Breath Taking: The Power, Fragility, and Future of Our Extraordinary Lungs; AND Breath: The New Science of a Lost Art

Book Title: Breath Taking: The Power, Fragility, and Future of Our Extraordinary Lungs

Author: Michael J. Stephen

Publication Information: New York, Atlantic Monthly Press, 2021, 311 pp., $26, hardcover

*****

Book Title: Breath: The New Science of a Lost Art

Author: James Nestor

Publication Information: New York, Riverhead Books, 2020, 280 pp., $28, hardcover

*****

“Shut your mouth… Breathe through your nose…. Exhale [fully]…. Chew [strongly]…. Breathe more, on occasion…. Hold your breath…. How we breathe matters.” (Nestor, pp. 201-214).

These points summarize guidance from one of two excellent new books on the topic of breathing. Such is the power of the breath that even a quick demonstration of deep breathing can be a revelation to a patient who is distraught. Our patients have often internalized the notion that anxiety or stress requires medication. However, clinical experience and abundant scientific research1 demonstrate how life changing it is when patients commit to the regular practice of deep breathing. Not only does their anxiety improve, but they experience a multitude of unexpected positive benefits, such as improved sleep and digestion, elimination of bruxism, and improved cardiovascular health.

Two recent books take very different approaches to the science and everyday relevance of breathing. Breath Taking: The Power, Fragility, and Future of Our Extraordinary Lungs by Michael Stephen, a researcher and pulmonologist at Thomas Jefferson University, is a professorial exploration of the lungs, the courage of patients in the face of devastating illness, and the importance of collaboration in the advancement of medicine.

Breath: The New Science of a Lost Art, by James Nestor, a science and sports journalist, takes a more journalistic approach in telling the story of “pulmonauts,” adventurers into the science and history of breath training. While Stephen’s book is a pleasant drive through a scenic landscape, Nestor’s New York Times bestseller2 is a roller coaster ride, bumpy and exhilarating.

Breath Taking opens with a review of lung physiology and the history of advances in pulmonology. The tales of researchers unraveling the mysteries of our lungs are engrossing, and leave the reader wanting more. For example, Stephen describes University of Toronto surgeon Joel Cooper’s fascinating quest to perform viable lung transplants, including his pivotal discovery that he could suture a bit of momentum around the bronchial connection (p. 208). Cooper’s passion and innovations increased the life expectancy of patients receiving lung transplants from a few weeks to the present average of 6½ years.

Breath Taking shines in its historical notes and its clinical anecdotes. Stephen tells stories of patients with cystic fibrosis, addressing their daily struggles with great compassion; he also devotes considerable attention to the possibilities and current limitations of gene therapies for these patients.

Stephen also advocates for innovative, interdisciplinary treatment of disorders of the airway. He introduces Kevin Neff, a successful salesman who lost his voice and his job after a viral infection. Diagnosed with functional dysphonia, Kevin struggled to adjust, and he began studying for a new career in finance. Despite having been told his condition was irreversible, Kevin was completely cured at the Cleveland Clinic Voice Center, where otolaryngologist Claudio Milstein massaged Kevin’s neck to break up scar tissue, and speech therapy helped him regain his voice (p. 198).

Stephen touches briefly on the history and science of yoga and deep breathing. He provides just enough information for the reader to understand how promising these techniques are. However, it feels like a missed opportunity in a book that is otherwise so satisfying, not to delve further into the impact of these techniques on our respiratory health. Stephen concludes with observations about COVID-19 and climate change, and how remaining healthy on this planet will require taking better care of our atmosphere and ourselves.

Breath: The New Science of a Lost Art is quite a contrast, when it comes to writing style, pace, and perspective. Nestor ventures into numerous unexpected avenues, shifting between science and personal experience. He interviews “pulmonauts” ranging from otolaryngologists and orthodontists to voice coaches, neuropsychologists, gurus, athletes, and opera singers. All agree: how we breathe matters, the health of our jaws and noses and sinuses and lungs are inextricable, and modern medicine is missing out on some very powerful healing methods.

Nestor himself participated in a study conducted by Jayakar Nayak, at Stanford, which found that enforced mouth-breathing for just 10 days led to profound worsening of cardiovascular and nasal health metrics, and these negative effects reversed once the subjects began breathing through their noses (p. 206). Breath is replete with information about breathing that will likely be new to even the most experienced clinician. As a clinical psychologist, I have been teaching patients breathing techniques for decades, and yet much was new to me. For example, Nestor explains how humming (p. 223) increases nitric oxide levels 15-fold, with associated health benefits. One recent commentary published in Microbes and Infection supported these assertions. It recommended studying humming and nasal breathing to improve outcomes in patients with COVID-19.3This book greatly heightens the reader’s awareness about everyday breathing and eating practices; it inspires us to think about how our patients are increasing their anxiety and decreasing stamina with poor breathing and chewing habits. Nestor delves into the topic of jaw health and its links with sinus health, citing anthropological evidence about how modern diets negatively affect our jaw shape and bone strength. These changes then worsen airway obstruction and sinus problems (p. 125). Nestor includes appendices containing detailed guidance on how to perform breath work effectively, and how to improve nasal and jaw health.

In summary, both books are well worth reading. Stephen’s is useful for physicians and those interested in medical history, and it deepens our appreciation of the complexity of our lungs. It highlights the courage and perseverance of lung patients and pulmonologists. Nestor’s is written for the general public, and is the more thought-provoking and practical of the two. I have already recommended it to patients and friends ranging from engineers to yoga instructors, and am incorporating some of its suggestions in my own life. I encourage interested colleagues to learn more about the power of the breath, in order to help our patients achieve the best possible health.