Breathing is an automatic response.  The diaphragm falls; air fills the lungs.  The diaphragm rises, pushing out the air. The action is repeated over and over again, without any mental acrobatics on our part.

So it was with me for most of my life.  Every day my breath came and went, in an endless cycle.  Whether sitting or standing, awake or asleep, the lungs and diaphragm continued the rhythmic dance of life.

Shortly after my fortieth birthday, however, something changed.  In the midst of a soccer game, as my feet pounded their way down the field, my lungs decided to alter the flow of air.  With each step it became increasingly more difficult to breathe.  By the time the goal posts were within sight, as I moved down the field with my team, watching the ball get closer and closer to the net, normal breathing was replaced by a whistling, high-pitched sound.

I played for a few more minutes, but when I felt dizzy, I took myself out of the game and paced the sidelines. I found that if I titled my head back and opened my chest, I could breathe. But it did not happen right away and the feeling of tightness lasted for hours after the game ended.

But, being as stupid as one could be, I did not report this to my doctor. Instead, on the following Sunday, I was out on the field once again, being surprised when the same thing occurred.

Fortunately one of my teammates was a nurse. She heard my wheezing, saw how hard it was for me to breathe, and told me I had asthma. I thought she was crazy, but I did follow her advice and went to see my doctor.

That was the first time that I had heard of exercise-induced asthma.  From then on, a regime of inhalers would be mandatory any time I played soccer, swam, or hiked.

Within a few years, the prescribed inhalers were no longer effective.  There were nights when breathing required so much effort that visits to the emergency room for prednisol treatments were the only option.

December 18, 2002 will be forever etched in my mind.  The day began as all my days, with an early morning trip to the gym.  After the workout, breakfast, a quick shower, I got dressed and drove to my high school where I worked as a teacher for the learning disabled.

The school day passed as usual, except that sometime in the afternoon a rasping cough appeared.  As the day progressed, the coughing became worse. I had some cough syrup in one of the closets in my classroom, so I doused myself.  It helped a little, but not for long. As soon as four hours were up, I took another swig. The coughing continued, now accompanied by a deep gurgle. My voice was a hoarse whisper, and every time I moved another round of gasping and choking was triggered.

I was so relieved when my word day ended and I could go home. I thought that if I could sit and rest, it would go away. That if I drank enough cold water, it would end. But I was wrong.

By the time evening fell, my sides ached as if I had multiple broken ribs.  Standing required supreme effort and walking even more.  I was both dizzy and disoriented.  Breathing was a forced activity.  Breathe in.  Cough until my eyes saw black spots.  Breathe in.  Cough some more. I couldn’t stand up straight, instead stood in the kitchen bent over the counter, holding on as if my life depended upon it.

Finally, around eleven o’clock, I begged to go to the hospital.  My husband ushered me into the car and drove to the Kaiser Emergency room in Hayward.  Shortly after we checked in with the clerk, an orderly appeared pushing a wheelchair.  It took both the orderly and my husband to maneuver me into the chair, a feat that would have been impossible on my own.

I was pushed through double doors and into the main treatment room.  I recall glaring lights, blue uniforms and white lab coats.  After a few preliminary checks, I was transferred to a quite hard bed in a private room.

“Breathe,” the nurse said.

“Breathe,” the doctor said.

“Quit coughing,” they both said, almost in unison.

“It’s all in your head,” the doctor said.  “You’re hyperventilating.”

Call it whatever you like, my mind wanted to say, but the coughs stole away the words.

“Breathe,” the respiratory technician said until she put her stethoscope to my chest and listened.  “There’s fluid in your lungs.  X-rays will tell if you have pneumonia,” she said as she walked out of the room.

Coughs and more coughs.  Drowning in a pool of water would have been less painful, or at least more merciful, as it would have taken considerably less time.

“Sit up,” a cart-pushing technician said.  A huge white machine was placed behind my chest.  It zapped and snapped and popped.  Then off went man and machine.

Minutes that felt like days passed.  The respiratory therapist returned.  “There’s no fluid in your lungs.”  By now breathing was extremely challenging.  Tears poured down my face, soaking my clothing.  Sitting up was virtually impossible, but reclining was not a solution either.  No matter the position, fluid prevented all but the tiniest bit of air from entering my lungs.

“She’s going into distress,” the therapist shouted through the door.  Within seconds, a horde of emergency room doctors and nurses surrounded my bed.  “We’re going to have to intubate.  Do you object?”

My head indicated no problem.  Living was a priority, and so whatever they chose to do to me would be wonderful.

“Wait, there’s one more thing we can try,” the therapist said as my entourage began pushing my bed toward a waiting elevator.  She asked for some type of injection, and as the doors closed, she stabbed my right arm with the needle. It must have worked, for when I came to, I was not intubated nor was I hooked up to a ventilator.

The next several days passed by with me barely conscious.  I wore a mask that produced prednisone steam twenty-four hours a day.  Whenever possible, the nurses encouraged me to stand next to my bed.  One minute was all that my wobbly knees could tolerate.

After three days of around-the-clock treatment, the doctors decided, in their infinite wisdom, that it was time to wean me off the prednisone.  Why?  Who knew.  The coughing had never subsided, and my lungs still gurgled like a fountain.  Nevertheless, the mask was removed and the machine turned off.

It was easy for me to predict what would soon happen, but optimism became my mantra.  Breathe.  Don’t cough.  No, don’t cough.  Hold it in.  Breathe.  No coughing.  Oh, no!  Here it goes again.  Call for the nurse.  Where’s the button?  There it is.  Push.  Did it work?  Will someone come?  Please come.  Breathe.  Breathe.  Breathe.

By the time a doctor arrived, my hands were tightly wrapped around the IV pole, my head throbbed, and the fluid in my lungs had gathered into an invading, nearly victorious army.

The machine was turned back on.  The prednisone provided some relief, but the coughing continued.  Even after several more days of treatment, my lungs refused to cooperate.  At one point death seemed preferable to living.

I asked my husband to call our kids and have them call me. I didn’t want to die without hearing their voices one more time.

They did call and each wished me well.  Tears poured down my face, and sobs made it difficult to speak.  My heart told me that this would be the last time that my ears would ever hear their voices, and that my eyes would never see another Christmas.

On December 20 the respiratory therapist decided to try antibiotics, even though repeated x-rays showed no sign of infection.  For some bizarre reason, the medicine worked.

By the next day, the fluid was nearly gone, and the doctor was able to reduce the prednisone treatments to once every three hours.  I was able to eat a complete meal for the first time in days. I felt stronger almost immediately, and that night my legs supported my body.

The day after that the nurse said that ICU would no longer be my home and I was moved to the regular ward.  Finally, on December 22 the doctor released me.

As my wheelchair passed through the hospital doors and into the crisp afternoon air, a smile crept across my lips.  My sides hurt, and breathing still did not come easy, but I had a glimmer of hope.

Driving home, we passed countless Christmas displays, but there was one that pushed me over the edge.  On a lawn was an old-fashioned manger scene, with figurines made of cheap plastic.  The baby Jesus reclined in His mother’s arms, and she looked at Him with a beatific smile gracing her face.  My heart filled with joy, for now it was made clear to me.  He had given me an opportunity to live, and for that, my entire family was grateful.