TAKE A DEEP BREATH | Sheethal Gloria Oommen
I started having asthma attacks at the age of three. We had just migrated, and I was having a hard time adjusting to my new life. My mother blamed the asthma on air pollution and the change in environment; my father said it was caused by eating ice cream; my grandmother was convinced it was because I was playing in the rain. Various extended family members chimed in with an impressive array of etiologies. One said it was caused by the evil eye, another said the bathroom in our house was in an inauspicious location, and a third said I was tormented because my mother would not give me a younger sibling.
I was taken to several local priests for healing prayers. While most of them just prayed over me, one told my parents I was being punished for the sins of my ancestors and asked my mother to fast and pray daily for a month. She did – bless her – but my ancestors must have been particularly terrible people, because her sacrifice did nothing to cure me. Another priest tied a long black string in knots, said a prayer for each knot, fastened the string around my waist and gave my parents strict instructions to not remove it until I was cured. I wore it for six months before it broke, but the attacks kept coming.
They took me to doctors, too, of course. In a fashion. By the age of four, I was familiar with the bitterness of powdered herbs mixed with honey, sugar pills soaked in alcohol, brown pills compounded and rolled in the local pharmacy, and commercial theophylline tablets, sometimes all taken on the same day. My attacks usually lasted hours or days, because nebulizers and inhalers were not available in the village where we lived until well into the nineties. No one told them that these medicines shouldn’t be mixed, because that was normal practice; doctors fully expected that a person who came seeking treatment was more than likely taking medicines from alternative practitioners simultaneously and would continue to do so after starting treatment.
I learned, as all children with asthma do, certain practical things about my condition. I noticed, for instance, that attacks were more likely to happen at night. I learned that during an attack, sitting up made it easier to breathe than lying down. I discovered that, with practice, I could make wheezes sound like bird calls (mild attacks could be boring affairs). I found out that exercise and prolonged bouts of laughing were guaranteed triggers. I determined conclusively that ice cream did not, in fact, have anything to do with my asthma attacks, though my father has never accepted this fact. I realized I never had asthma attacks when we visited my country of birth – the place I still thought of as home and missed terribly – during school holidays. I noticed that whenever my cousins from there came to visit us, I would inevitably have an attack the night they left to go back.
When I finally did get nebulized, sometime in the late nineties, and felt my chest relax within seconds, it was nothing short of a miracle. A few months later I got my first inhaler, and monthly midnight hospital visits ceased. My asthma eventually waned and disappeared, as childhood asthma does, but it taught me lessons that no textbook or lecture did, and I now realize how, in many ways, it shaped the physician I became. It taught me the body and mind cannot be thought of as separate entities. That tradition and faith are intertwined with health and disease everywhere, and people may hesitate to talk about how they feel their beliefs intersect with their health for fear of not being taken seriously. That seeking care, for many people, does not necessarily equate to going to a hospital or clinic. That migration and displacement affect people in ways that are not always obvious. That the same disease can be experienced very differently by two people based on where they live and what resources are available to them. That listening—not just to the complaints patients have, but the context their disease evolved in—makes a great deal of difference to the care we can provide and the level of trust and comfort they have in us. It can help us fight medical misinformation with empathy, and without making patients feel criticized or demeaned.
My asthma is a thing of the past, but some aspects of it never quite went away and linger on to remind me of what it taught me. Laughing too hard makes my airways a little irritated, strong emotions make my throat close up, and I still feel a pang of doubt before I eat ice-cream. Someday, perhaps, I will be able to overcome my own superstitions, and partake of any flavor of ice cream I desire.
Sheethal Gloria Oommen is a physician from Malaysia and an aspiring poet/author. She recently moved to the United States and hopes to become a psychiatrist. Growing up in a family that relocated frequently for work, she lived, studied and trained in various countries and became a keen observer of human behavior and cultures. Her writing and approach to medicine reflect these insights and her commitment to dispelling medical and scientific disinformation.