I’m sat with a clinician. She’s a lung infection specialist. We’re talking windows. Whatever clinic I go to, the conversation always returns to the windows. Windows that don’t open. Windows that can’t be closed, or let in a draft. Windows that need replacing, or windows that were better before being replaced. The irony isn’t lost on me. A respiratory specialist talking about the breath of the building. The breeze coming in. The hospital air moving out. In and out. Inhalation and exhalation. The clinic gasping for breath. All a reminder of the window’s early meaning, vindauga, the ‘wind-eyes’ of the building.
She recounts the story of a hot dry summer. I’ve heard it told before. In the outpatient clinic, staff and patients are wilting in the heat. Windows are open. It’s the older part of the hospital where it’s still possible to open them. Elsewhere the ability to open a window has been designed out of the architecture. Open windows cause aircon chaos. Anyway, here the windows are open, despite the awful noise of construction work below. But at least there’s good clean ‘fresh air’.
Then months later the clinic is thrown into crisis. There’s a new strain of respiratory infection in the cystic fibrosis population. This could easily be fatal for patients already struggling with repeat infections, any one of which could be their last. The inpatient ward fills up with CF patients on high-dose intravenous antibiotics. The labs try to track down the source of the infection and where it could possibly have come from. After much head scratching, suspicion turns to that warm summer, the open windows, construction work going on outside, the digging of foundations below ground level, dust escaping into the air, spores drifting on the breeze. Inhaled by the clinic. Inhaled by its patients. Then coughed up in blood-stained sputum.
In Terror from the Air Peter Sloterdijk offers a meditation on the material technics of breathing and breath. Respiration is something to be technically accomplished, to be assisted by air conditioning, restrictions on smoking, surgical masks, air quality measures, carbon monoxide monitoring, ducting and ventilation, and so on. But such technics are not evenly deployed. They are striated, unequally offering protections to some that are not enjoyed by others. Respiration takes place, we might say, within economies of respirational scarcity. Breathing isn’t dangerous for everyone, but it is for lots of us.
My meeting with the respiratory clinician is one of many undertaken in preparation for a new two year project funded by the Arts and Humanities Research Council on the material politics of buildings, breath and infections (PARC: Pathways, Practices and Architectures: Containing Antimicrobial Resistance in the Cystic Fibrosis Clinic, 2018-2020). There are around eleven thousand people with CF (PWCF) in the UK, a ‘chronic degenerative’ condition that makes breathing perilous. Extending respiratory life for them hangs on all sorts of things, especially aggressive antibiotic treatment. They’re used to the daily routines of inhaling antibiotics in aerosol form, delivered by nebulisers. Antibiotics as vapour, atmosphere, mist. All this suppresses infections for a while at least, but without getting rid of them completely. Those residual colonies of infection, the biotic remnant, are left to evolve into to potentially fatal, resistant, and transmissible cross-infective pathogens. CF lungs become ‘reservoirs’ of infection, harbouring a constantly changing ‘resistiome’.
Biopolitical reflections on breath were at the forefront of our thinking in putting the project together. Sloterdijk draws attention to the material fracturing and divisibility of air, of atmospheres, the structuring of breath and respiration through spaces, places and architectures. We might call these ‘anatomospheres’ in which respiration is seen to retreat or withdraw from shared atmospheres, into airs that are increasingly private. A proliferation of personal respiratory chambers. Breathing is less likely to take place between and amongst shared and entangled airs, than it is to take place in more hermetically contained, secured and surveilled atmospheres.
It’s not at all uncommon to think of bodies and buildings overlaying and substituting for one another. For Mary Douglas the building is the body’s original surrogate: ‘Going through the door’ she writes, ‘… express[es] so many kinds of entrance… crossroads and arches… doorsteps and lintels… worked upon the human body’. Bodies and buildings are awkwardly duplicated within one another, both symbolically and materially. Heidegger thought of buildings as ‘dwelling’ or the embodied finitude of being. Architecture is techne. Buildings lend bodies metaphorical sturdiness (the ‘building blocks of life’). By contrast, bodies give buildings both their liveliness and frailty, their decay, their facades (faces), their permeabilities (vindauga). After the Grenfell tragedy, who could not be wary of architectural clothing, the cladding (cloak) of the body/building? ‘This contrast is at its most intense’, Steven Connor once wrote, ‘… when the physical processes in question are least material, which is to say those carried on or in the air’. Breath disassembles buildings.
In thinking about Walter Benjamin, Böhme suggests that it is through respiration that one ‘breathes’ or absorbs the ‘atmosphere’ of a place. Respiration ‘allows this atmosphere to permeate the self’. He isn’t thinking about infections. Of course not. But he is possibly thinking about the way one might become infected by the atmosphere of a building, for both good or ill.
I have one final story. It’s about waiting. Or rather it’s about waiting rooms. The experience of most people with CF when they enter the architecture of clinical space is one of waiting. This is an acute source of anxiety for people who are told not to share one another’s breath. To sit, at least, ‘two or more chair widths’ from the next person. There must always be a space in which to breathe. A bubble of air around one’s chair. At one of the clinics, designers and architects were commissioned to make waiting more ‘comfortable’ and attractive. They were to give the experience of waiting the atmosphere of leisure, retail, hotel hospitality. Couches and sofas replaced the old 1970s plastic chairs. A new central open-plan plaza, or lobby area, replaced the specialist waiting rooms. Patients, visitors and staff could now move more freely amongst one another, all sharing the same atmosphere. All coming and going from treatment rooms and back again. That’s what the design of public space is supposed achieve, to optimise interaction, to foster networks, linkages, visibility. All, needless to say, known infection risks for people with CF.
Breath and breathing, together with the spaces that guarantee respiratory existence, become the basis for new forms of sociality. There are degrees of atmospheric entanglement and disentanglement. Timothy Campbell says of Sloterdijk that it is as if ‘… the former blood ties of family… had been turned outward from one’s person to now include the breathing space of those whose individual immunitary designs most closely match one’s own’ (97). Blood ties become breath ties. I’m thinking of people with CF when Sloterdijk recalls the devastating use of mustard gas at Ypres. We have to breathe. We have no choice but to breath. It’s the involuntary ambient nature of breathing that forces one to become complicit in one’s own destructibility. As Sloterdijk puts it ‘… unable to refrain from breathing, [they/we] are forced to participate in the obliteration of their own life’. The point is to ask, to whom does this respiratory obliteration most apply and under what kinds of lived material conditions? How are the technics of design and architecture tied into breath, breathing and even obliteration?
Böhme, G. (1993) Atmosphere as the fundamental concept of a new aesthetics. Thesis eleven, 36(1), 113-126
Brown, N. & Nettleton, S. (2016) ‘There is worse to come’: The biopolitics of traumatism in Antimicrobial Resistance (AMR). The Sociological Review, DOI: 10.1111/1467-954X.12446
Campbell, T. C. (2011) Improper life: Technology and biopolitics from Heidegger to Agamben, University of Minnesota Press
Connor, S. (2004) Building Breathing Space, A lecture given at the Bartlett School of Architecture, University College London
Douglas, M. (1966). Purity and danger: An analysis of concept of pollution and taboo, London: Routledge and Kegan Paul
Heidegger, Martin (1971) ‘Building Dwelling Thinking’ In Poetry, Language, Thought. Trans. Albert Hofstadter. New York: Harper Collins, 145-61.
Sloterdijk P. (2009) Terror from the Air, Los Angeles, California: Semiotext
Nik Brown is Professor in Science and Technology Studies in the Department of Sociology at the University of York. He is PI on the AHRC funded PARC project.