put the bottle in the sink.  You head for the kitchen.  Darn it, there’s the remote for the TV.  What’s it doing here? Okay, you’ll put the bottle in the sink.

BUT FIRST you need to put the remote away.  Head for the TV room.

Aaagh!  Stepped on the cat.  Cat needs to be fed.  Okay, you’ll put the remote away.

BUT FIRST you need to feed the cat…

So, here’s what happens at the end of the day: Laundry is not done, newspapers are still on the floor, bottle is on the table, bills are unpaid, checkbook is still lost, and the cat ate the remote control …

And, when you try to figure out how come nothing got done all day, you are baffled because … KNOW you were BUSY ALL DAY!!

That’s the ‘BUT FIRST’ Syndrome.”

~author unknown

I have for years blithely watched as various family members struggled with deadlines and due dates and arrivals and departures. There was always the last minute scrambling that occurred before heading out to any planned event. I always marveled at the frantic actions that accompanied any scheduled departure. I was baffled at the inability of so many to actually have a “To Do” list and yet fail miserable to get any item on it “Ta Done”. I believed myself to be immune to the plague from which so many suffer.

And then it hit. I’ve never really known whether it was age or stress or various life events that activates the “but first” disease, but it has hit me… with a vengeance. Along with the described progress of the disorder above, there is an accompanying cognitive disruption that culminates in a glorious confusion that prevents you from remembering exactly what you were even supposed to be doing or where you might be on the vaunted “To Do” list. I now find myself in the mortifying circumstance of mirroring the behaviors and symptoms previously regaled. I will share with all of you, my dear readers the criteria for this sad epidemic in our midst.

“But First” Disorder Diagnostic Criteria


Cognitive Disorders vs Stress Induction Disorder


Many theories have been introduced to explain this disorder, however at this time there is much controversy whether this disorder is a biological result of the progression of aging or whether environmental contributions have an impact. Additionally, there has been some speculation about the genetic contribution to the manifestation of symptoms. The increased occurrence with chronological age has led to it also being referred to as Age Activated Attention Deficit Disorder (AAADD). Further research is needed.


The symptoms of But First Disorder generally present at some point during adulthood. There is a broad range of ages in victims of this disorder; however parenthood appears to contribute somewhat to early onset of the illness.


Two or more symptoms, each present for a significant portion of time during acute attack periods

  • Highly distractible even with specific purpose, intent, and initiation of action (source of disorder name, “but first…”)
  • Tangential communication resulting derailed train of thought, often in the middle of the sentence resulting in frequent inquiry of “What the @#$% was I just saying?”
  • Motor function devoid of active cognition, as evidenced by walking purposefully into another room of the house and finding that no conscious reason for said journey is evident
  • Memory reengagement function creating unnecessary physical movement, as evidenced by returning to previous room in house and sitting down only to remember why the previous journey was made
  • Finding at the end of any given day five or more open tasks/projects with no significant progress or action accompanied by significant physical fatigue


  • Acute
    • This is generally an onset that accompanies a day planner/activity calendar that has no empty spaces
  • Chronic
    • BFD that occurs periodically with some regularity, usually when there is a large amount of tasks to accomplish and only a short duration in which to accomplish them (see paid time off deficiency)

‘But First’ Subtypes

External Distraction Type

  • Often found in (but not restricted to) new parents or parents of young children
  • Inability to finish sentences due to phones ringing, children requesting attention, pet challenges, text messages, instant messages, etc.
  • Appearance and nutrition frequently impaired due to interruptions in normal routines in these areas sometimes resulting in arrival to work with shoes of different colors or un-brushed hair, or possibly forgetting whether any food has been consumed during the day

Hyperactive Type

  • Designated by frantic activity and larger numbers of initiated tasks generally with no evidence of completion after several attempted initiations

Procrastination Type

  • Designated by long lists of tasks to be completed that have no decrease over time accompanied by other initiated activities
  • Designated task days derailed by the irresistible urge to watch the entire Netflix collection of Murder She Wrote


The most important part of treatment is allowing time and environmental cues to clear the mind of the sufferer, a reset, if you will. This can best be accomplished with a relaxing night out with an enjoyable companion. Spa treatments and massages are also beneficial. For extreme cases, more intense treatment is required. Oceanic cruises or at least a long weekend by a large body of water or other peaceful environment and application of appropriate beverages and nourishment can often significantly improve symptomology almost to complete remission. However, if symptoms re-present, repeat the aforementioned treatment.


There is currently no permanent cure for BFD. However, with proper alleviation of environmental factors and regular treatment, as above, the individual can learn to cope and improve social functioning. Additionally, appropriate treatment can prevent exacerbation of the disorder into full-blown CRS (Can’t Remember $#!%).

More research is needed to fully understand the condition and fully explore the most effective treatments… Actually, I think I’ll get on that exploration. *Hey, barkeep!…*

But First Syndrome

Daily Dose of “The Funnies”

Monster Spray: For Things that Go ‘Bump’ in Your Life
9 Chickweed Lane

Many people talk about being an optimist or a pessimist. They talk about drinking vessels with various descriptions of their contents as an assessment of being one of these. I’ve tried my hand at optimism, and I have been accused of being a pessimist; but in truth, I prefer to think of myself as a realist. I try not to expect the worst. I always try for the best outcomes, but I prepare myself for negative outcomes because I just want to have a fallback plan. Does that make me the harbinger of gloom and doom? Am I a Negative Nelly? I hope not. I certainly do not want to be.

In the course of human experience, I have found that my involuntary, sometimes unconscious response to events in my life, positive or negative, is to expect the worst and take what I get. If things turn out to justify my expectations, I’m never pleased with the results, but I use the outcomes to reformulate a plan to address the situation from a different approach. If things turn out better than I expect, I am relieved or elated. I worry that this approach is more negative than I would prefer, and knowing that negativity can actually serve as self-fulfilling prophecies in a neurolinguistic way, I have spent much effort attempting to change my way of thinking. The best I’ve been able to accomplish so far is to take a neutral stance in my expectations without giving bias to my fears or my wishes. It doesn’t work 100% of the time, though. I still find myself frequently looking over my shoulder and waiting for that alternate piece of footwear.

This is where that “expect the worst and take what you get” philosophy has really been the biggest detriment to my own peace of mind and happiness. While there may be some logical premise in expecting a negative outcome so that I am not surprised or disappointed, the side effect of this attitude is that I am not always able to relax and enjoy the positives that occur.

Perhaps it is a holdover from years of childhood superstitions and folk wisdom that became so ingrained that I cannot seem to shake off their lessons. Perhaps it is a result of traumatic experiences that have indelibly written their warnings on my memory to never get too comfortable with the good times of my life. No matter what the etiology, I find myself (like many others) when things are going too well looking under the bed for the monster, around the corner for the mugger, or over my head for the anvil. I know that I am not alone in this particular human frailty. There are many of us who cannot seem to enjoy life when it seems to travel smoothly avoiding the usual potholes that liter the road. It almost seems that we are tempting or cheating fate when all the stars and planets align to make the path we tread a bit too gentle and pleasant. We expect that other shoe to fall from the sky and squash us like a bug under one colossal heel.

I think it boils down to Maslow’s Pyramid of Needs. Anxiety generally stems in some part from the lack of these needs being met. The first tier is the basic needs that each person has for living, in other words biological necessities. The second tier is safety, shelter, and access to resources. People who have threats to meeting these basic of all needs have no energy to expend on other tiers, which involve things like social interaction, belonging, and achievement. For people who have experienced these threats and overcome them, the fear of falling back to that level is sometimes so real that it is difficult to shake off the constant thought that at any time, all could be lost. For others, the fear of losing the respect and love of family or other social supports may be as overwhelming as the idea of wondering where the next breath or morsel of food might be obtained. We fear being defined by our mistakes with the tarnish of failure marking not only ourselves but anyone with whom our lives might be linked.

What it all boils down to is that regardless of what tier we manage to attain, most of us never reach the pinnacle of self-actualization (especially in the current economic and social climates) because like toddlers struggling with learning to walk presented with a staircase, we cling to our highest achieved step looking down with fear that we will plummet back to the bottom. Any rock climber will tell you, “Don’t look down!” To ascend to the top, it is important to keep eyes on your goal, not where you have been. It is easier said than done. The fear of failing, falling, and losing the tenuous ground we have worked so hard to achieve keeps us from risking whatever progress we have been able to attain, but it traps us in the lowest levels of mere existence.

For some, this can become a debilitating depression or anxiety that paralyzes action and activity, isolating us from friends and family or making us such a misery to ourselves that we even shun the company that misery always loves. I have often wondered why this trait plagues some more than others, or if there is some way to inoculate our psyches against such attacks as you might vaccinate yourself against epidemic illnesses prior to a trip to undeveloped territories. Why shouldn’t we have monster spray to ward of the evil unknown lurking in the closet of anxiety? Why can’t we arm ourselves with the Acme Anvil Umbrella (which also protects against falling foot fashions)?

So much of what happens in our lives is a matter of choice. I am not necessarily saying that we choose everything that happens within our experience, but I am saying that choice has a much bigger part in how we approach the life we live than we might realize. This isn’t a philosophy welcomed by many. If life is a choice, then we have to take responsibility for the bad that happens in our lives as well as for the good. Too many of us get caught in the trap of relegating the responsibility for the bad stuff happening to us to the realm of evil or other people who carry out the evil. That is why I have avoided even using the phrase “happens to us”; it implies an external locus of control and puts all the responsibility outside of ourselves. The contradictory part of the philosophy, for me, is that the same people who talk about things happening to them will usually be the first to claim the victory and success in their own actions. Now, before some of my readers start calling “foul,” I know that there are people who attribute all success and goodness in their lives to their higher power. That is very generous of them, and it shows an element of piety that precludes pride. However, I still think that is giving over to an external locus of control that does no honor to human spirit and dignity, and yes, even to the higher power to which you ascribe merit but deny the free will given to humanity by same. For without free will, what is piety and goodness. If it is not by choice, where lies the merit. However, I did not intend to go off on a religious or metaphysical tangent. So, I will try again…

We live by our choices. Consciously or unconsciously, it is true. By saying this, I am not (with intentional emphasis) saying that we choose the negative aspects of our life or the occurrences that impact us in less than positive ways. Our choices are limited to our own responses and actions. We cannot choose for others (with the exception of the relatively brief period of parenthood or some aspects of other types of guardianship and political decisions). We cannot choose the behaviors of others or how they will treat us, but we do have the choice in how we respond, react, and behave.

Our lives are a series of choices that we make. While there are contributions of physical and biological directives that compel some of the actions that we take, we are unlike the rest of the animal kingdom in the development of a prefrontal cortex in our brains that provide us the cognitive benefit of decision. We can decide, maybe not so much what occurs by the choices of others, but we have the power to choose our own emotional and behavioral responses. This may not seem like much of a superpower to some, but it’s is one of those “sleeper” powers that have more impact than you realize. If you believe in evil or a spirit of antagonism, the inability for those choosing to act against us to impact our spirit, will, and emotions greatly reduces their powers.

So back to those monsters and shoes and such… We do have a built-in monster bane that we just need to activate: The power of our choices. We may not be able to entirely dismiss the monster under the bed, but we have the choice of whether we allow it to prevent us from taking actions of our own. We have the choice of whether to allow the fear of loss or failure to paralyze us. I think that I will start making some active choices in my life about how I respond and what (and who) I allow in my life to impact my emotions and self-concept. Will I be free of the monsters and anvils, probably not, but I can try to reduce their perceived control.

9 Chickweed Lane is a daily comic strip by Brooke McEldowney. It can be found at