The spirometer and the normal subjects

During one of the Life of Breath project research meetings in 2018, consultant Dr Sara Booth recounted the story of a school teacher who felt such pressure to consistently hold her stomach in when standing in front of the class that her subsequent propensity to breathe costally (from her chest) impacted on her ability to breathe in fully – with the result that her respiratory problems were exacerbated. As I sat listening to Dr Booth talk, I wondered: how much does such lived experience of being a woman in the world impact on the ability to fill our lungs? Are we not taking our fair share of air? I argue here that we must also consider how life experiences might impact on respiration. The way that we experience breathlessness is moderated by both the mind and the body. Furthermore, levels of breathlessness cannot be consistently linked to discrete phases of illness.1 Yet attempts to capture this experience with objective measures such as those offered by spirometry have obscured this multidimensional quality.2 As a result, the measurement of breathlessness in a strictly medical paradigm has privileged the physiological symptoms of breathlessness in a way that fails to account for the lived experience of the patient.3 Increasingly, researchers have demonstrated disconnect between the subjective individuality of breathlessness and its numerical correlation.4 In this chapter I argue that considering the history of the measurement of breathlessness sheds light on this recurring disjunct between objective and subjective measures. This chapter explores how the drive to translate breathlessness into quantifiable, scalable measures has been influenced by complex historical interactions between medical expertise, industrial interests and compensation schemes. Considering these historical interactions highlights the related processes by which we have variously decided which groups counted as medically