Heavy Breathing

Eugene Goodheart

I don’t make obscene phone calls, but people sometimes hesitate before they respond, because I’m a heavy breather. I have what is called late onset asthma, the kind that suddenly appears in middle age after a crisis, such as divorce. Children may outgrow their asthma, but late onset asthma is a rest-of-the-life sentence. In theory asthma can disappear as suddenly as it appears, but I don’t know of a single case of late onset asthma disappearing. Does asthma distinguish between the innocence of children and the guilt of adults? Of course not, but that is a thought in the mind of an adult asthmatic. Unlike emphysema, which destroys the elasticity of the lungs and is fatal, asthma seems like, but is not, a psychological disease because it doesn’t leave a mark on the body. The only traces it leaves are indirect ones, scars from pneumonia, to which asthmatics are particularly vulnerable. A manual my doctor gave me says that asthma is not an emotional or psychological disease, though emotional stress can exacerbate symptoms. I once consulted a psychoanalyst, who told me there was no psychological cure, but he could help me cope with the anxieties of having the disease. I am a reverse skeptic. There may be no evidence of psychological origins, but that doesn’t rule out the possibility.
    It began . . . I was visiting friends in the Berkshires for a weekend of what I hoped would be a lull in the anguish of recriminations between me and my ex-wife, anxiety about my children, resentments toward lawyers and the legal system in general. A number of childhood friends had converged on the summer home of the warmest, the most generous of friends, and it felt like a return to a childhood Eden, a childhood of course I had never really known. After lunch we took a long walk to settle the meal. The host proposed that we play touch football. We were scrimmaging for no more than five minutes when I caught a pass and suddenly had to struggle for breath. In terror I began to inhale and exhale rapidly. (Later I learned this was the worst thing I could do. When an attack comes, one must avoid panic and breathe as deeply and as slowly as possible.) I bent over instinctively, terrified, panting for what seemed an age. Nothing seemed to change except that breathing became more and more difficult. I saw the anxious, helpless looks of my friends, and heard voices discussing what to do. I thought I was going to die. I felt desperate, but I also felt—I’m not sure what to call it—guilt? I imagined the grief- stricken expressions of my parents, the desolation of my children. Why guilt, why not just plain terror and fear for myself? And then the attack subsided. It was the first of many.
    It had come without warning, though there were anticipations in a chronic cough that I had acquired in the preceding months. As a child, I suffered from hayfever, so my susceptibility to asthma should not have been a complete surprise. But the first attack was so sudden and overwhelming that I experienced it as a bolt from the blue, a visitation from an alien force that had nothing to do with me. In the days that followed, the attacks varied in severity; the shock of a sudden attack wore off, but it was replaced by alternating moods of fear, despair, and denial. The feeling that I can’t catch my breath is one of utter helplessness. There seems to be no prospect of relief. But I don’t succumb, not because of any will to survive, but because of an instinct that compels me to take breaths, no matter how difficult it is to breathe. I can imagine someone who has the prospect of frequent severe attacks contemplating suicide. But during an attack suicide would be an impossibility, because the compulsion to breathe is irresistible.
    Asthma is not all attack. It is a chronic condition, depending on its severity, of wheezing, the production of clotted sputum, tightness in the chest, postnasal drip, skin rashes; it is life threatening; it can lead to suffocation. In some sufferers attacks are infrequent and the chronic condition is in abeyance, so for most of their lives they are asymptomatic. In others (and I am one of them), even if you learn through the use of medication to stave off an attack, there is always a wheeze or a tightness in the chest or a dull sense of diminished breathing capacity.

I began a search for a cure, going from one doctor to another, never satisfied with the treatment, which as it turned out was always the same. The difference was in the attitudes of the doctors. Asthma doctors for the most part are an irritable or indifferent lot, because they deal with patients who are neither curable nor terminal. The patients just keep coming back, and though they fill the doctors’ coffers, the doctors must feel that their work is something of a scam. They are like the railings at a highway overlooking a ravine, there to make sure that I don’t careen off the highway into oblivion. I live in constant fear that I may at any time lose control of the wheel.
    There was the Boston Brahmin, Dr. Thomas Elliot, courteous, correct, candid about the limited knowledge about asthma despite countless books on the subject. He died on me. Robert Markoff was cut from completely different cloth: coarse, aggressive, impatient, he reminded me in his behavior of the army doctors who examine conscripts for draft classification. I was on a line of patients, to be given a series of tests without explanation, indeed without a word. When asked a question, Dr. Markoff would bristle in response. After a year I had had enough. My next doctor, Bromberg (I remember only his last name), was young, eager, friendly, but confused. Hours seemed to pass between the various phases of examination as he ran from one patient to the next. When he returned to me, he had to remind himself who I was. On the recommendation of a friend, I changed to a charming middle-aged immigrant from South America. Dr. Saul Fogelman was charming and seemed knowledgeable, but his casual and sometimes distracted manner distressed me. Phone calls constantly interrupted the examination. I had the distinct feeling that my visit was unnecessary: that both he and I knew what was the matter and what had to be done without the visit. He told stories about how people managed before the invention of the new drugs.
    One story in particular moved me. During the steamy summers, a father in western Massachusetts would wrap his asthmatic son in blankets and, in the dark, early morning hours before the sun had risen, climb a nearby mountain to the top where the air was thinner and clearer; there he would cradle him in his arms and wait hours, if necessary, for the boy to breathe normally again. Something in the telling suggested a certain disdain for our present dependence on drugs. It seemed to suggest a weakness of character on my part. Dr. Fogelman admired the heroic past. He shared my interest in literature and asked to see what I had written. I began to doubt him when I met a fellow sufferer at an academic conference. She had recently been affficted with a particularly severe form of the disease and, while walking in the street, wore a mask that covered her nose and mouth. She asked me what my peak flow reading was. I astonished her by not knowing what she was talking about. The peak flow meter is a device for monitoring one’s breathing capacity; a diminishing capacity is a warning sign of a possible attack. When I asked Dr. Fogelman why he hadn’t provided me with one, he said he didn’t believe in it—as if it were a matter of faith. After a serious attack, during which I called desperately for help but could not reach him and wound up in the emergency ward, I decided to change doctors. But not before I was hospitalized.

Away from the doctors, my life is uneventful. Three am is the dark morning of the soul (in the circadian rhythm of the day this is the worst time), a tickle or constriction in my chest ominously signaling the filling of the lungs, several coughs, one or two of them yielding phlegm, then a shortness of breath. In a prone position, the asthmatic is always at risk that his lungs will fill with fluid. I sleep with several pillows in a propped position. Not good enough. A sense of isolation grips me, even if my soulmate is sleeping close to me. This is a frequent, if not daily event for umpteen years. It has become part of who I am. A chronic disease, unlike a passing one, becomes part of one’s character, one’s self-definition. In time it becomes impossible to imagine oneself without it. One wakens to it as to a familiar that one resents. Asthma has been my routine almost as long as any routine in my life: going to school, teaching school, being married, parenting. It has made my identity, and like any routine, it tests my will and stamina. I wonder what would happen, how I would feel, if my asthma disappeared. Would it be a loss, a sense of something deeply part of me gone? Would I feel liberated or deprived? A grotesque question.
    During an attack I try to divert myself with listening to the radio or watching television. Music is less satisfactory than the speaking voice, because a speaking voice suggests a human presence that can help me and take me out of myself. Sometimes I struggle against the waste of time during an attack by trying to read or write, as I am doing now. Early morning TV is my distraction. I have seen Ronald Reagan in Shanghai and Bedtime for Bonzo several times, but the main fare is the endless recycling of news and commercials, especially the commercials promising salvation: relief from pain, removal of skin blemishes, restoration of hair, the delights of junk food, escape from daily labor and tedium to sunny climes. One commercial seems specially addressed to me: a woman in distress inserts an inhaler in her mouth and has immediate relief from wheezing. I know all about inhalers. They are useless in the middle of an attack.
    I turn off the TV and face the reality of the dark. Alone, I fantasize my death and count the number of people who will attend my funeral. Maybe, as with Ford Madox Ford’s funeral only three people will be in attendance—my second wife and my two children. The size of your funeral is your final grade:it says how important you were in the world, how much you meant to people. My uncle Sam had thirty, all family members. Two hundred thousand people followed Jean-Paul Sartre’s coffin to Pere LaChaise. I don’t even have a cemetery plot. Nor have I decided how to dispose of my body. The first glimmering of sun lightens my thoughts, my breathing becomes easier, and the usual anxieties about the prospects of the day return. I lie in •bed late into the morning, among used Kleenexes, clutching a tissue in one hand and a canister of inhalant in the other as a provision against an asthmatic attack. When I do get out of bed, I move directly to my study, spending hours among books and papers. Occasionally, I phone to break the monotony, still in my pajamas into the afternoon like Oblomov, the valetudinarian in my genes. The papers strewn about my study come to resemble Kleenex: faded pages of notes that come to no conclusions, fragments of ideas, the debris of thoughts without consequence to be discarded along with the used tissues.
    On a visit to Lake Como in Italy, I met the father of a friend of my wife who, as it turned out, suffered from severe asthma. He had been forced to retire from his business in order to devote himself to his illness. He lived in a villa on a mountain overlooking the lake. He was a burly man, inflated by the heavy dosage of prednisone he was required to take (prednisone makes the body retain water). When my wife and I arrived at the villa, we found him in his swimming pool. We immediately fell to talking (fell is the right word) about asthma. He was surprised I was so thin: “You must be immune to prednisone.” His case was much worse than mine. Incapacitated for years, confined to house and bed, he had almost given up hope. He was saved, however, by someone who had told him of a sanitorium in Davos, Switzerland, the site of Thomas Mann’s Magic Mountain. His wealth enabled him to spend several months there, and if Davos did not magically transform his life, it saved him. He urged me to go to Davos. It was a stunning idea, an opportunity to experience what Mann’s characters had experienced. It would turn the humdrum of heavy breathing into a kind of glamour. I played with the idea, but remained stuck in the humdrum and never went. The figure of the Italian has stayed in my mind as a figure of possibility.
    It was at Lake Como that I met a distinguished American respiratory specialist who was participating in an international conference, to whom I told my story. His response was: “Unacceptable.” He wrote out the name of a Boston doctor whom I have been seeing ever since. Dr. Frank Mason is a virtuoso medication prescriber: sixty milligrams of prednisone tapered down to five during a period of a week; six puffs three times a day of beclovent; two puffs twice a day of albuterol; uniphyl once a day. Dr. Mason has taught me the discipline of the asthmatic: how to anticipate symptoms through medication and not expose myself excessively to the elements: severe cold, stifling heat.
    Asthmatic attacks are triggered by allergies to dust, to plants, to foods, by changes in weather, by stress—the possibilities are endless. The allergist tests for them by pricking the skin of one’s back and arms a hundred times for reactions. The asthma sufferer is lucky if he can find the villain or villains. All he has to do then is refrain from eating chocolates or nuts or. . . . But in my case the villain has not been found. Little red blotches of allergic reaction appear on my skin, but none of them is significant enough to be the allergen that provokes the attack. My asthma is anallergic.
    Imagine the following scenario: a paranoid state with a sophisticated, heavily equipped army at the border, always anticipating enemy incursions that do not occur. Instead, illegal aliens slip through from time to time or a change in the weather produces an ominous cloud formation that suggests enemy troops on the horizon. The nervous commander, always ready to react, orders the troops to fire: occasionally in the confusion a soldier is hit with friendly fire. This is the condition of the asthmatic body, its glands prematurely firing or misfiring defensive secretions to annihilate nonexistent enemies, causing inflammation of the airways and constriction in breathing. Asthma is a war of the body against itself. Why, the doctors don’t yet know. At a holistic center, where for a brief period I sought help, the therapist asked me to close my eyes and imagine an invading army of bacteria, which I would surround and defeat. It struck me later that if my body was paranoid, why should I be encouraged to imagine an invasion? I also thought it odd that a holistic center should have on its staff an asthma specialist.
    My disease has become an existential condition. I am allergic to life itself as far as I can tell. The cure would be to seal me in a large vacuum chamber. On the other hand, I can turn my “condition” into sensitivity. I see and feel things differently from other people. I could see how Marcel Proust may have regarded his asthma as a blessing.
    One needs to be a scholar to remember how and when to take the medicine. Dr. Mason reminds me that I am a scholar, but this is hardly my favorite subject. Dr. Mason is an impressive figure: tall, handsome, unsmiling, a major player in his profession. At first he cautioned me about changing from Dr. Fogelman: “Don’t transfer your records yet—you may not like me.” Odd for a doctor to say. But I soon discovered what he meant. He has a passion for doctoring. In his office at six in the morning, he takes calls from his patients until seven. He insists that we call him, so that he can monitor our progress. He questions me closely about whether I have taken the medicine as prescribed. When I have forgotten he scolds, the way a father scolds a child. I am a year younger than him, and he terrifies me as my father used to terrify me. So I sometimes lie if I forgot to take a pill or failed to taper the medication as prescribed. Then I pay for it in my dreams. Dr. Mason has become the most significant authority figure in my life. He is driven and drives others. The nurses roll their eyes at the pace of his activity, his constant demand for quick action. He is obsessed with accomplishment, with making a difference. He is like a poet or painter of genius whose art is his life. Asthma is his canvas, a detached object. To think of it as having a soul or a spirit would mystify it, and prove an obstacle to its treatment. So he has little patience for the affect of suffering, except as a route to understanding the illness. (He is not untypical in this respect.) The suffering of a patient may be as professionally irrelevant as the color of an organism to a molecular biologist. But color is important: a student of mine who had been a professional nurse noticed my fingernails turning blue at the beginning of a mild attack, a sign of oxygen deficiency.
    When Goethe prophesied that the main institutions of modern civilization would be the theater and the hospital, he foresaw my own existence. First the hours of difficult, heavy breathing in front of the television set, where I seek the diversion that will relax my bronchial tubes. Then a calendar full of appointments with doctors: Dr. Mason; the internist to test my blood for diabetes; the endocrinologist to protect me against bone loss incurred by the taking of prednisone; the ophthalmologist to check against cataracts. (Among all the potential side effects of asthma therapy, osteoporosis is my particular affliction—I have only seventy percent of the bone density normal to men of my age and build. Just one in five people with osteoporosis is a male; most commonly it afflicts older women. It has no symptoms but can turn your bones into powder.) For efficiency’s sake, the doctors should arrange themselves on an assembly line and examine me as I pass them by.
    Dr. Mason has made a difference, but the price is high. Like a military man who wants a decisive victory and refuses to temporize with the enemy, he deploys all the force at his command. My medicine cabinet is an arsenal of prescribed drugs. But an excessive use of the inhaler can produce palpitations of the heart. On one occasion they were so severe and continuous that I had to be rushed to the emergency ward where a doctor applied a finger to my carotid artery and restored my normal heartbeat. He warned me of the danger of trying to perform the remedy myself: the wrong kind of pressure on the artery can be fatal. This makes me apprehensive about the toxicity of medical cures, so I wonder about an alternative or complementary therapy. Acupuncture, some say, cuts the phlegm. Do I dare to tell my doctor? I mention it while he is writing a prescription, and he shakes his head dismissively: “There’s no scientific evidence for it. If the patient feels better, it may be nothing more than the placebo effect.” I reply feebly: “I’ll settle for the placebo effect.” Dr. Mason doesn’t want to discuss the matter—as if it were beneath contempt. He picks up his dictaphone, summarizes the results of the examination and then to my astonishment speaks of the long conversation we had about acupuncture. The long conversation had lasted no more than thirty seconds. This man, who wants hard evidence for medical procedures, can characterize a thirty-second conversation as a long conversation. Time must be so precious to him that a second becomes an hour.
    The acupuncturist, unlike Dr. Mason, is a small, discreet man, economical in his gestures and speech. He cannot explain the method, only describe it. The body has meridians that the needles activate. He tells me there are different styles of acupuncture, and his preferred style is to prod the skin with a moxa, an herbal powder that he ignites and applies with a needle until the skin warms to the point of becoming uncomfortably hot. After every application, he takes my pulse to determine whether it had an effect. His taking of the pulse is a subtle affair, gently feeling it repeatedly from different angles. He cannot explain what he learned, though a symptom that things are not what they should be (that the energy level is not quite right) is that the pulse is slippery or, as the Chinese would say, “a pearl on a disk.” “The Chinese see the world in metaphors,” he tells me. I had six sessions, the minimum number required to judge whether the treatment was working. I couldn’t say it was, and the treatment ended. Since there were no promises, I didn’t feel cheated. But the experience inexplicably made asthma more of a mystery. My wife thought it made my hair look different, curlier, richer in texture. So maybe it made a difference.

I have given up the search for a cure. Call it a cop-out. Aren’t there enough clues in my story about the cause or causes? A divorce, a paradise I never experienced, a father who terrifies me. Actually, I don’t trust all these memories. My father also loved me deeply: oh, there’s another possibility, perhaps too deeply. But where does all this lead? It doesn’t change anything: the constrictions and secretions recur. So I’ve raised false expectations that I may be living a detective story—with clues scattered throughout and forming themselves into a solution. The truth is that this is a story about accommodation and about becoming philosophical: those interested in psychological thrillers can stop reading here.
    I am fortunate to be an academic, as my work consists of teaching, reading, writing, and thinking. All other activities are diminished by asthma. Walking, especially up a hill, becomes a struggle. (On a long walk around Walden Pond with a friend, I had to hold on to trees periodically. My friend teased me about “hugging trees.” Thoreau might have approved.) I don’t observe carefully when I walk or drive: the distraction of breathing turns me inward. Any household activity—sawing a piece of wood, lifting a garbage can, mowing the lawn—leaves me breathless. So does lovemaking, during which a little wheeze in my chest is my constant companion. My wife calls me Wheezer—which rhymes with geezer.
    Asthma is an old man’s disease. It slows the walk: “You are old, Father William.” So I sit at my desk or in an easy chair with papers and books on my lap, disgracefully irresponsible. It is my wife who has to put out the garbage on cold days when the frost bites into the chest. It is she who must run up stairs to find my misplaced inhaler in anticipation of an attack. It is she who. . . . A perverse thought: my asthma is a refuge—from the world, from the requirement to be active; It confirms me in my sedentariness. As my gregariousness dissipates with age, I want the excuse to be alone. Another thought strikes me about the resemblance between the scholar’s activity and the effluvia of asthmatic breathing: they both seem unprovoked and gratuitous, the products of excess serving no function except their own production.
    Asthma is a narrative of repetition. It is the workday extended into the weekend. The occasional crisis, a severe attack, produces variation, but every attack is a repetition of a previous one. I am never free of it, nor struck down by it. The famous nineteenth-century doctor, Sir William Ostler, said that asthmatics pant their way into old age. So does everyone else who lives into old age. Why take notice? Dr. Mason says that Ostler’s remark was a disaster for asthma research: why fund it if it is not a killer—like cancer, which seems to be striking all around me. Friends with brain, prostate, stomach, pancreatic cancer. That is drama. My friend Joseph has just had his stomach and spleen removed. On awakening from anesthesia he told the doctors that he didn’t have the stomach for another operation. He has been the golden boy of philosophy and experience: handsome, brilliant, the inventive maker of arguments and distinctions, a lover of women and loved by women. As a philosopher, he moved from analysis to wisdom. And now, struck down, he exemplifies the lessons of the examined life in his attitude toward the prospect of dying. He is all cheer and self-possession. “My only sadness,” he says, “is that I think of myself as a protector and I’ll be leaving behind those I’ve loved and protected.” Not a false note in this. I remind him—does he need to be reminded?—that he began philosophy inspired by the example of Socrates’ heroic defense of it in The Apology. I tell him that he reminds me of Socrates giving his farewell to his disciples in the Phaedo—but being Jewish he has a warmth Socrates lacks. Is it possible that I write this out of envy? How stupid! The sword has not delivered its final blow, so Joseph too wakes every morning to the thought.
    I think of my friends and the effect of illness upon friendship. Friendship is the frank exchange of intimacies, so what happens if the space of intimacy is more and more occupied by illness? Who wants to hear of another person’s illness unless it is a tradeoff for hearing about your own. Or the satisfaction that it is not you who is suffering—who wants the guilt of experiencing that satisfaction? Illness can corrode friendship if it becomes an endless obsession with one’s body. We all know the experience of not wanting to listen to others when we are ill, because listening interferes with an indulgence in our pain, our needs. Dignity, however, requires that we listen. We cultivate reserve, we silence our needs and listen to others without pleasure—unless, perhaps, we are Jews, who have the gift for suffering and communicating it—of turning suffering into the spontaneity of one’s relations with others. This is the birth of Jewish comedy: the awareness of the grotesquerie—not of suffering, but of its indulgence.
    What happens when two people compare illnesses (we might call the discipline comparative suffering)? One or both might want the satisfaction that his or her illness is the more serious, the more painful. You think you have it bad, listen to me. . . . Or the motive may be the opposite: to seek consolation that someone else is in a worse condition. Samuel Beckett’s Mercier suggests that we don’t need others to achieve this consolation: “When you fear for your cyst think of your fistula. And when you tremble for your fistula consider your chancre.”

But I am drifting from my subject, asthma, which has a venerable history. The word is Greek, adopted by the Roman Seneca who wrote of his own asthma and gave it the nickname now used by doctors, “rehearsing death.” Why “rehearsing death”? Because the asthmatic feels as if he were breathing his “last gasp.” But the attack turns out to be “a squall” of brief duration: “One could hardly, after all, expect anyone to keep on drawing his last breath for long, could one?” I did. One night I breathed as if it were my last for eight hours straight. (Dr. Markoff once told me that with time asthmatics become aerobic athletes.) While breathing hard and continuously, I must have asked myself Seneca’s question. Of course, given the fact that it is Seneca, we should expect what we get: pithy reflections on life and death. Rehearsing death holds no terrors for him: he reminds us that, since we were not conscious of distress before we were born, why should we anticipate distress after we die, when we will be returned to our original prenatal state? A sophistic evasion, because the anticipation does not arise from the prospect of death, but from dying: the terrifying change from one state of being to another.
    Did Seneca write the extended passage while having an asthmatic attack? Who knows? His stoic reflections seem to be his way of talking himself out of an attack while experiencing it. His breathing, he tells us, becomes more regular, more tranquil. The rehearsal for death leads not to the real thing, but back to the distress of living.
    Susan Sontag cautions us against turning illness into a metaphor: “A disease of the lungs is, metaphorically, a disease of the soul. Cancer, as a disease that can strike anywhere, is a disease of the body. Far from revealing anything spiritual, it reveals that the body is, all too woefully, just the body.” But the body is not just the body. It may be the “place” where the mind takes its toll and reveals itself. And even when the mind does not make the body ill, it is tested by the body, which finds out whether you have the soul of a whiner or a stoic and measures the strength of your will. What Sontag perceives in the displacement of physical suffering to the spiritual and the symbolic is a disrespect for the pain of the sufferer. It turns the victim into the guilty party. But metaphor also bestows meaning. In literature illness, catastrophes, and accidents are always metaphors or occasions for significance, or else why have them make an appearance? An accident like Ivan Ilych’s fall from a chair while hanging a curtain is judgment, a fall from grace. The illness that ensues and kills him is not even given a name: it is an it that becomes more and more ominous as the tale unfolds. Tolstoy refers to a floating kidney, but that is not where the main interest lies. Sontag speaks of the naming of a disease as damning, but not naming it is more damning, because it makes it elusive, mysterious, and overwhelming.
    Here are two contradictory views of asthma. Walking around the track of an athletic field, I see an elderly man with a wracking cough, breathing hard, spitting stuff: I glimpse what I might look like to others. The other view: in the splendid German film Celeste, which gives us the life of Proust from the point of view of his housekeeper, there is a memorable scene in which Proust suffers an attack and calls to her for help. She appears with a breathing apparatus for relieving symptoms. As Proust inhales the vapors, Celeste, close to him, breathes in sympathy. The camera zooms out and, from the distance, there is the appearance of a love scene. The romance of asthma.
    What is illness, how do we decide if someone is ill? He has symptoms. What are symptoms? Pain, aches, rashes, unusual secretions, an awareness of bodily events (we are unaware of our bodies when healthy). Illness is relative, measured by our relations to others. If there were not people born with two arms, one-armed people would be the norm. “But illness may prove fatal.” That is no argument. All of life is fatal. This is the consolation of the chronically ill. It takes time to settle into an illness, but when one does, life becomes normal. One needs to banish thoughts of what might have been; one needs to stop making comparisons.
    An illness may be a judgment of a wasted life. A chronic illness is a caution against all dreams of self-transformation. It is the cowardice of the body. It tells me what I cannot do, what I dare not do. But illness may also be an opportunity. Teddy Roosevelt overcame his asthma and became a Rough Rider. Jackie Joyner Kersee runs with fury, despite the fact that her racing victories end with asthmatic gasps. In my case, asthma is a form of imprisonment, a confinement to sedentariness, to a life of reading, spectatorship, and writing. Writing is the only action that doesn’t make me short of breath. The most famous of asthmatics, Proust, wrote long sentences. He breathed in his sentences as he could not breathe when he walked. Chronic illness narrows our choices, even helps us find a calling, a vocation. It is the quintessential condition of self-discovery, the boundary of existence that tells us what we are and what we are not, who we can be and who we won’t be. One adjusts to the boundary the way Greger Samsa adjusted to his insect body in Franz Kafka’s The Metamorphosis—though never completely. The spirit, weakly or strongly, depending on one’s strength, rebels from time to time. It says, “I am my illness.” It also says, “I am not my illness.”

Eugene Goodheart is the author of eight books of literary and cultural criticism, among them The Skeptic Disposition: Deconstruction, Ideology and Other Matters and Desire and Its Discontents. Other personal essays have appeared in Agni Review and The Sewanee Review.

“Heavy Breathing” appears in our Autumn 1997 issue.