By Kunal Mehra

“Move a bit closer to the board. There. Perfect,” he said, as he stood behind the X-ray machine. “Now take a deep inhale and hold it.”

My chest was hurting and I wanted to let go and exhale, but I did what he asked me to.

He wrapped up his work and we both walked towards his computer. The X-ray showed up there: the ribcage, lungs and the diaphragm cupping their bottom.

“What’s that?”, I asked, pointing at something towards the bottom of the X-ray.

“Your heart. You’re in good shape. It’s not too big. If it’s too enlarged, that can cause problems.”

‘But I thought you were supposed to have a big, wide, open heart, to make room for all things and all beings’, I wondered. I didn’t say it out loud, though.

“I’ll send your chart to the doctor; you’ll be able to see his notes on our online patient portal soon,” he said.

“Thanks,” I replied as I walked out the door.

~

It started on Independence Day, with hiccups every few minutes. I ignored them for the first couple of hours, choosing instead to sit in the backyard, enjoying the summer sunshine. But they wouldn’t go away. My chest would heave up and down every time I hiccupped and I started to feel tightness around my ribs. I couldn’t speak for more than a minute without hiccupping. After several google searches and way more anxiety than I could handle, I made an appointment with my primary care physician. I had never had this kind of problem and the newness of it made me anxious: What’s going on? What caused it? What’s the treatment? How long would it take to heal?

~

I started reading more about how the lungs, diaphragm and the heart work. The more I read, the more entrapped in awe I became. It was like falling in love with someone who’s been with you all your life, serving you faithfully and unconditionally every second of your life, but you never even bothered to acknowledge its dues, let alone thank it.

With every inhale, the diaphragm contracts and flattens, giving the lungs more space to expand. They widen and let the air in. Oxygen makes its way through the trachea into the lungs, before it gets absorbed into the blood flowing through the capillaries. When it’s time to exhale, the diaphragm moves up, making the lungs smaller and carbon dioxide makes its way up and out through the trachea. And so it goes, starting from our first breath, all the way through our last.

A couple of weeks ago, I was hiking in Lassen Volcanic National Park. It was a steep uphill hike and it was hot: even at 5,000ft, it was over 100F. I was, understandably, short of breath, but it never occurred to me to think about all that was going on in my body just so ‘I’ could keep moving. I never thought about that line of communication that ran from the mind (I want to climb uphill), to the brain (this guy’s crazy: he’s climbing uphill in 100F weather; we had better give him the oxygen he needs), to the diaphragm (let’s move up and down fast), to the lungs (let’s take in all that hot air and oxygenate it and send it to the heart), to the heart (let’s share this oxygenated blood throughout his body) and all over again.

How did I not pay attention to this silent foundational orchestra that sustains our lives, without which ‘we’ wouldn’t be ‘we’? Why did it take five days of almost nonstop hiccups and chest pain for me to start looking into this? 

~

That was the first time I had seen my chest X-ray. I never really had to and I didn’t think much about it. Going through painful frequent hiccups though, I was forced to think about how this whole orchestra got architected so meticulously and beautifully, so that when working as intended, it just works, without us having to pay any attention. I guess that’s what millions of years of evolution does. But it doesn’t take away the fact that the symphony plays inside us every moment of our lives, regardless of whether we acknowledge it or not.

And almost always, the reality is that we don’t acknowledge it, let alone be grateful for it. Given that we live inside our bodies, it’s ironic that most of the time, we’re not embodied: we spend most of our time in our minds, not in our bodies. The typical instances when we shift attention to our bodies is when something’s wrong…like when we start having strange hiccups, seemingly out of nowhere.

I imagine translating this to a service-based model. I have a dozen people waiting on me, ready to help with all sorts of tasks that I can’t do on my own. I don’t even need to tell them about it: they can sense what I need and get it done. Need a drink of water? There’ll be a glass of water next to me in a matter of seconds. Hungry? Lunch would be served within minutes. Need to fill up gasoline in the car? Done in fifteen minutes. The yard looks like it could use some professional landscaping? Couple of hours later, it looks blissful. Want some professional financial advice? Advisor found and appointment made by the end of the day.

All these times, I barely even look at the people helping me. The most I might do is maybe not deny that there’s someone at my beck and call, twenty-four hours a day, seven days a week. I also never thought about what would happen if even one of those workers decided to pause working for a bit.

What kind of person does that make me? And more importantly, how does my callousness make them feel?

~

After seeing four doctors, doing a bunch of tests and physical therapy, trying medications and changing my diet, the hiccups gradually subsided. I had occasional achiness in my chest, but at-least the worrisome hiccups were gone. I don’t know what caused it or what healed it, but it was a long-yearned relief.

~

Looking at my X-ray, there was something sacred about it. It wasn’t just a black-and-white photo of crisscrossing lines and curves. 

It was a reservoir for memories and moments that ranged from dramatic to seemingly mundane: the love and safety I felt when I recalled first being held by my mother; the soothing calmness of sipping warm tea while sitting on the couch and looking out the window on a cold rainy December night; the confusion and grief that I struggled with, when I drove around aimlessly, late at night, not really knowing where I was going, after being told by my girlfriend that she no longer wanted to be with me; the fear I felt when my wife and I got kidnapped at gunpoint in a cab in Ecuador, unsure whether we were going to survive it…the list goes on. Everything that happened during my life, it bore witness, it supported and sustained me, it was me. 

It was also a source of amazement, not just from a scientific point of view, but also from one of reverence and imaginative curiosity. It made me wonder if the diaphragm misses being close to the lungs on an inhale; if, on an exhale, it heaves a sigh of relief as it gets to cuddle next to the lungs again. What about the red blood cells? How do they feel when they get a refreshing dose of oxygen…do they silently thank all players in the symphony? How do the ribs know how far up and out they need to move on every breath?

It also made me feel I was eating a soup made of wonder and gratitude, sprinkled with a dose of guilt. I hope that there’s enough wonder and gratitude that it would soak up the guilt, so I don’t feel its sour taste anymore.

So, when I looked at that X-ray, it wasn’t just bones and white and black spaces I was staring at; I was looking at the mirror of life: us walking on tightropes, from one end of the rainbow of life to the other.

I was also looking at what my life had been and what it is, all of it passing through those spaces, kissing those bones, saying ‘thank you’ to those lungs, whispering ‘I love you’ to the diaphragm, cupping my heart in its palms and apologizing: Sorry that I never even acknowledged your work all these years. How do I make up for it? 

And the answer I got was another faithful heartbeat, another contraction and expansion of the lungs, another upward-downward movement of the diaphragm.

It was indeed love at first X-ray.

Kunal Mehra is a multimedia artist who likes photography, filmmaking, writing and hiking. He grew up in India and has been living in Portland, OR, since 2002. His writing has been published by the Press Pause Press, Active Muse and ‘Fleas on the Dog’ magazines, amongst others.

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