To Draw Breath

“We must remember God more often than we draw breath.”

~ St. Gregory of Nazianzus

She slowly walks into the emergency room, her chest marked with visible respiratory distress as her lungs quickly draw air in and out to meet her body’s increased demand for oxygen. The rapid oscillations of her chest wall make more apparent the unwavering, protruding abdomen which safeguards her unborn child lying just below her diaphragm. A stethoscope placed in the lower right portion of her upper back reveals the cyclic sound of crackles as if someone were gently crumpling a bag with his or her fingers. There is nothing gentle about her disease process, however, as we quickly realize she lacks oxygen, a serious pneumonia threatening the life of her and her child. Thankfully after a few days of oxygen, antibiotics, and rehydration, she recovers from her acute illness and is able to carry out her normal daily activities. All the while her baby lets us know she is well with a steady reassuring heartbeat and intermittent kicks and turns within her mother’s womb. And though we cannot see them, the unborn child’s breaths continue.

He arrives after a three hour boat ride from one of the rural health posts down-river. The imagined patient in my mind after the verbal sign-out given to me over the phone soon takes physical form. A child with swollen eyelids and a puffy face looks at me with a tired gaze, too tired to return the animated high-five and fist-pump routinely presented to my pediatric patients to distract them from the often unsettling hospital environment. He, too, is breathing more quickly than normal to provide enough oxygen to his body. With the stethoscope I am able to hear what will soon be visualized on the grayscale images of the ultrasound machine, a large and complex pleural effusion or collection of fluid inside the space normally occupied by his right lung. Further tests reveal his kidneys are also not functioning normally as they dump an excessive amount of protein from his body. Soon, we refer him to the hospital in the city of Iquitos for urgent drainage of the fluid with a chest tube and further necessary testing including a CT scan and laboratory analysis of the fluid in his chest. We are hopeful he will recover.

It is his second week of hospitalization with pulmonary tuberculosis and, although he had been improving, the physical state of his body quickly takes a downturn. The oxygen flowing through the small tubes leading into his nose is no longer sufficient to keep the most distant parts of his body saturated with this invisible yet life-sustaining gas. We place a face mask over his head to provide higher levels of oxygen. Despite our efforts he continues to breathe at a rate more than twice that of normal. His inspiration and expiration seem to blend together as the time between the two cycles steadily decreases. A stethoscope on his chest reveals a distant, muffled heartbeat almost inaudible to my focused and attentive ears. Again, the ultrasound helps us with our diagnosis. The invisible, reverberating ultrasound waves instantaneously converge- a distressed heart is seen bobbing side to side in a large pool of fluid. Its strong but vulnerable walls struggle to pump enough blood to the rest of his body. Shortly after as I stabilize a needle in his chest, his once-distant and hardly audible heartbeat makes itself known as I hear and feel the wall of his heart rhythmically stroke the tip of the needle draining the fluid around his heart. Despite our efforts to quickly reverse his accelerating disease, his bodily functions continue to deteriorate. And with every subsequent draw of his breath time draws us closer to his death. Thirty-two years of drawing breath are suddenly and tragically cut short.

***

To draw breath is to live. To draw breath is to purify that which harms us from the outside. To draw breath is to sustain the life of another who depends on us. To draw breath is to compensate for that which is suffocating. To draw breath is to fight for survival. To draw breath is to keep going when everything within and around is failing.

But to remember God more often than we draw breath is to allow Him to enter our whole being. It is to purify that which harms us from within. It is to depend on Him to sustain the lives of all. It is to help the other who is suffocating to breathe again. It is to emerge victorious rather than merely fight to survive. It is to transform failure into renewal. It is to truly unite ourselves with Him. To remember God more often than we draw breath is to live truthfully, joyfully, eternally.

Top Left: Procession of Señor de Los Milagros, a Peruvian devotion to the miracles worked by Jesus Christ; Top Right: Altar at a day retreat among the missionaries represented by the flags of our 5 different countries, Amazonian plants, textile, and canoe; Bottom Left: Youth group singing and delivering “get well” cards to hospitalized patients; Bottom Right: Beautiful and exotic, but venomous, caterpillar- DON’T TOUCH!