Category: books, literature, arts

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.

the breath can be used to heal the body

from the prologue

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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.

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.

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. ”

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?

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 .

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

“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

This review is for information only, is not intended for medical advice, and does imply endorsement of the author or his views, unless stated.

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

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

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

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

This graphic is from SundaySocial.tv