THE NEXT BREATH
September 10, 2012
By Kate Dernocoeur
Editor’s Note: Kate Dernocoeur is no stranger to dangerous and frightening situations, but this story, she said, reflects her most frightening experience, ever. Her survival wasn’t a sure thing for several minutes, and she evokes that desperation in her story.
One minute you’re in the kitchen, at maybe 9:00, 9:30 p.m., after you get home from school, famished. The under-counter TV is on while the water heats for tea. Your thoughts are maybe on the events of the day, maybe what you need to remember for tomorrow. You don’t really notice.
You pop open the fridge looking for something, anything, to eat. Something quick, to tide you over ’til morning. You see the leftover couscous still in the cooking pan, yeah, that’d be good. You reach for a fork and take a bite. You’re just doing what you always do, grabbing a bite before heading upstairs.
One minute, it’s all everyday, no big deal.
Then you realize something is not right. Suddenly, nothing matters—not the TV, not the fact that you’ve been lazy about your diet lately, not the inbox of e-mails upstairs. What suddenly matters is this: You can’t breathe.
This has a name. It is an airway obstruction. You have a full airway obstruction. What the heck? From a quick, casual bite of couscous? One minute you’re going for a forkful of the stuff, and the next, you can neither breathe out nor breathe in. You try. You cannot. The breeziness of two moments ago has died abruptly. The altered world threatens you as surely as a snake coiled and rattling—except you can’t even make a sound.
With breathing comes so much: shouting joy for a beautiful day, speaking one’s mind, and whispering, “I love you” to a sleeping child. Without it, you feel like you are looking at the kitchen through the wrong end of the binoculars. Without it, the lights are too bright, the TV too loud, the degree of instant desperation too shocking.
You know the dynamics here; you’ve studied airways, opened many in your years as a paramedic. It’s the first, most important thing in the flowchart of resuscitation: A-BCs. Airway, Breathing, Circulation.
This patient—YOU—does not have an airway. God!
A flood of neon-lit thoughts pour in. Can you make it over to the neighbor’s condo? What if they aren’t home? If you go out there, you’ll only have enough residual to try knocking on one door along the row. Can you risk the energy to try? Would they even know what is wrong, what to do? It’s January out there, bitter cold. If you collapse on the sidewalk, you won’t be found in time.
How can this be happening?
Can you move any air? You pull, hard, with your belly. It’s like sucking on a plastic water bottle; your ribcage collapses in, but no air moves. You press out, but nothing!
The memory of that time you had a bad moment choking on—of all things—a raspberry at a restaurant comes up. That was a partial obstruction, and the effort required to move air created a high-pitched squeak that silenced the rest of the tables. People turned to watch, wondering “What in the world?” Your friend was preparing to come around behind you to try the Heimlich maneuver when you finally—finally!—managed to suck in enough air to cough, once, twice, maybe three times, and then the moment was over. You departed quickly.
Now, there’s not even a pip of a squeak. Nothing. The silence in the house impresses you, the way it tries to smother the din in your head shouting, “Help, Help!”
You are alone. You are oddly concerned about the housemate finding you dead. This doesn’t seem very fair, after all. One minute you were just doing your everyday life. The next thing, your life may only have a minute left.
You’ve got to do something. Your body throbs with adrenalin. You are sheened with sweat. The room is raging hot, vividly bright. Your mind races. There is only one thing to try, and you might only have one chance. How many times have you practiced the logarithm? Thousands?
Open the airway. I’m trying. Got to get a breath. Got to get a breath. There’s no airway.
Heimlich yourself, go ahead. You’ve read the stories. It’s Reader’s Digest stuff, but people have done it; they’ve saved their own lives.
You eye the kitchen counter. Oddly, you recall installing it in the fall, admiring its pretty pattern. You step back from it, black stars beginning to dance across the scene. You place your right hand near the xyphoid and drop heavily against the edge of the brown imitation-granite counter.
“Uh!” A primal-sounding thing. A halfbreath of stale air expelled. Good! Air out means air in. Doesn’t it?
But no. You try inhaling until your ribcage aches. Nope. Nothing. The only sounds are the TV and a strange buzzing in your ears. Your muteness feels appalling. You lean over the sink, drooling. There’s a chance this might not go well.
You step back, dizzy. Position the hand again, habit entrenched from training. Maybe the in-and-up angle wasn’t quite right. Maybe you didn’t give it enough oomph. But that first time was surprisingly painful. Never mind. Do it again! You have to get that champagne cork thing going.
You ram into the counter again, hard, really, really hard, and it really, really hurts. You kinda collapse at the knees to achieve that drop angle, so the lungs have to compress.
“Uh!” There it is again, a sort-of grunt. You’ll take it. The drool is overwhelming. You lean over the sink, spit, spit again, and you tentatively try inhaling. Not too fast, easy does it. Alarm pulses through you still, but you’re hearing the high-pitched evidence of full-obstruction-turned-partial. Maybe, just maybe, this could end better than you were beginning to imagine.
You lean, spitting over the sink. The image of a filled balloon, opening pinched— that sound—comes to mind. You draw in with careful urgency. Please don’t close off again, please God let me breathe. Yes. Oxygen. Your heart is a drum accompanying the discord. Your belly sucks air, pulling hard, managing to deliver, little by little, some blessed relief. You manage a few throat clearing coughs. The lifeline is the size of a cocktail straw, but it’s enough for now. Head bowed, still drooling, you breathe. You breathe. You breathe.