Breathless on Sullivan Hill
It felt so good to be healthy.
I was on my first bike ride of the spring, and my body was performing magnificently. My legs were pumping hard, my heart was beating fast, and I was breathing better than ever. The air was lightly perfumed with the smell of flowers, and I breathed it in with huge, luxurious breaths until my lungs were full. It was a bright day, and as the sun shone down on me, I felt as though its warmth soaked into my skin and nourished the bones, joints, and muscles that made it possible for me to ride. Even my imagination flourished. One moment, I was a pioneer girl traveling across the prairie in a covered wagon, and the next, an explorer looking for the best spot for a new settlement. My spirit soared, my heart swelled, and I felt fully alive.
I also felt incredibly lucky. When I was just three years old, I was diagnosed with severe asthma, and it was only now as a teenager that I could do something as strenuous as taking a long bike ride. Most of my attacks were brought on by exercise, but they could also be caused by sinus infections, colds, allergies, and even laughing spells. I’d had countless attacks, and on more than one occasion, my life had been in grave danger.
My worst attack happened when I was very young—around six or seven years old. I’ve been told that I turned blue-gray from lack of oxygen and that the doctors in the ER took one look at me and then rushed me to the ICU. I don’t remember everything from the experience, but I do remember the day the phlebotomist came in to perform a blood draw. She wasn’t there to collect the usual venous blood, though. She needed arterial blood for blood gas analysis, and in order to reach the artery, she had to dig the needle deep inside my wrist. She couldn’t find it at first, so she plunged it in farther and farther until my bright red arterial blood began filling the syringe. The pain was excruciating, and the sight of it all made me break out into a cold sweat and nearly faint.
I have plenty of other memories from my attacks. I remember my dad weaving in and out of traffic and running red lights to get me to the ER as fast as possible. I remember rushing off stage during dance practice and staggering down the aisles to get to my inhaler. I remember the daily chest percussions, the twice-a-day breathing treatments, the long-term steroids and their accompanying weight gain and mood changes, and the sickening smell of coughed-up mucus. Once, we left my medicine in a parking lot on our way to Colorado, and my dad, exhausted from driving, paid a young man to drive an hour there and back to retrieve it. I remember teaching my friends how to use my EpiPen in case I was in such bad shape I couldn’t do it myself. When I was in third grade, I missed six straight weeks of school, and my teacher told my parents that I might have to be held back. I also missed being able to do things I wanted to do, like going on vacation with my best friend, roller skating at birthday parties, and going to the rodeo.
The only positive thing was that I was blissfully unaware of how dangerous my condition was. I didn't know that what caused my attacks was something so frightening as my airways closing up. It never crossed my mind that an attack could get so bad that I wouldn’t be able to breathe at all. And I certainly didn’t understand that people—even children—sometimes die from asthma.
Now, as a teenager with bigger lungs and more spacious airways, my asthma was finally under good control.
So, on that day, I was having such a wonderful time speeding along the trail and dreaming about enchanting people and places that I almost didn’t notice when the problem started. I was pedaling hard, having fun, breathing well, and then, there was a subtle change, a tightness through the chest, and breathing became just a bit more difficult.
I wasn’t too concerned. These little episodes were not unusual. They generally didn’t last long, and, in fact, I’d almost gotten to the point of ignoring them entirely. But I was conscientious, so I stopped the bike and began thinking about how to best get home.
I had two choices. One was to simply take the trail back the same way I’d come. It was an easy ride—nice and flat—but it was also long. It would take me at least half an hour to get home that way.
The other option was a shortcut. Sullivan Hill was a city street that cut a direct path between the trail and our house, and I estimated I could be home in fifteen minutes or less if I went that way.
There was a big disadvantage to Sullivan Hill, though: it was really steep. I think it was technically at a 17% gradient, but to me, it looked like it went up at about a 45° angle. Going down Sullivan Hill was pretty fun, but going up was hard, even in a car. Once, right after we’d loaded the car with grass pallets, my mom ran out of gas at the halfway point, and the car began rolling backward. It would have gone all the way to the bottom if my mom hadn’t slammed on the emergency brake as quickly as she did. I was in the car that day, and it frightened me so much that I’d stayed away from Sullivan Hill ever since.
But given my situation, I decided that the shortcut was the better choice.
Riding up Sullivan Hill was out of the question, so after making my way to its base, I hopped off the bike, leaned my full weight into it, and began to push.
Things went well at first. My breathing stabilized, my muscle fatigue improved, and I even began daydreaming again. Going uphill wasn’t easy, of course, but my legs were still strong, and I was able to maintain a good pace. I felt confident that I could make it to the house before my asthma got out of hand.
It wasn't long before things took a turn for the worse, however. The chest tightness that up to then had been just a nuisance progressed to the point that I couldn’t breathe in deeply enough to get air to all parts of my lungs. Then I started wheezing. It was soft at first, but it got louder and louder until I sounded like a blaring harmonica. I began breathing faster, too, and in order to get slightly more air, I’d started leaning over my bicycle handlebars. There was no doubt about it now. This was a bona fide asthma attack. And it was the first attack I’d had alone, without a way to contact anyone.
That’s when I reached for my medicine. And when I didn’t find it, my blood went cold.
I didn’t want to believe it. How could it be true?! I was mature and responsible—not the kind who’d leave her medicine behind. I’d been told over and over to take it with me wherever I went—and I always did.
In disbelief, I tore the medicine pouch from my waist, ripped back each zipper, and began a frantic, second search. My fingers shoved their way past crumpled bills, loose change, and other unessential items, grasping for my inhaler. At one point, I closed my eyes, and it seemed like it was just right there. I could practically feel my fingers wrapping around it, its mouthpiece between my lips, and the cool gust of albuterol rushing through my mouth and into my lungs.
But it was no use imagining. The medicine was not there.
My arms went limp, and the medicine pouch dropped to the ground. I stared blankly at it for some time, and then, a violent anger erupted within me. How could I have been so stupid?! How, after all I’d been through—the missed school days, the hospitalizations, the ICU stay?!
I wanted to cry. I wanted to shout out at the cars passing by to please stop and rescue me. But, by that point, I was already too short of breath to cry or shout. And even if I weren’t, I couldn’t afford to waste time. This attack was moving fast, and, without my medicine…
My eyes suddenly grew wide, and a horrific shiver went through me. What will happen without my medicine? How am I going to do this? How on earth am I going to get up that huge hill without my medicine? What if I can’t…?
Don’t think about that, Christine! You WILL make it. You will! But you need to calm yourself down first. You must stay calm. Getting upset will make things worse—it always does, and you simply cannot let that happen now. You must try your hardest to take slow breaths. I know you want to rush, but don’t do that, Christine—that will make things worse. Slower breaths, Christine, and every time you breathe out, say a word in your mind, any short word. Do that every single time, and you will calm down. Just take one step at a time, and you will get home. And when you get home, you will be fine. Just get home, and then you’ll be fine.
As I feared, the attack progressed quickly. By the time I was two-thirds of the way up the hill, breathing required so much strength that I was straining the muscles in my neck, shoulders, and chest to pull in air. Every breath was shallow, and, despite telling myself not to, I was breathing faster and faster. I was young and strong, but this was a rough, jolting, high-energy way to breathe, and before long, I was tired.
It got to the point where I couldn’t walk without needing to stop and rest. At first, I could go every couple of minutes before taking a break, but soon it was every minute—and then, every 30 seconds. Each time I rested, it got harder and harder to get going again. My lungs begged for more time, pleading with me to lie down, to give them a decent chance to improve.
I wanted to listen to them. I was growing desperate for a deep breath, and maybe if I stopped fighting so hard, I would get one.
But I knew I shouldn’t. I knew it with certainty, all the way down to my core. If I stopped, the attack would continue, my breathing would get worse and worse, and unless someone just happened to find me, I could die. Really, truly die. Right there, on Sullivan Hill, in broad daylight, at just sixteen years old.
That just couldn’t happen.
So, somehow, I found the strength—and the air—and I fought. I strained and heaved and pressed my feet into the asphalt again and again and again, and very, very gradually, I conquered that hill.
By some miracle, our back door was unlocked, and I stumbled into the house, gasping for air, and nearly doubled over. My purse with the medicine inside was on the kitchen table, right by the door, and with my remaining energy, I tore it open, grabbed the EpiPen, and slammed it against my thigh. I then grabbed the inhaler and, exhausted, half-crumpled, half-fell to the floor. I lay there motionless for a few seconds, and then I thrust the inhaler between my lips and plunged down on the canister over and over and over as fast as I could.
I lay there sprawled out on the floor for quite some time. As the epinephrine coursed through my body and the albuterol spread through my lungs, my wheezing stopped, my breathing slowed, and I felt all of my airways—both big and small—open. My heart was racing so fast it felt like it could explode, but I’d made it. The attack was over.
I turned onto my back and stretched out as far as I could, my fingers and toes reaching for the far corners of the room. The cool, tile floor felt good beneath my back, and I soon felt the panic and the terror of the day subside. I looked up and saw a few rays of sunlight spreading across the ceiling. I gazed at them for some time, and then, when I was ready, I closed my eyes, smiled, and took a deep breath.
The End
Christine Benton Criswell is a writer and physician in San Antonio, Texas. Her work will soon be featured in this year’s edition of Connective Tissue, the literary magazine for UT Health San Antonio. In her spare time, she enjoys reading, practicing taichi, and watching silent comedies.
