I used to throw the frisbee for Gus at Alta Plaza Park, an hour at a stretch. I’d launch the disc across the broad green lawn, waiting for the dog to tire, to rest under a tree, to grant me a reprieve from his implacable drive. When he did finally pause, I took pictures of him. And because my phone perpetually defaulted to Live Photo, the photos not only captured the dog’s image, but also the two seconds of his life that preceded it. A breeze slightly ruffling his fur, some grass bending under his foot. And once, quite clearly, a single breath that inflated and then deflated his heaving chest.
* * *
Unlike people, dogs are incapable of manipulating their breath. They cannot play with it to underline emotion, or tweak it to indicate distress. They cannot hold their breath on a dare or to avoid noxious smells.
Instead, dogs breathe automatically, at a measured pace, unless they are angry or afraid, in pain or exposed to the hot sun; then they will huff and rasp, wheeze or even gasp. Medical emergencies can make dogs labor for breath. Tumors in the lung, throat, nose or abdomen might cause them to pant. Strokes and seizures can force a dog to struggle for air. Profound physical assaults — an injury to the abdomen, blows to the chest or head, a deep bite wound — may produce unusual or arduous respiration in a dog.
In breathing, though, as with all things, dogs cannot pose. “There is honor,” Aristotle reminds us, “in being a dog.”
* * *
In Sunday School I learned that for people, life after birth begins with an inhale and ends with an exhale. Except with Adam. Because God breathed life into him, Adam began his existence on earth with his first exhale. Like everyone else, though, he died upon expelling a final breath, which God directly reclaimed.
My father took a less spiritual approach to the beginning and end of existence.
“Life,” he told me when I was young, “is a gift that ends in tragedy.”
“Why does it end in tragedy?” I asked.
“Because it ends.”
* * *
Mammals breathe autonomically, but the process of respiration is rigorously purposeful. For humans, every intake of air travels through an intricate series of tunnels: nose, windpipe, bronchial tubes and, finally, the millions of alveoli clustered inside our lungs. When fresh air arrives, the alveoli exchange the incoming oxygen with carbon dioxide molecules that are expelled in a subsequent exhale. After our bodies convert the newly received oxygen into energy, they deliver its detritus, more carbon dioxide, back to the alveoli to exchange, once again, for newly inhaled oxygen. Inhaling the fresh, exhaling the stale, intaking the virtuous, expelling the disgraced, breathing is an automatic and repetitive cycle of renewal and rejection.
* * *
When I was four, my father taught me to swim in the Officer’s Club pool at Hunter Air Force Base in Savannah.
“Hold your breath and put your face in the water,” he instructed me.
“But what if I have to breathe?” I asked him.
“You won’t,” he promised and, pulling my hands off the pool ledge, dragged me after him into the bright blue water.
* * *
To a limited extent, automatic breathing may be overridden by choice. People can deliberately modulate breath to facilitate swimming, singing and speech. In some circumstances, we autonomically arrest breath, most commonly when our faces are submerged in cold water. This “diving reflex” immediately seals airways against the influx of water and preserves the body’s existing oxygen supply for its most critical organs, the brain and heart. Although the reflex is most profoundly developed in ocean-dwelling mammals, human infants also have a notably strong response.
Whether deliberate or involuntary, mammalian ability to suppress respiration is finite. Unless otherwise forced by accident, injury, or foul play, a lung-breathing body cannot resist inhaling when necessary to preserve its life.
* * *
In 1967, the popular sixth-grade girls at North Hillsborough Elementary gathered by the flagpole after school to hyperventilate. My fourth-grade friends and I watched Jan Hermann huff and puff, inhale in short gasps and exhale in loud bursts, until she collapsed in a faint into Debbie Lutkenhouse’s arms. Then Debbie would have a turn, and Sandy, and Terry.
The sixth-grade boys looked, too, occasionally offering to catch a falling girl, to prop her up until she regained her bearings.
I was puzzled by the behavior, which was both titillating and alarming to watch. There must have been adults nearby, but I do not recall their intercession, and I believed it would be tattling to ask them for an explanation. So, although she was forbidding, I approached Jan on the blacktop to ask how it felt.
“Tingly,” she answered, before turning back to her friends.
Breathing games were not entirely foreign to me. I played with breath, too, holding mine when our car drove past the rolling graveyards in Colma, or through the rock tunnels that peppered the high road to Lake Tahoe. My friends and I expelled our breath when vampires or werewolves appeared onscreen in “Dark Shadows,” or if we walked by strange-looking men on Burlingame Avenue. We didn’t do these things to feel tingly, though; we did them to feel safe.
* * *
Throughout recorded history, humans have devised techniques to override the automatic breathing process for reasons both pagan and liturgical.
To pre-Socratic Greeks, breath represented a physical expression of human sentience and intelligence; Heraclitus defined the soul itself as “a warm exhalation.” Romans understood breathing as both divinely inspired and essential for life on earth. So, too, did the early Egyptians, Chinese, Israelites, and Hindus. To the ancients, breathing was an exalted metaphor for the most valued aspects of human nature.
Naturally, then, many early cultures sought to control individual destiny by regulating breath. Egyptians compiled Books of Breathing, funerary texts designed to enable the dead to continue existence in the afterlife. Greeks seeking a favorable hunt would blow out candles, uttering prayers to Artemis over the wafting smoke. In the Shetland Islands, people treated burn injuries by blowing on them three times and reciting a charm. Central Europeans responded to illness by percussively exhaling on the sick. In many parts of the ancient world puffing was thought to relieve jaundice, convulsions, colic, and other diseases. Bad luck and evil spells could be ousted by holding one’s breath in some cases, and expelling it in others.
Most major religious traditions have espoused similar respiratory behaviors. Blowing, hissing, breathing, and puffing were part of Christian baptismal rituals well into the 16th century. Sufis taught that a breath expelled without remembering God was “dead,” while an exhalation with God in mind was “alive.” Hindus, Jainists and Buddhists endorsed mindful breathing as a path to divine knowledge and vitality.
Breathing regimens were highly technical, and practitioners emphasized the importance of oversight, training and discipline for their proper execution. Masters of the various techniques stressed the dangers attendant to improper breath control: hiccups perhaps, but also asthma, catarrh, headaches, stinging eyes, throbbing ears, nervous irritations, blackouts, and worse. Breathing, they reminded their followers, should only be manipulated to enhance, not harm, the body and soul.
* * *
My father was a surgeon, austere by nature and too busy to play with his children in any event. I revered him, though, for his discipline and aphoristic certainties and, in order to spend time with him, I learned to tailor my interests to his. I woke early to jog with him along Hillsborough’s pre-dawn streets. I shagged golf balls he hit into the net in our back yard. I agreed that Hubert Humphrey wouldn’t just talk change, but cause change, and I knew not to waste time, because it was precious.
“You need a trade,” my father told me when I was ten, “so you won’t have to rely on a man to take care of you.”
“I’ll be a doctor, then,” I said, and he smiled.
My father began taking me on weekends to look at x-rays in the light box above his desk at work. He would trace for me the hairline fracture in a fuzzy white wrist bone, or the path of a screw he’d installed to stabilize a shattered elbow. Once, he brought me to the hospital to watch him repair the torn gastrocnemius of a patient who’d been too vigorous on the basketball court.
I felt privileged to witness my father transform for surgery, first emerging from the doctor’s changing room in his blue scrubs, then standing for long minutes at the prep sink, cleansing his arms and hands again and again with soap that stained his skin iodine red. Finished, he held his arms up and allowed the attending nurse to drape him in a long, cotton surgical robe, and tie a snug cloth mask over his mouth and nose.
“You’ll need to wear a robe and mask, too,” my father had thrillingly told me.
But when the nurse approached with the mask, I balked.
“If you don’t wear it,” my father admonished, “you can’t come into the operating room with me.”
“But how do I breathe?” I asked.
“The same way you always do,” he said. “In through your nose, and out through your mouth.”
And because I wanted to please him, I did.
* * *
Mammals must breathe deeply, diaphragmatically, through the nose, into the lungs and expanding belly, and out again through the mouth in order to maximize the efficient trade of incoming oxygen molecules for outgoing carbon dioxide.
Often, however, the experiences of daily life inhibit diaphragmatic breathing. Anxiety and fear, for example, reflexively suppress human breath. Pain engenders panting. When people experience or restrain strong emotions, or instead contrive artificial ones, they often and unconsciously default to irregular and interrupted breathing.
Thus, in his final confrontation with Moby Dick, Ahab cursed the whale: “for hate’s sake, I spit my last breath at thee.” Frederic Chopin, who struggled with stage fright, complained he felt “asphyxiated” by an audience’s “eager breath.” T.S. Eliot likened a smitten lover to “the asthmatic struggling for breath.” And Marilyn Monroe, exploited, exhausted and depressed, famously asked, “What’s the good of drawing in the next breath if all you do is let it out and draw in another?”
* * *
I was unconscious during my daughter’s birth, but awake for my son’s. From the other side of the blue curtain that stretched across my chest in the operating room, there was a brief silence, then a bustling between the doctors and nurses, a suctioning from a machine below my sightline and, finally, a low, choking gurgle that grew into a rasping scream, an exhausted wail.
A nurse held our son up for my husband and me to see.
“His lips are blue,” I observed, looking at the baby’s new face.
Jim was more alert than I, and agitated.
“Give him oxygen!” he called out to the nurse.
And, after a moment, she did.
* * *
When humans are at rest and unstressed, they respire an average of twelve to twenty times a minute, or approximately 22,000 times day. Unagitated, dogs breathe slightly more often than people, between fifteen to thirty times a minute.
Larger mammals breathe less often than smaller ones. Mice may breath up to 150 times a minute; elephants need only do so five or six times. Deep-diving whales, like the sperm and humpback, can last a full hour before taking in fresh oxygen. Elephant seals are champions of oxygen efficiency; huge and earless, ugly and ferocious, they may stay below water two full hours before coming up for air.
Some 5,000 species of mammals currently exist on the planet. Regardless of size, savagery, or environment, however, every one of them will decompensate within minutes if unable to obtain the amount of oxygen their brains direct them to inhale.
* * *
When Gus was six months old, I let him sleep outside the crate in our Sonoma bedroom. During that first night, I opened my eyes to see the dog standing by my pillow, close enough that I could feel his breath as he watched me in the darkness and calm. I put my hand on the dog’s warm head, but he did not lie down, and I fell asleep again, slowly, while he stood there beside me.
Weeks later, friends stopped by to help harvest the fig tree, which was bursting with fruit that late summer month. People filled the house and the garden, laughing and eating, working and resting, and I lost track of my puppy until he limped into the kitchen to find me. He was huffing and gasping, tongue lolled, and his left hindfoot hovered off the floor.
“Let me see, Gus,” I said, and grasped his paw, only to notice two sharp puncture marks, closely spaced and burbling bright red blood from the rattlesnake bite he’d come to show me.
Leaving the guests and the figs and the party behind, with my son in the backseat cradling the wheezing dog, I careened down winding mountain roads to an animal clinic that offered antivenin.
“It’s expensive,” the doctor warned. “Are you sure?”
“Of course,” I answered, startled, then asked, “How much?”
“Of course,” my husband said, when I called him to discuss it.
After the infusion, I was allowed to see Gus where he lay crated at the bottom of a wall stacked with cages containing other ailing dogs and cats, rabbits and a tiny goat. My dog whined when I sat by his crate, his stricken paw huge and swollen. I reached through the metal grating and put my hand on his panting ribs to soothe him, to keep him company, and to protect him from further harm as I knew he would surely protect me.
* * *
Gus, “Argos,” was named for Odysseus’s dog who, in Homer’s words, “fulfilled his destiny of faith” by staying alive for the twenty years his master was away fighting the Trojan War. Argos, old and weak, could only “drop his ears” and wag his tail when the king returned to Ithaca. Immediately afterwards, the dog “passed into the darkness of death” and Odysseus, seasoned warrior though he was, “dashed a tear from his eyes.”
The ancients famously revered dogs for their cognizance and loyalty. Plato praised his for their courage and gentleness. Aesop wrote of travelers who brought beloved dogs for company on long sea journeys. Lap dogs from Carthaginian Africa were prized for their beauty and temperament. Hounds from Celtic Britain were honored for their speed and keen sense of smell in the hunt. Alexander the Great adored his dog, Peritas, while Arrian of Nicomedia extolled his own as “most swift, and wise, and divine.”
Dogs, Socrates claimed, are the purest of philosophers, because they distinguish “the face of a friend and of an enemy through the criterion of knowing and not knowing.” And once knowing, dogs never abandon a friend.
* * *
Some years ago, my husband and I went to Bhutan to see the Tiger’s Nest, a 17th century Vajrayana Buddhist temple built cliffside in the upper Paro valley. The temple had been destroyed and restored numerous times, but was rumored to retain its ancient spiritual essence, the resonance of centuries of devotion by faithful pilgrims who’d traveled there to make offerings and hang prayer flags along its winding approaches.
It was necessary to travel with a guide, and ours was a serious young man who wore a belted black gho and Yankees cap.
“We will go slowly,” Jigme Norbu told us in his measured English, “and respect the air.”
Over the ensuing days, our guide shepherded us from Paro at 7,300 feet in elevation to Thimpu at 7,900, up to the Dochula Pass at 10,000, and then down again to the Punakha Valley at 5,000 feet. We often chafed at his bridal gait, but Jigme Norbu insisted our progress be deliberate, that we rest, that we spend a day or two at various waystations along the route to the temple.
“Walk slowly,” he admonished as we followed his stolid pace up the mountains. “The Tiger’s Nest will be there tomorrow, and the day after tomorrow, and the day after that.”
At last, Jigme Norbu guided us to a launch station above Paro where we’d spend the night at 9,000 feet before leaving, early the next morning, for a final climb of 3,000 feet to Bumdra and then Tiger’s Nest.
“We’ll walk a few hours to the rest stop,” Jigme Norbu informed us, “and then a few more to reach camp.”
But Jim and I had slept well the night before, and eaten a large breakfast. Our packs were tied to the sides of a small, nimble horse, and we were eager, unencumbered, tired of Jigme’s exhortations and restraint. So we scrambled toward the halfway mark, pushing past Jigme and the little packhorse, arriving at the rest stop in a fraction of the allotted time.
Within moments of our arrival, my chest began to heave.
“I need to sit,” I told Jim, but sitting only made it worse.
“I need to stand,” I told Jigme, who had kept full pace with us.
I wasn’t crying, but tears spilled down my face and water trickled from my nostrils. Sweat instantaneously soaked my sweaters and socks and underwear. My ears buzzed, and my vision contracted to the near periphery, expanded, then contracted again.
“Bend over,” Jigme Norbu directed me in his calm voice. “And breathe.”
* * *
Air is colder and less dense at altitude, with fewer oxygen molecules available per breath than people at lower elevations are accustomed to inhaling. In order to accommodate low-oxygen environments, the human body must be allowed a period of time to acclimate, to produce more hemoglobin and thereby enhance its ability to deliver oxygen to vital organs and tissues.
If acclimatization does not occur, or the acclimatization period is overly compressed, humans can become hypoxic. Within seconds, they may experience confusion, a rapid or delayed heart rate, shortness of breath, sweating, wheezing. Within minutes, those symptoms can progress to profound brain, liver and heart damage. Unless sufficiently reoxygenated, the hypoxic body will likely suffer a terminal event such as respiratory failure, brain death or cardiac arrest.
Acclimatization can be a time-consuming and painstaking process, particularly for those in a hurry to get where they’re going. In 1912, Robert Falcon Scott unsuccessfully raced the Norwegians to the South Pole to claim first discovery for England. Scott’s entire team of explorers, both human and canine, perished on the return journey. “To wait idly,” Scott wrote in his final days, marooned in the snow and suffering from altitude sickness, hypothermia and starvation, “is the worst of conditions.”
Altitude doesn’t affect all humans equally. Sir Edmund Hillary who, in 1953, became the first European to summit Mount Everest, was notably resistant to mountain sickness. Even Sir Edmund eventually succumbed, however, while visiting the Himalayas in 2001. Hospitalized for five days in Kathmandu, then airlifted to New Zealand for further treatment, Hillary was reportedly chagrined.
“Nature,” as Leonardo DaVinci recognized, “never breaks her own laws.”
* * *
“Bend over,” Jigme Norbu instructed in his calm voice. “And breathe.”
But I could not. Or, more accurately, I couldn’t exhale. I rabidly, expansively inhaled, but I was incapable of finding the bottom of the reflex. Gasping and huffing, I was the Big Bad Wolf; rasping and wheezing, I was the Fifth Chinese Brother. I gulped enough air to blow the house down. I devoured enough wind to hold the ocean in my mouth. Unlike the fabled respirators of my childhood fancies, though, I couldn’t expel the air I swallowed.
Then Jigme thwacked me between the shoulder blades, and I coughed.
“Breathe again,” he ordered.
And so it went, I doubled-over and inhaling for long seconds, Jigme Norbu smacking my back with the flat of his hand until, at last, after an unreasonable amount of time, I began to breathe on my own.
Exhausted, I sat down on a wide flat rock next to Jim. The mist that had hovered around us all morning turned to rain.
Jigme Norbu shook his head at me.
“I told you,” he said, “that you cannot fight the air.”
Then, fearful the rain would make the trail impassible if we delayed, he started slowly walking us up the mountain again towards Bumdra.
* * *
Regardless of elevation, people require more oxygen and breathe more rapidly in response to physical exertion. We also breathe faster when reacting to severe respiratory disease or viral infections. Under rare circumstances, a virus will specifically target the human lung, critically impeding its ability to receive and process oxygen. Covid 19 is one such germ. Planting its spiky surface proteins on the lung’s healthy cells, it coopts the organ’s normal function, sparking an inflammatory response that fills the lungs with fluid and debris, severely hampers oxygen intake, and forces the body to respire at ever faster rates to compensate.
To date, roughly 43 percent of the world’s human population has been infected by Covid, and still more have been exposed to the disease. Like breath itself, individual response to the virus is highly idiosyncratic. Absent vaccination, it is virtually impossible to predict whether an infected body will react asymptomatically, demonstrate flu-like symptoms, or suffer a cataclysmic immune response that upends or terminates its capacity to respire.
Acutely ill Covid patients often pant, shortly and shallowly, thirty to forty times a minute. Breathing, they report, feels like being smothered, or lung-stung by thousands of bees, sipping through a broken straw or inhaling through layers of sludge. Excruciating as it is to breathe on their own, it is preferable to being sedated and mechanically ventilated. Once ventilated, patients are far less likely to survive the virus.
* * *
Before my mother lost her mind to Parkinson’s disease, she called my sister or me at night when she couldn’t breathe.
“I want you to know,” she would gasp over the phone, “that I’m dying.”
My mother had been diagnosed eight years before, but she’d likely suffered the disease far longer. Her muted regard for the people she once deftly managed, her frequent observation that she was losing her ability to add and subtract, to process information, long predated her diagnosis.
My father would take the phone away from her, and talk to one or the other of us.
My mother had changed medications, he would explain, or she was anxious and tired.
“Everything’s under control,” he would assure us. “Nobody’s dying tonight.”
* * *
Parkinson’s patients often experience shortness of breath and stridor. They are prone to anxiety, and anxiety induces irregular respiration. They underproduce dopamine, and the drugs prescribed to replace this critical neurotransmitter can disrupt respiration.
Regardless, doctors agree, it’s important to calm and reassure breath-compromised individuals. As Jigme Norbu had once encouraged me, Parkinson’s patients should be instructed to expand their chests, breathe deeply into their ribs, and focus their minds on the long road ahead.
* * *
We were away from home when Gus had a stroke, but immediately recognized its evidence when we returned. He paced and panted, gasped and coughed. His head cocked bizarrely, incorrigibly to the left, and his eyes bugged as he wheezed. When we shut off the lights that night, he wouldn’t sleep, but instead breathed loud and hard, fast and then slow, punctuating his distress with constant, aimless motion across our bedroom floor.
* * *
We’d been waiting for a critical event since Gus’s diagnosis, nine months earlier, with virulent hemangiosarcoma. But we loved the dog so much, and our perception, our reason, were so distorted by other catastrophes – the mysterious new virus that by then had suffocated a million people to death, the shuttered businesses, the fear of contagion, my parents’ vulnerability and my mother’s progressive dementia, the interminable isolation, the wildfires raging around our rural home – that we lapsed into magical thinking. We imagined that our dog’s initial collapse, resulting in the excision of his blighted spleen, was an anomaly. That the blood chemistry which confirmed his terminal diagnosis had self-corrected. That this indomitable spirit, our extraordinary companion, would deftly confound nature and his disease to stay with us, to persist with us in the mutual adoration we were unwilling to surrender.
“Gus is dying,” I told my father on the phone the next morning.
“I’m sorry to hear it,” he said, and then paused for a long while, working, I know, to find the right words to educate me in the moment. My father who, at 89 years old, was confined to his home for perhaps the last year of his own life because otherwise the virus would surely catch and kill him. He, having outlived most of his friends and cousins, his sister and parents, his only son and, essentially, his wife, who spent her days strapped in a wheelchair or tied into bed, struggling to communicate through her profound confusion and obstructed lungs.
“You’ll get over it,” my father promised me. “You’ll get better.”
* * *
In ancient times, people grieved openly and elaborately when a beloved dog died. Egyptians from all spheres of life chose to be buried alongside their pets, while Greeks and Romans famously erected tombs in honor of their dogs.
A Roman stele, inscribed some two thousand years ago for “Patricus,” records, “My eyes were wet with tears, our little dog, when I bore thee to the grave.”
Bereft at losing his dog, a Greek mourner engraved another hoary tomb: ‘“I am in tears, while carrying you to your last resting place as much as I rejoiced when bringing you home in my own hands fifteen years ago.”
“This is the tomb,” reads another ancient grave marker, “of a dog, Stephanos, who perished, whom Rhodope shed tears for and buried like a human.”
The writer and teacher, Aelianus, doubted that Odysseus’s Argos had lived for twenty years, calling Homer’s claim “a playful tale.” And yet, as did I with Gus, Odysseus believed in the miracle of his faithful dog. “What a noble hound that is,” he commented, seeing Argos again on the occasion of his own spectacular and unlikely return to Ithaca. If the dog “were what he was” when Odysseus had first left for Troy, answered Eumaeus, “he would soon show you what he could do.”
* * *
As our Gus passed into the darkness of death he lay across my lap, with his head in my son’s hands and his hind legs in Jim’s. I focused on the weight of the dog, the warmth of his feet, which I held with my right hand, the pliancy of his beautiful black ear, which I stroked with my left. I marked the still existing fact of him, the living presence of him. I told myself to remember this moment, to remember that I was sharing it with my husband and my son, and with the doctor who crouched beside us holding a stethoscope. I comforted the dying dog, I crooned his name, I declared my love, I promised I would see him again. But in the process, in the hot quiet, the shock, the astonishment that we had reached this nexus, that I had called the doctor, that I had chosen to end my dog’s cherished life, I neglected to watch him breathe.
“Okay,” said the doctor as he softly bent over the beautiful animal. “It’s done.”
But I hadn’t seen my dog exhale.