Breathing

Breathing

Breath and spirit have been closely related in human thought—for millennia. In a lot of human languages, we use the same word to mean both things. Yet it’s easy to take breathing for granted, in spite of the fact it is maybe the most common human experience. In this episode, we’re going to think about every inhale and every exhale, and speak to people who have to think about breathing in a lot of interesting ways: a biathlete, a beatboxer, a dancer. We’ll dive deep underwater to a dark and dangerous cave in the Bahamas, travel to China to think about collective breathing, and reflect on the role artificial breathing plays in the perception of what constitutes life and what constitutes death.

Transcript for Breathing (Full Episode)

Jackson Roach: [00:00:00] This is State of the Human, the podcast of the Stanford Storytelling Project. What we do is take a common human experience like teaching or belonging or joking, and bring you stories that explore and deepen that experience.

This episode is about breathing. I'm Jackson Roach.

In this episode, we'll hear from dancers, divers, by athletes, beat boxers, doctors, and more. Breathing is maybe the most common human experience, but it's possibly the one that we pay the least attention to. I didn't even know how it worked before I started doing research for this show.

It's kind of crazy. Your brain sends signals to your diaphragm, telling it to contract and drop. This causes your lungs to expand, and air rushes in. The air moves all the way down into your lungs, and it ends up in these little air sacks called alveoli. The alveoli transfer the oxygen from the air into your blood, and they also take the leftover carbon dioxide out of your blood.

Your blood carries the oxygen around your body. Then, you relax your diaphragm, which causes your lungs to contract and squeeze all the air out. I hope that wasn't too long-winded.

It's easy to take breathing for granted, but we are not gonna do that. We're going to think about every inhale and every exhale.

First up, someone who has to plan every breath.

Brad Ross: I'll just start from the top.

Hi, um, I'm Brad Ross. I'm a sophomore here at Stanford, and I'm the music director and primary beatboxer for Stanford Mixed Company. I started as kind of a joke in senior year of high school. I sang in my high school acapella group. I was [00:02:00] so bad at the beginning, it took so long. You know, I watched the tutorials online-- how do you beatbox or whatever-- and they say, "do this," and you do it, and it sounds nothing like what you want it to sound like.

But you do it a hundred or a thousand times at least, and then it will. Um, so the sort of the kick drum sound, which sounds like this-- the way you make that sound is by popping your lips, but you sort of make your mouth shape like the shape that you do when you're saying the word "bo," B-O. So like [bo-bo, beat-boxing sounds], except  [beat-boxing sounds].

And eventually, it will sound like that, but it might not sound like that the first, you know, a hundred or so times you do it.

There's this really weird balancing just strike between using beats that put out air and beats that take in air. There's this alternative snare sound you can do, which is this-- and that's done by sucking in air, actually.

So if I'm doing the [ beat-boxing sounds], I actually have to breathe out harder than I normally do on the [ beat-boxing sounds] to keep the balance there. But if I'm doing the, you know, [ beat-boxing sounds], then definitely, I want a big breath before I start those.

Turns out that when you just breathe normally, you usually breathe into your lungs like-- and sort of your chest puffs out, right?

But it turns out that, like, to really take a good deep breath, you actually want to expand your stomach. It's like, you know, making the Buddha belly, 'cause your lungs actually expand downward as well, and they push your diaphragm out. To beatbox, you need as much air as you can, and so therefore, I have learned how to take effective breaths.

I think I'm more cognizant of, like, breathing in general. When you're trying to use your, your lungs to make art, you're much more aware of like, how much air do I have now? How much do I not?

Jackson Roach: That story was produced by Carissa Cirelli and Kate Nelson, featuring Brad Ross.

It's not just beat boxers that have to pay attention to their breath.

Ask any athlete, and they're probably pretty [00:04:00] aware of it. But ask a biathlete, and they'll tell you that one breath can make the difference between hitting and missing, winning and losing. Biathletes get on skis; ski really, really fast; stop; take a rifle off their back; shoot five targets; and then, ski away again.

Sports broadcasters: Well, you said she looked relaxed. She did. And, uh, Joanne Reid still looking, uh, very, very chilled. She's gone for lane number three...

Joanne Reid: When I first started out, it took me so long to shoot and I would breathe, breathe, breathe. Ah, breathe. And then I would hold my breath, and then I still couldn't find the target 'cause I just didn't have the motor control to do it.

And then I would run out of breath, and then I would breathe, breathe, breathe, and try and take the shot.

And meanwhile, all the people around me would be coming in, shooting their five shots, and leaving. I couldn't recover fast enough to start shooting.

My name is Joanne Reid. I'm a member of the United States Biathlon National Team, which is an Olympic sport that combines cross country skiing with rifle marksmanship.

My grandfather had possession of a biathlon rifle. That rifle passed to my mother, and then it passed to me because I was the only avid cross-country skier in my family. So I was basically the only one that could ever possibly have a use for it. And I just decided one day I was gonna go for it.

You have to stop and shoot, and you have to shoot well.

You have to sort of change your race approach in this way so that you're not going into oxygen debt, so that you're not really hitting that red line until you're done shooting.

Because you're lying on your ribcage, the motion of breathing needs to be [00:06:00] incorporated in the way that your rifle comes onto the target.

So as you exhale, your rifle barrel actually rises. And when you're done exhaling, or when you, when you decide to shoot, you should be on the level of the target. So you don't wanna exhale all the way because then you are gonna run out of oxygen if you have to hold it. But you exhale partially, and at that partial exhalation, you should be on the level of the target.

You pause briefly, and then you shoot.

Sports broadcaster: When I saw her, just as the zeroing started, that was...

Joanne Reid: And then you inhale, your barrel drops, you exhale, you come up to the next target.

Sports broadcaster: Pretty good.

Joanne Reid: And then you repeat that five times. And then you're off again, and you're, you're not really thinking about breathing, you're just thinking about finishing and sort of not passing out on the side of the trail.

Every now and then, everything will click. And suddenly, you know, it only takes me one breath between standing shots to shoot. So I will do, you know, three or four breaths to set up, and then it's shot, breathe, shot, breathe, shot, breathe, shot, breathe-- and I'm out.

When that happens, is the best feeling in the world.

You're barely even thinking about it 'cause you've done it so many times, and it happens really fast to somebody watching, but it happens very slowly for you.

Jackson Roach: Joanne Reid was interviewed by Carissa Cirelli and Kate Nelson.

Joanne controls her breath for just long enough to get a shot off after pushing her lungs to the limit. Our next story pushes us beyond the limit. You're gonna hear two voices. One of them is Janice Ross. She's a dance scholar at Stanford. The other voice is Jace Casey.

Jace will be performing a scripted piece written in the 1970s [00:08:00] by a choreographer named Tom Johnson. Everything Jace says, even the meta stuff, was written in the original script.

Janice Ross: I think it makes you uncomfortable, makes you uncomfortable to hear someone panting.

It's like a corporeal response, body to body

Jace Casey: In this dance solo, I am required to run around this space quickly while delivering this memorized text. Naturally, if I continue running and reciting, I'm gradually gonna run out of breath, and that's what this piece is about, and that's why it's called Running Out of Breath. Of course, there's nothing unusual about running out of breath. Everyone knows what it feels like. It is a universal experience...

Janice Ross: Running Out of Breath is a remarkable four page document written by a man named Tom Johnson in 1976 that presents a text for a dancer to push themselves to the point of exhaustion as a mode of performance.

Jace Casey: And according to it, the purpose is simply to observe someone run out of breath. Of course...

Janice Ross: It took, um, the medium of breath-- something that's ignored, discounted, and heavily concealed in dance performance normally-- and it suddenly put that front and center as the performance.

Jace Casey: Where there's not something else to listen to or think about, it is possible for the audience to exclusively focus its attention on watching someone run out of breath.

How long does it take? Does this happen rather quickly or rather gradually? Do we tend to breathe harder and faster ourselves, watching somebody else breathe harder and faster?

Janice Ross: We all [00:10:00] breathe. We all know what it is to start to feel, um, that we're not getting enough air.

Jace Casey: On a sort of philosophical level, that's what this piece is about. Meanwhile, there are other considerations, particularly, for me. For instance, am I gonna make it through this piece? Right now, I'm about halfway through, and if I've been pacing myself about right, I should still be able to deliver complete phrases without running out of breath.

Gradually, however, this will get harder and harder.

Janice Ross: The, the body is a leaky, messy medium for art making. And certainly in western theatrical dance, you conceal all effort. You conceal breath, you conceal sweat, and it elevates the body and the process. It's suddenly becomes something apart from our ordinary, everyday functional body that has needs, discomforts, pains.

Jace Casey: Of course, my vanity is at stake here. I don't want to appear weak or short-winded, and I'm tempted to cheat a little in order to make a better impression. There are several ways of doing this...

Janice Ross: And Tom Johnson is messing that up. He's saying, let's also put the, the nitty gritty of what it is for a body to work, to dance, just as much in our view as we normally put the beautiful, well orchestrated, flawlessly moving body.

It's almost like a piece of music. The feet are the bass beat. But then there's like, there's this slow and gradually and then rapidly accelerating breath on top of that, that you can't control.

Jace Casey: ...a good, honest performance of the piece. So the only way to perform effectively is to go out, set a brisk pace. So the only way to...

Janice Ross: That's reality [00:12:00] shaping the, the work of art, really, and the medium. Um, which is that no matter how good a runner you are, you are gonna come winded, finally, as you're speaking a text.

Jace Casey: It is a challenge to deliver these final sentences when, as I pause to also to take a breath. But I'll make it to the end. I will make it to the end. By now, you're probably wondering, why am I going through the struggle? My lungs ache. My legs feel like lead. My body feels like jelly.

After all, it's not my piece. I'm only the performer. But there are a number of reasons why I wanted to do this. It works on a number of levels, most of which I've outlined above, but perhaps most important, I'm proving to myself that I can meet the challenge.

Jackson Roach: When it's hard to breathe, nothing else matters. All you can think about is getting your next breath. Because without breath, you die-- really, really fast. Faster than you would without food or water or warmth. Our next storyteller goes deep underwater to appreciate the little air he has.

Andrew Todhunter: We were diving in a cave called Stargate. It is as an alien as any possible science fiction world. In this one passageway, above, you could see this soaring arcade. It almost looked like it had been built by these ancient prehuman or non-terrestrial beings. And so you'd flash your lights up and you'd see, you know, this stone and then your breath-- you'd see these bubbles and you, the bubbles would, you know, would go up.

But below, below there was no floor. So you're swimming, uh, out down [00:14:00] this passage with this soaring stone vault. And then it's just a black abyss. And we knew, I mean, we knew there was a floor, but it was like three or 400 feet below us. Something very ancient kind of gets kicked up there in your mind about what it would be like to be simply unable to, to breathe, unable to get to the air.

That's one of the things I really like about that kind of diving. There's undeniably the fact that you are down there with your life, uh, dependent on this equipment and on this limited amount of breath.

If you lost buoyancy control and decided to just sink, you'd go faster and faster and you, you know, you'd get more and more negatively buoyant, and then you would, you'd begin to convulse. And then you'd die.

It's breath as, as priceless commodity. We take it for granted. And when you go into these caves, you stop taking it for granted.

There's a system. So if there's some massive failure, you still have something to get you out.

Following along these nylon lines, that string between rocky features, and if you're off the line, you stop immediately. Find a feature and you-- then you're fixed. And then, from that position, you begin to sweep out with your other hand, sweeping in all directions, kind of, you know, going around like a clock.

If you're lucky, you will find the line in that sweep.

You become very impressed by the three dimensionality of the cave environment. Everything is irregular, you know, it's just like kind of being in a, in a jumble of rocks and sticks. It's all mineral.

It was very strange to know that you are, you know, fairly deep underground. That above you, 'cause you've been feeling it, is just rock and water. And that [00:16:00] you're breathing from a finite source. To be in absolute complete darkness, turn the lights out completely. And that's one of my very favorite states. There's a kind of a quality of, of, of disembodiment. You're just floating. And so the only thing you're hearing, or really aware of, is your breathing.

You breathe on the regulator and the, and the regulator goes [intense breathing sound].

When you breathe in, you hear it, you know, it's kind of Vader like. And then you-- when you hear the rumbling of the, of the breath go out. And so it's this very slow, rhythmic-- pull on the regulator. And then the rumble. And you're just floating there, and you feel like-- you just feel like you could be-- nowhere on earth, certainly.

I mean, you are gone.

You're just really that rhythm of the breath.

When you're there hanging in the cave, floating, and the lights go out and you're just sort of there, language kind of falls away. It's just this breathing.

It's like everything has been eclipsed, except that just exquisite sense of comfort and safety.

I find it so difficult generally to be a human being, and to be conscious of all of that grief and anguish and restlessness and self-loathing and our own mediocrity... awareness and mortality... impatience with others.

All of it just is just sort of gone.

The relief [00:18:00] of that is so delicious. You feel safe, feel kind of obliterated and saved. And it's as if it's only through the one that the other is achieved.

This is the safest and most content I may have ever felt on Earth. 'Cause it's perfect there.

Jackson Roach: That piece was produced by Melina Walling and Jackson Roach.

Breath and spirit have been closely related in human thought for millennia. In a lot of human languages, we use the same word to mean both things. Actually the Latin word "spiritis" means both breath and soul. Variations of this link are in so many languages. In Sanskrit, Hebrew, Arabic, Tibetan, Igbo, Hawaiian, Na-Dene, the words for breath and soul are etymologically related. In Mandarin, there's Qi. Qi literally means air, breath, or gas. But in a more figurative sense, it means life force. Qi is considered to be in all living things. It links everything together.

In our next story, we'll hear about Qigong, a practice of careful body movements and breathing techniques designed to balance your Qi.

Qigong has been practiced in China for thousands of years. When we think of breathing, we might imagine it as an individual action, but in many practices, including Qigong, breathing is about the collective. In the 1980s and '90s, a time of massive change in China, this collective breathing became collective action.

Professor Nancy Chen, a medical anthropologist at UC Santa Cruz, was in the right place at the right time to watch that change happen. [00:20:00] Katie Lan interviewed Professor Nancy Chen.

Katie Lan: A momentous moment in modern Chinese history was a death of Mao Zedong. His death in 1976 put into motion a massive transition for Chinese citizens. From that moment forward, the Chinese were destined for a completely different world where farmers no longer worked in communes, food and commodities were open to the market, and the country shifted to a less collectivized society.

Before this moment, China was really different. Nancy Chen, a professor of East Asian studies and medical anthropology at UC Santa Cruz, describes what it was like under Mao's rule from the 1950s to 1980s.

Nancy Chen: For about three decades, uh, it was very much a collectivized society. So, uh, it, it was not just about not having individual property, but everything was done in terms of the collective, uh, of the social units.

Katie Lan: In 1978, Deng Xiaoping opens China to business, to new cultures from across the border, and to new ways of thinking of the self.

Nancy Chen: This is when Deng Xiaoping had come into power, and he was very committed to opening up China to the world. And so this was the moment where it was not just bringing, you know, rock and roll bands like Wham to China-- it was also being able to print bestsellers, as opposed to, you know, the essays of Marx and Lennon.

Katie Lan: In the 1980s and '90s, Nancy Chen was in China witnessing all of these changes. She was doing field research in hospitals. She encountered what became known as a Qigong craze. Qigong is a Chinese practice of breathing, integrated with physical motion to channel the Qi energy throughout one's body.

Qigong looks a lot like Tai Chi, but it's a bit different because when people practice it, they incorporate breathing with intention of healing.

Nancy Chen: It's not just breathing in and out of your nose, but it's a healing practice in which breath carries the energy of [00:22:00] not only your body, but also the environment, and also through deep breathing.

A lot of, uh, taoist practitioners as well as, uh, Chinese medical practitioners considered Qi to be the animating force that creates life.

Katie Lan: The idea was that breath, by itself, could heal.

Nancy Chen: In some ways. Qigong was also a fad, uh, that was extremely popular to the point that it was called "Qigong Fever."

It would be groups of people, but they would be scattered across the park facing different trees, and some of them would be rushing up and running and scooping up, as if they were scooping air from the tree, and then putting it onto their body.

Katie Lan: Practitioners of Qigong believed that by harnessing the energy of life, chi, they could heal themselves. It was becoming extremely popular.

Nancy Chen: Qigong masters kind of became like rock stars. They would go around the country and have performances or demonstrations, and so you have these massive halls filled with people who had never practiced Qigong before, all of a sudden experiencing qi and freaking out, basically.

That was during the height of the, of the Qigong Fever.

Individuals who practiced all of a sudden felt that they could actually speak in tongues, or that they had so much qi in their body that they would actually have to run up and down the street.

Katie Lan: Soon, things started getting out of control.

Nancy Chen: Several masters were proclaiming to have powers of healing that couldn't be proven. Several Qigong masters came to proclaim that they had powers beyond the state. And so, very quickly, a lot of the state leaders realized, "Well, we've got to shut this down because this is not appropriate."

Katie Lan: The government cracked down on Qigong by making it a regulated medical practice and limiting those who could practice it.

Nancy Chen: So you had to have a license. You had to show before a board of examiners that you had this [00:24:00] ability to heal. In order to practice Qigong, you had to be officially recognized as someone who had been trained properly.

Katie Lan: So, Qigong switched from popular culture to an official state sanctioned practice. The collective nature of Qigong is part of the reason why it became so popular.

Perhaps breathing was a way for people to transition to a completely new political and economic landscape, a way to stay connected with others without becoming lost as an individual.

Nancy Chen: It was not just simply something new coming from the West. It was also something that was deeply present from the past, and it was a way in which individuals could heal themselves.

Breathing is political because it can change people's minds about themselves and minds about the world that they live in.

Jackson Roach: For a long time, we've thought of breath and life as the same thing. Modern medicine doesn't always. In 2013, Dr. Paul Fisher was asked to examine Jahi McMath. Even though her lungs were still moving with the help of a ventilator, he declared her brain dead.

Paul Fisher: I received a call. I forget even how they got my phone number, but I got a call on my cell phone from an attorney.

And it was a few days before Christmas in 2013, and the attorney wanted to know if I knew any neurologist who could go and perform a repeat brain death exam on Jahi.

I think my responses were, "It's awfully close to Christmas. I don't know who's going to do this." And I think finally I said, "What is it that you need?"[00:26:00] 

I'm Paul Fisher. I'm Director of Human Biology here at Stanford, but also a professor over in the medical school at the children's hospital in neurology.

The Jahi McMath case. This was a young girl hospitalized at Children's Oakland Hospital, and she was there for a tonsillectomy.

People think of tonsillectomy as a routine operation, and it is, but she had a lot of bleeding, and then she wound up experiencing a large insult to her brain where she didn't get blood and oxygen to her brain.

And so I walked in thinking I would go ahead and do a brain death exam like I normally do, and I thought I would drive over to Oakland, park my car, do an exam, and drive on home. I was told that no one was going to know about it or anything like that. It was all gonna be done privately and quietly. As I was driving there, I was talking to a nurse practitioner and she, and she said, "Paul, they just announced on the news that someone from Stanford is gonna be going and doing this brain death exam, and they actually gave your name on the radio."

Broadcaster: ...Christmas with Jahi. Now, in the meantime, a court appointed expert, Dr. Paul Fisher, will conduct an independent assessment on Jahi. Dr. Fisher will be back in court tomorrow with his...

Paul Fisher: I thought, "Oh, wow." Then when I drove over to Children's Oakland, I saw there were news and media trucks, and so I decided to try to get in in a very casual manner, and I was able to walk through all the news trucks without them realizing who I was. And then from there, met the family.

The family was shocked. They were grieving. They were upset. I think there was some element of [00:28:00] disbelief. Why did this happen? Somehow, someone let me down. What was going through my mind? This poor girl, and the poor family.

I asked them if they wanted to be in the room. I asked them if there was anything else they wanted me to do. I explained to them what I would be doing, that I wouldn't be creating pain.

And I wanted to be clear to everyone that I was there as a neutral person. I was actually appointed by the court, and I was just there to provide service, information, and hopefully, with that, the family then can come to the best decision in terms of what they do.

When I saw Jiha, she was already a, a couple weeks past the event where she had bled. She had been declared brain dead I think a week or so earlier.

People think about a brain death exam being overly fancy or technical, but it's really a series of physical examination-- things with your hands, or a tongue blade, or a flashlight, or with water. And you go through that as a neurologist, and you show that there's no evidence of any function of the brainstem, and there's no evidence of any function of the cerebrum.

She was still on a ventilator, so air is moving in and out of her lungs. Her heart is beating, you can see it on a monitor. Yet she's completely unresponsive.

I think the sound that a ventilator makes, particularly when a room is quiet, it sounds like a very lonely, depressing sound.

When I'm in [00:30:00] a room and just hear the repetitive hush of the ventilator, it's depressing 'cause I know it's often artificial breathing that may not return to normal spontaneous breathing that we hope for.

For any person who walks in off the street, whether it's family or a lay person, they would walk into that room and say, "Well, I see the heart waves. I see the breathing with the machine. She's alive."

We wound up in court on Christmas Eve of December 2013. They made a decision that the body could have a feeding tube inserted, stay on the life support with a ventilator and drugs to help heart, and then the body moved ultimately to the state of New Jersey. New Jersey's one of the 50 states that allows for religious objection to brain death.

Sometimes families don't believe in brain death as end of life. Even though it's equated with death, it's not the usual way that people think of death, where someone takes their last breath. We stop the machines, we know their heart and their breathing would stop, but we typically don't know when to do it.

That's an active role. It's very hard for families or parents to say, "Okay, turn off the switch." It's really hard.

Even though no one has ever recovered from brain death, you always say in the back of your mind, "Could this be the one?" The best I know is that Jahi McMath's [00:32:00] body is still, as of, I think the end of 2016, on some sort of machinery support in New Jersey. I don't know the details. I've heard that secondhand. There are reports of people sometimes going months or a year or so on machinery while still being brain dead.

This is longer than I've heard. I don't know where this will ultimately go.

But I think if you're human, a lot of us still have always a lingering doubt.

I don't doubt my conviction. She's brain dead, and we lost Jahi to brain death. But your mind wanders.

I think humanity's always been fixated on what is life and what is death. People equate breathing and heart very often with life, and that that's a, a longstanding human tradition across Western and non-Western cultures.

One of the biggest thrills in medical school for people who go that way is delivering a baby. The first time you are part of giving life, seeing the baby goes from a little bit bluish to making noise and breathing, you suddenly feel that it worked. The parents see that. They hear that, and there's a sigh of relief. Breathing has happened.

Over time, you become more comfortable with the finitude of your own existence. You do think about what defines life or death, who determines it? And then when should life end?[00:34:00] 

Jackson Roach: That story was produced by Jett Hayward and Kate Nelson.

This episode of State of the Human was produced by Kate Nelson, Jett Hayward, Melina Walling, Carissa Cirelli, Katie Lan, Claudia Heymach, Netta Wang, and me, Jackson Roach with a ton of help from Jenny March, Jake Warga, Will Rogers, and Jonah Willihnganz, and everyone at the Stanford Storytelling Project.

For their financial support, we'd like to thank the Vice Provost for Undergraduate Education, Stanford Continuing Education, the Program in Oral Communication, and Bruce Braden.

You can find this and every episode of State of the Human on iTunes. You can learn more about the storytelling projects, live events, grants, and workshops at our website, storytelling.stanford.edu, where you'll also find links to all the music you heard in this episode.

For State of the Human and the Stanford Storytelling Project, [deep inhale, exhale], I'm Jackson Roach.