By Dr. Paul Ehrlich
I have previously written about a condition called anxiety breathing a couple of times, here and here. It bears mentioning again because it came up in a different context from the previous ones. It is a distinctive pattern, in which the unconscious in and out of normal respiration becomes a labored process. As I illustrated previously that last little jolt of air can only be taken with conscious effort. This generally happens when people are under work and/or family stress.
A few days ago, a father was in my office to discuss his child’s asthma, and as he talked across the desk from me, I noticed that he exhibited signs of anxiety breathing. I pointed this out. He used this as an opportunity to unburden himself of his own worries about the child. At the end he thanked me and said that he had never had the chance to do so before to any of his child’s physicians, of whom there have been many. Then he asked if his wife could do the same. Of course.
After the father and child departed, my current pediatric resident, who had also been present, spoke to me and expressed gratitude for having witnessed this encounter. As I have heard many times over years with these residents, they appreciate working with me because it’s closer to the hands-on, patient-oriented, deductive brand of pediatrics they remember from their childhoods, or maybe only imagined, rather than the high-turnover version they are seeing in their current training. This exposure to anxiety breathing is one of those clinical pearls that old doctors like me pass on to young ones.
This resident is going to do a fellowship in pediatric cardiology starting in July of 2015. There couldn’t be a nobler calling in medicine (except for everything else). I said to her, “When you start your program, remember that your patients will be very sick, and their parents will be very anxious. If you have learned nothing else with me that you can take into your new career, it is that keeping an eye on those parents’ moods and giving them a chance to let go will help them, and it will help their children—‘your patients.’”
Image: Mel Brooks in “High Anxiety”