Into thick air

girl with an asthma inhaler
Photo: ScienceMag.org

My aunt would lie on her side on raised pillows, wheezing. She would speak between coughing and wheeze some more. Then she would pull out— what I considered a toy as a child— an inhaler, clamp it in her mouth and press, then suck in for a while before repeating. She would fall asleep when the wheezing eased.

I would soon learn her toy was actually an asthalin inhaler for asthma patients. And in the years that followed, I would soon be using them.

As a school girl, my bag had a pile of books like most children going to mediocre private schools in Kathmandu do. Nestled between them, always, was the inhaler, reading “salbutamol” on its label. I was likely to forget my lunch box some days, but never my inhaler.

My memory of how I first experienced an asthma attack is feeble. But I remember hearing the same wheezing sounds my aunt used to make, from inside me and thinking: okay, so this is what it was. My chest would feel tight, as though it was contracting to squeeze the breath out of me. And I would feel like my nose had stopped breathing in the air.

A puff, and I would slowly relax and go to sleep— incomplete homeworks giving me nightmares.

During Games classes, I mostly stood under the trees watching other children play. Running around left me quickly out of breath. But not being a participant in the sports my friends played, also made me feel left out. It gradually shaped my personality as a ‘loner’, pushing me into a place of introversion.

As a teenager, when I was studying in Darjeeling, India, the attacks suddenly stopped. It felt like a miracle, but mostly like my lungs had finally been set free. I would walk up and down the hills with classmates, or alone, breathing in the pine trees, and the moist air that carried nothing of the hydrangeas, azaleas or orchids, but pure rain. I lived.

But the one time we went down to Calcutta for a mock-parliament event, my lungs were clogged again. I felt a heaviness I had not missed. Only, it was worse than the feeling I had experienced in Kathmandu. I longed for the Darjeeling sky.

My trajectory as an asthmatic child was shared by my sister. But as someone who has mostly lived in Kathmandu, she graduated from asthalin to rotohalers and occasional nebulizers. As a working woman who rides around on her scooter through Kathmandu smog most days now, she is constantly coughing and wheezing. They have become a part of her countenance. What has it done to her lungs? I dread I will have to find out.

I read somewhere that our lungs grow to their best extent when we are children and much of our adult life depends on how much they expand in the first few years of development. At five, my nephew is already experiencing breathing difficulties. I cringe when I think of the possibility of him having to experience a childhood that is shackled by breathlessness, as the Air Quality Index constantly hovers close to 200.

Every time I read the index, I happen to think of my late grandmother, another asthmatic in the family. She would climb up the stairs slowly to get to the kitchen on the fourth floor and collapse at the landing every single time, sitting there for a long while to catch her breath before saying a word. In the last years of her life, she needed a constant supply of oxygen, blown into her nostrils through a thin pipe that she wore like a halter around her face. It left a permanent dent on her cheeks.

I recall her sitting still on her bed, moving as little as possible, because movement would leave her out of breath. When she passed away exactly ten years ago, Kathmandu air was still not as terrible as it has now become. There were still mornings when we would still wake up to the mountains. Now, we wake up to haze almost all the days.

My aunt, who goes on morning kora around Boudha Stupa every morning tells me there is always a layer of thick black particles on her jacket when she comes back from the perambulation. It has become the new normal. And she tells me, “Maa would not have survived the dust that Kathmandu has become. It’s a good thing she didn’t live to see what we have come to.”

Pratibha Tuladhar

writer