On & Off Campus Blog

Breath is Life: The Work of a Pulmonologist During COVID-19
Breath is Life: The Work of a Pulmonologist During COVID-19
By Dr. Michael J Stephen ‘91


My career is centered around the miracle that is our lungs, and their daily struggle to bring in oxygen, while keeping everything else out. The lungs are the only major organ in constant communication with the atmosphere, and it makes their job more difficult. We’ve understood their importance for centuries, with the Hebrew word ruach and the Christian concept of the Holy Spirit—both basically embodiments that breath is equivalent to life. In Eastern religions this is prana in India, and Chi in China. Siddhartha Gautama, otherwise known as the Buddha, had it right when he said in the 5th century BCE that a dedicated focus on the breath is the only path to nirvana.

After five years of writing and editing, I have a book coming out about the medicine and mystery of the lungs, Breath Taking. My ability and desire to write this goes directly back to BB&N, and there’s not an element of my education there that did not directly or indirectly affect this aspiration. From learning to read and write in the Lower School, to writing my first expository essay in the Middle School, to reading Shakespeare, Zora Neale Hurston, and Hemingway in the Upper School.

Learning to write and read critically starts in English class, but I also did a lot of reading and writing in my history classes as well, and I remember studying very intensely European, African, and American History. Strangely, I think learning mathematics at BB&N helped my writing tremendously, as did playing music. There’s a logic in both those disciplines that carries over to writing. The standards at BB&N were always very high, which frustrated me at times then, but I am certainly grateful for the lessons I learned and knowledge I accumulated.

While of course unplanned, Breath Taking turned out to be timely because of COVID-19. At Jefferson University in Philadelphia, where I work as a pulmonary and critical care medicine physician, we got hit very hard with COVID-19 cases in April and May. It was devastating because we had no effective medications to treat it, and there was a general feeling of helplessness, as well as personal risk, that I have never encountered in twenty years of working in hospitals.

The personal risk part became a reality for me as I came down with COVID-19 at the end of May, and after two weeks of fevers, muscles aches, and a deep brain fog, I ended up in the hospital with pneumonia and blood clots. The irony wasn’t lost on me that I was afflicted with the very disease I research and treat. I felt tremendous guilt as well as I passed it along to my wife and two young children. Fortunately, we all recovered completely and can now talk about a happy ending.

COVID-19 is not the only serious current danger to our lungs. Two other acute crises of the lungs have occurred of the lungs over the past few years--the vaping crisis, which is very relevant to the high school crowd with the high prevalence of use, and the wildfires seen in Australia, the Amazon Rainforest, and California. The most recent American Lung Association report stated that 150 million Americans are exposed to unsafe levels of pollution, about 45% of the population. This is up from 38% of the population in 2017. Lung diseases as a whole have increased 30% over the past few decades with all the other major disease categories showing a decline in mortality (the one exception is drug overdoses). Worldwide, 91% percent of the population is exposed to toxic levels of pollutants in the air. This leads to eight million premature deaths each year.

There is some paradox here, as a lot of positive progress in lung medicine has recently been achieved. A cystic fibrosis patient, a disease where the lungs get clogged with mucus, would live on average a few years in the 1950’s. Today that number is up to fifty and climbing. Lung cancer mortality is finally in decline after years of growth. Sudden death from asthma is down. We understand so much more about the immunology of our lungs today than even ten years ago.  Almost three thousand lifesaving lung transplant operations are performed in this country every year, up from two hundred in 1990.

I wrote Breath Taking because I love to read and write, and a lot of that love came from my teachers at BB&N. I think this comes across in the book, especially as Breath Taking also tells of truly miraculous things that I’ve seen happen when a patient has a positive attitude, and believes in themselves and their doctors. Many of these patient experiences with astonishing outcomes I cannot totally explain. I have seen this in medicine a lot over the year, including during COVID-19. That’s what makes medicine so interesting. There are both problems and mysteries in the world. Humanity can solve problems, but mysteries often remain unsolved.

Dr. Michael J. Stephen is an Associate Professor at Thomas Jefferson University in Philadelphia, and director of the Adult Cystic Fibrosis Center. His new book, Breath Taking: The Power, Fragility, and Future of Our Extraordinary Lungs will be published by Atlantic Monthly Press on January 19th, 2021. You can read more about him at https://mjswriter.com/