Breath and Beyond with Michael Stephen, MD
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What is the poetic prologue about the lungs and why does it set the tone for the episode?
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You're listening to The Nocturnist Conversations. I'm Emily Silverman. Air is so essential to life that our lungs and our breath have occupied an exceptional place in mythology and literature across time and culture. Our lungs, more than any other organ in the body, connect us to the outside world and each other. My guest today, pulmonologist Michael Stephen, has thought about the lungs more than anyone I know. He's an assistant professor of medicine and director of the Adult Cystic Fibrosis Center at Thomas Jefferson University. And as a pulmonary and critical care doc, he's also been on the front lines of the COVID pandemic. Before our conversation, I asked Michael to read an excerpt from the prologue of his book, Breathtaking, What Our Lungs Teach Us About Our Origins, Ourselves, and Our Future.
Here is Michael Stevens.
The lungs are a mysterious and even mystical organ. They are our connection to the atmosphere, the organ that extracts the life force we need to exist. We have acknowledged this power for centuries. The Hebrew word ruach literally means breath, but also means spirit of life. In the book of Job, the prophet's friend Elihu declares, The Spirit of God has made me, and the breath of the Almighty gives me life. This same concept is embodied in the New Testament, where the Apostle John says that Jesus breathed on his disciples, giving them the Holy Spirit. The life-giving power of the breath is acknowledged very early in the Bible. In the second chapter of Genesis, line seven reads, the Lord God formed man from the dust of the ground and breathed into his nostrils the breath of life, and the man became a living being.
Ancient Egyptian cultures also recognized the importance of the breath, the evidence of which we see today in the many ancient statues that have had their noses broken off, but otherwise were left untouched. This defacement was no accident, but a deliberate act by conquering groups to take the life, in this case the breath of life, away from these icons. Ancient knowledge about the power of the lungs was not limited to the Western world. Buddhism and Hinduism were based on an understanding of the potency of the breath. According to these disciplines, studying and harnessing the breath was the only recognized way to nirvana. Thich Nhat Hanh, a Vietnamese Buddhist monk, summarizes this ancient philosophy well in his 1975 book, The Miracle of Mindfulness.
Breath is the bridge which connects life to consciousness, which unites your body to your mind. The emphasis on the breath is not a thing of the past for Eastern religions. Breathing continues to occupy a central role in their teachings today. The Hindu name for the breath is prana, which, like the Western word ruach and holy spirit, is not just a word for air, but an acknowledgement of the breath as the ultimate life force. This knowledge is spreading back to the West through disciplines such as yoga and mindfulness. but also through techniques aimed at improving endurance and even intimacy. These practices demonstrate that the mind and the heart follow the lungs, not the other way around. Civilizations throughout history have equated the breath with the soul, using one term to refer to both.
In ancient Egypt, it was ka. In Zulu, umoya. In ancient Greece, pneuma. In Hinduism, prana. In his 1653 lectures on the whole of anatomy, William Harvey, the famous 17th century British physiologist, stated simply but profoundly, life and respiration are complementary. There is nothing living which does not breathe, nor anything breathing which does not live.
Thank you so much for reading that. I thought it was such a beautiful and poetic way to open this book about the lungs, and it's really a tour of the lungs, and I'm so excited to get into it a little bit. But before we do, I'd love to hear where you got the idea to write this.
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Chapters
8 chapters
1
What is the poetic prologue about the lungs and why does it set the tone for the episode?
0:00–6:07
2
How did Dr. Michael Stephen’s 25‑year study of lung medicine and the rise of lung diseases inspire him to write his book?
6:07–12:47
3
Why are lungs considered a neglected organ in both medicine and popular culture, according to the conversation?
12:47–18:39
4
What is the significance of cystic fibrosis in Dr. Stephen’s career and how does it shape the narrative of his book?
18:39–24:17
5
How does the Great Oxygenation Event explain the evolutionary transition from gills to lungs on land?
24:17–30:32
6
Why is breath work presented as a form of medicine and how can it help conditions like asthma, PTSD, and inflammation?
30:32–35:37
7
How does the concept of communal air and global pollution connect to lung health and climate change?
35:37–40:56
8
What personal impact did the COVID‑19 pandemic have on Dr. Stephen and how did it reshape his view of lung health?
40:56–45:03