Today, the Fourth Man. The University of
Houston's College of Engineering presents this
series about the machines that make our
civilization run, and the people whose ingenuity
An article in the New
York Times, about chronic obstructive
pulmonary disease, calls my mind to the
Kentucky blizzard of December, 1978. I'd been in a
long committee meeting. Thick clouds of second-hand
smoke had triggered a life-threatening asthma
My wife managed to ferry me through snowdrifts to
the Veterans Hospital. There I lay in a four-man
room as doctors struggled to nudge my blood oxygen
above the fatal borderline.
One of the four recovered while I was there. One
was drugged out, probably dying of pulmonary
disease and strapped to his bed. All night he'd
shout at me, demanding I come over and untie him.
But it was the fourth man who haunts me,
even now. He lay like King Tut upon his bier,
barely breathing -- skin like translucent vellum
over veins and bones. He emerged now and again from
the haze of his suffocating emphysema for a few
minutes of lucidity. And, during those moments, I
extracted his story.
He'd been with the Army in the Philippines,
captured at the beginning of WW-II. He'd made the
ghastly march up Bataan Peninsula. Of 76,000 men
who began it, 20,000 were killed -- beaten to
death, bayoneted, and suffocated. Many were forced
to dig their own graves, and were then buried
alive. Here in this pulmonary ward, I was once more
a twelve-year-old boy who'd been given night-mares
by images of those living burials in Life
Now this survivor, likewise struggling to inhale
air. He would soon die, and the odds that his was a
smoking death are given by the Times
article. Eighty-five percent of chronic breathing
cases are caused directly by smoking and the rest
by industrial pollutants and secondhand smoke.
Since 1965, the percentage of American smokers has
been cut in half, with far more men than women
quitting. But, with the population increase, the
total number of smokers has hardly
changed. The number of former smokers in
America has tripled in that time.
Add to smokers, the vast number who've quit
smoking, but whose lungs and bronchial passages
have been damaged, and you get nearly a hundred
million. The insidious thing about these diseases
is that half the existing cases are undiagnosed.
Thirty-five million Americans now live
with chronic shortness of breath, many not
real-izing where it's taking them. Perhaps I should
mention billions in health care costs, but what's
that against the cost in human life?
Tobacco remains as addictive as heroin and more
deadly since it's a legal over-the-counter drug.
And lung cancer is only one of its modes of attack.
Pulmonary disease is an equal threat.
That old soldier, that fourth man, won his first
war. Now you and I have to win the war against the
disease that finally claimed him. And we can: Keep
the prime enemy in sight. Give the tobacco industry
no quarter. This time you and I are in the trenches
-- we and those we love. This is our war,
and we can win it.
I'm John Lienhard, at the University of Houston,
where we're interested in the way inventive minds
J. E. Brody, Just a Few Simple Steps Can Keep the Air
Flowing Freely. New York Times, Tuesday,
Feb. 10, 2004, pg. D8.
I am grateful to Stanley J. Reiser, University of
Texas Medical School, for his counsel.
The National Institute of Health provides this
excellent Medline site on smoking:The American Lung Association provides this web
page on quitting tobacco.
It also provides this chilling site showing the
nature of lung damage:
This image of healthy and unhealthy lungs was adapted
from examples which appear in both web sources
The Engines of Our Ingenuity is
Copyright © 1988-2003 by John H.