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BREATH TAKING – a book review

We take 7.5 million breaths a year and some 600 million in our lifetime. Breath Taking is an exhaustive review of why and how our lungs work, and what happens to our lives when they are attacked and injured by disease.

Usually when we call something “breathtaking”- a sunset, a painting, a song, a mountain- we mean it is awe-inspiring, wondrous, beautiful, or astonishing. But in his book Breath Taking, Dr. Michael Stephen describes conditions that literally cause us to lose our breath- the multiple and serious diseases that affect the human lung.

Prologue: Lungs =Life
Michael J. Stephen, M.D.

BREATH TAKING

by Michael J. Stephen, M.D.

The Power, Fragility, and Future of Our Extraordinary Lungs

I was approached by the publisher , FSB Associates, asking if I would review the book, and offered a complimentary copy. Otherwise, I was not compensated for my review. Some of the links in this post are affiliate links which may help support this blog financially.

image of God and Adam on the Sistine Chapel by Michelangelo — “The Lord God formed man, and breathed into his nostrils the BREATH of life, and he became a living being.” Genesis chapter 2, mentioned in the prologue.

the breath can be used to heal the body
from the prologue

Part i-THE PAST

the lungs shaped our beginnings, physically and spiritually

We take 7.5 million breaths a year and some 600 million in our lifetime. Yet humans have not always understood breathing, how the lungs work, or even what oxygen is. In Part 1 Dr. Stephens steps into the past to relate the story of how we came to understand this critical part of our physiology.

The human respiratory system diagram- the throat, trachea, bronchi, and lungs — The human Respiratory Tract from the nose all the way down to the lungs and alveoli . (photo complimentary from Pixabay)

For years physicians tried to understand why premature babies have breathing problems, known as neonatal respiratory distress syndrome. It took a determined young woman physician, Dr. Mary Ellen Avery, to discover the cause and rename it hyaline membrane disease, descriptive of the underlying disease.

a tiny baby lying in a bed with a breathing tube — phots by Alex Workman, from the LIGHTSTOCK.COM collection, an affiliate link

part ii: the present

our lungs-and us-against the world

In this section Dr. Stephen introduces us to the interactions between the immune system and the lungs. Ideally we expect our immune system to protect our lungs from threat of infections due to pathogens like viruses-influenza and coronaviruses- and bacteria that cause pneumonia. In all of human history, including today, tuberculosis has caused more disease and death than the others combined.

But the immune system can go awry, and cause disease rather than protect us from it. Such is the case with asthma in which inflammation out of control can lead to first shortness of breath and progress into respiratory failure.

Published early in 2021, the book does not cover the COVID-19 pandemic extensively. Dr. Stephen did say this,

“The coronavirus story is one illustration of how our air is communal, that the world is interconnected, and warnings about potential global health threats need to be taken seriously. ”

WHY WE NEED TO VACCINATE THE WORLD — graphic from the Johns Hopkins Bloomberg School of Public Health Facebook page

Next Dr. Stephen devotes a large section to the “seduction of nicotine”, explaining why we should not start smoking cigarettes and why we should stop if we do.

I was intrigued by the story of a man named Buck who came from a modest background but was quite an entrepreneur. In the early 20th century smoking was becoming more and more popular, enabling Buck to make a fortune by creating and marketing a machine that rolled cigarettes.

He became so rich that he donated $100 million to a small college. The college administration was so grateful they renamed the school after him, James Buchanan “Buck” Duke. The college, now Duke University, ranks among the top universities in the United States, including the medical school. The men’s basketball program is one of the country’s most successful.

I wonder if Mr. Duke knew how addictive his fortune making product was, thus assuring his company of success?

from the Facebook page of WHO, the World Health Organization

part iii-the future

the lungs provide a vision of what’s to come

Next to the infections-pneumonia, bronchitis, influenza, COVID-19, tuberculosis -the lung disease most people know and fear most is lung cancer.

A diagnosis of lung cancer strikes fear in the hearts of its victims and their families, and for good reason. “80% of patients come ..with stage III or IV disease, both very advanced.” Compare the average five year survival rates for

breast cancer-90%
colorectal cancer-65%
lung cancer-18%.

Lung cancer causes more deaths per year than colon, breast, and prostate combined.
chapter 11

Lung cancer is treated with a combination of surgery, radiation, and/or chemotherapy. However, a small percentage of cancers are due to a genetic mutation that can function as a “kill switch” if found. For those who qualify, about 4%, such treatment can extend life much longer than the conventional treatment.

Another option is harnessing the immune system to attack cancer cells, and a new drug, pembrolizumab has recently been approved by the FDA.

Most important now is prevention, by decreasing cigarette smoking, reducing other inhaled carcinogens such as radon, and toxins from air pollution .

2 preserved human lungs, one normal, one damaged — Two preserved human lungs, one normal,-left, one damaged from disease-right. Photo by Dr. Aletha at the Denver Science Museum

part iv

life, love, and the lungs

Dr. Stephen introduces this section by reiterating the three main themes of his book-

the central importance of the lungs
the courage of patients afflicted by a devastating illness
the importance of hard work, intelligent observation, and collaboration in the advancement of medical science

He illustrates these themes by telling the story of the discovery , and advances in treatment of cystic fibrosis (CF), “the Most Heartbreaking Lung Disease”.

Again, it was a woman physician, Dr. Dorothy Anderson, who did the groundbreaking work which described the pathologic changes caused by CF, established the genetic origin of CF (a defective autosomal recessive gene), and developed the first test for CF.

My final thoughts

Breath Taking is an exhaustive review of why and how our lungs work, and what happens to our lives when they are attacked and injured, sometimes fatally .

Dr.Stephen achieves this by weaving stories of real people afflicted with lung diseases together with the scientists who studied those diseases, and the physicians who treat them.

He believes it is imperative for us to protect and improve the enivironment, especially the air we breath and challenges us to choose lifestyles that can save not only our own lungs but of everyone else on this planet. He discussed this in a piece written for Each Breath, a blog by the American Lung Association.

2020:The Year We Lost Our Breath

tops of skyscrapers obscured by smog — photo by Brandon at Lightstock.com

“The Clean Air Act (1970) was designed to protect public health and welfare from different types of air pollution caused by a diverse array of sources, and passage of this landmark legislation has saved countless lives. While we enjoy healthier air thanks to the Clean Air Act, climate change poses new risks to our air quality. We know air pollution harms health and can be deadly, and new research suggests that exposure to particle pollution can even increase the death toll from COVID-19.” (continue reading at the link)

Conclusion

Acknowledgments
Notes- more of an exhaustive bibliography
Image Credits
Index
Author bio on the inside back cover

The author- Michael J. Stephen, M.D.

Michael J. Stephen, MD, is an associate professor at Thomas Jefferson University in Philadelphia, and director of the Adult Cystic Fibrosis Center.

He has led numerous clinical trials and has cared for COVID-19 patients. Over the past two decades he has studied advanced end-stage lung diseases and worked with patients at diverse locales, including a Massachusetts prison hospital and a pediatric HIV clinic in Cape Town, South Africa.

A graduate of Brown University and Boston University Medical School, he lives in New Jersey with his wife and two children.

About this post

I chose all of the photos and graphics in this post, they are not from or affiliated with the book.

The two graphics were shared on Facebook by the organizations identified and I thank them.

I took the photo of the lungs which were part of the Expedition Health exhibit at the Denver Museum of Nature and Science.

The photo illustrating Genesis 2 is of course the ceiling of the Sistine Chapel at the Vatican, painted by Michaelangelo from 1508 to 1512. The photo,available on Lightstock.com (affiliate link), was shot by Rob Birkbeck.

exploring the HEART of breathing

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Dr. Aletha

This graphic is from SundaySocial.tv

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World of Wonders-a book review

World of Wonders is not about medicine, at least not human medicine. Although there is a chapter about the Southern Cassowary, Casuarius Casuarius, a bird that can and does kill people. All chapters are named for and describe a variety of common, familiar animals and plants-

WORLD OF WONDERS

In Praise of Fireflies, Whale Sharks, and Other Astonishments

by Aimee Nezhukumatathil

illustrated by Fumi Mini Nakamura

I frequently review health books on this blog, but you might not call World of Wonders a medical or health book. But if you’ve read some of my other book reviews, you realize I use that designation rather loosely.

Oh Aimee Nezhukumatathil teaches English and Creative Writing in the University of Mississippi’s MFA program. Born in Chicago to immigrant parents ,she has lived in Kansas, Arizona, Ohio,Iowa, New York, and Florida. Now she lives in Oxford, Mississippi with her husband and children.

(The photos I’ve used in this post are from my personal albums, not from the book or connected to it.)

The health/medical connection in this case stems from the author’s parents, Paz and Mathew. Both of Ms. Nezhukumatathil’s parents worked in healthcare during her growing up years. She dedicated this book to them. Now retired, they live in Florida and raise oranges.

a long billed white bird — two interesting creatures I encountered on a trip to Florida

a green iguana sitting on a ledge — two interesting creatures I encountered on a trip to Florida

Sometimes her parents lived apart, while working in different states.Her father, an immigrant to the United States from India, worked long hours as a respiratory therapist in a neonatal intensive care unit, NICU, at Good Samaritan Hospital in Phoenix, Arizona.

Yet every weekend we headed for the hiking trails of Camelback Mountain. I never saw any other Asian American there; I don’t know if my father noticed…I didn’t know anyone else’s dad who took the time to do this with his kids.

a saguaro and other cacti near Phoenix Arizona

During one assignment, the author and her sister lived with their mother in Kansas-on the grounds of a mental hospital. As a Filipina foreign-born psychiatrist, she treated mentally ill persons, some of whom “hurled racist taunts and violent threats” against her regularly.

We lived on the grounds of the mental institution, something no kids had done in decades, and the school district had to create a bus stop just for us. When I climbed the steps, I imagined myself a narwhal, with one giant snaggletooth-a saber-to knock into anyone who asked if my sister and I were patients there.

Other than that, World of Wonders is not about medicine, at least not human medicine. Although there is a chapter about the Southern Cassowary, Casuarius Casuarius, a bird that can and does kill people. All chapters are named for and describe a variety of common, familiar animals and plants-

Peacock Pavo cristatus
Monarch butterfly Danaus plexippus
Firefly Photinus pyralis
Octopus-Octopus vulgaris

a monarch waystation to aid the butterflies' migration — a waystation in Oklahoma for monarchs on the annual migration

But she also describes in detail strange, unique creatures I had never heard of.

Axolotl Ambystoma mexicanum
Touch-me-not Mimosa pudica
Narwhal Monodon monoceros
Catalpa tree Catalpa speciosa

marine animals in an acquarium — marine life at the Shedd Acquarium, Chicago

In the essay Flamingo, Phoenicopterus ruber, she reminisces about her freshman year in college when she and her girlfriends would go out dancing with an assortment of young men.

We were like flamingos flying long distance, mostly at night. So many kidnappings happen in the dark, when we think we are safe, in a routine, in a place where “bad things like that” just don’t happen. When a flamingo flies in daylight, it does look comical, its long legs dragging down under the fluff of feathered torso.

Someone called the police to say they found her body the next day at a local park.

Aimee is enamored over the Corpse Flower, Amorphophallus titanum, known for its “seriously foul smell.” She dated a man who “didn’t wince when I said inflorescence.” He wanted to see a corpse flower for himself despite it being a plant whose smell is similar to

what emanates from the bottom of a used diaper pail, a tin of sardines, and blue cheese salad dressing left out in the August sun

Since he was the only man who ever expressed such an interest,and who did in fact take a road trip with her to see a corpse flower, it’s not surprising he’s now her husband.

Throughout the essays (as the chapters were originally published) Aimee weaves stories about her life with her knowledge and insights about the unique plants and animals she loves to discover and explore. Sometimes it’s hard to tell where one leaves off and the other begins, as this excerpt from the essay Red-spotted Newt, Notophthalmus viridescens–

I look back at the many moves my family made during my childhood and I begin to understand the red-spotted newt more clearly. (it) spends years wandering the forest floor before it discovers a pond to finally call home. When you spend as long …in a search like this, you grow pickier, more discerning…

Illustrated by Fumi Mini Nakamura

As much as I enjoyed the prose, the illustrations by artist Fumi Mini Nakamura would be worth buying the book . The drawings complement the writing perfectly. Fumi was born in Japan and at 12 years old moved to the United States where she and her family lived in Northern California. She graduated from San Jose State University with a BFA in Pictorial Arts.

Aimee Nezhukumatathil’s website

Aimee has won numerous awards for her poetry. This book was the Barnes and Noble Book of the Year 2020, which is how I found it, while browsing in the store.

In these mini memoirs, Aimee wants to convince us that our lives are not that different from the other living creatures with which we share this planet. By discovering the unique features of these non-human beings, we may better appreciate the diversity of earth’s human inhabitants.

In its pages she invites us to join her in discovering a World of Wonders.

Don’t take my word for it ; listen to the author explain why she wrote this book and hear her read an excerpt.

exploring the HEART of a World of Wonders

a statue of Dorothy and Toto from the Wizard of Oz — Like Dorothy in the Wizard of Oz, Aimee is not in Kansas now.
This statue is in a park in Chicago.

I hope you enjoyed exploring the World of Wonders with me. Please consider purchasing a copy through BOOKSHOP.ORG. (This is an affiliate link.)

Bookshop.org is an online bookstore with a mission to financially support local, independent bookstores. They believe bookstores are essential to a healthy culture and they are dedicated to the common good. Bookshop.org donates a portion of every sale to independent bookstores.