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MANAGE YOUR SUBSCRIPTIONOn Being Unable To Breathe
STEPHEN T. BUTTERFIELD was a poet, English teacher, and the author of The Double Mirror: A Skeptical Journey Into Buddhist Tantra. His memoir about the late Tibetan meditation master, Chogyam Trungpa, appeared in Issue 142 of The Sun. Butterfield uses the lower-case "b" in "buddhist" because his teacher, Trungpa, "insisted on the small 'b' in his own usage, to distinguish from lineage, which is committed to meditation practice, from Buddhism as a philosophical scheme or system of religious rites and observances."
Something was drastically wrong with my lungs: every night, they made sounds like a basketful of squealing kittens. I was always coughing, had pains under the sternum, and could not push a car or even run up a flight of stairs without gasping like an old melodeon full of holes. This condition came on slowly; no single daily or weekly change was ever big enough to scare me out of my habits. For three years after noticing these symptoms, I continued smoking pot.
It requires effort and a certain amount of ingenuity to practice ignorance and denial. The symptoms register clearly enough; we are not that stupid. But they are explained away, or the attention distracted from them. It must be a chest cold. One more joint won't hurt. When I stop smoking the cough will disappear. I can stop any time. Tomorrow.
I decided to look into the problem after a long period of meditation practice, at a time when I was looking into my whole life: marriage, livelihood, everything. I gazed at the chest X-ray as though it belonged to someone else: thick white clouds in the center, where I felt the pain, and swirls, like mares' tails, reaching deep down into the bottom lobes. Air capacity for a man my age and size should be 5.5 liters; I had 2.8. The next step would be a biopsy. Meanwhile I read up on the possibilities, ruling out the ones that killed you in less than four years; I had already survived those.
According to the medical profession, the cause of sarcoidosis is unknown; my doctor is not convinced that it is a direct result of inhaling smoke. He thinks it is hereditary, actualized by environmental insult of some kind. The word "karma" is not part of his vocabulary. I find it a particularly evocative word, a doorway into an increasingly subtle understanding of how the process-patterns that we call "reality" fit together.
Lung disease runs in my family: asthma, emphysema, and bronchitis are common ailments. When I was a baby, I almost died of pneumonia, complicated by spinal meningitis; it was 1942 and the doctors said they had a new untested drug they would like to try as a last resort — they called it penicillin. My grandparents prayed for me round the clock. At least one of those methods must have worked. Pneumonia came back twice in my twenties. Of course I should not have smoked anything, but I did. Karma is the influence of a fact that cannot be abolished, no matter how intense the regret.
Sarcoidosis is a progressive inflammatory swelling of the alveolar membranes, gradually scarring the tissue so that it no longer exchanges gas. Oxygen will not pass into the body through a scar. The only method of treatment known to Western science is prednisone, a cortico-steroid drug which suppresses the inflammation; the drug does nothing, however, about the cause, which is still not understood. The side effects of prednisone are, alas, unpleasant: leg pains, weight gain, craving for sugar, dizziness, cataracts, liver spots, adrenal imbalances, possible weakening of the immune system, and worse, depending upon the dose. But if it is a question of being able to breathe, you take the medicine. It buys time.
How much time? More than if you had cancer, typically. I could wheeze out a sigh of partial relief and say, "I'm glad it's not lung cancer." Approximately one third of the cases get better, one third stay the same, and one third get worse. Even with treatment, it can get worse. I have lived with it for about seven years. Right now it is in remission. Maybe I will have a "normal" lifespan, whatever that is. When I watch my father stack and restack old newspapers for hours, put cat food into a dish, then forget he is feeding the cat and sit down at the table with the dish in front of him, a "normal" lifespan does not seem so desirable a goal.
Being a buddhist, I accept that nothing lasts, and that impermanence, suffering, and absence of solid reality are the three marks of existence. Saying this is one thing; living it is another. The actual presence of a chronic, disabling, possibly life-threatening disease is a relentless and vivid reminder of death. It wonderfully accelerates your spiritual journey.
We would like to avoid that kind of acceleration. Armies of joggers and physical fitness buffs are out there right now, trying to strengthen their cardiovascular systems and increase their lung capacities to ward off the message delivered by the Buddha that day in the Deer Park of Benares 2,500 years ago. Plenty of my readers could probably give me good advice on the diet and wholistic treatments I should try in order to cure myself and prolong my life. I would listen to this kind of advice, but what interests me the most is whether I can make use of the disease. Magazines are full of articles about this or that public figure who carried on a "battle for life" against cancer, AIDS, emphysema, kidney failure, or some other agent of transformation. The articles usually imply that these people are heart-rending models of quiet heroism in the never-ending struggle not to go gentle into that good night. Illness and death are assumed to be very bad news, perhaps a punishment of some kind, bogeymen in the dark closet of deep, dark fears.
I would rather not make a knee-jerk reflex toward “battle.” There is a message in my body; do I have to go to war about it? Paraphrasing the words of Dylan Thomas, do I have to burn and rave and rage? Can I make another kind of response? What is this message all about, where does it come from, what does it say? I don’t mean purely in a medical or scientific sense, although medicine and science are not to be lightly disregarded. Disease is experienced, and perhaps originates, primarily in the mind. What is it doing there?
Let us begin by examining the effects, without pity or hope. Being unable to breathe introduces challenging modifications ot your daily schedule.
In one of their movies, Sally Field wraps her arms around Burt Reynolds's neck, and her legs around his hips; he carries her that way into the bedroom. It is a sweet and tender scene. To be able to walk around screwing your lover against walls and doors, or to bounce her on the bed while imagining that you are very powerful, taking charge — to play that scene requires air. Oxygen must be taken in through the alveoli and pumped to the muscles. Otherwise Burt and Sally (especially Burt, since he is doing most of the work) would gradually deflate, crumple, and fold up on the floor, and their faces might as well be painted on the surfaces of withering balloons.
In terms of life passages, I am entering the withered balloon stage. Cortico-steroids and sarcoidosis are not all that bad, even though they tend to make sex less interesting than seaweed. Now, if I am to imagine myself as powerful and taking charge, the power must come from somewhere other than physical strength.
Singing is punctuated with interesting silences at times, depending on the duration of the line to be sung. If the line is much over ten syllables, my voice simply disappears. "Whoops," the lungs wheeze. "Sorry, we are having technical difficulties." Then I might like to go cross-country skiing with my singing friends, but I don't; for them, it would be like having to take a giant snail out for a walk.
Household projects are scaled down drastically. I would like to dig flowerbeds and build an addition onto the living room. "Too bad," says the body. "Be grateful you can still walk across the yard." Ten years ago I swore that I would never own a rider lawnmower. Now I bless the person who invented it. If I had to make my living as a construction worker, I would be finished. I am in the same health class as victims of black lung.
When somebody's car gets stuck in the snow, there is not much I can do. Pushing or shoveling are out of the question. I become sharply mindful during bad weather, driving fully present, right on the dot all the time. I like that; going over the mountain to the store in January is almost an adventure.
But not being able climb the mountain — ah, that really hurts. Years ago I could, and did, hike up
almost all the peaks in New Hampshire and Vermont. I loved mountain air. I loved swishing through leaves, coming around a bend in the trail and catching sight of a distant peak — the lines and folds, the twist of the path winding up the ridge, the wooded plateaus and cliffs. It all looks like a model of a mountain on a big topographical relief map. Then, as you get close to the slopes, the features become huge, the folds turn into steep ravines full of complex detail, the nubs enlarge into crags high overhead, partially screened by foliage, waiting to be discovered, at which time they will dissolve again into gestalts of moss, bushes, talus, fissure, and ledge. The mountain always eludes comprehension; it is pure magic. From the peak, in the evening, the whole valley sings and shimmers with the receding calls of birds, which keep winking on and off over the forest like thousands of bubbles manifested as sound. The greater the distance, the fainter the sound, and the vaster the space it fills.
In my twenties I dreamed of climbing someday in the Himalayas; I collected pictures of mountains and read about the great expeditions to the sky. But now, even as low as Katmandu, I would need an oxygen tank. In the Alps, taking the cog railway from Grindenwald to Jungfrau, I had to get off at 9,000 feet to keep from passing out.
Walking anywhere with friends, especially uphill, is an occasion for silence; I cannot walk, talk, and breathe at the same time. Every gram of oxygen must be used for locomotion; there is nothing left over. Superfluity must go. This becomes an amazing metaphor: in my life, in my mind, what is superfluous? Anger that freezes into resentment; jealousy; greed; gossip; ego-clinging; pretense; embarrassment; any form of fixation; running after pleasure; the discursive thought that maintains the story-line of me. These things are very costly, in terms of the life-energy that it takes to keep them going. They are what conversation is mostly about. I cannot take in enough oxygen to support them anymore, except by holding completely still, and doing nothing else. When the oxygen is diminished below a certain point, you must choose, absolutely, between feeding all your mental bloodsuckers and taking care of your true business. You cannot afford to keep them around as pets. What an opening, what discovery, follows from that simple realization: could I ever afford it? Can anyone? What made me think that I could not let go of this expensive baggage before now?
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