Asthma in the Family

Essay Dr. Aicha Hind Refai

A night shift in October. Asthma month. In the emergency room, the patients are everywhere. Lying on stretchers in booths, sitting on chairs against the walls in the corridors. Hair matted, faces half-hidden behind green masks, they endure attached to IV poles. Respiratory therapists move from one patient to the next, residents listen to chests and rest a reassuring hand on the arm of a patient. They talk to a relative or exchange views on how “tight” a patient still is.

Michael, the ER attending, leans against a wall and watches from the corner of the room. He knows which patient is not likely to walk out home tonight and will need a couple of days admission to the wards- and which one may go bad, need intubation and an ICU admission. He calmly waits.

Bob says, to no one in particular, “I am nervous”. He is the senior resident, always nervous in the ER; he suspects “one of these patients” is ready to take a turn for the worse. The way he says it, the patient is taking a turn to the worse just to spite him. He looks at me briefly and says, “You don’t look good”: something else he’ll have to worry about.

Asthma is a bad word in my family; I never heard it said aloud. My father grew up an orphan after his mother died of asthma in the 1930s: at age 8, he came back from school one day and saw women blocking the door to the house and packing the courtyard; that is how he found out his mother had died during an attack.

I don’t remember when we kids found out. The story was only briefly told, none of us had details and we could not bear to ask. Thinking of our father, a little orphaned boy coming home to a dead mother, provoked such intense sorrow that we in tacit agreement banished the word asthma from our vocabulary. We did not want to touch more pain.

I stood behind the counter documenting and watching monitors; the nurses handed me vital signs records - thoughts ran through my head. My father named me after his mother. I inherited her redhead but not her asthma. My father called me by her nickname and smiled when people commented I looked “so much” like her. I never wondered what

went on in his mind through all that. He was a calm and gentle man not given to brooding. Now I wondered where he hid the grief that we kids could not bear to approach.

My chest was tightening, and I felt faint. I pushed my body against the counter trying to steady myself. Bob slid quietly behind me, held me by the shoulder and steered me towards the exit. Michael waved us out and took over my spot at the counter. We stood in the cool evening air. Taking slow deep breaths, I visualized waves of air washing through me. Bob never said anything.

“I need to call my dad,” I said.

“In a couple of minutes. Breathe some more,” he answered.

On the phone, Dad's voice filled the space in my head. I knew he would have set aside the book he was reading and have removed his eyeglasses. While talking to me, he would be rubbing his eyes.

"Isn’t the ER busy tonight?" he said.

"It is…. Lots of patients with asthma."

A silence, then he said: “It is good you are there to help."