It will take the average reader about 10,000 breaths to read from here to the end of the book. If I’ve done my job correctly, starting now, with every breath you take, you’ll have a deeper understanding of breathing and how best to do it. Twenty times a minute, ten times, through the mouth, nose, tracheostomy, or breathing tube, it’s not all the same. How we breathe really matters.
By your thousandth breath, you’ll understand why modern humans are the only species with chronically crooked teeth, and why that’s relevant to breathing. You’ll know how our ability to breathe has deteriorated over the ages, and why our cavemen ancestors didn’t snore. You’ll have followed two middle-aged men as they struggle through a pioneering and masochistic 20-day study at Stanford University to test the long-held belief that the pathway through which we breathe—nose or mouth—is inconsequential. Some of what you’ll learn will ruin your days and nights, especially if you snore. But in your next breaths, you’ll find remedies.
By your 3,000th breath, you’ll know the basics of restorative breathing. These slow and long techniques are open to everyone—old and young, sick and healthy, rich and poor. They’ve been practiced in Hinduism, Buddhism, Christianity, and other religions for thousands of years, but only recently have we learned how they can reduce blood pressure, boost athletic performance, and balance the nervous system.
By your 6,000th breath, you will have moved into the land of serious, conscious breathing. You’ll travel past the mouth and nose, deeper into the lungs, and you’ll meet a midcentury pulmonaut who healed World War II veterans of emphysema and trained Olympic sprinters to win gold medals, all by harnessing the power of the exhale.
By your 8,000th breath, you’ll have pushed even deeper into the body to tap, of all things, the nervous system. You’ll discover the power of overbreathing. You’ll meet with pulmonauts who have used breathing to straighten scoliotic spines, blunt autoimmune diseases, and superheat themselves in subzero temperatures. None of this should be possible, and yet, as you will see, it is. Along the way, I’ll be learning, too, trying to understand what happened to me in that Victorian house a decade ago.
By your 10,000th breath, and the close of this book, you and I will know how the air that enters your lungs affects every moment of your life and how to harness it to its full potential until your final breath.
This book will explore many things: evolution, medical history, biochemistry, physiology, physics, athletic endurance, and more. But mostly it will explore you.
By the law of averages, you will take 670 million breaths in your lifetime. Maybe you’ve already taken half of those. Maybe you’re on breath 669,000,000. Maybe you’d like to take a few million more.
Part One
THE EXPERIMENT
One
THE WORST BREATHERS IN THE ANIMAL KINGDOM
The patient arrived, pale and torpid, at 9:32 a.m. Male, middle-aged, 175 pounds. Talkative and friendly but visibly anxious. Pain: none. Fatigue: a little. Level of anxiety: moderate. Fears about progression and future symptoms: high.
Patient reported that he was raised in a modern suburban environment, bottle-fed at six months, and weaned onto jarred commercial foods. The lack of chewing associated with this soft diet stunted bone development in his dental arches and sinus cavity, leading to chronic nasal congestion.
By age 15, patient was subsisting on even softer, highly processed foods consisting mostly of white bread, sweetened fruit juices, canned vegetables, Steak-umms, Velveeta sandwiches, microwave taquitos, Hostess Sno Balls, and Reggie! bars. His mouth had become so underdeveloped it could not accommodate 32 permanent teeth; incisors and canines grew in crooked, requiring extractions, braces, retainers, and headgear to straighten. Three years of orthodontics made his small mouth even smaller, so his tongue no longer properly fit between his teeth. When he stuck it out, which he did often, visible imprints laced its sides, a precursor to snoring.
At 17, four impacted wisdom teeth were removed, which further decreased the size of his mouth while increasing his chances of developing the chronic nocturnal choking known as sleep apnea. As he aged into his 20s and 30s, his breathing became more labored and dysfunctional and his airways became more obstructed. His face would continue a vertical growth pattern that led to sagging eyes, doughy cheeks, a sloping forehead, and a protruding nose.
This atrophied, underdeveloped mouth, throat, and skull, unfortunately, belongs to me.
I’m lying on the examination chair in the Stanford Department of Otolaryngology Head and Neck Surgery Center looking at myself, looking into myself. For the past several minutes, Dr. Jayakar Nayak, a nasal and sinus surgeon, has been gingerly coaxing an endoscope camera through my nose. He’s gone so deep into my head that it’s come out the other side, into my throat.
“Say eeee,” he says. Nayak has a halo of black hair, square glasses, cushioned running shoes, and a white coat. But I’m not looking at his clothes, or his face. I’m wearing a pair of video goggles that are streaming a live feed of the journey through the rolling dunes, swampy marshes, and stalactites inside my severely damaged sinuses. I’m trying not to cough or choke or gag as that endoscope squirms a little farther down.
“Say eeee,” Nayak repeats. I say it and watch as the soft tissue around my larynx, pink and fleshy and coated in slime, opens and closes like a stop-motion Georgia O’Keeffe flower.
This isn’t a pleasure cruise. Twenty-five sextillion molecules (that’s 250 with 20 zeros after it) take this same voyage 18 times a minute, 25,000 times a day. I’ve come here to see, feel, and learn where all this air is supposed to enter our bodies. And I’ve come to say goodbye to my nose for the next ten days.
* * *
—
For the past century, the prevailing belief in Western medicine was that the nose was more or less an ancillary organ. We should breathe out of it if we can, the thinking went, but if not, no problem. That’s what the mouth is for.
Many doctors, researchers, and scientists still support this position. There are 27 departments at the National Institutes of Health devoted to lungs, eyes, skin disease, ears, and so on. The nose and sinuses aren’t represented in any of them.
Nayak finds this absurd. He is the chief of rhinology research at Stanford. He heads an internationally renowned laboratory focused entirely on understanding the hidden power of the nose. He’s found that those dunes, stalactites, and marshes inside the human head orchestrate a multitude of functions for the body. Vital functions. “Those structures are in there for a reason!” he told me earlier. Nayak has a special reverence for the nose, which he believes is greatly misunderstood and underappreciated. Which is why he’s so interested to see what happens to a body that functions without one. Which is what brought me here.
Starting today, I’ll spend the next quarter of a million breaths with silicone plugs blocking my nostrils and surgical tape over the plugs to stop even the faintest amount of air from entering or exiting my nose. I’ll breathe only through my mouth, a heinous experiment that will be exhausting and miserable, but has a clear point.