My husband and I live in a cottage in the foothills of Los Angeles, where nature feels very close. Beyond our front door, an ancient flowering vine overhangs a brick porch. Tangled up within the vine is a whole world in miniature: abandoned birds’ nests, dangling spiderwebs, powdery organic deposits. For years, we marveled at the vine’s ecosphere—but we never grasped its intense biological power until one spring morning I will never forget.
“I’m going outside,” my husband said. “I feel like pruning.”
After finding his clippers, Patrick started to yank and trim the tangled greenery. Then I heard a loud, strangled cough. “Yech!” he exclaimed, violently stomping and shaking himself. “I feel like I just inhaled toxic waste—my lungs are on fire!”
Because Patrick has asthma, sudden fits of wheezing and shortness of breath are nothing new to him. This was different. Some dusty emanation from the vine had triggered a fierce pain from his trachea to the deepest culs-de-sac of his lungs. An hour after his noxious gulp of air, though, he felt better. I figured the worst was over.
Another day passed, and my husband’s nose began to run. He was also clearing his throat more than usual. He was coming down with a cold, we decided. My main concern was its timing: Later that week, we were supposed to leave for New York.
Before our departure, Patrick armed himself with antihistamines and an inhaler. He felt OK on the flight, but the next day he was tired after walking just a few blocks. We chalked it up to the bustle of Manhattan and rushing to make the curtain of a play.
Finally, while we were seated in our hotel room later that night, alarm bells went off. My husband’s face was flushed, his pulse was fast, and he said he felt as if he was breathing through “a barrel of phlegm.” Could he have pneumonia? How had I overlooked such an obvious possibility?
“I’d better listen to you,” I said quietly.
I pressed the side of my head against Patrick’s back to listen as he breathed in and out. The racket on both sides—like the groan of a low-pitched, badly played accordion—was unlike any sound I remembered from previous asthma attacks. Through the cartilage of my ear, I could practically feel the rattle of secretions in his airways. Think again, my doctor brain commanded. Whatever was making my husband sick, it was no ordinary wheezing, cold, or even pneumonia.
We pondered our next move. Should we hunt down a doctor? Weighing the pros and cons of visiting a strange local emergency room versus limping back home to Los Angeles, we opted for the latter. Meanwhile, Patrick doubled his standard asthma doses while I lined up an urgent medical appointment. En route to JFK Airport, I almost asked the taxi driver to turn around. But Patrick shook his head.
At last, we sat face to face with Roy Young, our internist in Los Angeles. A seasoned pro, he quickly listened to the din in Patrick’s chest. Then he pulled out his prescription pad.
“We’ll get a chest X-ray and blood work, of course, but you’re starting on steroids right now,” Roy said. “And azithromycin.”
“What about this stuff I’m coughing up?” By then, Patrick was producing tablespoonfuls of thick sputum.