This morning I was giving a patient my standard pep talk about quitting alcohol and smoking. I informed him that abstinence from alcohol will allow his gastritis to heal (hopefully putting an end to his pesky habit of vomiting blood) and will help out his liver. Then I helpfully pointed out that smoking is also bad for his health. That’s when he interrupted me. “You know,” he said, “I should call you Obama. Because all you talk about is change, change, change!” Ha!