I suddenly awoke from a fretful sleep, sitting upright quickly, trying to breathe deeply in between aggressive coughs.  I simply couldn’t catch my breath, with each inhale the irritation in my lungs grew and my coughing multiplied.  My mind raced to the PSA about Tuberculosis I had seen countless times on the television in Hong Kong and my heart skipped a beat.  What if I had caught it?  What if they had to quarantine me and I would be stuck in a hospital in Asia with some contagious disease? 

I thought back to the machines scanning people’s temperature each time we crossed the border from Hong Kong to China, feeling uneasy with the prospect of being pulled aside and carted off to be further isolated.  I ached to breathe deeply but such a task was impossible.  It was 3am, I laid back down and focused on drawing air in slowly.  I had another two weeks in China before I was scheduled to return to the USA, I would see how I felt in the morning and make the call from there.

As fate would have it, I would not see those additional two weeks in China; the following day I could hardly control my coughing fits as I dialed the office and told them I would be flying back that day.  We rebooked my flight, I packed up my little home away from home and stepped outside the Cosmopolitan hotel to catch a cab. 

Almost immediately my hand flew to cover my mouth as another fit of coughing overwhelmed me. As I breathed in I felt as though I was sucking on the back of an exhaust pipe.  The air was hazy today, heavy with pollution, but similar to many I had experienced while living here, I simply assumed I had caught some sort of cold or something and needed to rest; or I had TB. 

Upon arrival back in the States I went straight to my doctor and was told that I had an infection and should take antibiotics.  Three weeks later, the cough had not retreated, so I was again prescribed more antibiotics.  After six weeks, fearing my white blood cell count was taking an incredible hit, I stopped taking the antibiotics and called a lung specialist in Philadelphia.  While the violent coughing fits I had experienced in Hong Kong were more subdued, I was still struggling with a loose cough in my chest revisiting me every evening; something didn’t feel right.

After a series of tests, I was informed that I had developed chronic obstructive pulmonary disease as a result of the poor air quality and extensive pollution exposure.  From now on, whenever I was exposed to heavy pollution or smoke, my lungs would become highly sensitive and agitated.  There was no way to reverse the damage, but the doctor told me I could limit the discomfort and further damage by reducing my travels in heavily polluted areas and any direct exposure to smoke. 

I was prescribed an inhaler to use before I went outside in polluted areas and advised that I should wear masks from now on.  It was literally as though the pollution of China had entered my lungs and taken up residency…and there was no way to evict.

After confirming the diagnosis I continued to travel to Asia for work, pretty extensively. I wasn’t living there full time anymore so I could limit my exposure to some extent, and the inhaler and masks did help.  Interestingly enough my role in my career transitioned from one of manufacturing management, to consulting on the human rights conditions of the workers in those factories. I had grown a personal awareness of the intensity of toxic fumes each time I stepped on a factory floor.

When I began to wear my masks every visit, I was not looked at as an outsider, in fact I blended right in (well, as much as a blondish/burnet western white girl can blend in Asia).  Cruising the streets of Hong Kong and various cities throughout China, it’s not uncommon to see people wearing masks, actually it’s quite normal, which is strange when you consider it in a broader context.

It’s estimated that in 2010, outdoor air pollution of China contributed to more than 1.2 million premature deaths in the country. I developed my condition in 2007; since then the citizens of countless Chinese cities have had to endure days of smog that were so dangerous schools and businesses were closed and people were advised to stay in their homes.

As we continue to grow more aware of this critical issue, we dabble with the risky option of simply adapting to the self-inflicted degradation of our environment. I recently came across the latest fashionable “smog masks” that braced the runways at Fashion Week both in Paris and China. Seriously, check out the article in this link.

Personally, I found this concept to be a bit grotesque… as it seems like a failure of my species to push the dial in the right direction.  It felt to me like adaptation, like frogs sitting in a pot of water with the temperature set to boil, and no awareness of their impending doom.  The presence of the masks at the runway show was interestingly timed, apparently being inspired by the Chinese marathoners who had recently donned pollution masks due to air quality concerns while completing the Beijing Marathon in October.

Perhaps it was a political statement, but it was equally a statement of an up and coming commercial trend. Campaigns such as the one launched by Max Factor in which they sponsored a selfie photo contest for consumers to post selfies wearing pollution masks paired with their Sino Weibo makeup line lends itself only to distract rather than educate. We are walking a fine line here…

It’s a bit strange that when I think back on my time living in Hong Kong, I don’t think immediately of the pollution, I don’t recall the taste of the hot, thick air, or remember what a hard transition it was for me to get used to. Like everything in life, we adapt, we become numb (like those boiling frogs) to the harmful things around us when we are constantly bombarded with them. But when I read back on my journals documenting my life there, I find the signs were everywhere, I see the struggle that I bore to adapt, my methods of coping, and the path that inevitably led me to my condition:

April 2007: “Just up the road from my apartment is the entrance to a beautiful hike- about 3.5K to Pok Fu Lam, and another 7.5K to the Peak.  I love that it is so close- it is such an important escape for me.  I am slowly adapting to the pollution, but it is difficult.  When I am immersed in the mountains and can breathe deep, I realize how thirsty my lungs are for fresh air.  It is so beautiful, breathtaking views, the clean smell of trees and dirt, rich green tropical foliage- it is amazing.”

It is a startling thing, to suddenly feel the impact of pollution, and to be immediately and aggressively affected by it. I can literally feel my lungs resist the air when I am in a smoggy city, or standing near people smoking cigarettes.  This awareness has made me even more conscious of our impact on the environment, and how that directly impacts our own ability to continue living within it.

If you’ve been wandering with me for a while (particularly via Instagram), you probably realize how much I love wild places.  I adore trees. I feel my most alive when I am in nature, climbing trees or mountains, snowboarding down steep lines in fresh powder, sitting on a surfboard in the ocean watching a pod of dolphins surf the waves around me.  Being outside, in the elements, ignites an awareness of living that I have never been able to experience when I have hit the streets of any man-made place. It is almost indescribable. The woods were my sanctuary when I lived in Hong Kong, they were my escape, my place to find relief for my exhausted lungs, a place to retreat and drink deeply the air that had been given back to me, refreshed with the breath of the trees.  Having this condition has made me all the more aware of how essential wild places are when it comes to the quality of the air that we breathe in the long term.

I’m not a fan of wearing masks when I travel.  As you might have read in my previous post– I love to smile, and love the places that a simple smile has taken me.  Behind a mask, it is much more difficult to connect with new people in a new place.  You can’t help but feel incredibly separate from both the people and environment surrounding you.  You are much more self conscious (particularly in those countries where masks are not yet “the norm”) and feel isolated.

Recently I spent a week in Santiago, Chile.  The first few days I was okay, as it had recently rained, and I avoided wearing masks simply because I wanted to blend in and try to get a sense of the place from a more local perspective. But by the third day I had to find masks, fast. Ale and I spent a good part of the day running around the city from Pharmacia to Pharmacia trying to find N95 or N100 masks rather than the standard painters masks that all were offering.  At the end of the day we finally found a box of N95 and much to the shock of the shop keeper bought the whole box (instead of the single one they were used to selling). Here in Chile it is still not the norm, despite the poor air quality in many of the cities.

For me though, it is too late for this to simply be a choice.  As I experienced during a recent trip to several European cities that had me coughing for weeks, my condition is only going to be heightened as time goes on, so masks must become a constant companion each time I visit a developed or developing place.

I know plenty of people who have spent years in these places and do not (noticeably) suffer from my condition.  I share this story, these thoughts, simply because I want us all to take pause and think about what we are doing to ourselves, to one another, to the generations that will follow us (the generations born from us).

When I lived in the smog, I adapted; at the time I was not motivated to push for change, to advocate for an alternative way of living. Those around me had accepted it as the “norm” and I simply learned to live with it. My perspective now, looking back, is quite different.  If I could do things differently in this case, man I would have. I would have done everything in my power to keep my precious lungs protected as I ventured off to build my career.  Had I only known.

Personally, I do not see the development of better, more functional and fashionable masks as progress, even though those things will benefit me as I continue to run around cities of the world.  I see progress when I see forests saved and placed into conservation; I see progress in restoring deforested areas, when I find living walls and alternative production methods being used that emit zero air emissions.  I see progress when I see effort to change what we know to be broken.

I’m still finding my way, trying to understand my role in being a part of this change, leading an effort or supporting one that is far greater than myself.  But I know I am meant to take this course, I know this is a cause worth raising my voice for, I know there is so much opportunity for us to turn our creative minds toward solutions that stop the damage rather than simply covering it up with another trendy product.

For now, I’ve got a box of masks in my bag, no matter the destination airport. But when I escape to the wilderness, I am leaving those babies at home.

If you would like to learn more about the air pollution issues in China and the health impacts of smog exposure, please watch the incredibly powerful and personal documentary recently released by Chai Jing entitled Under the Dome.