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The Life of Breath : a new project on breathlessness and COPD

posted on February 6, 2025

Research Summary: The Life of Breath Project

Project Type: Interdisciplinary Medical Humanities Research Initiative
Primary Focus: Breathlessness, chronic obstructive pulmonary disease (COPD), and the cultural, philosophical, and experiential dimensions of breathing
Institutions: Durham University Centre for Medical Humanities (lead) and University of Bristol
Principal Investigators: Jane Macnaughton (Durham) and Havi Carel (Bristol)
Project Duration: Five years, commencing October 2014
Funding Source: Senior Investigator Award (joint application)
Research Approach: Multi-phase study combining literary/cultural/philosophical analysis, empirical studies of aware breathers and respiratory patients, ethnographic clinic observation, and patient interviews to examine mismatch between measured and experienced breathlessness
Central Mechanism: Bridges the gap between medical humanities insights and clinical practice by examining breath as a somatic, cultural, and spiritual phenomenon rather than purely mechanical process
Collaborative Framework: Interdisciplinary research group “Breathing Space” including clinicians, medical anthropologists, historians, and experts by experience
Key Innovation: Integrates humanities scholarship with clinical research to reframe understanding of pathological breathlessness and improve COPD patient care

Durham University Centre for Medical Humanities is delighted to announce that we will be hosting a new project jointly with the University of Bristol from October 2014. The project is called ‘The Life of Breath’ and it is the result of a successful joint Senior Investigator Award application by Jane Macnaughton (Durham) and Havi Carel (Bristol). This project has been in development for around two years and was stimulated by Jane’s interest in the phenomenology of smoking and Havi’s groundbreaking work on the experience of illness.

Jane and Havi came together sharing a vision of the potential for critically engaged medical humanities to make a difference in understanding an important somatic symptom, breathlessness, and how related clinical conditions, such as chronic obstructive pulmonary disease (COPD) are investigated and treated. Breathing is a basic physiological mechanism but it also has enormous cultural, spiritual and emotional meaning. We talk about a first and last breath as marking the beginning and end of life. Breath has traditionally been seen as what connects spirit and body and it is strongly affected by mood and emotion. But despite being so laden with meaning in so many cultures, modern western medicine views it in purely mechanical terms. We want to study the unexplored richness of breath in culture, and then bring this richness to the clinic, where breathing’s pathological counterpart, breathlessness, is the focus.

Our five year project will start by examining breath and breathlessness in literary and cultural history, philosophy and medical history. There has been surprisingly little written on breathing and on the symptom of breathlessness from these perspectives. In the second year we introduce empirical work: a study of ‘aware breathers’ (athletes, singers) and respiratory patients to uncover differences between non-pathological and pathological breathlessness. We will also conduct an ethnographic study looking at the impact of the clinic culture on breathless patients in terms of their bodies, language, and ways of understanding their condition. We will interview COPD patients to try to understand the mismatch between measured and experienced breathlessness, a puzzling clinical phenomenon. As the outputs from humanities research and medical anthropology emerge, in years three and four we will start to explore further with our clinical collaborators how these ideas might inform clinical research and practice. At the core of our project will be our research group, ‘Breathing Space’, where collaborators, including clinicians and experts by experience, will meet regularly to learn from each others’ perspectives, examine a wide variety of ideas about breath, breathing and breathlessness, and discuss research outputs in an interdisciplinary context.

We are fortunate indeed in having gathered a range of expert collaborators to join our exploration of this fascinating and neglected topic. They are: Tim Cole, History of Medicine, Bristol; James Dodd, Respiratory Neuroscientist and Clinician, Bristol; Clair Henderson, patient involvement, British Lung Foundation; Alice Malpass, Anthropology, Bristol, Anne Millar, Respiratory Physician, Bristol; Corinne Saunders, English Studies, Durham; Andrew Russell, Anthropology, Durham; Ronit Yeoli-Tlalim, History of Medicine, Goldsmiths; Gareth Williams, Clincial Medicine and History of Medicine, Bristol; David Swann, Designer, Huddersfield; Veronika Williams, Primary Care Research, Oxford. We will all be expertly shepherded by Mary Robson, our research group facilitator. The project will be looking for three postdoctoral associates in literary/cultural studies, history of medicine and anthropology, as well as PhD students in medical humanities and philosophy.

In developing this project at Durham we have had valuable support from the Institute of Advanced Study and the Wolfson Research Institute for Health and Wellbeing at Durham, and we look forward to the IAS becoming the home for our regular Breathing Space meetings.

We will continue to keep CMH Blog readers posted on the development and progress of the Life of Breath and look forward to hearing from those who have an interest.

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