When my little sister was about a year old she contracted something that resulted in a protracted hospital stay and a tracheotomy.
When she returned home, the intercom in her room was turned on high, the sound of her breath whispering in and out of the metal tubes in her throat echoing through the house as if the house itself were alive and breathing. Silence or a sudden gurgling sound meant her tubes had clogged, that she was suffocating, and we’d sprint to her room and vacuum out the tubes with a machine that made an even more terrible noise. It never got normal. It was always life or death.
So decades later when my 5-year-old suddenly started wheezing after a playdate one evening I wasn’t taking any chances. I turned on the shower and steamed up the bathroom and we played games on the tile floor until our pajamas were soaked and her breathing sounded safe. Still, I sat next to her bed all night listening to her breathe and then took her directly to the doctor in the morning. Diagnosis? Asthma.
And so began another vigil, our ears always tuned to the sound of her breath. She was a natural athlete so that helped, her lungs got stronger. But we never took it for granted. Any wheezing and she was on an inhaler or in an ER.
Because if you stop breathing, you die. It’s that simple. It’s why whether you’re suffering from heart disease or cancer or any of the innumerable nasty diseases out there, “cause of death” will probably be pneumonia. Because when you stop breathing, you die.
Which is why COVID 19 is so challenging. The doctors I’ve spoken to all talk about how our normal expectations of how respiratory diseases progress are no help here — and hence our instincts about how to track or treat our symptoms are just plain wrong. For example patients appear in ERs complaining they’re short of breath. And when their blood oxygen levels are taken, there’s good reason. Given the numbers, they shouldn’t even be walking let alone talking. And more often than not, the walking-talking patient suddenly collapses, the lungs overcome by the virus.
It’s insidious. It sneaks up on you, slowly filling your lungs with fluid. And then suddenly, the fluid thickens and the lungs seize up and breathing — the gentle expansion of the lungs to bring in oxygen that passes through the air sacs to the blood cells and on to the heart and the brain — stops. One doctor I spoke to said it’s almost as if the fluid swamping the lungs suddenly becomes glassy — they can see it on scans. It hardens, freezing the lungs in place.
And when the lungs can’t expand, when the air sacs harden, you can’t breathe. And you die.
Our apartment in New York is near a major intersection, a major hospital just blocks away. We’d hear sirens at least once a day. Now when I speak with friends and colleagues anywhere in the city, I hear sirens constantly. And the stories tell me why.
“He was fine. He’d had a fever a few days before but he was fine. And then he couldn’t breathe.”
“She had a sinus headache – but that’s all. And then she suddenly couldn’t breathe.”
“Okay he threw up but he was getting over it. He even had his appetite back. And then he couldn’t breathe.”
What do you do when you can’t breathe? You call an ambulance. And they do their best to get you oxygenated but it’s at best a stopgap action. They know they need to get you to a hospital before your heart stops and your brain shuts down. And so EMTs risk their lives to take care of you, sitting next to you in a cramped ambulance while the driver races you through the streets to get you to the doctors and machines that will save your life.
Which is why some of the actions taken by groups frustrated by the rules requiring them to stay at home make me so furious and so sad. Not content to simply voice their opposition, protesters in multiple states launched “Operation Gridlock” campaigns.
In Michigan, for example, they arrived en masse and filled the streets of the state capital with parked cars, preventing ambulances and patients and healthcare personnel from reaching local hospitals.
Now I’m all for protest – the freedom to express your opinion is what makes America great. But as it’s often said, “your right to swing your arms ends just where my nose begins.” And impeding someone’s ambulance is an absolute violation of not only the patient’s rights but the rights of all the medical personnel involved.
I also understand that this worldwide shutdown is having terrible economic impacts, people losing not only jobs, businesses and livelihoods but their health insurance, housing and sense of self. There is no doubt that it’s a terrible burden and will continue to be a terrible burden until we develop a cure or a vaccine. So we have every right to feel angry and depressed. But we do not have the right to impact another person’s right to breathe.
Some of the protesters might disagree. They argue that the shutdown itself is imperiling lives. But it’s a false contest – the Virus vs. Our Way of Life or even Life vs. Livelihood. Because our “way of life” - and even our livelihoods as we’ve been used to practicing them - are over.
And we can stomp our feet and complain and protest. We can block streets and march onto cordoned-off playgrounds and lick produce in grocery stores and refuse to wear masks in public — all things that have happened in America this week in the name of individual “rights.” We can, in short, abdicate any responsibility for anyone else in the pursuit of “freedom.” But as Andrew Cuomo reminded us this week, “When the freedom they wished for most was freedom from responsibility, then they ceased to be free.” FYI he was quoting from Gibbon’s “The History of the Decline and Fall of the Roman Empire,” which should give us all pause.
Bottom line, if a pandemic teaches us anything, it’s that for better or worse, we’re in this together. And the sooner we accept this, the better.
There is an interesting chart circulating on social media and I’ve shared a version that was created by Celina Canales. Other versions give a nod to everyone from Elizabeth Kubler Ross to behavioral psychologists and even business management gurus. But it boils down to this. A terrible thing has happened and we are scared. And now we have a choice about how we are going to behave.
All I ask is that you don’t stop an ambulance.
(Thank you so much for all your emails. Reach me at WelcomeToThePandemic@gmail.com. And find me on Twitter at @epagenyc or on Facebook at ElizabethPage.)