|June 29, 2020|
We can no longer take breathing for granted
|Human lungs look like two hooded monks in pink billowy robes, bowing toward the heart that beats between them. If you could roll a pair out flat, the surface area of all those little bronchioles end to end would cover the area of a tennis court. A healthy set not only absorbs the oxygen our cells need to burn energy, it also rids the body of about 70 percent of its waste. |
The lungs of an asthmatic---my lungs---are redder, more inflamed, and sometimes scarred. Dust, smoke, pollen, pollution, animal dander, stress, and infection can invite an attack. As a kid growing up in the suburbs of Salt Lake City and on my grandparents' ranch in southern Idaho, all of the above triggered me. Especially animals. I couldn't bear to be away from them, even though sneaking onto the bare back of my grandfather's horse or dressing cats in doll clothes guaranteed a trip to the ER. I didn't care; it was worth the price of admission.
I wish I could say the same thing now, about the price, because these days the ER is the last place any of us want to be. Living on a remote mesa between Colorado's San Juan Range, to the east, and Utah's red-rock deserts, to the west, where it's possible for me to hop the fence and wander freely on millions of acres of public land in any direction, I am aware of my good fortune.
Here's the catch: I can only get out on the land if I inhale a blast of albuterol. This is where my luck could run out. Since March, inhalers have been in short supply because many COVID-19 sufferers need them to ease their respiratory distress. I have only one in my possession. People with lungs like mine stand a greater chance of dying from the virus. These days I'm chewing on osha root, inhaling steam infused with tea tree oil, and feeling more vulnerable than I'd like.
It's not dying of the disease that scares me, though. It's living a life with more damaged lungs than I already have. Post-COVID lungs can be so permanently, thickly scarred that one might not ever breathe the same again. To be unable to saturate my organs and limbs with oxygen so my body can continue to ramble through rough country---up summits, over ridgelines, through slot canyons---it's this thought that terrifies me.
I went on to trash my lungs despite all those childhood asthma attacks, where I was at times blue-lipped and whistling through an airway as narrow as a drinking straw while my mother blew through red lights to get me to the hospital. In high school, I smoked clove cigarettes and sucked on fat, greasy bongs. After dropping out of college, I dated a punk rocker who had me inhaling what I later learned was crack cocaine---I was too naive to know what it was and too depressed to ask. I just smoked whatever he lit.
Then, at age 21, I discovered rock climbing. I cleaned up my life, swapping sleazy bars and mosh pits for crags of every kind: granite, sandstone, limestone, quartzite. But I also spent a lot of time in climbing gyms, inhaling the dust that absconded from chalk bags. It was just my luck that indoor climbers can take in levels of particulates that exceed safety limits in the workplace.
It wasn't long ago---just last summer---that I bemoaned the shape my lungs are in. But that was 2019, another lifetime it seems. My experience of not getting enough air is now trivial compared to that of a COVID patient or a Black man with a police officer's knee on his neck. (Eric Garner. George Floyd. Manuel Ellis. Javier Ambler. Say their names.) The very act of breathing is in question these days.
It was the early spring of 1989, and I was 23 years old. Three of us were camped on the south slope of Mexico's Pico de Orizaba, the third-highest peak in North America. In the icy flint of first light, 14,000 feet above the Gulf of Mexico, my companions, who I'll call M. and L., steeped a stout black tea, which I declined---one too many hits off my inhaler had adrenaline skittering through my veins like phantom cockroaches.
We'd already been to this base camp ten days earlier. On that initial visit, before the first night was over, all three of us were feeling warmish and had a dry cough. By morning we were too sick to climb and too sick to descend; for three days we burrowed in our bags, larval and hacking. At some point, my breathing began to crackle like Saran Wrap. L. is a nurse and an Exum mountain guide and knew the situation wasn't good. M., my then boyfriend, was obsessed with immortality and in denial. Me, I was just trying to breathe. When a truck chugged up the hill and off-loaded a group of British climbers, L. convinced M. that we should hitch a two-hour ride back down the mountain to seek medical attention.
At a hostel in Tlachichuca, a doctor pressed the bell of his stethoscope to our chests. "Bronchitis," he said to my companions. "Pneumonia," he said to me. I waved off everyone's worry. Because of my asthma, colds and flus all too often left crud in my lungs. I'd learned how to push through it---although not while trying to summit an 18,491-foot volcano. I popped the antibiotics and said, "Let's get back to the mountain."
On the morning before our summit bid, I still didn't feel so great. I was about to say so when three young men from one of the Indigenous groups in the region strode into our camp, bright-eyed and smiling. They were dressed in the same sort of attire noted by British explorer Henry Cadell in 1906 when locals guided him to Orizaba's peak: cotton or wool serapes and thin leather huaraches on sockless feet. Meanwhile, we huddled in mashups of Gore-Tex, down, and fleece.
The men sat. From wool satchels they each pulled out two clear plastic bags---one damp with fresh tortillas and the other slimy with uncooked hot dogs. They wrapped the latter food with the former and devoured it all. Then they took off their huaraches and slipped a plastic bag over each foot before putting their sandals back on. They stood, gave thanks for the company, and, before we could offer spare socks, were off again. It was a crazy late start and with no gear, but they were moving fast. It must not be too bad, I thought.
On summit day, I rose just after midnight. On the glacier, I doubled over my ice ax after every feeble kick step with my crampons, gulping for air like a goldfish that had cleared the bowl and lie flopping on the floor, its mouth a pointless O. My partners were patient and mustered far more encouragement than I deserved. Somehow we made the summit, as a blood-orange sun juiced the snow and a smoky-blue swath of velvet claimed the hills below. But I felt wretched for weeks after.
To ask if the summit, wondrous as it was, was worth it---that's not the right question, is it? It was reckless to climb in my condition; it put my companions at risk and could have endangered whomever else would have been involved in a rescue, had I needed one. Plenty of more experienced mountaineers have died on Orizaba. But I was so young. Living with asthma was my normal. Climbing with pneumonia, smoking whatever was lit---it was a sick way of trying to be like everyone else, taking breathing for granted.
This pandemic and the murder of George Floyd---like so many other Black men who have died in police custody gasping the words "I can't breathe"--- provide sobering reminders of how vital breath is. Breath is also stolen by a lack of clean air, which in America has gotten much harder to come by in a short period of time.
The American Lung Association estimates that nearly half of the American population breathes unsafe air. Air pollution in the U.S. causes between 90,000 and 360,000 deaths each year. Outdoor particulate pollution, which comes from burning things---coal, gasoline, forests, chemicals---is made up of particles 35 times smaller than a grain of sand. Such matter penetrates almost every one of the body's defense systems and can corrode the alveoli, or air sacs of the lungs, which can lead to asthma or pneumonia. It can cause or worsen illnesses such as chronic obstructive pulmonary disease, lung cancer, and emphysema. Nanoparticles of certain types of air pollution have been found to affect the brain and are causally linked to developmental problems in children and neurodegenerative diseases such as Alzheimer's.
Since President Trump took office, air pollution in the U.S. has worsened; diminished air quality was linked to nearly 10,000 more deaths in 2018 than in 2016. And air quality matters more than ever: coronavirus patients in areas with high levels of air pollution are more likely to die from the virus than patients in areas with cleaner air. Knowing this, consider that industrial polluters do most of their dirty business at the edges of disadvantaged communities---in particular, Black and Native communities whose underserved residents are already more likely to die from COVID-19 complications. Particles form in the atmosphere from chemicals emitted by power plants, industrial facilities, and automobiles, and the ones that are smaller than 2.5 micrometers in diameter have the most adverse effects on human health. A 2018 air-quality study published in the American Journal of Public Health found that Black communities endure this type of air pollution 1.54 times more than the overall U.S. population.
While we were distracted, understandably, by the pandemic's body count and near Depression-era levels of unemployment, the Trump administration was rolling back clean-air laws. It released corporate polluters from compliance with routine monitoring and reporting of pollution. It passed the rollback and replacement of Obama-era clean-car regulations while at the same time dismissing recommendations from the Environmental Protection Agency's scientists for stricter overall national air-quality standards. Since 2011, federal regulation of coal-fired power plants has cut mercury pollution levels by nearly 82 percent, but Trump's current EPA administrator, Andrew Wheeler, a former coal lobbyist, has been finalizing a rule to undo that progress as well.
Air pollution isn't just an urban issue. Air quality in our wilderness is directly affected by the current administration's partial repeal of an Obama-era rule that limited methane emissions from drilling operations on public lands. It weakened another rule aimed at reducing air pollution in national parks and wilderness areas. Last year a report by the National Parks Conservation Association found that 96 percent of our national parks have hazardous air quality, while another report determined that pollution in the parks can rival that of the country's 20 largest major cities. In 88 percent of those parks, air pollution posed a direct threat to sensitive species.
The tragic irony is this: 2020 is the year that life as we knew it changed, with a pandemic sweeping the country and a young woman filming and posting most of the eight minutes and forty-six seconds it took for a white police officer to kill George Floyd by kneeling on his neck. It is also the 50th anniversary of the Clean Air Act.
Last October, not long before the novel coronavirus spilled into human hosts in Wuhan, China, I was traveling through the Altai Mountains of western Mongolia on the trail of ancient horse warriors. The trip was one part book research, one part adventure. Three friends joined me for the latter.
I arranged for a local guide to take us into a remote corner of the country near the Russian border---a hard-to-access area inhabited seasonally by just a few Kazakh families and their herds of yaks, sheep, goats, and horses. Our interpreter, who told us to call him Paco after we butchered his real name, met us wearing a clinical mask. Beads of sweat snaked down his temples, and his cough was deep and dry. We asked if he was up for the trip as he hoisted our bags into a Soviet-era van. He ignored the question, of course. Mongolia is a poor country, and guiding us was no doubt a much needed source of cash.
We'd started our journey in Ulaanbaatar. In the coldest months, intensive coal burning congeals with smog from traffic and industry pollution to qualify the city as the world's most polluted capital. As a result of recent droughts and severe, harsh winters that killed off hundreds of thousands of herd animals and drove previously nomadic families into the city, 45 percent of the Mongolian population now lives there. Many of the people we saw were masked and coughing; respiratory disease in the country has increased at a rate of 270 percent over the past ten years, and pollution-caused pneumonia is the second-leading cause of death among children under five years of age. The city's massive, coal-fired power generators spill out tsunami-size waves of dense black smoke, which mingle with that from the rubber tires and plastic bottles that many residents burn in their woodstoves because they cannot afford to buy fuel. (Meanwhile, as the coronavirus spread across the globe, U.S. Department of Energy secretary Dan Brouillette announced that the administration would pump money into coal-based technologies at home and in developing countries.)
After traveling several hours to the northwesternmost edge of Mongolia, we reached a wide, sweeping river valley stitched by silver threads of water. Paco pointed out the last Mongolian military outpost before the Russian border, then confessed that we didn't have a permit to be there. "Act dumb if the military stops us," he said. "I'll do the talking."
We passed by without incident, then rolled up to the first random mud hut we saw and asked if we could bed down for the night. In Mongolia, hospitality is valued as much as the steppelands themselves, so the family didn't hesitate before inviting us to sleep in a back room where yellowed pieces of linoleum were tacked to the dirt floor and walls. It wasn't long before our bellies were stuffed with mutton soup, homemade noodles, biscuits, and yak-butter tea. Then we climbed into our bags, ready for sleep to find us.
It never did, thanks to Paco's cough. It sounded serious, and I fretted about his health, our hosts' health, and our own. At least he's wearing a mask, I thought. But during the night, when I got up to pee, my headlamp swept over his bag, and on the dirt floor next to his boots lay Paco's mask.
Paco seemed better the next day. We left our hosts with a few useful gifts and some money to compensate for the precious food stores used to feed us. Then we wandered a wide, boulder-strewn hillside with dark, brooding rocks and dry, rasping grasses, where Paco was as excited as I was to find the rock art I'd wanted to examine for my writing project. The relics offered insights into an ancient culture that revered the Eternal Blue Sky overhead, which many Mongolians still hold as sacred. A few days later, our group parted ways.
My return to the States was one of those grueling multi-day trips---the kind of marrow-draining journey in which everything happens at the wrong time or in the wrong place, and you somehow miss out on all but the most ephemeral measures of sleep, food, and hydration. I had only been home a few days when I drove to Salt Lake City to give a talk at the University of Utah. En route, a deep, dry cough started, then a fever. In just a few hours, there was that familiar Saran Wrap sound, accompanied by murderous aches and fatigue. Here I go again, I thought. Pushing my limits, taking my health for granted.
Who knows what I said in Salt Lake. Or who listened. I can't even recall driving back to Colorado. All I know is that by the time I got to the clinic in Telluride, the town nearest my home, my doctor immediately pressed an oxygen mask to my face then hooked me to an IV full of drugs. I was sick enough to induce fearful tears in my otherwise stoic husband. It was three weeks before I turned the corner. During that time, I used a special machine that nebulized medicine into my lungs day and night. I ingested a multitude of antibiotics. Six months on, I still don't feel quite myself. A five-mile walk on easy ground sends me straight to an Epsom-salt bath and then bed.
It turns out that my three travel partners caught it, too. I was still coughing when the first known COVID-19 cases were unfolding in Wuhan in December. Since then, so many people---my mother, the rancher down the road---have suspected that we caught the coronavirus, perhaps from Paco, while traveling in Mongolia. But that's unlikely. To date, despite its dismal pollution and respiratory-disease statistics (both of which are factors that increase mortality rates for COVID-19), UNICEF reported in mid-April that Mongolia had only 331 suspected cases, 31 of which were confirmed. While these numbers are probably understated due to a lack of testing and tracking, Mongolia may have dodged the worst of the pandemic because it shut its border with China shortly after the outbreak was reported. It then locked down its own cities. And it doesn't hurt that so many people in Ulaanbaatar already wear masks or stay indoors due to the coal-coated air. In other words, even if we factor in reduced accounting and reporting, it appears Mongolia has suffered far less from the pandemic than the country I flew home to.
If my friends and I did actually catch the coronavirus during our travels, I still wouldn't hang it on our good guide. There's a danger in dodging our own part in all this by making sure our eyes are on Asia as the source of everything contaminated. After all, it's developed countries like the U.S. that outsource manufacturing to the region so we can buy more for less. It's easy to blame Asia for selling those darling pangolins in wet markets, but we Westerners also have ravenous, insatiable appetites. The laptop on which I write this essay, the shoes I'll wear to hit the trail when the work is done---they're affordable because they're made in places where there are fewer regulations on working conditions and pollutants, including the ones that poison the air.
My own fragile lungs, the insults they've suffered, make it clear: all of us, even the ultrarunners and Mount Everest summiters and others who possess lung function like a superpower, need clean air. Not only to live well and actively but also to survive COVID-19 and whatever lung-loving pandemic comes next. Of course this all pales to what communities of color are up against. African Americans who get outside for the same reasons---to live well and actively---risk profiling, abuse, or getting killed when going for a run or bird-watching. (Armaud Arbery. Christian Cooper.)
Imagine a second term for the current administration: Four more years of exempting factory farms from reporting harmful emissions linked to respiratory problems. Four more years in which manufacturing facilities spew poisons like mercury, benzene, and dioxin without fear of oversight or penalty. Four more years without rules to regulate fracking's release of poisonous chemicals linked to nervous-, respiratory-, and immune-system devastation. Four more years of a president inciting racial violence and police brutality instead of seeking ways to unite the nation. Don't forget, too, the unprecedented rate at which Trump has removed protections from the nation's public and Native lands, like those in the Bears Ears and Grand Staircase--Escalante National Monuments, which were accomplished in large part to open those areas to dirty energy development.
Many of our cities---like my Salt Lake hometown, which is now included in the American Lung Association's list of top 20 cities with the worst air---are already racking up weeks or months in which residents are being urged to stay indoors or wear masks due to pollution. If breathing clean air was ever a given in America (and, really, was it ever?), those days are over.
Bristle when your boss, your spouse, or your neighbor says 2020 is the year of a new normal---there's nothing normal about all this. To accept it as such is a complacency that will kill us. But even before this year, we knew that we'd have to drive less, fly less, buy less soon. We knew that we were living on borrowed time, because glaciers were melting, species were dying, wildfires were burning. More recently, we've all known (if only in some tiny crevice in the back of our minds) that when the stay-at-home orders are lifted, even if a vaccine becomes available, we'll all have to continue to live, in many ways, as we were living this spring.
So what do we take with us when we remove the masks and move forward? What should be on our post-pandemic, post-protest packing list for a more sustainable and equitable world?
Maybe it's two lists: the personal and the planetary. Personally, be willing to actively change your life so that all of us, not just some of us, may live well on this earth. If Black and Brown people are disproportionately harmed by carbon and chemical emissions, then it matters all the more that those who are able insist on working remotely. Swear off Amazon. Make do with one jacket instead of two. Get off the parenting crazy train that has us shuttling our kids five days a week to soccer practice, swim meets, violin lessons; maybe we'll just unleash them to climb the trees in the park. Fight fracking and coal burning like our lives depend on it, because they do. And start fighting racism the way we've fought the coronavirus: Assume you have it. Listen to the experts (hint: they are not white people). And fight the spread, at home and in your community. To be asymptomatic is not enough to flatten the curve.
And vote. Vote for those who would choose clean energies and eternal blue skies. Vote for those who would make medicine and health care available to everyone. Vote for the end of land grabs and choke holds. Vote for fewer cops and far more social programs, including reparations for those who have been under the knee for 400 years. Your lungs will thank you. Communities of color will thank you. The land will thank you. Every animal, every vegetable, every rock face, river, and snowy slope will thank you and, in return, sustain you, sustain all of us.
The other day, I walked through a little-known canyon that harbors at its head a heart-shaped pool of water. The canyon is chock-full of gold boulders, safe enough for a human to move through without trouble but not the kind of place you run into deer or rabbits or coyotes. So I wasn't thinking about animals---just the stone, the water, and the sky---when a Mexican spotted owl shot out from the jumble I was in, its great wings beating the air into my ears, its hand-size talons just inches above my prickled scalp. This owl's northern cousin sharply declined during the heyday of clear-cut logging in the Northwest's old-growth forests and became a symbol for the sweeping environmental reforms that were achieved through citizen action. That hunting, flying metaphor for all that we have protected took my breath away in the only way I want it taken now until the end of my days.
When I reached the heart-shaped pool, my own heart still pounding, I knew this, too: in this strange new world, let us be able to say that, along with our lungs, we put this four-chambered vital organ to the test. For restraint. For generosity. Let us say we found it to be strong.