Instant gratification, instant ramification, and motivation

This past week, I noticed as I went into one of my patient's rooms that he had a can of chewing tobacco at the bedside. I didn't say anything, but I did let the surgical resident know. The next time I went in, as part of my assessment I asked to see his mouth, and noted to him the discoloration on his teeth and gums I could see from chewing tobacco, and talked briefly about cancer risks. I mean, after all, he had just had a surgery for lung cancer, so you'd think that would be motivating.
Nada
So later in the day, when he expressed concern about his high blood pressure, I went in and told him of the negative effect that tobacco has on blood pressure by increasing systemic vascular resistance (SVR; yes I still remember your lecture Dr. Blad!) that the heart has to push against.
That's when he had an aha! moment.
"Oh, I bet that's why my blood pressure doesn't come down easily"
Yes, exactly.
Then he thought about the feasibility of changing.
"Won't my blood pressure go up as I'm going through withdrawal of tobacco?"
Yup, sure will, but that is just a number of days compared to the long-term years effect on your blood pressure from continuing tobacco use.
And then I told him I'd ask the resident to prescribe him some nicotine gum to help him quit.

It's like a textbook set-up of life coaching! To make a change, you need to find what motivates you, connect that to the wanted change, and then figure out the nitty-gritty hows of change.

For some reason, the immediate effect of elevated blood pressure made more of an impact on him than the distant-and-more-detrimental mouth cancer effect.
But then again, we use that thinking process all the time.
Sure eating junk will increase risk of diabetes and heart disease, but it's the weight gain that is the clincher for dieting.
Brushing prevents gum disease, but it's the bad breath that gets the job done.

I'm imagining that as civilization has progressed, we've gotten faster at production and feedback, leading to a framework of rapid choices for speedy consequences. Great for initial reaction, but not so thoughtful on the long-term effects. Republican representative Peter Roskam observed that "we've become an instant-gratification culture that is now clashing with a system of government created by our founders that couldn't even contemplate instant gratification." Which makes it sound that maybe we should change our government, but I'm voting for the more flexible and sustainable option: change ourselves.
I hope we have a little more patience, a little more self-awareness, and a lot more compassion for others. I hope we think of making positive long-term impacts, even if we may never get the benefits.
In the philosophical co-intelligence of the Greeks,
A Society Grows Great When Old Men Plant Trees Whose Shade They Know They Shall Never Sit In