Monday, June 1, 2020 -
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The power of one breath


May you be inscribed in the book of life” is the blessing we wish one another as we stand at the cusp of each new year. My hands shake at this very moment as I write those words that have left my lips thousands of times over my life.

This past year I lived ever so fleetingly — yet powerfully — the literal meaning of those very words. This past year, I experienced on a deep cellular level the terror of what it means to have life, to have breath, suspended from you.

In short, I choked.

Bear with me, dear reader, as I share what happened. I tend to be more of a low-key person, as well as someone who values my privacy.

But this time I feel an obligation to share this story in order to increase awareness in synagogues or, for that matter, in any house of prayer where there is fellowship and food, but where choking and preparation for such an eventuality are not necessarily priorities.

As I was standing at kiddush in shul (and interestingly, I rarely eat at kiddushes), I reached for a little piece of London broil, and just as I “swallowed” it — or so I thought — a friend I hadn’t seen in a few years who, in the intervening years, had married and had a baby, appeared before me. We were both excited to see one another, but suddenly I found myself responding to her with a huge grin on my face — but in pantomime.

I couldn’t make a sound.

Instantly, something felt wrong. But I thought nothing of it. How many times have we mistakenly swallowed something and within seconds the situation straightens itself out on its own?

At that point I had no idea that silence — an inability to talk or to make a sound — is the tell-tale sign of choking.

I kept twirling my index finger at the side of my cheek, indicating to my friend that any minute now I’ll respond, that I was just waiting for a piece of food to go down.

It felt like it was getting worse. But at this point I was still not worried nor had any clue what was happening, or that I was in danger. My friend did the talking and I did the smiling, my eyes popping out for emphasis.

Suddenly there was a shift, and I understood the situation was getting worse and was not going to resolve itself on its own. But lurking danger or choking was still far from my mind. I pantomimed by pointing to the bar and tilted my hand toward my mouth, to capture the motion of drinking from a cup.

She understood and patiently followed me. I poured myself a cup of seltzer, but I can’t recall if I had a sip or not (which is curious information because some say that the act of drinking while choking actually accelerates the process). Suddenly with an indescribable split second force, I immediately, biologically and intellectually, understood I was choking. To death.

The vice-like grip that tightens and clenches your trachea shut, happens with incredible speed.

Instantly, clear as day you know, in physical, biological terms as well as with the knowledge of the mind, that your life is hovering in the balance. It feels like the Angel of Death is standing right there. The adrenaline is crashing through you as thoughts rush through your mind.

Your body is in crisis, yet you are crystal clear on what is happening.

With my right hand in the air, I “wrote” the numbers 9-1-1 to my friend. I then folded my hands in the Heimlich maneuver toward my stomach, to communicate I was choking and what I needed. I don’t know how, but somehow over the years I missed knowing about the universal sign indicating choking: hands on the throat.

She wrapped her hands around my belly and began thrusting with the Heimlich motions. I have no idea whether she was trained (turns out she was); in fact, for some reason, I assumed she wasn’t. The crowd around us was chatting, completely unaware of the situation.

She is thrusting. But the choking is only getting worse. Now I start to worry. I am still completely conscious and aware of everything. We communicate in pantomime for her to get help. I understand time is of the essence.

Being the refined lovely person that my friend is, a screamer she is not. But she screams for help. Yet with the commotion of the crowd and to my anxious ears, her call for help feels faint. In my state, everything seems magnified, taking an eternity.

Inside my head I am silently shouting: “Hurry! Faster! I’m choking!!”

“I’m really choking!!”

“It’s getting worse!!”

Only after the incident did the doctor explain to me the process that was unfolding. The body perceives that the oxygen supply has been cut off from flowing to the organs. In other words, it senses the imminent danger, and it panics and responds accordingly.

Another lady standing by (mysteriously enough, no one seems to be able to identify her — I wish I could thank her!) suddenly assessed the situation and with urgency belts across the hall for someone who knows the Heimlich. Again, although it was probably mere seconds, to me it felt like an eternity.

Suddenly, from the corner of my left eye, I see a rabbi rushing toward me, his face struck with deep concern and fear. At once, I feel relieved to know someone certified will be helping me (thankfully at this point I have no idea that my friend was certified, too, and that the Heimlich had thus far failed to clear the obstruction), but I also feel fear because I see the rabbi’s face. I see his perception of the situation, as he sees me.

At this point people are crowding around. People are cheering me on with encouraging messages. People are standing behind me; I am cocooned by care and support. Others are horrified. Silent. The faces of those before me, their eyes —terror-stricken.

I see them all, as each sharp blow after sharp blow comes, and my airway remains obstructed, the vice-like clenching getting tighter and tighter.

This is the point where I feel that if the obstruction is not cleared somewhat soon, I could possibly die. It’s a strange feeling — the dichotomy of being perfectly healthy, even at a party of sorts, dressed in Shabbat finery and completely conscious, yet intimately and so suddenly faced by the possibility of death, is bizarre. I will spare you my internal morbid thoughts.

I am aware that the second Heimlich attempt wasn’t working. I feel helpless. There is a sense of acute urgency, of the vice tightening still more. It’s so frustrating, because I feel my body shutting down and there’s nothing I can do.

This is not a case of mind over matter. I feel like I want to do something to stop it, but this choking thing has a mind of its own and I am completely at its mercy. The obstruction is real.

Apparently, I remained externally calm. But inside I understood what was happening. I slowly began to feel the real possibility of life leaving me.

The body communicates it to you. So do the gazes of those around you. The faces encircling me — ah, those up-close faces I can still see them before me . . . all those terrified eyes that were meeting and reflecting mine . . . they all started ever so slightly to become that much hazier as I began losing a stable footing . . .

It felt far away, but suddenly I hear another cry for help. I know the voice. It’s a friend’s. She is calling for her husband: a doctor. She keeps calling his name. Again, for me the waiting feels interminable as that vice-like grip keeps tightening more and more; the fear of what could  G-d forbid happen shaping into the possibility of it becoming real.

Finally he arrives. He starts with the Heimlich. But again, nothing is happening. I always naively thought and pictured someone performing Heimlich and then magically an object flies out of a choking victim’s mouth. Yet here I was on the third Heimlich attempt. This time by a doctor, no less.

Just then, I understand that Hatzalah has arrived. And just then, as I receive another sharp jab, just as suddenly and quickly as the onset of this freaky incident, a shift takes place. Something has changed.

I wilt in the doctor’s arms. Saliva trickles from my mouth. Even though it’s just a drop, it’s enough; my breathing is restored. My body relaxes. The battle is over. I’m OK. I will live.

I owe my life to Dr. Ariel Brandwein. Starting with the inception of this story, from the wonderful friend with whom it all began and who supportively remained by my side throughout, to the rabbi who performed the Heimlich for quite a while, to my friend who screamed for her husband to come, to the first person who hugged and held me, to the person who called the amazing first responders of Hatzalah of the Upper West Side, to the other very dear friends who were there and held me up in various ways and, of course, to the rabbi of the shul, Rabbi Allen Schwartz — I am grateful to them all.

The entire shul of Ohab Zeddek rallied behind me that day. I am forever grateful.

Other than being sore and sustaining some serious black and blue marks as well as losing my voice or speaking funny for a few days, I was fine.

Immediately following an incident like this, it is common to become very aware of your swallowing and not to swallow reflexively. Thankfully, it took me only a few days to get back to normal eating. Everyone assumed I lost weight during that short interval. But being that my solution was Haagen Dazs, the answer was a solid “no” to that.

I have since spoken with a few other choking survivors. It is remarkable how similar our experiences felt. How tangible the feeling of hovering between life and death was.

Although we all know this since as far back as we know ourselves, it is incredible how, after the experience of choking, the idea that life is compressed to one definition — breath — becomes so visceral.

We wake up each morning and the first words out of our mouths are Modeh Ani. We are grateful for another day. We are grateful to have been granted life.

Yet, we never quite actively give this thought. For the most part, we just passively assume that an endless supply of air will always be there for us to sip breaths from. We don’t actually stop and consider the possibility of its limits.

Ironically, just before this incident, I had read When Breath Becomes Air by Paul Kalanithi. The title alone sensitizes you to the power of one breath.

But the experience of choking made me feel the meaning and power of one breath in the terrifyingly deepest way I ever could imagine.

We wish one another a year of life, we pray each Rosh Hashanah to be inscribed in a Book of Life. What does the Book of Life mean? It means breath. One breath. That is what life actually boils down to: a string of breaths. One after another.

As we get older, we learn that ultimately life is a string of moments and experiences that teach us how to separate the chaff from the wheat. This was my most profound lesson so far:

Without thinking, we take thousands of breaths each day. Not just when we work, play or exercise. But it’s there for us, working the whole time even if it feels effortless, even when we are sleeping. Each breath so precious and so dear.

These days, I try to mindfully breathe in gratitude. I’m more conscious of the breathing process and sometimes find myself somewhat dissociatively observing its working apparatus with wonder. When I feel the wind of my breath on my face, or on my hand — it’s beautiful. If there is a moment when it’s audible, I pause with gratitude.

For the most part, though, I returned pretty quickly to the mode of sipping endless breaths passively, feeling the illusion of security that there’s an endless air supply and that breathing is just “normal.”

But it’s not.

Breathing is extraordinary.

It is a gift. Each and every one of my breaths truly is a gift tethering me to this world.

It’s interesting how when we say something “took our breath away,” what we mean is how wonderful and pleasurable something was to the extent that we experienced the feeling of something out of the ordinary happening to our body — of our hearts skipping a beat. “It’s breathtaking,” we say, when what we are actually expressing is ultimate alive-ness.

Back in the day when I practiced yoga and teachers would constantly talk throughout class, sometimes sharing thoughts that might have been foreign to me, I know this sounds so corny, but I created a little Jewish mantra for myself in my head: “neshama-neshima,” soul-breath.

In Hebrew, the two words are composed of the same letters; breath and soul are essentially the same word, the only difference between the two words being the letter “yud” (which stands for G-d) in neshima, breadth. Neshima, the five-letter word breath in Hebrew, has the letter yud at its center.

G-d, as symbolically expressed in the letter yud, the One Who endows us with each breath, with a life of breaths or the breaths of life, is right there in the center of each and every neshima, of every single breath.

If we have that, on its most stripped down, basic level, if we have breath, we really do have everything.

So I wish you, dear readers, a year of life, a year lived breath by breath, where you sometimes stop and feel the waves of your breath, with gratitude.

Because life distilled, is breath.

It’s that simple and that true.

What I want to say is, if I randomly choked on a piece of London broil at a kiddush — even just a small bite size piece, even after thoroughly chewing it, it can happen to anyone.

Remember: If you can’t talk, if you can’t make a sound — you are choking!

Thankfully, I had a happy ending. But I wasted precious time at the beginning because I lacked the awareness of what was happening to me, and that time could have been spent for intervening with Heimlich a good couple of minutes earlier.

If you are choking, place your hands at your throat, get someone’s attention immediately, communicating the universal sign that you are choking.

If you are a clergy member, or a board member of a house of prayer, please ensure a few people trained in First Aid and the Heimlich maneuver are present at all times during social events involving food.

Please hold First Aid training courses at your house of worship — the more members who are qualified to react and help, the higher the chances of a life being saved.

Parents, please take First Aid trainings and learn the Heimlich maneuver.

I understand that the Heimlich maneuver is not perfect and is tragically not always effective.

But in my case, it saved my life. It can work.

I hold out hope for a year with no freaky emergencies. No illnesses. A year of sipping breaths of air with physical and psychological ease that feels normal.

I wish you a year of life, strung together by many breathtaking moments, a year in which you feel the wind of your breath with the peacefulness of the mantra: “neshama-neshima.”

Ketiva va-chatima tova and Shana Tova u-metuka.

Copyright © 2019 by the Intermountain Jewish News

Tehilla R. Goldberg

IJN columnist | View from Central Park

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