Kaitlyn Hung
The prickle of outdoor air dances through my nostrils, its unfamiliar temperature and humidity filling my lungs. I inhale—diaphragm, chest, stomach—in in in. I exhale—whoooosh–pushing the air out out out that same path with a powerful contraction of my diaphragm muscles. A heavy sense of calm coats my body and mind. I breath in, chest expanding to pull air into my lungs, and then… chk. The catching of my breath. Like a blockage in my esophagus, stopping the air from passing. Hssssss. Air tries to infiltrate the blockage in a harsh, jagged effort. I hear a whistling wheezing as I try to inhale, slowing the breath down into an infinitesimally small stream, as if that would allow just the right amount of air to pass into my lungs in a smooth swoosh. But then … chk. The passage fully closes, and no more air goes through. But, the inhale continues, not having registered this fact, and a vacuum is generated, negative space that must be filled. The cough bubbles up from deep inside, pushing up up up. I try to stop it, to claw it back down from where it emerged, but it cannot be stopped. In a final surprise attack, the breath erupts out in a massive, crackling cough, filling the silent classroom as we listen to the droning chemistry lesson. Or the Spanish presentation. Or the English reading. Heads spin. Stare. Voiceless whispers of does she have covid, oh she’s sick!, an imperceptible leaning away, shifting over, my breathing or lack thereof filling others with fear and discomfort. My next inhale is a crackly mess, followed by a series of gradually quieter coughs. Smooth breath in, smooth breath out. My shoulders drop and I fall into the chair in relief. What was the teacher saying? Breath in, breath out. Two breaths later, it starts again.
…
I laid in the CT scan machine in one of those transportable rooms that could be a library or a science classroom. The machine was white, the walls were white, not a single painting of smiling kids or a peaceful landscape marring their blankness. The machine whooshed back and forth in a series of clicking noises as I tried to hold still, radiation passing through skin and bones to convey what lay within. After 15 minutes, the machine grew silent, and I walked out of the portable with anticipation and hope, plus a side of increased cancer risk.
Three days later, I was back in the hospital to review the results. At 20 years old, I was decades younger than the patients around me. What was wrong with me? What had I done to end up here? In the exam room, the doctor scanned her card to access the blocky computer. With two clicks, she opened the images, revealing a canvas of the night sky, light sparkling out of darkness and streaking across the sky like a shooting star. Except, the sky was my lungs and the stars were blood vessels and airways. She pointed at the screen, describing how the little white circles were blood vessels, pumping oxygen from the lungs out to the rest of the body. Next to them lie the bronchioles, the airways transporting oxygen from the atmosphere into my tissues. At the base of my lungs, the circles grew bigger, the airways surpassing the blood vessels in diameter. Pointing at these circles, the doctor declared: You have bronchiectasis.
Brachiosaurus? I asked.
150 million years ago, tromping through the flat prairie grasses, roaming the coniferous forests and arid plains of what would become North America, lived the Brachiosaurus. Each stomp left a deep, rounded imprint in the packed soil, four little claws poking out from the top, the weight of 62 tons compressing the earth. From 35 feet up, the world looked a little different. The gingkos, cycads, and seed ferns were tasty morsels, chunks to be swallowed whole. Birds were tiny pests, and even the mountains seemed climbable, if not for the energy required to move each unthinkably heavy leg. While the Brachiosaurus might be known for its iconic neck, gliding through the air in its full 30-foot majesty, it is named for its interestingly proportioned arms. Scrap the image of tiny T-rex arms, short and silly; the Brachiosaurus had long, thick arms, extending far past its hind legs to give it the name arm lizard. Perhaps a bit rude to describe one of the largest dinosaurs to ever exist. It held that title until the 20th century, when the fossils of the Argentinosaurus revealed a creature 10 tons heavier and 40 feet longer. Regardless, the Brachiosaurus holds a special place in our hearts as a gigantic, peaceful herbivore with a ridiculously long neck.
…
As a kid, I was always moving. I have three generations of monkey in my family according to the Chinese zodiac calendar—my grandfather, Yeh Yeh, my dad, and my sister—and though I’m technically a horse, monkey certainly runs in my blood. I was climbing out of my crib by age 1 and doing the monkey bars at 2. I tried all the sports. I grew up in a neighborhood where sports weren’t simply a fun hobby, but a ticket to the top colleges, if you were good enough. I bounced from the Yellow Jacket soccer team to Meadow Swim and Tennis; I tried ballet and tap and jazz and hip hop; I ran around the bases in T-ball. When it became clear my hatred of cold water and early mornings wasn’t going to fade, I started lacrosse, my dad’s sport. We’d watch recordings of Northwestern’s women’s lacrosse team win victory after victory, my dad commenting on their smooth plays. Did you see that cut? Look, #2 is wide open! Ground ball, ground ball!
I never knew how to answer those questionnaires: Are you more out of breath than your peers? The question stood quietly on the page, innocently accusatory. What if I answered yes, but there was nothing wrong with my lungs and I was simply out of shape? Though I’d never been the best at any sport, I’d always been moving. The monkey energy fueled my activity, from swim and lacrosse, to lacrosse and taekwondo, to taekwondo and crew.
In the end, I responded truthfully: I don’t know. I was too busy sprinting across the field watching the yellow lacrosse ball to know. If you were huffing and puffing to get across the field, the solution was two more laps around the field. The fastest sport on earth, my coaches would say. The state of your lungs didn’t matter. Can you run across the field? Go do it, and then do it again.
…
I watched Avatar the Last Airbender for the first time in high school at the prompting of my friends, who were shocked I’d never seen it before. I had always liked to think about my element—would it be fire, earth, wind, or water? The obvious choice was water—I’d been a swimmer for much of my childhood and an islander in the wet shadow of Seattle. Or perhaps it was earth. You couldn’t separate me from the land—I was always hiking, naming trees and fungi, eating edible berries off the trails. But there was something about wind, forbidden yet compelling. Maybe it was the bias of Avatar—Aang the Airbender was the star of the show, after all.
I’d be running (or rowing, or biking), when all the sudden, a strong gust of wind would sweep through, disrupting the quiet air with a powerful headwind. Each step forward (or stroke, or peddle) required immense force to overcome the resistance, ten times harder than it’d been a second ago. The whooshhh drowned out all sound, until it was just me and the wind and my movement. I’d have a clear view ahead, all my pesky baby hairs swept away, if not for the sharpness of the wind causing me to squint, the world reduced to a blurry sliver. Was it the force of the wind slowing me down to a crawl, or the force of me on the wind, so fast I created my own barrier?
Most times, though, air worked against me. It didn’t like being trapped in a damaged maze of airways. It sought freedom, a way out, even if it cost me a coughing fit. We’d fight—me, holding my breath, trapping the air in stagnation as I held the muscles around the lungs tight, and the air pushing up up up, forcing the muscles to contract, to expand the lungs, to let in a new breath and let out a raggedy cough as air escaped to the freedom of the atmosphere. Air won, every time.
…
The lungs are an amazing organ. 15 times per minute, air from the atmosphere is sucked down into the lungs, traveling through a maze of increasingly narrow branching tubes until it reaches a dead-end. One of 375 million dead-ends, to be exact. The oxygen passes ghostly through the walls, off to fuel our tissues. It waves goodbye to carbon dioxide, who makes the opposite journey, up and out into the atmosphere. It brushes past little feather dusters waving gently back and forth, anchored onto airway tubes like the floor of an ocean. Mucus bounces from duster to duster, an elevator out of the lungs, catching dust and pathogens on the way. This creates a built-in defense system, keeping the airways clear and functioning.
But… what if the tubes were a little wider? Just a smidge, less than a millimeter? The feather duster elevator would cease to function, smothered by mucus, a permanent resident of the airways. Pathogens, no longer transported out, would begin to spread and multiply, launching a full-on infection. Air would no longer smoothly travel through the airways, and the breath would come out in a wheezing cough.
Such a small change disrupts the whole system. Now expand that 10,000 times. How can a single organ support the mass of a gigantic brachiosaurus? Oxygen must reach from the tips of its tail all the way to its tiny head, 82 feet away. An impossible feat of nature.
Enter: super lungs.
150 million years ago, a different mix of molecules floated through the space we call air, 5-10% less oxygen than we breath in now. Couple that with the gigantic size of the brachiosaurus and you’ve got a real dilemma on your hands. First, get rid of the inefficient pumping of air in and out, then bind the lungs tightly to the rib cage and diaphragm, a rigid structure allowing oxygen to continuously stream into the lungs and out to the blood stream, and you’ll get super lungs. Now, only birds, the living ancestors of dinosaurs, have anything near these super lungs, powering their flight. If you could have any superpower, what would you choose? they asked in school. I probably said something silly like invisibility! or super speed! If I could go back, I’d answer super lungs.
…
There is no treatment for bronchiectasis. The damage to the lungs is permanent. The best the doctor could say was exercise more. With forceful enough breathing, the pace of inhalation-exhalation could drive the mucus up up and out of the lungs, keeping it clear and infection-free. Exercise more? I’d done four hours of sports daily throughout high school, amid wheezing and coughing. How could I keep up that routine in college, with classes, clubs, and building community competing for my time?
Now expand out to the rest of my life. What does aging with bronchiectasis look like? Aging is not a recognized end point for the Food and Drug Administration, and few studies track disease and the effect of medication for long. Will old age bring infection after infection, constant wheezing and coughing? Will reduced lung capacity fail to fuel my monkeying around—my jumping and running and hiking and rowing? What is a future with no movement?
…
Spring, 65 million years ago. The grasses shivered as the last of the winter wind swept down from the mountains through the low prairie. Ferns stretched up towards the spring sun and horse tails danced in the breeze. The great stomp of the magnificent Brachiosaurus echoed through the open plain as it crushed grasses underfoot, trekking towards the conifer forests in the distance. Meanwhile, a giant rock from space, nine miles in diameter, crested through the sky, arcing through the solar system to reach our planet. A faint rumbling in the distance grew louder and louder, the ground beginning to vibrate, until suddenly, the earth was shaking underneath the Brachiosaurus’s feet, deep quakes seemingly emanating from miles below. The Brachiosaurus’s square base, steadily holding up its long, heavy neck, shifted slightly off balance, neck swinging just a little too far to the right. The Brachiosaurus began to fall, crashing into the ground in a boom that is silent amid the shattering world. Though it was midday, the sunlight dimmed, casting a shadow over the prairie as soot and silicate dust, no bigger than a micrometer, rose into the air. In the day after the impact, the Brachiosaurus rose and tended to its injuries. But as the dust settled in the atmosphere, the plants stretched higher and higher to seek out sun that was not there, wilting and growing pale, decaying on the prairie floor, no new sprouts to take their place. The seeds lay dormant in the soil, waiting for a signal from the sun that would not come. The Brachiosaurus grew hungry, its beloved ginkgo and cycad trees nowhere to be found, it too, withering in the shadows. It took 15 years for the soot to finally clear, for the sun to peek out again and grace the Earth with its warmth.
Was wind the Brachiosaurus’s element? Did it feel powerful as it swung its 30-foot neck through the air? As it trudged through the open prairies, alone with the wind, tens of feet above the rest of the world? As it absorbed the wind, oxygen coursing through its super lungs to power its movement? Was the wind its companion, its friend, its medium?
In the end, wind was the Brachiosaurus’s downfall. When the silicate dust and soot rose into the atmosphere, the wind didn’t blow it away, returning it to its home in the earth. Rather, it welcomed the dust for 15 full years, dancing and mingling together until wind and dust were indistinguishable. Their friendship blocked out the sun, killing the conifers beloved by the Brachiosaurus, until the dinosaurs starved and became lost to the world, forever.
We are left searching for their stories in buried fossils. Most dinosaur fossils are of decay-resistant, mineralized bones, or occasionally a feather or an egg. Lungs, on the other hand, are a soft tissue, a fragile organ breathing life into their bodies. Their easy decomposition means preservation requires special circumstances—rapidly burying the soft tissue with sediment in the absence of oxygen. Combine that with the huge size of the Brachiosaurus and you get a very rare event. Indeed, no dinosaur lung fossils has been discovered, the closest being the lungs of birds that flew alongside the dinosaurs 120 million years ago. Instead, paleontologists spend their lives piecing together the stories of the dinosaurs from the bones up. In discovering fossils of a costovertebral joint and a set of ribs, they deduct a structure that would support rigid lungs. The paleontologists must hypothesize, imagine, and create a lung structure supported by these bones, for the definite facts are forever lost to us. They step into the dinosaur, try on the rib cage, the vertebrae. They feel the lungs pushing air into their body, not pumping but rather pulling in oxygen continuously. They empathize with the dinosaur, with the full 60 feet of length, of what it might be like to tower over the world, each step a mini earthquake.
…
Last year, I had to change my health insurance, leading to hours-long calls with robots and sometimes humans. Somehow, the inhalers I’d been taking for the past five years were no longer supported, forcing me to switch to a new medicine, this time a fun purple circle inhaler. After two weeks, my inhales and exhales were smooth and straightforward. I no longer constantly thought about breathing, conscious of my impact on the classroom, the gym, my roommates. I basked in this phase, certain it would fade, like it always did. But the months passed, and the smooth breathing stayed. The inhaler molecules continued to bind their receptors, relaxing the airways, giving air the freedom it desired.
I had never felt seen, truly seen—not in viewing my lungs for the first time, radiation transposed to pictures; not even in the official diagnosis, in reading the scientific literature describing the biology of the condition. Yet, somewhere in the world, a team of chemists and biologists had come together to design this medication. Though they had not met me or seen me or heard of me, they had designed this drug, seeing into my lungs and all those like me. In science, there is empathy. Though the Brachiosaurus is long extinct, it is not alone. 160 million years after the Brachiosaurus’s last breath, scientists around the world dig and poke and polish their fossils, imagining their world, their structure, their essence. In studying the innerworkings of lungs, the absorption of oxygen that unites all animals, we become united across space and time—connected.
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Kaitlyn Hung is a fourth-year studying biology and data science. When she’s not researching microscopic nematodes, she enjoys practicing Taekwondo, going for walks, and trying new crafts!
