The First Person I Have to Calm Is Myself

For most of my professional life, I managed crises.

Campaigns failed.

Systems crashed.

Clients panicked.

Projects fell apart two days before launch.

I learned that the first rule of crisis management is surprisingly simple:

Don't become part of the crisis.

Then COPD arrived.

Later, the transplant.

Suddenly the crisis wasn't in a conference room.

It was inside my chest.

If you've never experienced severe shortness of breath, it's difficult to explain.

The body has a remarkable ability to convince the brain that the next breath may not arrive.

Logic becomes optional.

Panic arrives fully prepared.

Medicine has a name for what happens next: the Dyspnea-Anxiety Cycle.

I have a simpler name for it.

The Spiral.

Breathing becomes harder.

The brain gets frightened.

Fear makes breathing worse.

Poor breathing creates more fear.

Repeat until somebody interrupts the meeting.

For years, that somebody had to be me.

Not because I'm particularly brave.

Because nobody else lives inside my head.

I've learned that before I reach for an inhaler, I first have to deal with the person creating the most trouble.

Myself.

I switch into what I call technical mode.

Instead of thinking,

"Something is terribly wrong."

I tell myself,

"Interesting. The lungs are misbehaving again. Let's see what's actually happening."

It's amazing how much difference one sarcastic sentence can make.

It creates just enough distance for the analytical part of my brain to get back to work.

Am I actually short of breath?

Or am I breathing too fast because I'm frightened?

What's my oxygen saturation?

My pulse?

Did I eat?

Could this be low blood sugar pretending to be a lung problem?

I've been fooled by that one more than once.

The body enjoys practical jokes.

Unfortunately, they're rarely funny at the time.

Then I sit down.

Stop moving.

Use pursed-lip breathing.

Wait.

Collect information before collecting disasters.

Sometimes the answer is obvious.

Sometimes it isn't.

But I've discovered something reassuring over the years.

My imagination progresses much faster than my disease.

A slight cough becomes rejection.

A drop in energy becomes pneumonia.

An unusual sensation becomes tomorrow's hospital admission.

Meanwhile, reality is usually far less creative.

That's not to say symptoms should be ignored.

Quite the opposite.

They deserve attention.

Just not panic.

Experience has taught me that calm isn't the opposite of vigilance.

Calm is what allows vigilance to work.

Today, when a breathing episode starts, I still don't enjoy it.

I doubt I ever will.

But I trust the process more than I trust my first reaction.

The first reaction usually assumes catastrophe.

The process asks better questions.

And after years of living with damaged lungs—and now transplanted ones—I've learned something that would have made my younger self smile.

The first emergency I have to manage isn't in my lungs.

It's in my head.