Three

NOSE

“You look like shit,” says Dr. Nayak.

It’s early afternoon and I’m back at the Stanford Department of Otolaryngology Head and Neck Surgery Center. I’m splayed out on the examination chair while Nayak nudges an endoscope up my right nostril. The smooth desert dunes I journeyed through ten days ago look like they’ve been hit by a hurricane. I’ll skip the details; let’s just say my nasal cavity is a mess.

“Now your favorite part,” says Nayak, chuckling. Before I sneeze or can consider running away, he grabs the wire brush and pushes it a few inches into my head. “It’s pretty soupy in there,” he says, sounding somewhat pleased. He repeats with the left nostril, places the gunk-covered RNA brushes into a test tube, then scoots me out of the way.

For the past week and a half I’d been waiting for this moment. I’d anticipated removing these plugs and tape and cotton to be a celebratory scene involving high-fives and nasal sighs of relief. I could breathe like a healthy human again!

In reality, it’s minutes of discomfort followed by more obstruction. My nose is such a mess that Nayak has to grab a pair of pliers and insert several inches of cotton swabs into each nostril to keep whatever is up there from spilling onto the floor. Then it’s back to the pulmonary function tests, an X-ray, the phlebotomist, and the rhinologist, repeating all the tests Olsson and I took before the obstruction phase. The results will be ready in a few weeks.


It’s not until I get home that evening and rinse my sinuses several times that I can take a first full breath through my nose. I grab a coat and walk barefoot to the backyard. There are wispy plumes of cirrus clouds moving across the night sky, as big as spaceships. Above them, a few stubborn stars punch through the mist and cluster around a waxing moon.

I exhale stale air from my chest and take in a breath. I smell the sour, old-sock stink of mud. The black-label ChapStick of the damp doormat. A Lysol whiff of the lemon tree and the anise tinge of dying leaves.

Each of these scents, this material in the world, explodes in my head in a Technicolor burst. The scents are so sparkled and alarming that I can almost see them—a billion colored dots in a Seurat painting. As I take in another breath, I imagine all these molecules passing down my throat and into my lungs, pushing deeper into my bloodstream, where they provide fuel for thoughts and the sensations that made them.

Smell is life’s oldest sense. Standing here alone, nostrils flaring, it occurs to me that breathing is so much more than just getting air into our bodies. It’s the most intimate connection to our surroundings.

Everything you or I or any other breathing thing has ever put in its mouth, or in its nose, or soaked in through its skin, is hand-me-down space dust that’s been around for 13.8 billion years. This wayward matter has been split apart by sunlight, spread throughout the universe, and come back together again. To breathe is to absorb ourselves in what surrounds us, to take in little bits of life, understand them, and give pieces of ourselves back out. Respiration is, at its core, reciprocation.

Respiration, I’m hoping, can also lead to restoration. Starting today, I will attempt to heal whatever damage has been done to my body over the past ten days of mouthbreathing and try to ensure ongoing health in the future. I’ll put into practice several thousand years of teachings from several dozen pulmonauts, breaking down their methods and measuring the effects. Working with Olsson, I’ll explore techniques to expand the lungs, develop the diaphragm, flood the body with oxygen, hack the autonomic nervous system, stimulate immune response, and reset chemoreceptors in the brain.

The first step is the recovery phase I’ve just done. To breathe through my nose, all day and all night.

The nose is crucial because it clears air, heats it, and moistens it for easier absorption. Most of us know this. But what so many people never consider is the nose’s unexpected role in problems like erectile dysfunction. Or how it can trigger a cavalcade of hormones and chemicals that lower blood pressure and ease digestion. How it responds to the stages of a woman’s menstrual cycle. How it regulates our heart rate, opens the vessels in our toes, and stores memories. How the density of your nasal hairs helps determine whether you’ll suffer from asthma.

Few of us ever consider how the nostrils of every living person pulse to their own rhythm, opening and closing like a flower in response to our moods, mental states, and perhaps even the sun and the moon.


Thirteen hundred years ago, an ancient Tantric text, the Shiva Swarodaya, described how one nostril will open to let breath in as the other will softly close throughout the day. Some days, the right nostril yawns awake to greet the sun; other days, the left awakens to the fullness of the moon. According to the text, these rhythms are the same throughout every month and they’re shared by all humanity. It’s a method our bodies use to stay balanced and grounded to the rhythms of the cosmos, and each other.

In 2004, an Indian surgeon named Dr. Ananda Balayogi Bhavanani attempted to scientifically test the Shiva Swarodaya patterns on an international group of subjects. Over the course of a month, he found that when the influence of the sun and moon on the Earth was at its strongest—during a full or new moon—the students consistently shared the Shiva Swarodaya pattern.

Bhavanani admitted the data were anecdotal and much more research would be needed to prove that all humans shared in this pattern. Still, scientists have known for more than a century that the nostrils do pulse to their own beat, that they do open and close like flowers throughout the day and night.

The phenomenon, called nasal cycles, was first described in 1895 by a German physician named Richard Kayser. He noticed that the tissue lining one nostril of his patients seemed to quickly congest and close while the other would mysteriously open. Then, after about 30 minutes to 4 hours, the nostrils switched, or “cycled.” The shifting appeared to be influenced less by the moon’s mysterious pull and more by sexual urges.

The interior of the nose, it turned out, is blanketed with erectile tissue, the same flesh that covers the penis, clitoris, and nipples. Noses get erections. Within seconds, they too can engorge with blood and become large and stiff. This happens because the nose is more intimately connected to the genitals than any other organ; when one gets aroused, the other responds. The mere thought of sex for some people causes such severe bouts of nasal erections that they’ll have trouble breathing and will start to sneeze uncontrollably, an inconvenient condition called “honeymoon rhinitis.” As sexual stimulation weakens and erectile tissue becomes flaccid, the nose will, too.

After Kayser’s discovery, decades passed and nobody offered a good reason for why the human nose was lined with erectile tissue, or why the nostrils cycled. There were many theories: some believed this switching provoked the body to flip over from side to side while sleeping to prevent bedsores. (Breathing is easier through the nostril opposite the pillow.) Others thought the cycling helped protect the nose from respiratory infection and allergies, while still others argued that alternate airflow allows us to smell odors more efficiently.

What researchers eventually managed to confirm was that nasal erectile tissue mirrored states of health. It would become inflamed during sickness or other states of imbalance. If the nose became infected, the nasal cycle became more pronounced and switched back and forth quickly. The right and left nasal cavities also worked like an HVAC system, controlling temperature and blood pressure and feeding the brain chemicals to alter our moods, emotions, and sleep states.

The right nostril is a gas pedal. When you’re inhaling primarily through this channel, circulation speeds up, your body gets hotter, and cortisol levels, blood pressure, and heart rate all increase. This happens because breathing through the right side of the nose activates the sympathetic nervous system, the “fight or flight” mechanism that puts the body in a more elevated state of alertness and readiness. Breathing through the right nostril will also feed more blood to the opposite hemisphere of the brain, specifically to the prefrontal cortex, which has been associated with logical decisions, language, and computing.

Inhaling through the left nostril has the opposite effect: it works as a kind of brake system to the right nostril’s accelerator. The left nostril is more deeply connected to the parasympathetic nervous system, the rest-and-relax side that lowers temperature and blood pressure, cools the body, and reduces anxiety. Left-nostril breathing shifts blood flow to the opposite side of the prefrontal cortex, the right area that plays a role in creative thought, emotions, formation of mental abstractions, and negative emotions.

In 2015, researchers at the University of California, San Diego, recorded the breathing patterns of a schizophrenic woman over the course of three consecutive years and found that she had a “significantly greater” left-nostril dominance. This breathing habit, they hypothesized, was likely overstimulating the right-side “creative part” of her brain, and as a result prodding her imagination to run amok. Over several sessions, the researchers taught her to breathe through her opposite, “logical” nostril, and she experienced far fewer hallucinations.

Our bodies operate most efficiently in a state of balance, pivoting between action and relaxation, daydreaming and reasoned thought. This balance is influenced by the nasal cycle, and may even be controlled by it. It’s a balance that can also be gamed.

There’s a yoga practice dedicated to manipulating the body’s functions with forced breathing through the nostrils. It’s called nadi shodhana—in Sanskrit, nadi means “channel” and shodhana means “purification”—or, more commonly, alternate nostril breathing.


I’ve been conducting an informal study of alternate nostril breathing for the past several minutes.

It’s the second day of the nasal breathing “Recovery” phase, and I’m sitting in my living room, my elbows on the cluttered dining room table, softly sucking air through my right nostril, pausing for five seconds, and then blowing it out.

There are dozens of alternate nostril breathing techniques. I’ve started with the most basic. It involves placing an index finger over the left nostril and then inhaling and exhaling only through the right. I did this two dozen times after each meal today, to heat up my body and aid my digestion. Before meals, and any other time I wanted to relax, I’d switch sides, repeating the same exercise with my left nostril open. To gain focus and balance the body and mind, I followed a technique called surya bheda pranayama, which involves taking one breath into the right nostril, then exhaling through the left for several rounds.

These exercises felt great. Sitting here after a few rounds, I sense an immediate and potent clarity and relaxation, even a floatiness. As advertised, I’ve been entirely free of any gastroesophageal reflux. I haven’t registered the slightest stomach ache. Alternate nostril breathing appeared to have delivered these benefits, but these techniques, I’d found, were usually fleeting, lasting only 30 minutes or so.

The real transformation in my body over the last 24 hours came from another practice: letting my nasal erectile tissues flex of their own accord, naturally adjusting the flow of air to suit the needs of my body and brain. It happened because of simply breathing through my nose.

As I’m quietly contemplating all this, Olsson comes barging in. “Good afternoon!” he yells. He’s wearing his shorts and Abercrombie sweatshirt, and he plops down across from me while placing a blood-pressure cuff around his right arm. This is the same position he’s assumed for the last eleven days straight, in pretty much the same clothes. Today, however, there’s no bandage, nose clip, or silicone plugs up his nose. He’s also breathing freely through his nostrils, taking in easy and silent inhales and exhales. His face is flushed, he’s sitting upright, and he’s so keyed up with energy that he can’t stay still.

I figured that some of our new, bright outlook on life was psychosomatic until a few minutes later, when we checked our measurements. My systolic blood pressure had dropped from 142 ten days ago—a deep state of stage 2 hypertension—to 124, still a bit high but just a few points from a healthy range. My heart rate variability increased by more than 150 percent, and my carbon dioxide levels rose around 30 percent, taking me from a state of hypocapnia, which can cause dizziness, numbness in the fingers, and mental confusion, and placing me squarely within the medically normal zone. Olsson showed similar improvements.

And there’s potential for much more. Because pulsing nasal cycles are only a small part of the nose’s vital functions.

Imagine for a moment that you’re holding a billiard ball at eye level a few inches from your face. Then imagine slowly pushing that entire ball inside the center of your face. The volume the ball would take up, some six cubic inches, is equivalent to the total space of all the cavities and passageways that make up the interior of the adult nose.

In a single breath, more molecules of air will pass through your nose than all the grains of sand on all the world’s beaches—trillions and trillions of them. These little bits of air come from a few feet or several yards away. As they make their way toward you, they’ll twist and spool like the stars in a van Gogh sky, and they’ll keep twisting and spooling and scrolling as they pass into you, traveling at a clip of about five miles per hour.

What directs this rambling path are turbinates, six maze-like bones (three on each side) that begin at the opening of your nostrils and end just below your eyes. The turbinates are coiled in such a way that if you split them apart, they’d look like a seashell, which is how they got their other name, nasal concha, after the conch shell. Crustaceans use their elaborately designed shells to filter impurities and keep invaders out. So do we.

The lower turbinates at the opening of the nostrils are covered in that pulsing erectile tissue, itself covered in mucous membrane, a nappy sheen of cells that moistens and warms breath to your body temperature while simultaneously filtering out particles and pollutants. All these invaders could cause infection and irritation if they got into the lungs; the mucus is the body’s “first line of defense.” It’s constantly on the move, sweeping along at a rate of about half an inch every minute, more than 60 feet per day. Like a giant conveyor belt, it collects inhaled debris in the nose, then moves all the junk down the throat and into the stomach, where it’s sterilized by stomach acid, delivered to the intestines, and sent out of your body.

This conveyor belt doesn’t just move by itself. It’s pushed along by millions of tiny, hair-like structures called cilia. Like a field of wheat in the wind, cilia sway with each inhale and exhale, but do so at a fast clip of up to 16 beats per second. Cilia closer to the nostrils gyrate at a different rhythm than those farther along, their movements creating a coordinated wave that keeps mucus moving deeper. The cilia grip is so strong that it can even push against the force of gravity. No matter what position the nose (and head) is in, whether it’s upside down or right-side up, the cilia will keep pushing inward and down.

Working together, the different areas of the turbinates will heat, clean, slow, and pressurize air so that the lungs can extract more oxygen with each breath. This is why nasal breathing is far more healthy and efficient than breathing through the mouth. As Nayak explained when I first met him, the nose is the silent warrior: the gatekeeper of our bodies, pharmacist to our minds, and weather vane to our emotions.


The magic of the nose, and its healing powers, wasn’t lost on the ancients.

Around 1500 BCE, the Ebers Papyrus, one of the oldest medical texts ever discovered, offered a description of how nostrils were supposed to feed air to the heart and lungs, not the mouth. A thousand years later, Genesis 2:7 described how “the Lord God formed man of the dust of the ground, and breathed into his nostrils the breath of life; and man became a living soul.” A Chinese Taoist text from the eighth century AD noted that the nose was the “heavenly door,” and that breath must be taken in through it. “Never do otherwise,” the text warned, “for breath would be in danger and illness would set in.”

But it wasn’t until the nineteenth century that the Western population ever considered the glories of nasal breathing. It happened thanks to an adventurous artist and researcher named George Catlin.

By 1830, Catlin had left what he called a “dry and tedious” job as a lawyer to become a portrait painter for Philadelphia’s high society. He became well-known for his depictions of governors and aristocrats, but all the pomp and pretention of polite society did not impress him. Although his health was failing, Catlin yearned to be far away in nature, to capture rawer and more real depictions of humanity. He packed a gun, several canvases, a few paintbrushes, and headed west. Catlin would spend the next six years traveling thousands of miles throughout the Great Plains, covering more distance than Lewis and Clark to document the lives of 50 Native American tribes.

He went up the Missouri to live with the Lakota Sioux. He met with the Pawnee, Omaha, Cheyenne, and Blackfeet. Along the banks of the Upper Missouri, he happened upon the civilization of the Mandan, a mysterious tribe whose members stood six feet tall and lived in bubble-shaped houses. Many had luminous blue eyes and snow-white hair.

Catlin realized that nobody really knew about the Mandan, or other Plains tribes, because no one of European descent had bothered to spend time talking to them, researching them, living with them, and learning about their beliefs and traditions.

I am traveling this country, as I have before said, not to advance or to prove theories, but to see all I am able to see and to tell it in the simplest and most intelligible manner I can to the world, for their own conclusions,” Catlin wrote. He would paint some 600 portraits and take hundreds of pages of notes, forming what famed author Peter Matthiessen would call “the first, last, and only complete record ever made of the Plains Indians at the height of their splendid culture.”

The tribes varied region by region, with different customs, traditions, and diets. Some, like the Mandan, ate only buffalo flesh and maize, while others lived on venison and water, and still others harvested plants and flowers. The tribes looked different, too, with varying hair colors, facial features, and skin tones.

And yet Catlin marveled at the fact that all 50 tribes seemed to share the same superhuman physical characteristics. In some groups, such as the Crow and the Osage, Catlin wrote there were few men, “at their full growth, who are less than six feet in stature, and very many of them six and a half, and others seven feet.” They all seemed to share a Herculean make of broad shoulders and barrel chests. The women were nearly as tall and just as striking.

Having never seen a dentist or doctor, the tribal people had teeth that were perfectly straight—“as regular as the keys of a piano,” Catlin noted. Nobody seemed to get sick, and deformities and other chronic health problems appeared rare or nonexistent. The tribes attributed their vigorous health to a medicine, what Catlin called the “great secret of life.” The secret was breathing.

The Native Americans explained to Catlin that breath inhaled through the mouth sapped the body of strength, deformed the face, and caused stress and disease. On the other hand, breath inhaled through the nose kept the body strong, made the face beautiful, and prevented disease. “The air which enters the lungs is as different from that which enters the nostrils as distilled water is different from the water in an ordinary cistern or a frog-pond,” he wrote.

Healthy nasal breathing started at birth. Mothers in all these tribes followed the same practices, carefully closing the baby’s lips with their fingers after each feeding. At night, they’d stand over sleeping infants and gently pinch mouths shut if they opened. Some Plains tribes strapped infants to a straight board and placed a pillow beneath their heads, creating a posture that made it much harder to breathe through the mouth. During winter, infants would be wrapped in light clothing and then held at arm’s length on warmer days so they’d be less prone to get too hot and begin panting.

All these methods trained children to breathe through their noses, all day, every day. It was a habit they would carry with them the rest of their lives. Catlin described how adult tribal members would even resist smiling with an open mouth, fearing some noxious air might get in. This practice was as “old and unchangeable as their hills,” he wrote, and it was shared universally throughout the tribes for millennia.


Twenty years after Catlin explored the West, he set off again, at age 56, to live with indigenous cultures in the Andes, Argentina, and Brazil. He wanted to know if “medicinal” breathing practices extended beyond the Plains. They did. Every tribe Catlin visited over the next several years—dozens of them—shared the same breathing habits. It was no coincidence, he reported, that they also shared the same vigorous health, perfect teeth, and forward-growing facial structure. He wrote about his experiences in The Breath of Life, published in 1862. The book was devoted solely to documenting the wonders of nasal breathing and the hazards of mouthbreathing.

Catlin was not only a chronicler of breathing methods; he was a practitioner. Nasal breathing saved his life.

As a boy, Catlin snored and was wracked with one respiratory problem after another. By the time he reached his 30s and first went out West, these problems had become so severe that he’d sometimes spit up blood. His friends were convinced he had lung disease. Every night Catlin feared he would die.

“I became fully convinced of the danger of the habit [mouthbreathing], and resolved to overcome it,” he wrote. Through “sternness of resolution and perseverance,” Catlin forced his mouth closed while he slept and always breathed through his nose during waking hours. Soon, there were no more aches, pains, or bleeding. By his mid-30s, Catlin reported feeling healthier and stronger than at any other time in his life. “I at length completely conquered an insidious enemy that was nightly attacking me in my helpless position, and evidently fast hurrying me to the grave,” he wrote.

George Catlin would live to be 76, about double the average life expectancy at the time. He credited his longevity to the “great secret of life”: to always breathe through the nose.


It’s the third night of the nasal breathing phase of the experiment, and I’m sitting up in bed reading, taking slow and easy breaths through my nose. I’m not breathing this way out of some “constant adult conviction,” as Catlin wrote. I’m doing it because my lips are taped shut.

Catlin suggested tying a bandage around the jaw at night, but that sounded dangerous and difficult, so I opted for another technique, which I’d heard about months earlier from a dentist who runs a private practice in Silicon Valley.

Dr. Mark Burhenne had been studying the links between mouthbreathing and sleep for decades, and had written a book on the subject. He told me that mouthbreathing contributed to periodontal disease and bad breath, and was the number one cause of cavities, even more damaging than sugar consumption, bad diet, or poor hygiene. (This belief had been echoed by other dentists for a hundred years, and was endorsed by Catlin too.) Burhenne also found that mouthbreathing was both a cause of and a contributor to snoring and sleep apnea. He recommended his patients tape their mouths shut at night.

“The health benefits of nose breathing are undeniable,” he told me. One of the many benefits is that the sinuses release a huge boost of nitric oxide, a molecule that plays an essential role in increasing circulation and delivering oxygen into cells. Immune function, weight, circulation, mood, and sexual function can all be heavily influenced by the amount of nitric oxide in the body. (The popular erectile dysfunction drug sildenafil, known by the commercial name Viagra, works by releasing nitric oxide into the bloodstream, which opens the capillaries in the genitals and elsewhere.)

Nasal breathing alone can boost nitric oxide sixfold, which is one of the reasons we can absorb about 18 percent more oxygen than by just breathing through the mouth. Mouth taping, Burhenne said, helped a five-year-old patient of his overcome ADHD, a condition directly attributed to breathing difficulties during sleep. It helped Burhenne and his wife cure their own snoring and breathing problems. Hundreds of other patients reported similar benefits.

The whole thing seemed a little sketchy until Ann Kearney, a doctor of speech-language pathology at the Stanford Voice and Swallowing Center, told me the same. Kearney helped rehabilitate patients who had swallowing and breathing disorders. She swore by mouth taping.

Kearney herself had spent years as a mouthbreather due to chronic congestion. She visited an ear, nose, and throat specialist and discovered that her nasal cavities were blocked with tissue. The specialist advised that the only way to open her nose was through surgery or medications. She tried mouth taping instead.

“The first night, I lasted five minutes before I ripped it off,” she told me. On the second night, she was able to tolerate the tape for ten minutes. A couple of days later, she slept through the night. Within six weeks, her nose opened up.

“It’s a classic example of use it or lose it,” Kearney said. To prove her claim, she examined the noses of 50 patients who had undergone laryngectomies, a procedure in which a breathing hole is cut into the throat. Within two months to two years, every patient was suffering from complete nasal obstruction.

Like other parts of the body, the nasal cavity responds to whatever inputs it receives. When the nose is denied regular use, it will atrophy. This is what happened to Kearney and many of her patients, and to so much of the general population. Snoring and sleep apnea often follow.

Keeping the nose constantly in use, however, trains the tissues inside the nasal cavity and throat to flex and stay open. Kearney, Burhenne, and so many of their patients healed themselves this way: by breathing from their noses, all day and all night.

How to apply mouth tape, or “sleep tape” as it’s also called, is a matter of personal preference, and everyone I talked to had their own technique. Burhenne liked to place a small piece horizontally over the lips; Kearney preferred a fat strip over the entire mouth. The internet was filled with suggestions. One guy used eight pieces of inch-wide tape to create a sort of tape goatee. Another used duct tape. A woman suggested taping the entire lower half of the face.

To me, these methods are ridiculous and excessive. Looking for an easier way, over the last few days I conducted my own experiments with blue painter’s tape, which smelled weird, and Scotch tape, which crinkled. Band-Aids were too sticky.

Eventually I realized that all I or anyone really needed was a postage-stamp-size piece of tape at the center of the lips—a Charlie Chaplin mustache moved down an inch. That’s it. This approach felt less claustrophobic and allowed a little space on the sides of the mouth if I needed to cough or talk. After much trial and error, I settled on 3M Nexcare Durapore “durable cloth” tape, an all-purpose surgical tape with a gentle adhesive. It was comfortable, had no chemical scent, and didn’t leave residue.

In the three nights since I started using this tape, I went from snoring four hours to only ten minutes. I’d been warned by Burhenne that sleep tape won’t do anything to help treat sleep apnea. My experience suggested otherwise. As my snoring disappeared, so did apnea.

I’d suffered up to two dozen apnea events in the mouthbreathing phase, but last night had zero. I suffered no creepy insomniac hallucinations, no late-night ruminations on Homo habilis or Edward Gorey. I never woke up needing to pee. I didn’t have to, because my pituitary gland was likely releasing vasopressin. I was finally sleeping soundly.

Meanwhile, Olsson went from snoring half the night to not snoring for even a minute. His apnea events dropped from 53 to zero. The bright-eyed, cotton-haired Swede I’d felt so guilty about abusing had been reborn. Earlier today he was smiling, so convinced of sleep tape’s healing power that he kept a piece of it stuck to his lips for the rest of the morning.

Sleep, and life, had become something that Olsson and I embraced again. Now, sitting in bed, with a little stamp of white tape stuck to my lips, I flipped to the last page in Catlin’s Breath of Life, the final paragraph he’d ever publish in his long life of research.

“And if I were to endeavor to bequeath to posterity the most important Motto which human language can convey, it should be in three words—SHUT-YOUR-MOUTH. . . . Where I would paint and engrave it, in every Nursery, and on every Bed-post in the Universe, its meaning could not be mistaken.

“And if obeyed,” he continued, “its importance would soon be realized.”