BREATHLESS

“The drama is a perfect foil for the realities of the scourge of
cardiovascular disease—certainly the number one killer in the US—
and so avoidable.”
—Roger Price,
Pioneer in Functional Breathing and Airway Health;
Author of The Way We Breathe Is Killing Us
“It is rare to find a book that is both medically insightful and
emotionally precise.”
—Mark Burhenne, DDS,
Founder of Ask the Dentist;
Author of The 8-Hour Sleep Paradox
“Dr. Sokolina takes this complex science and through real life stories
reveals how to change the course of chronic disease.”
—Nathan S. Bryan PhD,
Author of Functional Nitric Oxide Nutrition
“Works like Dr. Maria Sokolina’s empower readers to ask better
questions, seek informed guidance, and take an active role in
their well-being.”
—Sandra Kahn,
Author of Jaws

BREATHLESS
A MEDICAL MYSTERY OF
THE HIDDEN EPIDEMIC
MARIA SOKOLINA
Copyright © 2026 Maria Sokolina
All rights reserved.
The manufacturer’s authorized representative in the EU for product safety is:
Authorised Rep Compliance Ltd, 71 Lower Baggot Street,
Dublin D02 P593 Ireland
(www.arccompliance.com)
Breathless
A Medical Mystery of the Hidden Epidemic
ISBN 979-8-90102-198-9 Paperback
979-8-90102-199-6 Hardcover
979-8-90102-200-9 Ebook
For Mike, Matt, and Benjamin—
and for the family who crossed oceans with me,
in life and in memory.

Contents
Introduction 13
Chapter 1. T he H eart of the Matter 19
Chapter 2. While the C lock Stands Still 31
Chapter 3. What A bsence L eaves B ehind 47
Chapter 4. P atterns i n the F og 55
Chapter 5. Between the Shock
and the Investigation 61
Chapter 6. Li ving on Fi re 73
Chapter 7. C lues i n the D ark 87
Chapter 8. “In His Sleep” 101
Chapter 9. T he Mask of Survival 115
Chapter 10. Fi ght for L ove and B reath 131
Chapter 11. T hrough the N arrow P ass age 143
Chapter 12. When B reath B ecomes L egacy 155
Chapter 13. B efore It’s T oo L ate 169
Chapter 14. T he R eturn of T ouch 181
Chapter 15. Di et of D esi re 195
Chapter 16. T he L anguage of F ood 213
Chapter 17. C ravings and C ross roads223
Chapter 18. T he Hi dden F lame 241
Chapter 19. T he A rrows P oint B oth Ways259
Chapter 20. The H ope of R ebuilding 279
Chapter 21. T he P attern Was R eaching F urther 297
Chapter 22. The Shape of T ensi on 313
Chapter 23. Fault Li ne 327
Chapter 24. Before the Tw o Li nes337
Chapter 25. New Maps349
Chapter 26. Home, R ewritten 357
Resources367
Acknowledgments373
When we are no longer able to change a situation,
we are challenged to change ourselves.
—Viktor Fr ankl

I n t r o d u c t i o n · 13
Introduction
I stood alone on the spiky shore of the Galápagos Islands, where
ancient lava flows had hardened into dark stone. The wind tangled
in my hair, and the ground felt raw and alive. Hundreds of black
marine iguanas, creatures so strange they seemed pulled from
myth, stretched across the volcanic rock before me, sunning their
salt-encrusted bodies after foraging deep in the sea. Their long,
almost human-like fingers stretched across the warm lava, their
skin glistening. Their movements were graceful. Some climbed trees.
Others chewed seaweed. A few disappeared under the waves, capable
of holding their breath for nearly an hour.
I couldn’t stop staring. Regular iguanas, the ones we know on the
mainland, rarely enter the water. They live on land, eat insects, and
only slip into the sea when they have to escape predators. But these?
These had changed and adapted. Faced with starvation and a hostile
environment, they became something entirely new. These iguanas,
when facing prolonged food shortages, can actually shrink their
skeletons. Their bones become smaller, their bodies tighter, as an
evolutionary response to survive.
At that moment, I thought about us, humans, and how we, too, adapt.
As a dentist, I see patients every day who are drained, clenching their
jaws, and suffocating silently at night. People grind their teeth until
14 · B RE AT HL E S S
they crack. They’ve been told their symptoms are “normal.” Snoring is
seen as a generational habit. Fatigue is just modern life, and insomnia
is due to stress.
I’m not so sure about any of that.
I’ve noticed that human jaws are shrinking. Tongues no longer fit
in the mouth. Teeth are crowded and twisted. I’ve observed bone
growing in unusual places, called palatal tori and mandibular
ridges. It’s as if the body is trying to compensate for something lost.
Could this be the result of the sedentary, lack of movement lifestyle
progressing through human history?
What if these are signs of another form of adaptation? One we haven’t
yet learned how to read?
What if I stopped treating the symptoms and started decoding the story?
Then I remembered Darwin. Almost two centuries ago, he stood
somewhere near this very place, observing the animals. Here, he
began asking the right questions.
That day on the Galápagos, I realized the mysteries I was seeing in
my dental chair were clues. They were part of a larger evolutionary
story about sleep, breath, adaptation, and survival.
The iguana’s transformation is a visible, measurable reaction to scarcity.
Yet, why are human faces shrinking in an era of abundance? Why
are we witnessing narrower airways and sleep disorders at epidemic
rates? Could this be a biological response to our modern environment—
processed foods, sedentary habits, artificial lighting, chronic stress?
As dentists, we see these subtle patterns every day. However, we
occupy a strange corner of the medical world—close to the airway
I n t r o d u c t i o n · 15
and to the brain, yet often left out of the conversation. We witness
evolution in real time, but rarely are we asked what we see.
Over three decades, I began noticing a troubling pattern. The same
patients who returned with broken teeth, TMJ pain, or periodontal
disease were also grappling with chronic medical conditions—high
blood pressure, atrial fibrillation, diabetes, acid reflux, arthritis, and
even depression. These weren’t isolated dental problems; they were
signals of something deeper and systemic. People in their thirties
were already talking about feeling old and exhausted.
Even more alarming, I saw children in elementary school suffering
from poor sleep, behavioral issues, and diagnoses like ADHD. It
became clear to me that the traditional boundaries between dentistry
and medicine weren’t serving our patients. We’ve been trained to
work in silos, but health doesn’t live in a silo.
In this book, I’m searching for a more united approach that honors
the wisdom of both traditional medicine and dentistry, one that
brings them together to form a clearer path toward real healing.
Realize that the mouth is not separate from the body, and the body
is not separate from the story it’s living.
This book is my attempt to give voice to what’s been silent. It is born
from three decades of dentistry, from nearly twenty years of treating
sleep, from my own story as a long-suffering orthodontic patient,
and as a doctor trained in both the full-body approach of Russian
medicine and the precise isolation of American dentistry. It’s an
attempt to draw an elegant, readable picture from the various signs
we find in the mouth and to offer hope for those who are tired and
gasping for air without knowing why.
Sometimes, the key to surviving the modern world lies hidden in
our oldest instincts.
16 · B RE AT HL E S S
I chose to write this book as fiction with real expert voices because
health is not pure science but a deeply personal story. Clinical texts
often make conditions like sleep apnea or CPAP struggles feel distant.
Behind every diagnosis is a person with fears, habits, and hopes.
Fiction allows me to bring these human dimensions to life, revealing
not only how decisions are made in moments of vulnerability, but also
how healing unfolds through relationships, trial and error, moments
of intuition, and unexpected breakthroughs. Through the eyes of
my characters, readers can feel what it’s like to search for answers,
to struggle, to be misunderstood, and finally to begin seeing the
situation under a different light.
At the same time, I’ve put real insights from trusted experts into
the narrative, grounding the story in evidence-based medicine.
This blend helps break down the invisible wall between patient and
medical professional, making the clinical world more transparent
and relatable. Ultimately, this is the book I wish I had read earlier in
my journey. I would like my readers to reflect, ask better questions,
and recognize themselves in the lives of others. Stories can carry
truths in ways facts alone never can.
At its heart, this is a story about healing, but not just the kind that
happens in clinics. It’s about the process that unfolds when family
members begin to understand each other. When a mother sees herself
in her child’s symptoms. When a man recognizes his fatigue not as
weakness but as a signal.
I’ve seen how a dramatic, near-death moment can awaken an entire
family, pulling them out of autopilot, forcing them to look at one
another with new eyes. In that awakening, something beautiful can
happen: the return of love, empathy, and care. As banal as it may
sound, healing the body often opens the heart.
This book is for those who dare to ask not, “What’s wrong with me?”
but instead, “What is my body trying to say?”
I n t r o d u c t i o n · 17
It’s for the reader who loves family dramas and medical mysteries,
because in real life, those two are often intertwined. Illness doesn’t
happen in a vacuum. It spreads through marriages, generations, or
sometimes silence.
We don’t read books like this just for information, but to feel less
alone and to find hope where once only confusion existed. If you’re a
parent, a partner, or someone who’s simply tired of feeling tired, you
may see yourself or someone you love in these pages. You’ll discover
that the unexplained symptoms, the broken sleep, the mood swings,
the clenching, the burnout . . . they’re not just random. They are
connected with real, actionable solutions woven throughout this story.
If you’re a medical or dental professional, this book is an invitation
to reignite your curiosity and to see each patient as a mystery worth
solving. With a view shaped by evolution, philosophy, and integrative
care, this story may help you rediscover the wonder in your work and
protect you from the soul-eroding fatigue that comes from treating
body parts instead of people.
My hope is that everyone will walk away with insight, with a new
lens for looking at your own body, your patients, and your family—a
view that lets you see how health and dysfunction pass through
generations. This book might change the way you observe and care
for others, and for yourself.

T h e H e a r t o f t h e M a t t e r · 19
CHAPTER ONE:
The Heart of the Matter
Olga
Olga thought the worst part of her morning was the bitter taste of
yesterday’s argument, until she heard the sound that split her world
in two.
The day had begun like any other, unusually warm for fall, with a
beautiful symphony of colorful leaves outside her window. As Olga
walked from Zoyi’s room to the bathroom, she paused for a moment
to admire them.
I still have to make a peanut butter sandwich, pack my lunch, and get
Zoyi ready for school.
Off to the side, she noticed the habitual mess of dirty plates next
to the kitchen sink. Chinese takeout leftovers spread a stale, greasy
smell of garlic.
She stepped up to the bathroom sink and retrieved her toothbrush.
From the kitchen, the coffee machine hissed. Olga loved that
comforting aroma of freshly brewed coffee. It had been Eugene’s
ritual since she joined him here in America. Every morning, he would
wake up and brew the coffee. In the beginning, he would bring it to
20 · B RE AT HL E S S
her in bed some days, like in a romantic French movie. It was hard
to imagine anything like that now. The sharp needle of yesterday’s
argument pricked her heart again.
Olga began brushing her teeth. Suddenly, she heard a thud.
What did he drop this time?
A deep, guttural groan echoed through the room. Another heavy
crash followed.
Olga’s heart skipped. A cold spasm gripped her stomach. Panic’s sticky
sweat ran down her back. Her feet barely touched the floor as she
dashed to the nearby kitchen.
She found Eugene lying next to the kitchen cabinets. His body was
twisted at an unnatural angle. His face was a greyish pale, lips tinged blue.
Time seemed to freeze around her. Eugene’s chest was absolutely still.
The faint ticking of the clock echoed, while the thunder of her pulse
roared in her head.
She fell to her knees beside him.
“Eugene! Wake up!”
She gripped his shoulders and shook him. Frantic, she slapped his
cheeks, just like in the movies when someone loses consciousness.
She remembered the emergency protocol she was taught as a dental
assistant. I need to give him ammonia to breathe and lift up his feet.
For a moment, she thought he might have just fainted, that it was
something minor, just a moment of dizziness.
T h e H e a r t o f t h e M a t t e r · 21
But the cold, heavy stillness of his body frightened her. Her legs
shook as she ran to get her phone. Panic made her fingers slip. She
dialed 9-1-1, but words tangled in her throat. A lump overlapped
her voice as she spoke to the dispatcher. “My husband . . . he’s not
breathing! I think he’s having a heart attack!”
“Stay calm, ma’am.” The operator’s voice was steady, offering her a
small thread of hope. “Do you know CPR?”
“Y-yes,” she stuttered. Her dental office had recently mandated first
aid training for all employees. The CPR lessons from last week surged
to the forefront of her mind. “Yes, I do.”
“Put the phone on speaker mode. Start compressions. I’m sending
help now. I will stay on the line with you,” the dispatcher instructed,
her voice firm and urgent. Then she asked, “Are you at 532
Woodland Drive?”
Olga placed her trembling hands on Eugene’s chest and began the
compressions. “Yes,” she choked out.
His body felt rigid and lifeless beneath her touch. She interlocked her
fingers, straightened her arms, and began pressing down. Counting
under her breath, each compression felt like a battle against fate.
The dispatcher counted alongside her, urging her to breathe, to
maintain her own rhythm steady as she fought to breathe life back
into Eugene.
As she pressed, flashes of memory crashed through her mind, swift
and painful. She thought of the time they met as little kids. They had
grown up in the same apartment building in St. Petersburg, Russia.
They attended the same school and had almost always been the best
of friends. She remembered the bond they shared, how they would
spend hours talking, laughing, and playing games in the yard so
22 · B RE AT HL E S S
many years ago. Eugene had always been there under her skin, even
when life took them in different directions.
She heard the rhythmic voice of the 9-1-1 operator. The compressions
seemed to stretch on for eternity. Her arms were tiring, but she
ignored it and kept going. Tears fell onto her hands as she pressed,
and her blond curls clung to her face.
Her thoughts flashed through the years when Eugene left for America,
how their lives diverged, yet they remained connected by the letters
he sent. Olga would receive colorful envelopes with his handwriting.
Each one detailed his new life in a foreign land. His words felt like
tiny pieces of his world, a world she thought she would never see as
her own.
“Come on, Eugene, breathe! Please!” she shouted. Her hands pushed
harder, maintaining the steady rhythm of the compressions. Inside,
a storm of thoughts raged.
Don’t you dare leave me now. I cannot live without you. What about
Zoyi? You have to wake up. We have Zoyi to take care of.
Her memories and feelings were a swirl, fighting against the present
terror. She had once dreamed of a life with Eugene, a life brimming
with promise. Now, that assurance teetered on the edge of destruction.
Would it all come crashing down?
She had followed him to America, believing in the future they
could build together, in the connection they shared. But now, with
Eugene’s body unresponsive beneath her hands, she couldn’t help
but feel that all those beautiful dreams had been built on something
fragile and too easily shattered.
The wail of sirens pierced through the fog in her mind.
T h e H e a r t o f t h e M a t t e r · 23
“Open your door!” The operator’s voice echoed in Olga’s ears. Her
knees were numb, refusing to cooperate. With her last drops of energy,
she stumbled to the door. Two paramedics rushed in.
A tall woman, her graying hair pulled back into a tight ponytail,
took charge immediately. She assessed Eugene’s condition with swift
precision and checked his pulse.
“Unresponsive. No pulse. Starting compressions—go!” she
commanded sharply, already moving into position. “Start bagging.”
Another paramedic, a man with a serious expression, hurried to
set up the bag-valve mask. He attached it to an oxygen tank and
secured it over Eugene’s face.
He grabbed the defibrillator from his bag, pulling out the electrodes
with practiced ease. “We’re going to shock him,” he said to Olga. His
voice was calm, yet urgent. “You better leave.”
Olga shook her head. No way I am leaving him now.
“Pads on. Charging. Clear on my mark.”
“Clear!” The lead paramedic shouted, stepping back from Eugene’s body.
The other paramedic administered the shock. The force of the current
surged through Eugene’s body like a violent pulse, rattling his limbs.
The ECG on the portable monitor beeped erratically as the readings
spiked, then settled into a weak rhythm.
“Pulse return! We’ve got a pulse!” The lead paramedic called out,
his voice coming to Olga’s ears through the heavy fog of terror and
despair. She did not want to leave the kitchen. She was praying to
someone powerful now. Do not take him, please. I need him so much.
24 · B RE AT HL E S S
Eugene’s chest rose and fell with labored breaths. The other paramedic
swiftly inserted a needle into his arm, setting up the IV line to
administer fluids and medications. They worked diligently over him—
one adjusting the flow of fluids through the IV, the other ensuring
the oxygen mask stayed securely in place over his face.
“Continue bagging him,” the lead paramedic instructed. She checked
the IV and prepared another dose of medication.
“Let’s work on him here for a bit. We don’t want a crash in the rig,”
said the lead paramedic.
Olga was hit by a wave of dizziness. She had to stay strong. Her eyes
darted to the doorway. There stood Zoyi in her pajamas, staring with
wide, wet eyes, filled with confusion and fear. Olga hurried to her,
trying to shield the scene with her body. Her legs were heavy, but she
forced herself to kneel in front of Zoyi.
“Baby, it’s okay,” she whispered, her voice trembling. “Vse budet
horosho. I promise.” She pulled her daughter into a tight hug. Zoyi’s
tiny body shook against her. “I’ve got you. We’re going to be okay.”
Zoyi clung to her mother, her sobs muffled into Olga’s shoulder.
“Amiodarone administered,” the woman paramedic confirmed, her
eyes shifting to the monitor. She turned to Eugene, her gaze sharp,
searching for any signs of stability.
“We need to move him now.”
As they transferred Eugene onto the stretcher, Olga absorbed the
chaos unfolding around her. She heard the wind whispering against
the windows and sensed the sterile scent permeating the room as
the paramedic team maneuvered Eugene’s limp body.
T h e H e a r t o f t h e M a t t e r · 25
Olga hurried toward the paramedics without a second thought.
“I’m coming with you,” she said, her voice trembling. “Please, let me
go with him. I need to be there.”
With a calm, firm presence, the lead paramedic said, “Ma’am, we
need to keep the space clear for the equipment and to focus on your
husband’s care. You can follow us in a separate vehicle, but you can’t
ride in the ambulance right now.”
Olga’s breath caught in her throat. The tragic heaviness of the situation
hit her all at once. “But . . . I can’t just let him go without me,” she
protested, her voice breaking.
The paramedic offered a sympathetic look. “I understand,“ he said,
“but we’re doing everything we can to help him.”
Olga’s legs were weak. She sat down, spotting Eugene’s socks
abandoned on the kitchen table.
They wheeled Eugene out of the apartment.
Her mind raced, trying to comprehend everything that had happened.
How had they gotten here?
The night before swirled inside Olga’s head.
She thought of the harsh words she had thrown at him in frustration.
They had been arguing in the kitchen after dinner. The leftover plates
from their rushed meal sat on the counter. Olga had been irritated by
that constant mess. Eugene, exhausted as always, had sat slouched at
the table, staring at his phone.
Olga had already cleaned the house that day to the best of her abilities
in between Zoyi’s school activities and her work. Yet, the kitchen
26 · B RE AT HL E S S
still felt cluttered. The dirty dishes were mocking her. Eugene had
promised to help, but he never did. His energy seemed nonexistent.
Every attempt to motivate him fell flat. His constant fatigue had become
a source of tension between them. She had to manage everything:
her career, the house, and Zoyi. She felt so desperately alone in this.
Olga’s patience had snapped when she walked into the kitchen after
putting Zoyi to bed and found the same stack of dishes from dinner
still untouched . . . for the thousandth time.
Eugene was slumping on the chair. When she asked him to clean up,
his only response was a weary sigh.
“Why can’t you just help me for once?” she’d shouted. Her voice boiled
with anger. “I’m working here, Eugene! I’m doing everything! And
you—you’re just sitting there! Do you even see what I’m doing? Why
is it always me?”
Her words settled in the kitchen, harsh and raw. The frustration
she had held inside for months finally spilled out. She didn’t care if
the whole world heard it. “You can’t even do the dishes, Eugene! It’s
always the same damn thing—you’re always too tired! Well, guess
what? I’m tired too!”
Eugene had looked at her with total helplessness. He didn’t say a word
in his defense. He never did. Instead, he rubbed his tired eyes and
muttered a soft apology, which only fueled her anger.
“You’re always apologizing, but nothing changes! You can’t even
help with Zoyi. I’m running around like a damn fool, trying to fix
everything myself. Nadoelo. I can’t do this anymore!” Her voice broke
as she snapped.
The silence that followed was suffocating. Eugene had turned away,
his back bent even more, as if hiding from her brutal words.
T h e H e a r t o f t h e M a t t e r · 27
Olga left the kitchen, consumed by anger. Frustration gnawed at
her, and an overwhelming sense of sadness lingered.
The argument had ended there, with both retreating to different
corners of their lives and separate bedrooms, reflecting the widening
gap between them. Olga had stopped sleeping in the master
bedroom some time ago, not only because of Eugene’s snoring but
also due to the lack of physical warmth and the constant arguments.
As she sat in the same kitchen, after watching him so still and
lifeless on the floor, the weight of that argument returned in waves.
She had been furious inside for a long time, so angry with him for
not being there and not helping. But now, she realized it wasn’t just
about the dishes or the cleaning. It was about him being drained
all the time. Most likely, it was something deeper.
His fatigue and constant exhaustion had been there long before
this night. He always seemed to be on the edge of falling asleep at
the dinner table or during conversations. That part irritated Olga
beyond her control. It had become normal, part of their routine.
She had been so focused on the daily grind, on keeping everything
afloat, that she never took a step back to think that maybe there
was more to it than just “fatigue.” She had assigned it to stress, to
the weight of his “start up,” to the pressure of everything he was
dealing with.
Now, as she sat in the silence of their apartment, her mind was
racing. How many times had he gone to the doctor, complaining of
feeling tired or struggling to keep his eyes open?
The answer was always the same: “You have to lose weight. You have
to eat better. Stop smoking. Cut the alcohol. Start your exercise
routine.” That’s all doctors ever said. It was always dismissed as
normal, just a product of his age, lifestyle, and weight gain.
28 · B RE AT HL E S S
Doctors brushing him off always frustrated Olga.
Now, looking back, she saw it differently.
It wasn’t just the weight or the stress. It was more.
This had been creeping in for years.
The exhaustion that never let up. His inability to get a good night’s
sleep. He had drifted further and further away from her, emotionally
and physically. This wasn’t normal. It wasn’t just “getting older.”
The unraveling was gradual. No one noticed as it happened.
She knew she had to move. Get to the hospital. Find someone to
watch over Zoyi. Her mind exploded with fiery thoughts, leaving
her paralyzed.
She had never seen it before. Caught up in the demands of
everyday life, she was always trying to keep their world from
slipping out of control. She hadn’t paid attention to the signs. Now,
she could no longer deny it. She had to figure out what was going
on with Eugene.
The dream of a new life with him. The connection they had shared in
childhood. The future they had started to build together. It all seemed
so fragile now. Very distant, like something from another world.
What if she was too late? What if the dream had slipped away?
What was she going to do without him? She could not live without
him here in America. He was the one who knew everything. How to
pay the bills. How to deal with the bank and the mortgage. She was
absolutely alone here with Zoyi. They would not survive.
T h e H e a r t o f t h e M a t t e r · 29
“Is Daddy going to die?” Zoyi’s small voice broke through the
whirlwind of emotions, pulling Olga back to the present. Her daughter,
standing next to her, was frozen with fear and confusion. Olga felt
the warmth of her little body, the wind of her breath. Olga opened
her eyes, trying to gather herself together, to reassure her daughter
even, as her own panic consumed her.
“No, solnyshko,” she whispered, pulling Zoyi close. She felt the softness
of her curly hair. “Daddy’s going to be okay.”
Deep down, Olga wasn’t sure. Her world was shattering. She struggled
to hold the pieces together.

W h i l e t h e C l o c k S t a n d s S t i l l · 31
CHAPTER TWO:
While the Clock
Stands Still
Olga
The ambulance pulled away, sirens fading into the morning. For a
moment, Olga stood frozen in the hallway. She couldn’t breathe. She
couldn’t think.
Returning to Zoyi, her hands moved on instinct, guided by the
muscle memory of a woman who never let chaos show on the outside.
Olga pulled the blue dress over Zoyi’s head with one hand, already
reaching for the pink jacket hanging in the hallway. Meanwhile, Zoyi
struggled with her yellow socks, her little fingers fumbling, eyes
swimming with tears.
“Here, let me,” Olga said. She knelt briefly, slipping on the red sandals
and pushing her feet into them.
She grabbed Zoyi’s hand. In one breathless motion, she pulled the
door open and rang the neighbor’s bell.
Natasha opened the door, still wrapped in her bathrobe. A pleasant
aroma of something freshly baked wafted through. They were
32 · B RE AT HL E S S
friendly. Their kids shared the same class, yet despite efforts, the
children had never truly played together. This wasn’t the moment
for small talk.
“Please, I need your help,” Olga said, her voice catching. That lump
in her throat wouldn’t go away. “Eugene is in the ambulance. I have
to go to the hospital. Can you take Zoyi to school? Maybe watch her
after if I’m still there?”
Natasha nodded, her eyes filled with concern and fear. “Of course.
I’ll take her to school and keep her until you’re back.”
Olga crouched to Zoyi’s level, gently brushing the tears from her face.
“Sweetheart, I need you to stay with Natasha for a bit, okay?” Her voice
was soft, reassuring. “She’s going to take you to school with Max.”
Zoyi sniffled but agreed, still clinging to her mother.
“Call the school to let them know I’m dropping her off and might
pick her up later,“ Natasha said softly. She took Zoyi’s hand. ”Don’t
worry, I’ve got her.“
Olga only nodded. She couldn’t say a word, holding her tears in place.
The drive to the hospital was a blur. Olga’s heart pounded as she
stepped through the sliding doors of Palisades Hospital. It looked
more like a hotel than a medical facility. Colorful flowers filled big
vases, and inviting soft couches lined the lobby.
A hospital receptionist greeted her near the entrance. “How can I
help you?”
“My husband was rushed here in an ambulance not long ago. His
name is Eugene.”
W h i l e t h e C l o c k S t a n d s S t i l l · 33
“Ma’am, could I have your name and ID, please?”
She checked Eugene’s information on the computer. “Yes, he’s been
admitted,” she confirmed. “I’ll have someone escort you to the ICU
waiting area. Please clip on your pass.”
Olga noticed the vivid orange pass. “ICU” stood out in bold
black letters.
As she followed the hospital escort, her legs were heavy, like she
had thousand pound weights attached to them. The sterile, bright
lights of the emergency department obscured her vision. She barely
registered the sounds of bustling nurses and beeping monitors
around her. She focused only on the distant knowledge that Eugene
was somewhere inside, unconscious, fighting for his life.
Olga was led to a small room with two cushioned chairs facing
a low table littered with outdated magazines. A box of tissues sat
untouched in the center. The air carried a subtle scent of antiseptic
and stale coffee.
“May I see my husband?”
“The doctor will see you soon.”
The minutes dragged on, and Olga felt she might suffocate from the
waiting. Her heart raced, and a familiar cold sweat broke out across
her back.
Olga had lost all track of time when a doctor in a white coat over
black scrubs stepped in. His warm eyes and compassionate voice cut
through Olga’s overwhelmed consciousness.
“Hello, I’m Doctor DeFeo. It’s a pleasure to meet you, Olga.”
34 · B RE AT HL E S S
Olga nodded, struggling to process the words.
“Your husband is in critical condition. We managed to restore a
heartbeat. Right now, he’s on a ventilator to support his breathing.
He’s receiving intensive care. We’re closely monitoring his brain and
organ function.”
Olga felt the doctor’s words like sharp nails striking through her
mind. She saw his lips move, heard the sentences, but their meaning
kept slipping past her. The doctor took a deeper breath, and a cold
drop fell through her stomach. In a split second, she experienced
that familiar sensation of falling, like in nightmare dreams where
the ground disappears.
“I need to ask, does Eugene have any advance directives, a living
will, or someone designated with medical power of attorney?“ The
question hung in the air. “This helps guide our decisions if he’s
unable to speak for himself.”
“What is it? I do not understand!” Olga couldn’t swallow. A sharp
pain on the left locked her breath in place. Her eyes burned from
the inside. She understood every English word, but the phrases
themselves felt unreal. In Russia, no one spoke about death or
directives. It was a forbidden topic, unsettling and avoided. As
if acknowledging mortality could bring it closer. People simply
lived as though they would live forever. Olga had been raised with
that silence.
“An advance directive is a legal document in which an individual
specifies the type of medical care they would or wouldn’t want
if they become unable to communicate their wishes,” Dr. DeFeo
explained. “It can detail preferences such as whether they’d want
to be on life support, receive CPR, have a feeding tube, or receive
end-of-life care.”
W h i l e t h e C l o c k S t a n d s S t i l l · 35
Pressure built behind her eyes, a physical ache. Her brain felt too full
to absorb anything more.
“Some people also name a healthcare proxy,” he went on. “Someone
they trust to make decisions for them if they’re unconscious or unable
to communicate. Do you know if Eugene ever filled something like
that out?”
She had no idea. Her thoughts spun in a whirlwind of fear and
disbelief. In America, she always let Eugene handle the complicated
things like insurance, paperwork, and decisions. Now, she stood
alone with questions she had never imagined answering. Each one
tightened the panic in her chest.
“End-of-life care? A feeding tube?” she whispered, almost choking
on the words. It felt unreal, like lines from someone else’s tragedy.
Eugene had never signed anything, as far as she knew. None of it
made sense.
“We never talked about it,” Olga said softly. “He is only forty-two.”
Dr. DeFeo nodded, calm and professional, no drama in his
face. “All right. We will note that. For now, our focus is on
stabilizing him.”
After Dr. DeFeo left, the ICU nurse continued with routine questions.
She was asking if Eugene had any medical conditions or allergies.
But all Olga could hear in her head were those words: “End-of-life
directives . . . Keep him on a machine.”
What would Eugene want?
“Do you have your husband’s insurance information with you?” she
asked. Her tone was clinical, almost distant.
36 · B RE AT HL E S S
Olga searched for her purse and found Eugene’s insurance card. She
handed it over.
“You can see him now,” the ICU nurse said, completing the final line
of intake information.
Olga followed the nurse down the sterile corridor, her heart pounding
in her chest with every step. The smell of antiseptic was sharp in
the air, mixing with the sound of distant beeping machines and
muffled voices. Her mind started processing the chaos of the morning,
the sight of Eugene falling unconscious, and her fight to keep him
alive with CPR. Now, she was here, in the hospital, in the ICU, and
everything felt like it was happening too fast.
The nurse stopped in front of a door and pushed it open. Olga
hesitated, then stepped inside. The sight that greeted her nearly
stopped her heart.
Eugene lay motionless on the bed, his body enveloped in thick
blankets. Olga sensed an unusual, deadly chill emanating from
them, sending shivers through her. He was connected to multiple
machines, some beeping in monotonous, indifferent rhythms, while
others traced thin, flickering lines across dim screens. Yet, the only
sound that truly reached her was the pounding in her ears.
She moved closer to his side. His lips were gray, his skin pale and
waxy. The warmth she had always associated with Eugene was absent,
replaced by an unnatural stillness. She couldn’t make sense of the man
she had just been talking to. The one who laughed and joked. Now, he
lay there, unmoving, cold to the touch.
The chill seemed to crawl under her skin. She shivered uncontrollably.
The sight of him, so lifeless under the blankets, sent a sharp stream
of pain through her body. His chest rose and fell with the hiss of the
W h i l e t h e C l o c k S t a n d s S t i l l · 37
machine that breathed for him. Olga reached out to touch his cheek.
His skin felt like lifeless porcelain. A creeping horror washed over
her: This is what a morgue must feel like.
The nurse, standing a few steps back, noticed the shiver. She explained
gently, “It’s part of the cooling treatment. We’re lowering his body
temperature to help protect his brain while we stabilize him.”
Olga’s eyes locked on Eugene’s face. It was hard to see him like this.
Is he still in there? Will he ever come back?
Eugene appeared in her mind as vividly as if he were standing beside
her. She recalled his first visit to St. Petersburg after he had moved
to the United States with his family. He seemed so American then.
His Russian carried a faint foreign accent, and his smile had that
unmistakable American brightness, radiating confidence, well-being,
and success. No one smiled like that in the gray streets of St. Petersburg.
It was such a contrast to the slightly crooked, forward-tilted broken
teeth she remembered from their youth, the ones he used to hide when
he laughed. He was still the boy she had grown up with, yet also a fully
formed, successful man. They connected effortlessly, although at the
time, Olga was caught in the whirlwind of her own life—her university
studies for her biology degree and the all-consuming first love that
would later become her first marriage.
The 1990s in Russia were wild and unstable. After the collapse
of the Soviet Union, being a woman who did not have to work
became a symbol of real success. Olga married into a “New Russian”
family, one with connections and privilege. Russians held an
unspoken belief: an educated, beautiful woman proved her worth
by managing the household with elegance, creating order and taste
in a chaotic country, and most of all, by becoming a mother. Olga
embraced that role with all her perfectionism and desire to build
something beautiful.
38 · B RE AT HL E S S
She thought about Eugene only when his letters arrived in bright
envelopes. They seemed to hold the scent of a different life from abroad.
He remained just a memory, a small bright light beneath her skin.
The dream she had built for herself slowly shattered into a thousand
pieces of frustration. Years of trying to get pregnant took an immense
emotional toll. Nothing seemed to work. Eventually, her marriage
dissolved in a tragic and painful way. Olga felt like a failure, and she
found herself slowly withdrawing from the world around her.
Eugene called her in that dark moment. This time, everything was
different. He was calm, grounded, reflective. He spoke about his life
in America and his ambitions. Olga felt a warm tenderness growing
inside her. She had never imagined she would be with him in this
way. It was an invitation to something new. When he asked if he
could visit, she said yes.
When he arrived, it was as though time had folded itself, bringing
them together. Being with him had always felt easy. Eugene was no
longer just the friend from childhood; he was a man. She could see a
future together. He seemed like someone she could be with in a way
that felt right. She imagined the children they might have—little ones
who would look like them in their youth, running around with that
same energy and playfulness.
After that visit, he had asked her to visit him in America. It seemed
like the answer to everything she had been struggling with. She was
ready to leave behind the life she had in Russia and was open to this
unknown chapter with a new purpose. She felt secure in Eugene’s
presence, comfortable in a way she hadn’t been in years. It was a
reunion and reawakening.
She visited Eugene in the States for the first time. It was supposed
to be temporary, but being with him felt natural. At that point in
W h i l e t h e C l o c k S t a n d s S t i l l · 39
her life, she realized she didn’t just want a partner. She wanted
someone who truly knew her. They laughed at the same jokes,
finished each other’s sentences, and slipped into a shorthand built
over decades. It was a comfortable trust, a sense of safety, warm
and romantic.
Before she flew back to Russia to finalize her move, they got married.
It wasn’t planned. It felt so right.
Just a few days ago, he had talked to Olga about getting a dog for
morning walks. He had joked with Zoyi about her messy room. Now,
it all seemed surreal. Those moments felt like they belonged to a
thousand years ago.
He was young, just forty-two. Nearly healthy. Brimming with plans.
Yes, they liked good food. Yes, he enjoyed fast food now and then, and
cola when she wasn’t looking. Eugene filled the pantry with potato
chips, fat and crispy, in multiple flavors. Olga despised the habit
because he left crumbs and greasy spots everywhere. He insisted the
chips helped him focus during late night work.
But they were happy. Active. Curious. They ventured out to
restaurants, relishing the discovery of new places together. Life
felt full.
“We’ll give you some time later, but I need to take you to the waiting
area now.” The nurse’s voice brought Olga back to reality. “The
cardiologist will visit you soon.”
Dr. Druz, the ICU cardiologist, entered the room with a gentle
smile just as they were about to leave. She carried herself as if this
tragic story were routine to her. Her hair fell loosely around her face,
framing her warm eyes.
40 · B RE AT HL E S S
“Olga, I understand this situation feels overwhelming. Let me explain
the steps we’re taking for Eugene. It might bring you some clarity.”
“First, when someone goes into cardiac arrest, like Eugene did, it
means the heart stops beating, and circulation halts,“ she explained
gently. ”Without blood flow, the brain and other organs are starved
of oxygen. That can lead to serious damage if not addressed quickly.“
She paused, letting it all sink in.
Right after the arrest, you initiated CPR. That was critical. You kept
blood circulating to the brain. If done quickly, it can minimize
damage. EMTs used a defibrillator to shock the heart and restart
it. The sooner that happens, the better the chances for recovery. But
even if we’re successful in restarting the heart, we need to take extra
precautions for his brain.
Olga’s heart skipped a beat. “What is going on with his brain?” The
familiar pressure built behind her eyes.
“That’s where the coma induction comes in,” Dr. Druz continued. “We
use medication to safely induce a state of controlled sedation, kind of
like a medical coma. The purpose is to slow down brain activity and
protect the brain from any further harm. When the brain is sedated,
it doesn’t need as much oxygen, and that helps it recover better.”
Olga felt the room tilt. The floor seemed to slide away beneath her.
“He is in a coma?”
“Yes,” Dr. Druz affirmed with a slight nod. “It’s a protective measure.
We aim to reduce the risk of any secondary brain injury following
cardiac arrest.”
Olga took another breath. Her mind felt like it was going to explode.
W h i l e t h e C l o c k S t a n d s S t i l l · 41
“And now he’s undergoing cooling,” Dr. Druz continued. “It’s a process
called therapeutic hypothermia. We lower his body temperature to
slow down brain metabolism, prevent swelling, and protect the brain
from oxygen loss. This method is one of the best-proven ways to
improve recovery after cardiac arrest. Especially when started within
the first six hours.”
Olga’s mind was oversaturated with the new information. Cooling,
a coma . . . It all felt absurd.
“It sounds like a lot, but every step is designed to give Eugene the
best chance,” Dr. Druz explained to her. “After cooling for about
twenty-four to forty-eight hours, we’ll start warming him up slowly.
This helps avoid any complications. The idea is to make the process
gentle, allowing his body to adjust gradually.”
Olga nodded, feeling the mix of dread and relief.
“And then, when he’s stable, we will slowly reduce the sedation, and
he’ll start waking up. During this time, we’ll carefully assess his brain
function and check for any signs of neurological damage,” Dr. Druz
explained. “Rehabilitation will be important too, but the goal is to help
him recover, whether it’s through physical therapy or cognitive support.”
She moved her hands slowly, marking each word with careful emphasis.
Dr. Druz gave Olga a reassuring smile. “This is a journey, but it’s one
that has a better outcome for patients who undergo this treatment.
The MRI was done, and there was no visible brain damage. With the
right care and time, Eugene has a good chance of making a recovery.”
Something in the doctor’s explanation gave Olga a glimmer of hope.
Olga’s voice quivered. “What are the chances?” she asked. “Will he
be okay?”
42 · B RE AT HL E S S
“I can’t promise anything right now, Olga,” Dr. Druz said softly.
“You literally saved his life. We’re doing everything we can.” The
cardiologist squeezed Olga’s arm and quietly left the room.
Olga looked around the room. It had no windows, no sounds except
those that seeped through the walls. Through those thin partitions,
she heard what grief sounded like when it was raw and unrestrained.
A woman sobbing. A child’s voice, small and questioning. She didn’t
see anyone else. Yet, she felt the presence of sorrow surrounding her.
No clock on the wall, no sense of time; this room was built for grief
and uncertainty.
A social worker appeared at the doorway, her smile gentle
and rehearsed.
“Olga? I’m here to talk about what happened.”
Olga shook her head. “I’m all right.”
Words would have required air. Everything seemed unnecessary,
even dishonest.
The social worker nodded, then left.
Olga found herself thinking about God. Not in any practiced or
religious way, but in the way people do when science suddenly stops
making sense. She wasn’t praying; she didn’t know any sacred words.
She had never been given any religious explanations in St. Petersburg,
where such things were forbidden. Every spring her mother sent her
to the synagogue to buy matza, no explanations offered.
Her first real encounter with God had been under the Chuppah.
It happened during her small wedding to Eugene, as she signed
the Ketubah.
W h i l e t h e C l o c k S t a n d s S t i l l · 43
Now she searched the silence for someone larger than herself.
Someone who might actually be listening.
How could something like this just happen?
She had believed in American medicine. In the systems, the
technologies, and the expertise. How come no one had seen it coming?
The waiting seemed endless. Her mind was pocked by the fear that
she might never see Eugene the way he was before. Olga glanced
down at her phone. The number of notifications was a reminder of
the world continuing to move outside of this small hospital room.
She pulled out her phone. First, she sent a quick message to Eugene’s
parents. Then, she fired off another to the dental office where
she worked.
“Eugene had a heart accident. He is in the Palisade Hospital ICU.”
Almost immediately, her phone began to beep uncontrollably,
notifications flooding in from family and friends. Olga was
overwhelmed by a wave of guilt but couldn’t bring herself to
respond. With no energy for conversations, she turned off
her notifications.
Eugene’s parents arrived at the hospital shortly after Olga’s message.
His father entered the room slowly, the buttons of his jacket straining
across his middle. His mother followed, her lips pressed into a thin
line. Even here, they moved in their familiar rhythm. A few clipped
words exchanged, the palpable friction of two people who had argued
for decades yet remained bound by habit.
They viewed their togetherness as an act of kindness toward their
grown children, setting an example of unity despite the circumstances.
44 · B RE AT HL E S S
Perhaps it was also the only way to avoid becoming lost, unable to
survive apart in a country they did not fully understand.
Olga had never been close to them. They always carried a current of
dissatisfaction in their voices, constant judgment in their eyes. Her
mother-in-law’s subtle, critical remarks about her parenting had long
ago taught Olga to keep her guard up, to measure her words carefully.
The bottom line was simple for Olga: they did not provide warmth,
and she worked hard to avoid contact whenever she could.
She had always promised herself she would never become like them—
never teeter on that edge of control or feel the need to constantly
correct. Yet, in rare moments, especially when she tried to change
something in Eugene’s behavior, she heard the faintest echo of her
mother-in-law in her own tone. She hated to admit the resemblance.
Olga forced something that was meant to be a smile, but it felt more
like a grimace. “Hello,” she said, her voice flat despite her best effort.
Her mother-in-law gave a curt nod. “What happened?”
“You can see him in the ICU room,” Olga replied, her tone neutral.
Her hands tightened around each other until her knuckles turned
white. She rose, taking a small step back. Already retreating.
“It’s time,” she said,” I have to pick up Zoyi from school.” She walked
slowly to the ICU desk. “When will he wake up?” she asked, almost
afraid of the answer.
“We’ll begin reducing his sedation tomorrow morning,” the nurse
explained. “Then, we’ll start the process of warming him up. You
can go home for now and return tomorrow.”
“Eugene’s parents want to see him.”
W h i l e t h e C l o c k S t a n d s S t i l l · 45
Olga longed to stay with him, but her body was already shaking with
exhaustion. She had to make arrangements for Zoyi.
Her whole being felt fragile and old once she walked out of the ICU.
Olga picked up her daughter from school, moving like a programmed
toy, going through the motions without really being present. She took
Zoyi home, made her a simple meal, and sat quietly in the living room,
watching her play with her toys. Zoyi didn’t ask any questions, her
usual chatter completely absent, until it was time for dinner, bath,
and bed. Zoyi refused to sleep in her own bed and curled up next to
Olga in their master bedroom.
Olga’s eyes burned with exhaustion, but sleep refused to come. She
cried soundlessly through the night, her mind unable to rest, caught
between moments of drowsiness and waking. She felt the warmth of
Zoyi’s body, and heard the loud sound of her breath, noting mentally
that Zoyi slept with her butt up for a significant part of the night, her
legs jerking in restless movements.
Olga snapped out of her sleepy haze when she felt a wet sensation in the
bed. She moved Zoyi to her own bed and started removing the sheets.
She didn’t feel rested at all, but she had to keep going. Olga walked to
the kitchen to make herself a cup of coffee. The horror of the previous
morning settled over her like an entrapping net, and the darkness of
the unknown stretched out before her.
She got Zoyi ready and took her back to the neighbor’s house, asking
Natasha once again to take Zoyi to school. With a final kiss to her
daughter’s forehead, Olga headed back to the hospital to be there
when Eugene woke up.
For a moment, she almost turned toward her dental office, the place
she worked with the same turn she made every morning. The routine
used to suffocate her.
46 · B RE AT HL E S S
Mornings: chores, Zoyi, school, work.
Evenings: the same, just in reverse.
It was all so overwhelming.
Now, everything seemed so small.
She missed the comfort of that routine. The order it brought. The
illusion of control.
She thought of Dr. Sokolina. She was her boss, but also her only friend
in America, the one person who made her feel seen in this new world.
They worked side by side in the dental office, connected by patient
care, curiosity about people, healing, and the question of why some
lives fell apart while others stayed afloat.
They had both come from St. Petersburg, carrying the same language
and a shared mindset into their American lives. Olga admired the way
Dr. Sokolina could read the human body. She looked inside a mouth,
observed a bite, a tongue, a breathing pattern, and understood what
the body was hiding. Olga had watched her solve cases that other
doctors missed.
If anyone could make sense of what happened to Eugene, it was her.
If anyone could explain how something like this could strike without
warning, it was her.
She parked next to the hospital and checked her phone. Eight missed
calls. Five messages.
All from Dr. Sokolina.
W h a t A b s e n c e L e a v e s B e h i n d · 47
CHAPTER THREE:
What Absence
Leaves Behind
Dr. Sokolina
At first, I thought Olga was simply late. By noon, I realized I was
mistaken. By evening, I grasped something far more troubling.
I was annoyed at first. Olga didn’t show up that morning to work.
It wasn’t like her. She was responsible, precise, reliable. In a dental
office, every person is essential. Her absence was immediately
noticeable. I always told my team, “I’m not a huge corporation
with some stars and regular people. Every single one of you is
my star.”
That morning, Olga didn’t leave a message, no explanation, just an
empty assistant’s chair and a full schedule.
I checked my phone repeatedly. My office called her. Then they tried
Eugene. Still, nothing.
After a couple of hours, my irritation had dissolved into worry. I kept
imagining the worst. Olga was a big and precious part of my life.
More than that, she made my patients feel better.
48 · B RE AT HL E S S
That’s important. I’ve lost count of how many people have told me,
“I hate dentists.”
Sometimes, they say it with a nervous laugh. Others scream it with
clenched fists. Many patients burst into tears before I even ask, “How
can I help you?”
I get it. Dentists are the punchline. The fallback career. The ones who
didn’t quite make it into medical school.
That’s the story, anyway. It’s supported by movies, Broadway shows,
and cartoons.
The truth is, I didn’t become a dentist because I couldn’t become a
doctor. I became a dentist because I wanted to be in control of the
treatment I can provide with my head and hands without relying on
anything else. I wanted to create beauty and, at the same time, make
people healthier. Even back when I was only sixteen, I decided to get
into that profession because I liked to understand the structure and
the function of our bodies in that specific area. I did not find teeth so
fascinating, but the idea of the combination of art, which dentistry
requires, and medicine under my direct guidance attracted me.
Anyway, every time I hear that message about hating dentists, it still
hurts. In our profession, you have to grow a thick skin. Yet, beneath
it all, you must remain compassionate and curious. That’s why I
designed my office to be spacious and inviting, with soft lighting
that created a relaxed, almost spa-like atmosphere.
That day was especially difficult without Olga, but I had to keep
helping my patients.
I had studied many dental disciplines, including orthodontics,
periodontics, and implant placement. But it wasn’t just the idea of
W h a t A b s e n c e L e a v e s B e h i n d · 49
saving teeth that fascinated me. I was drawn to something larger. I
wanted to see the whole body reflected in the mouth, to understand
how it functioned as one system. How did stress or poor habits leave
such visible marks? Teeth grinding, jaw pain, enamel worn down to
brown patches—each told a story.
Alignment and aesthetics have always been important, but I was
beginning to sense something larger at play, something beyond the
teeth themselves. I thought of other patients with similar patterns—
people whose teeth seemed to shrink over time, whose jaws absorbed
forces far greater than their lives should require. This couldn’t be
the entire story, though I hadn’t yet uncovered the full explanation.
Could this be connected to a deeper health issue? Posture, breathing,
or something else entirely? Each patient arrived as an unknown
world, and the success of treatment depended on how clearly the
doctor could read the clues.
I was thinking about the connections between the teeth, the jaw,
and overall health. I knew the body was interconnected, but how
deep did these links go? And why did certain people have teeth that
deteriorated so quickly while others did not?
My mind circled back to the question that had consumed me for
months. How could I truly help my patients? I wanted to address the
root causes of their problems, not just the symptoms.
My expertise had always centered on the aesthetics of the smile, but
I had begun to sense something was missing. My patients deserved
more than just a beautiful smile. They deserved a healthy smile,
supported by a body in balance. Fixing the teeth was not enough if
the forces destroying them were never understood.
The challenge lay in assembling all the pieces of the puzzle to see
the whole picture. Medicine and dentistry were two halves of that
50 · B RE AT HL E S S
puzzle, just as the head is part of the body. Yet, the two fields behaved
as if they belonged to separate worlds. The head to one, the body to
another. As if a patient could be divided without consequence.
Why did so many doctors treat patients like a headless horseman,
disconnecting the mouth from the rest of the body? The mystery lay
in that blind spot. What exactly was hiding there?
Toward the end of my day, my worry for Olga kept growing. I found
myself thinking about the first time I met her. Eugene had brought
her to the office as a new patient. She had just moved from Russia,
and they were looking for a new dentist. As soon as Olga walked in,
I couldn’t quite place who she reminded me of, maybe Sarah Jessica
Parker from Sex and the City or Jennifer Aniston from Friends. But
once we started talking, I noticed something even more charming:
a curiosity about life and people that matched my own.
We were both from St. Petersburg, sharing that thoughtful, intellectual
way of moving through the world. Olga’s speech, with the rich cadence
of the Russian language, drew me in immediately. Her words carried
an old-world elegance. An intensity in her eyes revealed how carefully
she observed everything around her.
In Russian, we have the formal pronoun “vi,” unlike the familiar “ti.”
Some use it only for elders. Others rarely use it at all. For me, it has
always been a way to show respect for a person, regardless of age. I use
it in all professional settings with patients, employees, and colleagues.
Many Russian speakers react strongly to my choice. But not Olga. I
never had to explain it to her.
She had warm, curious light brown eyes. I sensed immediately that
I wouldn’t need to spell out the delicate moments that unfold in a
dental office every minute of the day. She understood them naturally.
Patients would feel at ease with her. No instructions were needed.
W h a t A b s e n c e L e a v e s B e h i n d · 51
After the consultation about her dental status, I offered Olga a position
at our office. It was before Zoyi was born, and though Olga had hesitated
at first, the idea of working alongside someone who understood her
background, who shared similar roots, felt like an opportunity she
couldn’t ignore. It would take several years before Olga was ready to
start since she needed English language courses and the necessary
licenses to practice. Then Olga had Zoyi, so there was a daycare
schedule to arrange. It had been a slow and difficult process, but I had
admired Olga’s dedication to building a life for herself in a new country.
I respected the thoughtful way she approached each challenge.
Warmth filled me as I recalled our many conversations over the years.
We didn’t just speak the same language literally. We shared curiosity,
intellect, and a deep love for learning.
One conversation in particular stood out in my memory. Just a few
months ago, Olga shared her thoughts on the differences between
medical education in Russia and what she had encountered in the
United States.
“I’ve always thought doctors in Russia knew more,” she’d said after
reviewing the medical history of a young patient who took ten
different pills a day. “They understood the nature of disease, the
real causes. But they didn’t always have the tools to treat it. Here . . .
it’s like they only see the symptoms. Pain? Painkillers. High blood
pressure? Pills. No one looks at the whole picture.”
She wasn’t wrong.
My education back home had been very broad. We studied everything:
dermatology, general surgery, OB-GYN, and infectious disease. Even
as a dental student, I was exposed to the body as a whole, not just the
teeth. When I came to the US, the focus narrowed. Dental medicine
became its silo.
52 · B RE AT HL E S S
“I think I got the best of both worlds,” I had told her. “But the real
education isn’t in school. It’s in staying curious always. Science doesn’t
stop evolving, and neither should we.”
Olga had smiled then, an ironic smile revealing her beautiful white
teeth. “It’s a different kind of thinking here,” she said. “Like applying
an algorithm to something that breathes.”
Exactly. Algorithms help; they give us structure, speed, and clarity.
But real medicine, the kind that changes lives, doesn’t come from
charts and steps. It comes from sitting with the patient. Seeing and
listening. Solving problems no textbook ever prepared you for.
That conversation had lingered in my mind for a long time. I realized
how much my own journey had shaped my perspective on medicine,
on life, and on the kind of doctor I wanted to be. My background has
given me a unique approach, blending the broad, holistic perspective
I had gained in Russia with the specialized knowledge I acquired in
the US. More than anything, it was the ongoing process of learning,
the commitment to growing as a doctor, as a person, that truly made
a difference in how I practice dentistry.
Her message finally came through: “Eugene had a heart accident. He
is in the Palisade Hospital ICU.”
The text was frightening. Yet, with a touch of clarity, I felt
almost relieved.
A hurricane of thoughts whirled inside my head. Eugene, a young,
almost healthy man of forty-two, had such a severe, undiagnosed
heart condition that it placed him in ICU in a moment. I remembered
the man I had first met almost ten years ago in my office—sporty,
energetic, with great posture. A tennis player full of ambitious plans.
How different he was now.
W h a t A b s e n c e L e a v e s B e h i n d · 53
He was sluggish, overweight, and constantly tired. Some of the
traits I attributed to his very demanding start-up career, some of it
to Olga’s great cooking skills. He was a grown man with a family, not
a young boy chasing destiny. I noticed the change like that in a lot
of men in my practice over the years. For some reason, domestic life
has that hypnotic effect on a man. Family happiness has a physical
representation with pounds on the belly and other areas. I did not
mention anything to Olga, so as not to add “gasoline to the fire” of
complaints. Olga was not happy with Eugene’s involvement at home.
Even with all that in mind, I knew Eugene had annual physicals.
I had to delve deeper into what had happened to him.
I sent a message to Olga: “Please tell me how I can help you.”

P a t t e r n s i n t h e F o g · 55
CHAPTER FOUR:
Patterns in the Fog
Olga
Olga sat next to Eugene’s hospital bed, feeling dizzy from the buzzing
fluorescent lights. Fear rose in sharp waves, and guilt clung to her
skin like sweat. Did she push Eugene too hard? How had she not seen
this coming? When she had entered the room, Eugene lay in the same
still position as yesterday, only without the heavy cooling blanket.
One thought kept circling in her mind: Will he recognize me when
he wakes up?
In that split second, he opened his eyes. He blinked, then asked,
“Where did I leave my laptop?”
Olga was taken aback by the mundane nature of his first question.
“Your laptop?”
Eugene repeated, his tone detached, “I need to check something.
There’s a deadline.”
Olga stroked his cheek, her fingers brushing against the coarse
stubble and the faint tickle of newly grown hair along his cheekbone,
bristly beneath her touch. He felt much warmer now. Around him,
56 · B RE AT HL E S S
several machines flickered and beeped. The air carried the dry chill
of hospital ventilation, edged with the sharp trace of alcohol wipes.
“Eugene,” she asked, her voice steady despite the tremor beneath, “do
you know where you are?”
Eugene looked around, puzzled. “Hospital. You brought me here
because I fainted? I fell on my head?” He touched his face.
Olga simply gazed at him, examining his face under this “new light.”
Eugene began to speak. Initially, she assumed he was sharing a dream.
Then it dawned on her—he was recounting a memory.
“Remember those almond croissants I found for you?” Eugene began.
“You had just moved to the States. I wanted to surprise you.”
Olga tilted her head. “What do you mean?”
“I went out looking for a bakery. Walked for miles,” he chuckled. “It
was a mission. I had to find the perfect French bakery.”
“At six in the morning?” Olga asked. A smile flickered across her face,
a brief nod to those early, carefree days. “You disappeared for hours.”
“I got lost,” he said, chuckling softly. “But I finally found that little spot
with warm, buttery croissants. You were still asleep when I got back.”
The memory was like an old toy to Olga, long forgotten and suddenly
back in her hands. “I remember,” she said. “You brought those pastries
and coffee . . . I thought I was dreaming.”
Eugene kept talking, almost as if he hadn’t heard her. “So, I walked in,
right? Holding the box like it’s treasure. And I dropped to one knee
P a t t e r n s i n t h e F o g · 57
and said, ‘M’lady, breakfast is served!’” He laughed again, mimicking
the same flourish he’d used all those years ago.
Then . . . he started over.
“I still remember that morning,” he said. “You had just moved here.
I wanted to surprise you.”
Olga felt trapped inside a song that played on repeat. The details of
the story never changed. Eugene added gestures to some moments,
laughing at his own jokes.
Olga asked softly, “What do you remember about the morning
you fainted?”
Eugene closed his eyes, as if searching within. “I remember some
pieces of conversation in a white hallway,” he said. “But it wasn’t in
our house. It was probably my dream.”
Olga understood that Eugene had just awakened from a medical
coma, but she had that déjà vu moment. She had observed similar
episodes before his accident that did not make sense. Eugene was
moving in a heavy fog without visibility for quite some time. He had
strange memory lapses or occasional confusion over simple tasks.
He would forget important events or could not find his socks. That’s
when it hit her. She had witnessed so many things that happened
in the past with Eugene and let it slide. She looked at the person in
front of her, sitting on a bed, supported by pillows, and all those
moments just flew into her memory. His constant tiredness. His
upsetting way of being distant from hers and Zoyi’s life.
After all, life has a way of making you move on. You have to stay afloat
by filling the scary cracks with routines and habits.
Doctors had brushed Eugene’s complaints aside as stress, fatigue,
and the regular course of events that happened when building a
58 · B RE AT HL E S S
startup. Now she realized those little hints weren’t just coincidences.
They were pieces of a bigger puzzle. This was not just Eugene’s
indifferent behavior. She clearly perceived that something longterm
about his health or his mind wasn’t right. She had to figure
out what.
Olga knew that no one would see it with the same clarity as she
could. The doctors had already dismissed her concerns. Whenever
she asked Eugene to highlight the memory lapses or his constant
fatigue, the response never changed. “You have to eat healthy
and exercise.”
At the same time, they did not live with Eugene and were not
able to observe the full picture. She had a biology degree. She
spent years learning about the human body and the systems that
worked in intricate ways. Olga had read countless books because
she was curious. She liked all the stories of Sherlock Holmes and
Dr. Watson. Olga knew that the answers weren’t always where
you expected them. The more she thought about it, she realized
that the things she had observed could be the clues to this major
medical incident.
She had to save her family, the most precious gem she’d ever received.
Olga once thought her life wasn’t good. Looking back now, it was
almost perfect. She knew she needed to fight for it.
Olga pulled out her phone and opened the Notes app. Her thoughts
briefly flickered to Darwin and Wallace. They had changed the world
by documenting the smallest details in their diaries and tracking
patterns no one else had seen.
Maybe discoveries are made by noticing what others overlook, she
thought. She created a new page and entitled it “Eugene’s Health—
Observations and Strange Events.”
P a t t e r n s i n t h e F o g · 59
That’s when David showed up.
Eugene’s old friend stood at the foot of the bed, wearing his familiar
half-smile of concern. He listened to Eugene’s story, nodding politely.
Eugene began telling it again.
David glanced at Olga. Her eyes met his, filled with surprise and
worry.
The third time Eugene launched into the same tale, David interrupted,
“So, you walked in, right? Holding the box like it’s treasure. And you
dropped on one knee and announced, ‘M’lady, breakfast is served!’”
gently finishing the story for him.
Eugene blinked. “Wait . . . did I already say that?”
David nodded. “A couple times.”
“Oh. Huh.” Eugene glanced at the blanket. “Weird. I don’t remember.”
Olga’s heart skipped a beat.
She had noticed this before. In the past, when Eugene worked late into
the night or endured long stretches of poor sleep, he would become
forgetful. Once, he couldn’t recall any details of the anniversary they
had just celebrated. Another time, he completely forgot about Zoyi’s
dance recital until two days later, when the memory returned to him
as if it had never been lost.
At the time, she couldn’t tell if he was joking or simply distracted.
This was different.
The repetition struck immediately. It was frightening.
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She pulled out her phone and opened the Notes app. This wasn’t for
the doctors; it was for herself. A strange, instinctual urge compelled
her to capture this moment.
“Eugene is repeating the story. Doesn’t remember telling it. Doesn’t
remember events starting from the night before falling in the kitchen.
Forgot Zoyi’s recital before. Must track these.”
Then she looked up, her gaze fixed on Eugene. She wondered how
much of him had truly come back.
And how much still hadn’t.
B e t w e e n t h e S h o c k a n d t h e I n v e s t i g a t i o n · 61
CHAPTER FIVE:
Between the Shock
and the Investigation
Olga
Olga was struck by the terrifying thought that she may lose Eugene
in a new and irreversible way. The fog in Eugene’s mind had been
gathering long before the morning his heart gave out.
Shaking, Olga stepped out of the room, leaving Eugene and David
behind. She spotted a doctor hurrying down the hallway and caught
up to him.
“Doctor, I’m worried about Eugene’s memory,” she said, keeping pace.
“He’s been repeating the same stories. He didn’t remember anything
from before he collapsed.”
The doctor slowed slightly. “He’s stable,” he replied. “Vitals
are holding.”
“But something’s off,” Olga insisted. “Earlier with his friend, he was
genuinely surprised to hear he’d already told the same story three
times. Just months ago, he was confused about Zoyi’s recital, our
anniversary . . . whole parts of past days are just missing.”
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Olga approached the nursing station and repeated the same concerns.
“The EKG shows improvement today.”
“He needs rest,” the nurse said. Her gaze had already shifted
to the next room. “He’s lucky to be alive,” she added with a
rehearsed smile.
Olga stood there, frustration building behind her eyes. She wanted
to say more, to make them see what she saw, but they were focused
on the crisis he’d survived, not the subtler signs of what might be
coming next.
They didn’t want to discuss his memory or his sleep. They didn’t ask
what he had been like before this happened. Their focus was on the
heart: the rhythms, the electrical signals, and the medication levels.
Amiodarone. Beta blockers. Anticoagulants. All necessary. Yet none
of it explained what was truly happening to him.
* * *
Olga and Eugene were invited to the small consultation room at
Palisade Hospital later that morning. Eugene was lying back in a
chair. Olga, sitting beside him with her phone in hand, thought his
face expressed a mixture of exhaustion and anxiety. She opened her
Notes app and began to take notes, which gave her some sense of
control over the overwhelming situation.
“Olga, Eugene,” Dr. Reno sat across from them at his desk and greeted
them with a warm smile that reached his eyes, the corners crinkling
as his face lit up with genuine kindness.
Olga thought he looked like an actor from Grey’s Anatomy.
B e t w e e n t h e S h o c k a n d t h e I n v e s t i g a t i o n · 63
“I understand this is a lot to process, but I want to explain how
we can help Eugene move forward, and I’ll walk you through the
procedure step by step. It’s important to be fully informed, so you
both feel comfortable.”
“Eugene, what we’re looking at here is an implantable cardioverterdefibrillator,
or ICD,” Dr. Reno began, his voice calm and steady, a
contrast to Olga’s own rapid pulse.
“This is a small device we’re going to implant in your chest,” the
doctor said, looking straight into Eugene’s eyes.
“It monitors your heart rhythm. If it detects a dangerous one, like the
rhythm that stopped your heart that morning, it delivers a shock to
restore it.”
He paused, noticing Eugene’s tension. “I know the idea of a shock
sounds frightening, but it’s important to know that this is lifesaving.
Without the defibrillator, you’re at risk of sudden cardiac
arrest, and we don’t want that to happen again.”
Olga’s hands became very cold, and she glanced at Eugene. She
noticed his clenched jaw and the small drops of sweat on his forehead.
She stopped typing her notes and tenderly took his hand.
Dr. Reno gave her a small nod of approval before continuing. “The
device works around the clock, monitoring your heart. If it detects
a dangerous rhythm, it will first try to pace your heart with a small
electrical impulse. This is low-energy and is meant to fix minor
rhythm problems. But if that doesn’t work, the defibrillator will
deliver a stronger shock to reset the heart.”
Eugene’s eyes widened slightly, and his breathing became more
shallow. He finally spoke, his voice shaking, “The shock . . . how
bad is it? Does it hurt?”
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Dr. Reno paused with clear compassion in his eyes. “I won’t lie to
you, Eugene, it can be uncomfortable. It’s like a sudden, forceful
thump in your chest, but it’s over in a second. The goal is to stop the
life-threatening rhythm and allow your heart to restart normally.”
“How exactly does the shock work?” Olga asked, trying to understand
the specifics for herself as much as for Eugene.
Dr. Reno nodded. “Let me show you.” He reached for a model of an ICD
on the table beside him and began to explain with a demonstration.
“This,” he said, holding up a small device, “is a basic version of the
defibrillator. It’s about the size of a matchbook. It gets implanted
under the skin, usually here,” he pointed to the left side of his chest,
“and it’s connected to leads that go into the heart. It’s always on,
constantly monitoring your heart’s rhythm. If it detects a dangerous
arrhythmia, it will deliver a shock.”
He pressed a button on a mock-ICD and a small light blinked. “This
is the pacing function,” he said. “It sends a small electrical impulse,
like a tiny jumpstart, to try and fix minor rhythm issues.”
Then, he demonstrated a shock by pressing a different button. The
light on the model blinked brightly, signaling a high-energy shock.
“This is the big one. It’s like hitting the reset button on your heart.
You may feel a powerful jolt, but it’s over quickly.”
Eugene recoiled slightly, tightening his jaw more, visibly disturbed
by the simulation.
Dr. Reno noticed but continued with an empathic tone, “I understand
it’s hard to imagine, but this shock is life-saving. It resets the heart’s
electrical system, allowing it to begin beating normally again.”
B e t w e e n t h e S h o c k a n d t h e I n v e s t i g a t i o n · 65
Olga looked at Eugene. She could see his fear: “This device is your
safety net. Think of it as a security system mechanism, something
that can prevent the worst from happening.”
She paused, looking at Dr. Reno. “How long will he have ICD?
Does he have to come to check it on a regular basis? What if it
stops working?”
Dr. Reno smiled, appreciating Olga’s focus. “The ICD will last
for several years, typically around five to seven years, before the
battery needs to be replaced. We’ll do routine follow-ups every
six months to a year, where we’ll check the device’s function
and make sure everything is working properly. It’s simple
and painless.”
“What about battery replacement? Will he need another surgery?”
Olga asked.
“Yes,” the cardiologist replied. “But it’ll be very superficial.”
Eugene was still quiet, processing everything. He looked at Dr. Reno,
then back at Olga.
“Eugene,” Dr. Reno said, meeting Eugene’s eyes, “I know this isn’t easy,
but this device can really help you. It’s not a cure, but it’s a huge step
in making sure you stay safe. You will work with a team of specialists
to support you through this process.”
Eugene finally blinked in agreement, his grip on Olga’s hand
tightening just slightly.
Olga noticed he still seemed tense. Yet, Dr. Reno’s confidence had a
calming effect on him.
66 · B RE AT HL E S S
Olga understood they still had so much to learn. At least now, they
had a direction. They’d face whatever came next together. Olga placed
her other hand over his and stroked it slowly. No words, just the tender
promise between their palms.
Dr. Reno took a deep breath and looked at both Eugene and Olga,
“Before we move forward with the implantation of the ICD,” he
continued, his voice calm, “there’s one more step we need to take. We
need to confirm the exact nature of the arrhythmia that caused the
cardiac arrest. For that, we’ll be referring you to an electrophysiology
lab at another facility.”
He paused, allowing the words to settle before continuing. “In this
procedure, doctors will deliberately induce a controlled arrhythmia,
essentially replicating the event that occurred that morning. They
will temporarily stop your heart, Eugene, and we’ll monitor it closely.
This will enable us to confirm the exact issue with your heart’s
electrical system.”
Eugene looked up, his face paling. “You’re going to stop my
heart again?”
Dr. Reno nodded, his tone reassuring. “Yes, but this is a controlled
procedure. You’ll be carefully monitored the entire time. Once they’ve
confirmed the diagnosis, they’ll immediately implant the defibrillator
to prevent any further episodes.”
Sensing his rising anxiety, Olga gave Eugene’s hand a reassuring squeeze.
Dr. Reno continued, “This procedure is necessary. It ensures we’re
addressing the correct problem and that the device will be effective.”
After thanking Dr. Reno, Olga and Eugene returned to his hospital
room. Eugene settled back onto the bed. His eyes were already heavy.
B e t w e e n t h e S h o c k a n d t h e I n v e s t i g a t i o n · 67
“I have to pick up Zoyi,” Olga said softly, brushing a hand over his arm.
“Give her a kiss for me . . . ” Eugene mumbled. His voice was barely
audible as sleep overtook him mid-sentence.
* * *
The house was quiet. Olga sat curled on the edge of the couch, the
glow of her laptop screen flickering across her tired face. Dozens of
tabs were open—medical journals, hospital websites, patient forums.
She wasn’t reading anymore, just scanning, searching for something
to make it all feel less terrifying.
They’re going to stop his heart again.
Zoyi had finally fallen asleep in Olga’s bed. Earlier, she’d sat silently near
Olga, watching cartoons on mute, stacking her toys in neat little rows.
She hadn’t asked questions, just stayed close, like she knew something
was wrong but didn’t have the words to name it.
The phone rang. Olga picked up on the first ring.
“Hello,” she said, her voice low and cracked.
“Olga,” came Dr. Sokolina’s warm voice. “I’ve been thinking about
you. How are you holding up?”
Olga let out a breath. “Not great. I’ve been reading everything I can
find, but it just makes me more anxious. I can’t stop thinking about
it. They’re going to stop his heart. What if it doesn’t come back?”
She sighed. “I’m sorry I haven’t been to work this week,” she admitted.
“ I can’t focus on anything else.”
68 · B RE AT HL E S S
“I understand,” Dr. Sokolina said. “These are extraordinary
circumstances, Olga. Taking a leave of absence is completely reasonable.”
Tears coursed down Olga’s cheeks.
“You think so?” she whispered. “I just . . . I feel like I’m failing at
everything. At work. At home. With Zoyi . . .”
“I think,” Dr. Sokolina said firmly, “you’re responding to a crisis with
everything you have. That’s love.” She paused, letting the words sink
in. “And I am here to support you,” she added softly.
“I found this article . . . I wanted your opinion on it,” Olga managed
to say. Her voice caught.
Before she could finish, the words crumbled. A sob rose in her
throat. She turned away from the phone, unable to speak. Her chin
trembled first. Then the tears broke loose. She couldn’t hold them
back anymore. Olga ended the call.
After Olga stopped crying, she felt all that anxiety, grief, and fear
wash out through her tears. Her thoughts drifted back to when
she first arrived in America. Everything was new, exciting and
unknown.
He had wanted to show her everything. To introduce her to a life so
different from the one she had left behind in Russia.
When her three-month visa was nearing its expiration, Eugene
didn’t hesitate. He made an appointment at City Hall, determined
to ensure she could stay with him. The paperwork was signed.
Vows were exchanged in the most intimate ceremony they could
have imagined. Just like that, Olga became a permanent part of
his life.
B e t w e e n t h e S h o c k a n d t h e I n v e s t i g a t i o n · 69
Olga and Eugene signed a Ketubah, a Jewish document in which
the husband promises to care for his wife. They were not religious,
but signing something from an ancient tradition felt sacred, like a
protection of their union from above. This handmade document,
adorned with delicate vines and Hebrew script they couldn’t fully
read, felt heavier than paper. It carried the weight of traditions and
oaths. They were married, and their future felt secure.
Even then, things weren’t as simple as they seemed. Eugene was ready
to continue building their life together. Olga, however, stood at a
crossroads. Her degree in biology, earned in Russia, felt distant and
disconnected from the life she was trying to build in America. She
had no clear path to follow. She wanted to work. But what could she
do with a degree that felt so out of place in a new country? She liked
evolutionary biology. What was she supposed to do with her passion
for understanding biological processes when the world around her
was so different from what she had known?
However, amid the turmoil of many paths and confusion, one thing
remained clear in her heart. She truly wanted to start a family with
Eugene. She dreamed of the beautiful moments they would share.
Being the best mother possible was her goal, and the thought of
building that life with Eugene filled her with warmth. Despite the
uncertainty surrounding her career, she found comfort in this
vision. She imagined the names of their future children and the
activities they would enjoy together. It would be different from
their Soviet upbringing. She was determined to do better than her
parents or Eugene’s.
Now, unable to fall asleep, Olga couldn’t help but wonder how it had
all come to this. From the carefree days of discovering new foods and
experiences together, to this moment filled with fear and uncertainty.
She couldn’t shake the nagging feeling that everything was shifting
beneath them, and it terrified her. She longed for things to return
70 · B RE AT HL E S S
to that earlier time. A time when Eugene was healthy and energetic,
when their biggest concern was where to eat next or how to win a
game of tennis.
Those months had been filled with precious treasures—the discovery
of new steps in a new world, and, most of all, different sides of
adult Eugene.
Food had been their first shared passion. They were always exploring
new restaurants, trying dishes she’d never tasted before. From
the salty freshness of sushi to the indulgent sweetness of pastries,
each meal was an adventure. Eugene loved surprising her with new
experiences. He had such a creative spark, always coming up with
something unexpected.
Olga smiled slightly at the memory of the time he gave her
strawberry-flavored edible lingerie, presented as a dessert teaser
on a tantalizing iris bouquet, just to see her reaction. She thought
his imagination knew no bounds. Every day of that period brimmed
with surprises and discoveries about each other. She recalled when
he handed her a jar of chocolate body cream—something that felt
both strange and intimate, an inside joke between them. It was
absurdly charming. These little things, these spontaneous gifts,
made her feel as though she was always discovering something
new with Eugene.
It wasn’t just food or odd gifts that filled their days. Eugene had
a contagious energy that inspired her. He wasn’t just a man who
worked tirelessly; he also had big dreams. He always talked about
starting his own software company. The idea of creating projects
for banks, solving problems, and building something from the
ground up fascinated him. He talked about being his own boss,
developing something no one envisioned yet in his industry, and
it was impossible not to get swept up in his passion.
B e t w e e n t h e S h o c k a n d t h e I n v e s t i g a t i o n · 71
He took her to a tennis court downstairs from his building one
afternoon and taught her how to play. She had never held a racket
before, but Eugene was patient, encouraging her. They laughed so
much at her endeavors. He’d been a great tennis player as a child.
His enthusiasm made everything feel possible.
She had never imagined that the two of them would face their current
challenges. Who could?

Li v i n g o n Fi r e · 73
CHAPTER SIX:
Living on Fire
Dr. Sokolina
Eugene and Olga haunted my mind day and night, their story stirring
memories of countless others. The scattered details Olga shared
gradually tightened into a single, chilling pattern I had witnessed
far too many times before.
Eugene’s memory lapses, his constant exhaustion, the snoring, and
gasping for air every night painted a picture of something much
deeper. Olga had mentioned long before the accident how they had
started sleeping in separate bedrooms. It was better for her sleep.
Yet, with a hint of sadness, she acknowledged it wasn’t good for their
emotional connection.
I had tried to find the positive sides in that new course of action. One
day, I explained to Olga on the phone, “I watched many reels on social
media recently about a different perspective on sleep. The way people
think about sleep is changing. It’s not like in ancient times. Back then,
a woman was just an addition to her husband. If a husband snored,
the wife simply accepted it. Now, both partners expect to sleep well
and feel rested the next day.”
Olga stayed quiet. Yet, even in her silence, I sensed disapproval.
74 · B RE AT HL E S S
“It’s becoming a trend: nearly a third of new American homes now
feature two master bedrooms. Architects have finally acknowledged
this shift and included it in their blueprints.”
“I do not think it is great for their bond,” sighs Olga. “Physical
distance often comes at the cost of intimacy.” Olga was speaking
generally about all couples. Yet, I felt it was a very sensitive issue.
Olga had also shared how Eugene would fall asleep anywhere—at
his desk, behind the wheel of the car. She had even bought him
a special travel mug for coffee. It was meant to keep him awake
during long drives to meet clients. His eyes struggled to stay open.
Eugene was proud of his projects all over the world. Some work kept
him awake through the night, others demanded early mornings,
and he didn’t have consistent time for sleep. His body adjusted to
foreign time zones without ever leaving home, going to bed at one
hour and waking at another, never settling into a consistent rhythm.
The fatigue became constant without a clear solution.
Olga described the coffee rings left on tables, half-empty cola cans
abandoned wherever he sat, and crumbs of potato chips ground
into the floor.
“That drives me crazy,” Olga repeated, her irritation barely concealed.
“Uborshitsa. I’m not his personal cleaning service.”
I knew how much she cared about keeping the house beautiful and
in order.
After finishing my phone call with Olga, I couldn’t ignore the pattern
emerging in Eugene’s symptoms. This wasn’t an isolated case; I had
seen it many times before in my patients. I called it the domino effect.
Over the years, Eugene had experienced multiple dental emergencies
Li v i n g o n Fi r e · 75
caused by clenching and grinding his teeth—episodes that led to
broken teeth and jaw pain. Each time, he was genuinely surprised,
insisting he hadn’t eaten anything hard.
I had explained to him repeatedly that it wasn’t food or chewing
that caused the damage. It was what happened before that. The
activity his body performed long before a meal ever touched
his teeth.
As I thought about Eugene, another man came to mind. He had
visited my office earlier for a cosmetic consultation. He longed for
the smile of his youth but didn’t want to harm his existing teeth. He
was a bulky man, with overdeveloped chewing muscles that flexed
constantly as he spoke, giving his face a square, compressed look.
When he settled into my orange chair, I placed a special pillow
behind his neck, just as I always did for Eugene. This is known as
forward head posture, where the head is carried in front of the body
due to an altered cervical curve.
When he opened his mouth, the pattern revealed itself immediately.
Clear imprints of his teeth lined the edges of his tongue. Brown
abrasion marks and notches cut into the gum line. Toruses, large
bony growths, pressed beside the tongue. This wasn’t random.
Something inside his body had been working overtime, day and
night, long before he ever walked into my office asking for a
better smile.
Over the years, I had learned to recognize this pattern. Strong
people with exhausted systems. Smiles rebuilt again and again,
without anyone stopping to ask why they kept breaking. When
he showed me a photograph from his wedding day, taken nearly a
quarter of a century ago, the difference was striking. His teeth had
been three times longer then, full and untouched, before the forces
of compensation began their work.
76 · B RE AT HL E S S
Could it be that Eugene’s multiple broken teeth, joint pain, sleep
disturbances, and fatigue were just clues pointing to a bigger
picture? Now, looking back at everything Olga had shared, it was
clear. Eugene’s condition wasn’t just about one issue. It was the result
of several overlapping problems, finally converging into something
much more significant.
A gentle knock on the door interrupted my thoughts. I looked up.
My dental assistant stood in the doorway. “Dr. Sokolina, your next
patient is waiting,” she said.
The patient, an elegant woman in her mid-thirties, was visibly fatigued.
I smiled politely and greeted her. “So, tell me,” I asked, “how can I
help you?”
The woman shifted in her seat, clearly uncomfortable. “I want to
align my teeth.”
“Have you had any orthodontic treatments before?” I asked.
The woman winced. “Yes, I had braces as a child, but I didn’t wear
my retainer after they came off. Over the years, my teeth shifted back
to crowding. I had clear aligners before my wedding, but my teeth
moved again. I just want to fix it once and for all.” She smiled.
Her teeth were slightly crowded, but her smile was visibly smaller
than her face. I noticed big black corridors of air in between her teeth
and cheeks, like a little painting fitted in a big frame by mistake.
For a moment, the room seemed to blur.
Four teeth removed.
A shrinking smile.
Li v i n g o n Fi r e · 77
Relapse.
Fatigue.
Sleep disturbance.
Eugene.
I had heard this story too many times. It was beyond coincidence.
I sensed the familiar pattern forming. This woman wasn’t the first
case of repeated orthodontic treatment I’d encountered. “How many
teeth were removed during your orthodontic work?” I asked, seeking
to confirm my suspicion.
“Four teeth here and four wisdom teeth,” the woman said, tapping
the middle of her cheek with her finger.
“Please tell me about your medical history. Diabetes? High blood
pressure?” I went on, listing the medical problems of modern times.
The woman replied, “I don’t really have any medical problems,
but I’ve been seeing an integrative medical doctor because
I’m constantly tired and have trouble sleeping. I feel like I am
choking at night. The doctor ran a lot of tests, and we even did a
sleep study.”
I felt for a moment as if I was inside the movie, Groundhog
day. The same story as Eugene—four teeth removed, jaw pain,
headaches, and now difficulty sleeping—a picture I had seen
before. Eugene’s face came back to me with uncomfortable clarity.
His orthodontic history. The extractions. The grinding. The
headaches. The connection was becoming clearer in my thoughts.
I’d always believed that removing teeth in orthodontics could have
unintended consequences, but now it was becoming a theory that
needed exploration.
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“I understand your frustration. Crowding isn’t aesthetic, and
cleaning between your teeth becomes difficult. But there are
solutions. We can use clear aligners or braces to straighten your
teeth again,” I offered.
The woman glanced up, a slight frown on her face. “How long do
I need to wear the retainer after treatment?”
“It’s essential to wear the retainer for life,” I answered firmly. “If
you want your teeth to stay in place, you’ll need both a fixed
and a removable retainer. When teeth shift like yours did, the
foundation of your jaw has been compromised. Without constant
support, the teeth will inevitably change position again.”
I escorted my patient to the front desk to discuss the course
of action. The woman added, “I want the broadest smile like
Julia Roberts.”
I started thinking about all the patients who had the same issue—
teeth removed, alignment altered, the jaw shrinking over time. What
happened to the human jaw? I pondered. Why does it seem like more
and more people are coming to me for orthodontic work and then
needing to repeat it later in life?
I recalled our conversation with Olga. It was after I mentioned that
Eugene had four teeth removed to straighten the others.
Olga looked at me and asked, with a hint of frustration, “Why is this
happening? Why does it seem like everyone has these problems now?
Has the human jaw actually gotten smaller over time? Why are so
many people struggling with this?”
I thought for a moment, then said, “There’s a book I read called Jaws.
It explained it in a way that finally made sense to me.”
Li v i n g o n Fi r e · 79
“The idea is that our jaws have been shrinking over generations,” I
continued. “We eat softer food. We chew less. Faces grow differently.
But the tongue hasn’t changed. It’s the same size it’s always been.”
I paused. “So, now we’re trying to fit the same tongue into a smaller
space. And when there isn’t enough room, it has to go somewhere.
Backward. Into the airway.”
The questions were flowing. My patients’ struggles were making me
reevaluate the systems that could be applied not just to their teeth,
but to their entire health.
I am turning into Olga with her notes. I smiled under my mask.
At some point, my mind reached for something I had been looking
forward to. I thought about my meeting with Inna. We always discuss
topics like that. She has been my friend for two decades. I had known
her and her now ex-husband Alex for many years, almost since I
arrived in the US. Alex once rescued my friend’s car during a blizzard
in Brooklyn, shoveling out snowdrifts taller than a man. It was the
night of my roommate’s birthday, and Alex had shown up like a hero,
shovel in hand. I was struck by his warmth, his instinct to help.
He had always been like that—generous, quick to laugh, always
surrounded by friends. His dark humor could fill a room. I
remembered sushi dinners where my cheeks hurt from laughter.
Alex was big, broad, and solid. His neck seemed to vanish into a soft,
rising swell of skin that led to a generous double chin, which bounced
when he laughed. A wide forehead and round cheeks framed his face.
He wore his weight like a costume, putting it on and taking it off with
diets and bursts of exercise.
Alex, Inna’s husband at the time, was the one who introduced us.
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He talked so proudly about his wife, how she was in dental school
just like me. Through him, our friendship began. Over the years,
it deepened. Inna was admitted to a very prestigious orthodontic
program—the same program I dreamed of joining but couldn’t. We
built our practices side by side, rebuilding our immigrant lives in a
new environment. Eventually, our friendship became our own sacred
thing. We celebrated victories and mourned failures. It’s a rare fortune
to meet a like-minded individual who mirrors your ambitions.
Alex loved pleasure—gourmet food and drinks, people, and stories.
He couldn’t stay away from joy for long. Inna was a fantastic cook
and very goal-oriented. Sometimes, she’d put him on strict regimens,
and for a while, Alex would try to lose weight and exercise. But it
never lasted long.
I could not forget the day I learned they had separated. It was during
the early days of practice building. I had asked Inna, “Why now?”
She’d shrugged. “We just grew in different directions. I want to build
the most successful practice I can, while Alex wants to have a good
time. He helps everyone and throws himself into everything. We don’t
understand each other anymore. And . . . I can’t stand his snoring.”
I was in shock. “But you have so many friends in common,” I said.
“Won’t they be forced to choose sides?”
Inna smiled gently and brushed her heavy black bangs from her
forehead. “No,” she said. “We’re not going to make anyone choose.
We’re still going to be friends.”
I didn’t believe it then. But time had proven me wrong. They had
stayed close. They had celebrated their daughter’s bat mitzvah
together. Her wedding, too. The three of them—Inna, Alex, and their
daughter—had remained a family, just . . . reconfigured.
Li v i n g o n Fi r e · 81
I had been looking forward to my annual dinner with Inna for weeks.
Since our lives had grown busy with practice ownership, children, and
professional travel, these rare meetings became sacred rituals for more
than two decades. I carefully selected the venue: Bouley Botanical, an
avant-garde restaurant in Tribeca, where over four hundred edible
plants lined the walls in living vertical gardens. I wanted to transpose
us to the garden for a moment, in the middle of a busy week. The
space was famous for the aroma of fresh basil, tarragon, lemon balm,
and thyme, herbs growing in neat copper containers along the walls.
It was exactly the kind of environment where we could talk about
everything and nothing. We would lose ourselves in the intimacy
of shared memories, professional frustrations, and future projects.
I mentally rehearsed my thoughts and explanations about Eugene’s
accident. The story was tragic, but strangely romantic, a breathless
awakening. With all the pain it carried, I believed there might still
be a positive outcome for Eugene and his family, too. I always live by
the principle: look for the silver lining in any circumstances.
Inna, too, had a gift. She was an excellent strategist, especially
with marketing and social media. Her ideas were always a source
of inspiration for practiced growth. Our dinners were equal parts
therapy and mastermind sessions. Sometimes, we even brought tough
cases to the table. We explored them from different angles—dentist
to orthodontist, parent to parent.
I could already picture the evening in my mind—a glamorous dinner
at a chic restaurant. This time, though, I had so much more to share.
Olga’s story. Eugene’s case. All the pieces of the puzzle I had been
pulling together in my mind.
I imagined myself in a stylish, abstract-patterned dress with a deep
blue hue. The high-heeled stilettos would add just the right touch
of confidence. It would be one of those rare moments when I could
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take off my dental scrubs and let my mind wander beyond the clinic
walls. I was eager to talk to Inna to discuss the evolution of human
health and what might be causing these new patterns. Inna would
understand my concerns, and maybe, together, we could find some
answers. I could get her orthodontic perspective on Eugene’s and
other patients’ cases. I felt the excitement of anticipation.
The workday had just ended when Olga’s message arrived.
I picked up the phone and called her right away.
Olga began to cry. “I don’t know where to begin,” she said. “Eugene
had the procedure today. They stopped his heart and implanted
the shocker.”
“This is great,” I said. On the other end of the line, I heard sobbing.
“I feel so guilty. I yelled at Eugene the night before the accident. I
screamed at him for not helping around the house, for being messy, for
not being there for Zoyi or for me. I didn’t know what else to do. He’s
been so distant, and I’ve been carrying everything alone. I just snapped.”
I listened and felt so compassionate toward Olga’s situation. The
weight of caregiving is very heavy, especially in a relationship strained
by health issues. It could lead to such moments.
“It’s okay to feel overwhelmed, Olga. You’re doing your best. Remember
to give yourself some grace during times like these.”
I wanted Olga to focus on something else.
“I read the article you sent me several times. You are a real Sherlock
Holmes. I did not know that Sudden Cardiac Death has such a direct
correlation with bad sleep.”
Li v i n g o n Fi r e · 83
Olga took a deep breath. She began to speak again, this time with
clearer focus. “I’ve been keeping a medical diary of Eugene’s health
problems. I just need to make sense of it all.”
Then she said, “Allergies,” almost like she was reading from memory.
“He couldn’t breathe through his nose. Ever. He was constantly
clearing his throat. When I asked what was wrong, he said it felt
like something was dripping back there, like it never stopped.
He complained about heartburn and kept Pepto-Bismol on the
nightstand, like a habit. Later it was Tums. All the time.”
She let out a breath.
“He snored so loudly it felt like the walls vibrated. Sometimes his
breathing just stopped, and I lay there listening, counting seconds.
He woke up exhausted, no matter how long he slept. He was anxious
all the time. Short-tempered. On edge.”
She sighed.
He started forgetting things. Simple things. Conversations we’d had
the day before. Where he put his keys. Why he walked into the room.
And he didn’t want to move anymore. He used to enjoy walks, tennis,
anything. Then even the idea of going outside felt like too much. He
sat on the couch, scrolling, staring, withdrawn.”
She stopped for a moment.
“It had been happening for a while,” she said. “But life was so busy.
One thing after another. I never had time to stop and think about
what it all meant. It seemed as if life was slipping away from him,”
she added. “Neither of us noticed it happening.”
She paused, then continued.
84 · B RE AT HL E S S
“The doctor informed him about his high blood pressure. He’s only
forty-two. They attribute it to genetics—his parents faced similar
issues. And now, there’s atrial and ventricular fibrillation.”
I didn’t interrupt. The pieces began lining up in my mind. Many
patients had shared similar stories with me before.
I continued with my fascination over the article Olga found: “Look
at this, over ten thousand adults, most of them just like Eugene.
No diagnosis or warning signs, no one acted on. The ones whose
oxygen dropped below seventy-eight percent at night had more than
double the risk of sudden cardiac death, even without a single trace
of heart disease.”
Olga sighed again. “That’s sad, but one thing that used to get under
my skin before the episode . . . now, it doesn’t matter at all. He was so
playful before Zoyi was born, but after her birth, I was so focused and
tired. We had this understanding to face those difficulties together.
But several years ago, I began to doubt if he even loved me. After
I put Zoyi to bed, I’d put on the old romantic movies we used to
watch back in Russia. Eugene would dismiss them and just fall asleep.
Physical closeness used to be important to me. It didn’t matter that
I wore lingerie he used to like, or the jokes and routines we used to
do. Nothing worked.”
“Eugene is alive. You saved his life. That is important,” I said. “The
article showed the risk is highest between midnight and six a.m.,
when everyone assumes the heart is safest. That’s what makes it so
dangerous; it hides in sleep. Even doctors don’t always think to check.”
Olga started to cry again with loud sobs. “It is absolutely stupid to
think about those little moments in a big picture, but I’m probably
looking for reasons to defend myself. I feel tremendous guilt that I
screamed that night before the accident. I know I found this article
that explains all his symptoms, but inside of me I feel that I am the
reason his heart stopped.”
Li v i n g o n Fi r e · 85
She paused again, before resuming. “It’s been like this for a while.
I can’t ignore it anymore. I know something is wrong. He’s getting
worse, and I don’t know how to help him.”
I felt a profound empathy for Olga. I had witnessed this pattern
before in patients—the slow, creeping accumulation of symptoms
often dismissed or overlooked until they became impossible to
ignore. This was Eugene’s story now, unfolding before me in these
small, documented pieces and etched in my memory.
“I was taught something in Russia,” I continued. “We were always
told to collect evidence, to look at the little things and see how they
all fit together. I remember reading a book by Darwin on evolution.
He recorded his observations during his expeditions, especially in
the Galapagos. His attention to detail, his ability to look at every
small change . . . it reminded me of how I need to collect data to
see the bigger picture.”
Olga’s voice cracked on the phone. “I keep thinking . . . if I hadn’t
screamed at him that night . . . if I had just seen how drained he
really was . . . maybe it wouldn’t have happened.”
I listen. Her guilt was raw, pouring out in waves.
“And just when I thought it was over, after they put the shocker in . . .
the doctor released Eugene from the hospital. He told me there’s
another procedure in two weeks with sedation. I don’t know if I
can live on fire for so long . . . The wait is unbearable.”
“Why didn’t they just do it all at once?”
Silence. Then, another sob broke through: “They said his heart . . .
wasn’t ready.”

C l u e s i n t h e D a r k · 87
CHAPTER SEVEN:
Clues in the Dark
Olga
Olga gazed out of the hospital window. The wind swept through
the branches, shaking loose red and orange leaves that twirled in
Khorovod. For a moment, she felt like one of them. Carried helplessly
by the gusts of fate, she had no choice but to follow the chaotic flow
of destiny.
She waited once more for Eugene to wake up after sedation. Her
nerves felt like steel ropes.
She continued to wear the “everything will be great” mask for
Eugene, but the stress was taking its toll. That morning, she had
looked at her hairbrush and noticed a big chunk of her curly blond
hair in it. Olga felt a constant tension in her neck, as if her head
was crowded with too many thoughts, too heavy for her spine.
Passing mirrors, she caught sight of her rounded shoulders. A
flash of irritation surged through her. This was the posture she
had watched in Eugene, the one that used to annoy her. Now her
body had learned it too.
Olga remembered it vividly. She had believed her greatest fear was
in a past. Eugene was safe.
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She asked him how he felt, hoping the worst was behind them.
“I feel like I went through a hurricane,” he murmured.
Olga remembered the moment Dr. Reno, the cardiologist who had
performed the procedure, stepped into the room. “Eugene, Olga, I
want to go over the next steps now that we’re at the postimplantation
phase.” His piercing blue eyes seemed to look straight through to
the heart of things. Yet, they never lacked kindness.
Eugene looked up. She could see he believed this wholehearted
nightmare was finally behind him.
“What’s next, Doc? What happens now?”
Dr. Reno pulled a chair closer to the bed. His voice was calm,
yet it carried an unsettling weight. “First, Eugene, I want you to
understand that the device we’ve implanted is already working. It’s
actively monitoring your heart,” he said, pausing for effect, “but it
hasn’t been activated fully yet.”
Olga leaned in, her brow furrowing. “Activated? What does that
mean? We’d discussed that you would do the whole procedure while
he is under sedation.”
“Olga, Eugene . . . I want to explain exactly why we chose to wait before
fully calibrating the device. A few days ago, Eugene’s heart didn’t just
slow down or flutter. It stopped. He went into ventricular fibrillation,
one of the most dangerous heart rhythms we know. In that state, the
heart quivers chaotically and can’t pump blood. Without immediate
intervention, it leads to sudden cardiac death. Only about three percent
of people survive that kind of event outside a hospital.”
He paused, allowing the weight of that number to truly land.
C l u e s i n t h e D a r k · 89
“When Eugene came in, we confirmed the diagnosis by performing
what’s called an electrophysiology study. In short, we intentionally
induced a controlled episode of arrhythmia while his heart was
being monitored. We stopped his heart briefly to prove the rhythm
disorder and understand its exact nature. We confirmed this wasn’t
just a one-time incident, it’s something his heart is vulnerable to.”
Olga clenched her teeth and fists. Eugene, she noticed, was grayish pale.
Dr. Reno continued. “Under normal circumstances, we would
calibrate the implanted defibrillator by testing both functions: the
low-voltage pacing for tachycardia and the high-voltage shock for
ventricular fibrillation. But Eugene’s heart had just been through
trauma. Testing both shocks, especially the high-energy one, might
push his heart beyond its limit.
He turned to Eugene. “Your heart is weak, Eugene. Not in a permanent
way, but right now, it’s recovering. Like a boxer who just got back on
his feet after a knockdown. It’s not the time to spar again.” He leaned
slightly forward as he spoke, giving the sense that every word was
meant for each of them alone.
Eugene nodded, releasing a heavy sigh.
“So, we’ve decided to wait two weeks,” Dr. Reno concluded. “Let your
heart recover. Then we’ll bring you in under sedation. We’ll calibrate
the device safely and test both scenarios. No unnecessary risks today.”
He paused, meeting both their eyes. “The device is already watching
over you. But we need to be smart about pushing it into action.”
Olga was deeply disappointed. It seemed endless. She noticed shiny
drops of sweat on Eugene’s face. His lips, usually plump and red, had
turned a grayish-blue.
90 · B RE AT HL E S S
“But will he feel it?” she asked, her voice trembling. “Is he going to
be in pain?”
Dr. Reno shook his head reassuringly. “During this testing process,
Eugene will be sedated. You won’t feel anything when we induce these
rhythms in the lab, Eugene. You’ll be asleep, so you won’t experience
the shock at all. The goal is to ensure the device works, detecting
arrhythmias and responding appropriately.”
Eugene closed his eyes for a moment, absorbing the information.
“So . . . you’re going to put me under again?” He paused, then asked,
“How long will it take?”
“Yes,” Dr. Reno explained, “you will be sedated, just like during the
procedure. The test will be quick, and we’ll monitor everything
carefully. Afterward, you’ll wake up, and we’ll check how the device
responded. If everything works as it should, we’ll send you home
with the knowledge that your ICD is fully functional and ready to
protect you.” The easy warmth of his Southern manners softened
his statement.
Eugene took a deep breath and slapped the bed with his palm. “What
if something goes wrong?”
Dr. Reno reassured him, “The device is designed to be fail-safe. The test
will ensure it’s ready for any situation, and afterward, we’ll monitor
you closely during follow-up visits to make sure it continues working
perfectly. You’ll be safe, Eugene.” Dr. Reno continued, maintaining
eye contact with him.
Eugene swallowed hard. His hands, resting on the white hospital bed
cover, began to shake slightly.
Olga looked at Eugene. Anxiety washed over her in heavy waves. She
had seen him so close to death before. The thought of a shock, no
matter how necessary, made her feel sick.
C l u e s i n t h e D a r k · 91
Olga nodded, but she still couldn’t escape the feeling that the
intensity of the moment was too much for her to handle. His heart
is so frail. She found herself thinking about that realization every
night. The stress was already beginning to take its toll. She felt a
wave of fatigue wash over her, so deep and overwhelming that it
almost made her dizzy. The adrenaline from earlier was wearing
off, and the exhaustion hit her like a truck. The sharp, sterile smell
of disinfectant lingered in the air.
Dr. Reno left.
Shaking off her thoughts, Olga stood up to stretch her legs. She
stepped outside to breathe in the tingling cold of fall air. Wind
danced with red, orange, and yellow leaves. The wood-burning
Halloween air reminded her of life beyond the hospital. Costumes.
Decorations. Zoyi waiting for trick-or-treat. She leaned against the
wall, her eyes closing briefly.
Olga’s mind drifted, back to a different autumn.
Fall in St. Petersburg always arrives early. By mid-August, the air
sharpens, skies turn silvery gray, and trees rustle like pages of an old
book. Fall and summer aren’t seasons for relaxation. They define the
mood for everything ahead. A signal for action.
It meant mushroom picking in the damp, mossy silence of the forest.
Fingers stained with soil and pine resin. Olga admired the baskets,
heavy with brown-capped and golden chanterelles. Their earthy
perfume lingered, pine needles clinging to her coat all the way home.
She remembered standing with her mother in the warm kitchen.
They washed, sliced, and dried mushrooms together. Steam rose
from pots on the stove. Bubbling jams of raspberry, cowberry, and
blueberry simmered.
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Her mother once remarked, while sealing a jar, that the beauty of
a woman could be seen in how she prepared for winter. “When
your husband or child opens a jar in February,” she had said, “they
should feel your love.”
The memory pulled Olga inward. She could almost smell it now,
the deep, rich aroma of dried mushrooms, mingled with the lush,
sugary redolence of raspberry jam spooned over warm bread. She
used to love the look of arranged rows of glass jars on the pantry
shelves. Each one was a small act of devotion, a promise of comfort
on a long winter night.
Now, in New York, the seasons follow a different rhythm. Summer
stretched into October, and Halloween decorations rustled in the
breeze among golden maple leaves. Today, in this crisp air and
golden light, she felt a ghost of it, a whisper of home. For a fleeting
moment, she was that beautiful girl again, with stained fingers and
her mother’s words echoing softly in her mind.
Even surrounded by nature’s colors, she couldn’t escape the constant
thoughts agitating in her mind. Olga worried endlessly about
Eugene’s future. Concerns that something could go wrong kept
her awake, even when her body begged for sleep.
Olga returned to the hospital room and glanced at Eugene. He
was already engrossed in his laptop, eyes glued to the screen,
fingers tapping nervously at the keys. She knew he was trying to
distract himself.
His hands still shook slightly, lips parted just a little. He kept
scrolling, clicking, typing. Anything to stay focused on something
that felt solid.
Work.
C l u e s i n t h e D a r k · 93
It was the one constant he had left. The only thing that gave him a
sense of control. Everything else around them seemed to collapse
like a house of cards.
* * *
The first morning home, Eugene sat at the kitchen table with a halfeaten
bowl of oatmeal and Zoyi’s school folder open beside his
elbow. Crayon-colored construction paper spilled out alongside
printouts from Google Classroom. His eyes scanned the teacher’s
comments, red pen looping around spelling mistakes and unfinished
math problems.
“Why are her grades so low?” he asked. He held up a worksheet, a
frowning face sticker clinging to the corner like a judgment.
Olga noticed Eugene’s short, bitten nails. His anxiety was beyond
the limit, she thought.
His green eyes lingered on a page filled with crooked letters and
uneven lines.
“Podcherk. This is her handwriting?” he asked, frowning. “I’ve never
seen it before.”
Olga was washing dishes. She turned around. “She types most things
now. That was just a writing exercise.”
He held the page up, his face reflecting a strange mix of sadness and
frustration. “They don’t teach cursive anymore?”
“Eugene,” Olga said gently, “no one writes by hand now. Everything’s
on tablets. That’s just how things are.”
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He shook his head. “In Russia, we were taught to write with feathers.
Carefully. Pushkin wrote with his hand. That’s why his poetry still
breathes after two centuries.”
Olga rolled her eyes but remained silent.
Eugene gently set the page down. “There’s a connection between the
hand and the brain. You feel the words before you even write them.
That’s how thought becomes art.”
Olga was torn. Should she be happy that Eugene was finally paying
attention to homework? Or upset because he didn’t grasp how hard it
is to raise a child?
“She’s struggling in every subject,” she said. “I’m trying to help her with
her homework. Maybe she needs a tutor.”
“Tutor for second grade? I didn’t have one. I don’t recall your tutor either.”
This is a different time and a different country. Many kids in her class
have help. Others are going to additional after-school classes to excel
in school subjects.
“This is ridiculous,” Eugene smirked. “I’ve never heard anything
like that.”
“Because you’re not taking Zoyi to school.”
The conversation was drifting toward their usual duel scenario.
Suddenly, Eugene pushed the papers aside and rubbed his chest where
the shocker sat just under the skin. The calibration was coming up in
two weeks. Every day felt like a countdown.
Zoyi came bounding into the kitchen in mismatched socks, her arms
full of cardboard and glitter. “Papa, look!” she exclaimed. “I made a
volcano that explodes with baking soda! Want to see?”
C l u e s i n t h e D a r k · 95
Eugene forced a smile. “Of course, baby. After school, okay?”
She nodded and leaned into him, hugging his side. Her face lingered
there, pressed against him a little longer than usual.
* * *
Olga moved back to their bedroom despite Eugene’s snoring; she
felt that she had to be there to act in case of a repeated episode.
Her racing mind and his gasping for air were not the best relaxing
environment. Olga started with melatonin gummies. She explored
CBD drops. Nothing helped. She had a sensation of turning into
a Zombie.
That night, Zoyi stood at the bedroom door in her pajamas. Her
blond curls cascaded over her shoulders as she clutched her stuffed
dog. “Can I sleep here? With you?”
“You have your own bed now,” Olga said softly. “Papa needs
to rest.”
“But I stayed here with you while he was away . . .”
Olga glanced at Eugene. His head had already sunk into the pillow,
eyes closed, but not asleep.
“Come on, let’s try your room,” she whispered.
Later that night, Olga woke to a small shadow curled beside her,
breath loud and heavy. Zoyi had made her way back again, squeezing
herself between her mother and the edge of the bed. Olga didn’t have
the heart to move her. She felt the mattress dip with every twitch
of Eugene’s restless legs. His snoring was loud.
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At 4 a.m., warmth spread beneath the blanket, damp and unexpected.
Olga’s body tensed. Reaching behind her, she found Zoyi curled like
a kitten, still asleep but soaked. Quickly, she got up, peeled the sheet
away from under Eugene, and carried her daughter to the bathroom.
No words.
When she returned, Eugene was sitting up.
“What happened?”
“Nothing,” Olga replied hastily. “Go back to sleep.”
“She wet the bed?”
Olga hesitated. “She’s scared, Eugene, of monsters in the closet and of
being left alone. She needs time to learn to sleep on her own.”
“She’s eight.”
“She’s a child, and her world is falling apart. She was with us that
morning, remember? She can’t find the words, so her body speaks
for her.”
He was silent. She noticed the faint tremor in his fingers. Instinctively,
his hand moved to his chest.
“Again?” she asked.
He nodded. “Every morning now. A flutter. Like wings in a cage.”
Olga looked at him. His face was swollen, pale, as if someone had
pressed pause on his body overnight. The skin around his eyes sagged,
waterlogged and bruised. Olga understood that he was trying to act
C l u e s i n t h e D a r k · 97
like the father he hadn’t had a chance to be. Olga noticed that her
habitual anger started to boil again. She did not let it go. It was hard
to hold too many pieces alone.
“I’m scared, too,” she said. “You have to tell that to the cardiologist.”
Eugene squeezed his forehead. “I mentioned this to my primary care
provider many times before the accident. He told me to stop drinking
coffee. Guess what? I don’t drink coffee anymore since my accident,
but it still races every morning. I’m barely functioning without my
five cups of coffee.” He paused, considering. “Maybe I should drink
those energy drinks instead.”
Olga opened her Notes app on the cell phone: “Racing heart every
morning. Not from coffee.”
After they brought him home from the implantation, he spent most
of his days asleep or slouched on the couch, laptop balanced on his
knees, a bag of chips by his side. The aroma of her soups and stews
wafted past him without effect. Instead, he tapped DoorDash. A
carnitas burrito arrived, so overstuffed it barely closed. Cheese and
sour cream oozed onto his fingers, leaving greasy streaks as he ate.
When he spoke, it was only to ask Zoyi about her day. The question
sounded flat. Mechanical. Empty.
Zoyi kept asking about the dog he’d once promised. Each time, he
would only answer, “We’ll see.”
Every time he shifted, crumbs slipped from his fingers, speckling his
T-shirt, his belly, and the cushions. Olga despised it, yet she waited
until evening to clean, after he had moved with his laptop to the
bedroom. His green eyes, usually quick and bright, were now hooded
by swollen lids, their color dulled. He spoke with a slow sadness,
sighing deeply after each sentence, as if bearing a wordless grief that
had settled in after the doctors had, quite literally, touched his heart.
98 · B RE AT HL E S S
* * *
Now sitting with Eugene after the “calibration of the ICD” procedure,
Olga glanced at her notes.
Dr. Reno entered the room: “The device is set up, and we will see you
at check-up in two weeks.” He turned to leave. Olga stopped him.
“Doctor, did Eugene mention that his heart races every morning? Is
that normal?”
Olga brought out a printed article from the Journal of Clinical Sleep
Medicine that detailed that forty-nine percent of patients with AFib
had sleep apnea, compared to thirty two percent in a control group.
It described another study that showed a four-fold increase in the
prevalence of AFib in patients with sleep apnea. But she did not
want to create a conflict and instead just handed the printed pages
to the doctor. “I found this article that shows the high correlation
between atrial fibrillation and sleep.”
Dr. Reno studied Olga with intense focus.
“Let me check our data.” He grabbed the article.
The doctor eventually returned to the room, holding a referral slip.
Eugene ran a hand down his face. The thought of hearing something
new, something that would mean more wires and tests, filled him
with dread. “What else is wrong?”
“I remember reading something in your history,” Dr. Reno replied. “I
checked the data from your device. The timing concerns me. Many
arrhythmias, especially those tied to autonomic instability, can occur
right after sleep or during REM. It makes me think something might
be happening at night that’s straining your heart.”
C l u e s i n t h e D a r k · 99
“Like what?” Eugene asked, his anxiety rising.
“Sleep apnea is at the top of the list,” Dr. Reno said. “I’ve seen it cause
sudden oxygen drops that put stress on the cardiovascular system.
In someone with a defibrillator and a history like yours, it’s not just
snoring. It can provoke dangerous rhythms.”
A wave of validation swept over Olga. She was not just a worried wife;
she was an investigator who had found one missing link. Though she
was drained, it felt good.
“Look,” Dr. Reno continued, “we need to understand what’s happening.
I’m ordering an in-lab sleep study with full cardiac monitoring. A
home test wouldn’t be enough. This required precision. We’ll be
watching your heart, breathing, brainwaves, and oxygen. Everything.
We also need to rule out central sleep apnea, which is when your brain
simply fails to send the signal to breathe.”
“You think that’s possible? Central sleep apnea?” Eugene asked.
“Yes. It’s less common, but we do see it in patients with a cardiac
history and implanted devices. If you have apnea, whether obstructive
or central, we need to address it immediately. You’ve already had a
major cardiac event.”
As Olga sat listening to the exchange between the doctor and Eugene,
the exhaustion of the past two weeks swept over her. Yet, she still
couldn’t rest. Even in that fog of fatigue, she continued to document
Eugene’s complaints on her phone.
It was becoming her routine now. Documenting symptoms, ignored
warnings, and missed signs was her endeavor to bring an enormously
tragic situation under control. Each detail was a clue. Another piece
of the puzzle she was determined to solve.
100 · B RE AT HL E S S
“Morning headaches. All-day sleepiness. Total exhaustion. Dry mouth.
Sore throat.”
Some symptoms she attributed to the recent surgery. Others she
realized had started long before.
Sleepless nights offered her too much time to reflect. She rewound
her life, questioning how they had arrived at this moment. They were
hanging on the edge of something they still didn’t fully understand.
The device was calibrated. Yet, nothing felt resolved.
Eugene’s heart was a ticking question.
Would they ever uncover the true reason for what happened that night?
Next stop: the sleep center. And if it did offer a solution . . . would
they even be able to afford it? With Eugene’s money tied up in
a startup and Olga not working, they weren’t just fighting for
diagnosis. It was a fight for his life and for their financial survival.
Would the sleep study uncover the missing piece? Or would it just
raise more questions?
Two weeks ago, Olga was full of hope. She believed that after Eugene’s
defibrillator procedure, he was finally done with it. She could start
her normal life again.
“ I n His S l e e p ” · 101
CHAPTER EIGHT:
“In His Sleep”
Dr. Sokolina
Some days begin with purpose. Others start with a distant rhythm.
On a rainy Wednesday afternoon, I absorbed every detail of my
practice designed to calm the nervous system. Muted lighting set
a tranquil tone. The open airiness invited peace. State-of-the-art
equipment stood ready, alongside sleek cabinetry. Precision and
beauty, both working together toward healing.
It’s not just the tools but the people. I work with a team of women
who believe deeply in the gentle transformation that happens
when someone feels truly seen. Whether it’s a hygienist covering
a patient who feels cold or my treatment coordinator pausing
her schedule to comfort someone who cries in the presentation
area, we all understand that true healing starts long before the
first X-ray.
I first met Amanda on that Wednesday afternoon. It was one of those
grey, slow New Jersey days where time feels thick in the air. She
walked into my office wearing a tailored navy suit. She had the look
of someone who had already powered through five depositions—high
heels, perfect hair, and pain behind the eyes.
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She wasn’t here for cosmetics or sleep. She pointed to her jaw and
said, “This thing’s been killing me.”
She ran her hand from her jaw to her ears, then up into her temples.
Stretching her neck, she spoke.
“I’ve had earaches. Headaches around my temples. It throbs when I
chew,” she said. Her frustration was palpable. “I’m on my third night
guard. None of them helped.” Then she added, a bit awkwardly, “It’s
probably stress.”
Stress. That was her explanation for everything. Clenching. Long
hours. It was the cost of being a successful attorney in a highstakes
firm.
On paper, it seemed like textbook temporomandibular joint (TMJ)
disorder.
However, her eyes told a different story. They were dry. Unfocused.
Exhausted in a way no nightguard could fix.
I asked, “How’s your sleep?”
She waved a hand, dismissive. “I get six hours. I’m fine.”
Fine. The most dangerous word in healthcare.
“Do you wake up rested?”
She hesitated. Just a beat. “I wake up.”
“Open wide for me,” I coaxed softly.
Her throat was nearly obscured.
“ I n His S l e e p ” · 103
An anesthesiologist might refer to it as a Mallampati Class IV—the
kind that quickens the heartbeat before administering general
anesthesia, as it necessitates backup plans and additional tools. For
me, it was another clue. Patients with this classification often struggle
to breathe once they fall asleep.
I angled the light slightly. “Just breathe through your nose,” I added,
suspecting it wouldn’t be easy for her.
Her tongue was wide, pressed along the edges, scalloped from years
of pushing against her teeth. It seemed as if it had been searching
for space it never had.
Her upper jaw was narrow, vaulted high like the Gothic cathedrals I’d
seen across Europe. These structures, built long before the Renaissance,
were beautiful. Yet, they were designed more for echo than breath.
Eugene’s is quite similar.
When I touched her jaw muscles, she flinched.
“Does that hurt?” I inquired.
“Yes,” she replied without hesitation. “All the time.”
Her chewing muscles were taut and swollen beneath my fingers.
She caught my eye. “I do not like that part of my face. My jaw is too
square. I tried Botox to relax those muscles for a while, but it always
comes back. I didn’t like having that huge amount of toxins in my body.”
They didn’t just hold tension; they carried a lifetime of compensation.
Her oral architecture was the kind I’ve come to associate with chronic
survival mode.
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I adjusted the light, tilting it just a bit.
“Can you breathe comfortably through your nose?” I asked. I already
knew the answer wouldn’t be simple.
She blinked. “I . . . I don’t know how I breathe.” A pause lingered.
“I’ve never thought about it.”
I adjusted the light to look inside her nose, noticing the thickened
nostrils and the deep red shadow inside the swollen turbinates (small
structures inside the nose that cleanse and humidify air).
“When your mouth is closed,” I said, “where does your tongue
usually rest?”
She hesitated. “I don’t know,” she admitted. “I’ve never thought about
that either.”
“Do you often wake up with a dry mouth?” I inquired.
She frowned, searching her memory. “I don’t really register it. But I
always keep a glass of water next to my bed.”
I nodded.
“How are your mornings?”
“I have to force myself out of bed,” she didn’t hesitate. “I never wake
up refreshed. But I have to get up. On weekends, I just sleep in . . .
twelve, sometimes sixteen hours, if I can. But even then, I don’t feel
better once I’m up.”
“Where do you feel headaches?” I wanted to direct her thinking
toward collecting the clues.
“ I n His S l e e p ” · 105
She massaged the spots above her ears and at the back of her head.
“Do you remember your dreams?”
“No.” A small shake of her head. “My brain is too busy to dream.”
“How do you make it through the day?”
She gave a short, nervous laugh that wasn’t laughter at all. “Coffee.
Six or seven cups.” Suddenly, I remembered Olga complaining about
her husband living on coffee all day.
I watched as her smile tried to hold, then slipped away. “Sometimes
I close my office door and just . . . zone out.”
This is the kind of confession patients make only after carrying it for
far too long.
I could sense her frustration and exhaustion. I could see her pain,
hear it in the way she said “I’m fine,” feel it in the way her jaw fought
every movement. But I didn’t yet know how to put all the pieces in a
sustainable structure.
I didn’t treat sleep.
I treated teeth, joints, and smiles. I softened bites, eased muscle
tension, and balanced occlusions.
But none of that would touch the weariness in her eyes.
So I gave her the name of a sleep specialist to have a sleep study. I
wrote the referral with a strange ache in my chest, like I was standing
outside a house, knowing something was wrong inside but not yet
having the key. At that moment, I felt again in search of a mentor. In
a way, Inna was my mentor and a reflection of who I am.
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After work, I went home and began thinking about how to dress for
dinner with Inna. I felt proud of my home. Every room reflected a
part of me. I surrounded myself with dark Japanese wallpaper and the
artwork from places I had dreamed of visiting as a child. The cement
sink in the minimalist bathroom reflected my love for stillness, for
structure, and for an urban kind of beauty I learned to appreciate
only after I moved to the West.
Inna and I only saw each other once a year now. It became our marker
in time. A moment to ask myself, “Who am I now?”
I stood in front of my closet, considering what to wear: linen, silk,
structured cotton. I’ve always believed that clothes are a kind
of language. You don’t need to speak but can say everything by
how you walk into a room. I can usually tell who I’ll feel close
to just by how they dress. It is not the labels but the intention of
putting themselves together—the way they combine texture, color,
confidence, and restraint. Style, for me, is intuition made visible.
Yet, I was raised in appreciation of beauty. My mother had a
philosophy: “A woman must beautify her family.” She put me in figure
skating and music. She started my orthodontic treatment when I
was just four. She taught me that caring for my skin was an essential
survival skill, something I had to learn before starting school, because
once school began, she warned, it might already be too late. My mom
believed in the transformative power of aesthetics and pressed that
belief into my bones.
When I lived in Russia, we didn’t choose our clothes; the government
chose them for us. We had to hunt for anything relatively fashionable.
I remember standing in line for winter boots for eight hours during
my medical school winter break. It was a high-risk kind of hunting.
You might wait in line and still come home with nothing. But if you
got your winter boots, it was like flying business class. That moment
“ I n His S l e e p ” · 107
held a kind of superiority without borders. A joy that outshone even
the pleasure of wearing the wrong size of boots because your size
was already out of stock.
People born in a capitalist country might never grasp that kind
of happiness.
A deep layer of me, buried under all this structure and curation, still
believes this could all disappear. One day, I might wake up from my
American dream and find myself standing in line again. The line is
long for potatoes, lipsticks, and boots.
People often tell me I have energy. But I know the truth. It’s fear. It’s
the muscle memory of scarcity.
I still find it amusing that when I lived in Russia, I thought all
foreigners dressed beautifully. Once I moved abroad, I realized
that most people in the West don’t pay nearly as much attention to
their outfits. There are very few exceptions. Ironically, it’s often the
immigrants from Eastern Europe who are the best dressed. I guess
we have to take extra efforts to express ourselves.
An absolute mystery to me was how to communicate with my
American peers, how to truly understand them. It wasn’t just the
language. Everything else mattered too: elementary knowledge of
summer camps, riding the bus after school, prom, bar-mitzvahs.
Even the idea of school cafeteria activities shaped the connection
between people. Without basic points in common, forming a strong
line of communication seemed impossible. For that simple reason,
I was always searching for a mentor. I imagined that after dental
school, I would meet someone who would help me find myself
professionally and personally. He or she would be knowledgeable,
confident, advanced. Someone I could follow, step by step, into a
secure professional future.
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I looked for that mentor among my teachers at NYU’s dental school,
but I was an immigrant in a separate evening program. We were
so foreign. We even smelled different, literally. We couldn’t express
ourselves in rich English. And our professors were equally tired in
the evenings. We were a salad of unfamiliar ingredients, and no
one wanted to be the dressing. The connection never happened.
I told myself that was okay. I’d find my mentor once I started
working. I imagined an employer who would take me under their
wing, teaching me the proper way to practice American dentistry.
That dream didn’t come true either.
Looking back, I understand why. Who wants to invest their time
in teaching someone completely unknown? A stranger is a danger.
I also came to realize that life is similar to the school system. You
need to have an idea of the direction you want to go in. A mentor
doesn’t have to be a physical person. It can be the author of an
article, or a friend who shares an idea after a course. You have to
be curious. You become the director of your own school, selecting
your mentors.
Practicing dentistry or medicine is so diverse that one person could
never teach you everything. You choose a subject, like periodontics
or implant dentistry, and start searching for experts. You analyze
what they say, apply the diamonds of their experience to your own
situation, then turn the page and move to the next subject.
After dental school and residency, I was lost. Dreams and courage
filled me, yet confidence was nowhere to be found.
One of my teachers in residency once said, “You have to look
confident. Patients read their treatment success in your posture
and eyes.”
“ I n His S l e e p ” · 109
I was crushed. How could I appear confident when uncertainty
loomed over my treatment’s success? What if the patient returned
in pain? What if the restoration failed?
The teacher instructed, “You have to pretend.”
I’ve replayed that advice in my mind countless times.
But Inna, in her own way, became a teacher to me by example. I was
just starting my business. She was starting hers. It was our shared
business school, and we lived in the trenches.
You have to lead people. They need to follow your guidance.
But how can I guide when I’m not even sure of myself?
I pretend and lead with compassion.
I reached up and pulled down the dress. It wasn’t new or flawless, one
I had worn before. Yet, it always made me feel like myself—sharp,
structured, soft in all the right places. I hate itching.
It wasn’t perfect, but it felt right.
My phone blinked. A red circle of notification appeared.
I stared at the screen, rereading it over and over. Initially, I suspected
it was some kind of phishing scam. Had Inna’s phone been hacked?
Was this a twisted donation ploy? The mind does peculiar things
when it refuses to accept reality.
However, it did not have a link or specific ask, just a flat, unreal
sentence: “Will have to reschedule our meeting. Alex passed away.
Will keep you posted about funeral arrangements.”
110 · B RE AT HL E S S
My breath caught. My stomach dropped. Instinctively, my hand went
to my heart.
I kept reading that bleeding sentence as if it held a code I hadn’t
cracked. It burned behind my eyes.
At first: a mistake, spam, a dark joke.
Alex was just forty-seven.
I called Inna. My hands trembled so hard I could barely hold the
phone. I clung to hope, desperate for it to all be a mistake.
When she answered, I blurted out, “It’s not true, right?”
On the other end, only sobbing—raw, unrestrained. Then, through
the tears, her voice broke clear: “True. He’s gone.”
“How?” The word escaped my lips, barely more than a whisper.
“In his sleep.”
In that instant, it felt like a boulder fell from the sky. It crushed me
whole, shattering my existence into pieces.
* * *
Our long-anticipated reunion had taken place not in a restaurant, but
in a funeral home filled with lilies and polished wood. Dim lighting
and muffled sobs surrounded us. A solemn order of service and the
frightening grief had replaced the imagined laughter of dinner.
Alex lay in an open casket, dressed in a crisp black business suit
and a stiff white shirt that looked freshly starched. Nothing could
“ I n His S l e e p ” · 111
disguise the stillness. His skin had a pale, waxy sheen, somewhere
between shadow and marble. It was as if the light no longer knew
how to touch him.
His full cheeks had flattened. Lips, usually curved into a joke or a
sarcastic greeting, were now pressed into a line. He looked like a
mannequin version of himself.
That can’t be real. I am trapped inside a nightmare, my mind insisted.
Around the room, his friends filled the silence with stories. They
shared memories of travels together and celebrations. They spoke of
Alex’s creative, humorous talents and his legendary gift for turning
any disaster into an adventure. Laughter moved through the room,
thin and bittersweet.
Inna sat in the front row, her eyes swollen and red, a wad of tissues
clenched in her hand. Her daughter sat nearby, unmistakably Alex’s.
I had always pictured her as radiant, joyful, full of life. Now that
brightness was gone. It was replaced by an endless grief.
Alex wasn’t only Inna’s ex-husband. He was her lifelong friend,
her partner in building a future, and the father of their daughter.
His absence drummed louder than any eulogy. Words fell short of
capturing the magnitude of such a loss.
Alex and Inna had married young and had their daughter not long
after. Inna was preparing to leave Russia for the United States, and
Alex simply couldn’t imagine life without her. So he proposed.
It was an impulsive, romantic and sincere union. He couldn’t
bear the thought of her building a future without him in it. They
kind of grew up together in the process of building a new life
in America.
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But time, as I knew too well, had a way of exposing differences
that early love tends to blur. Inna was determined. She was always
climbing, always chasing the next milestone: dental school, then
orthodontics residency, then launching her own practice from
scratch. Precise and efficient, she was fueled by long to-do lists
and a hunger for growth.
Alex, on the other hand, adored a good time. He had charm in
abundance, the kind of magnetic warmth that made everyone
feel like his best friend. He liked comfort. Familiarity. He enjoyed
being helpful, generous, and adored. Pushing limits wasn’t in
his nature.
They didn’t have a stormy breakup. Just a slow disentanglement.
Inna moved forward. Alex stayed where he was. When they finally
separated, it was no drama. Mutually understood. Still, it was
clear he never stopped loving her. They lived in the same building,
helping their daughter together. He was always around, fixing the
computer network in her office, setting up new software, and even
driving hundreds of miles to help with a broken tire on the road.
It was the type of relationship I found the most precious gift life
can offer.
After the wake, I joined many of Alex’s friends at his favorite
restaurant. The atmosphere was strangely alive, as if Alex himself
were still there. Laughter echoed as people recounted his jokes,
shared stories, and exchanged memories about his quirks. The
room buzzed with warmth and affection, but beneath it all curled
a silence no one dared to break. No one truly knew the real reason
he had died. I didn’t feel comfortable asking, but the question
tormented me.
I saw familiar faces. People I had met at the very beginning of my
American journey. It was fascinating to see how immigrant lives can
“ I n His S l e e p ” · 113
twist, transform, and flourish in unexpected ways. Subconsciously,
I began forming an algorithm, a mental model of who survives and
thrives. Alex had touched so many lives with his generosity and
unfailing support. His life had been short, but deeply meaningful.
Still, his loss felt surreal, as if it hadn’t truly happened.
The phone buzzed. The screen lit up with Olga’s name.
“I was right. Something’s wrong with Eugene’s sleep. They’ve referred
us for a sleep study.”
A moment later, another line appeared: “How was Bouley Botanical
with Inna?”
I replied, “From botanicals, it was only white lilies.”
Silence. Three question marks blinked on the screen. Minutes
stretched. Finally, the next message arrived.
“Who died?”
A lump rose in my throat, and tears pressed close to the surface. The
parallels between the two men, Eugene and Alex, were unbearable.
Both in their forties. Overweight. Snoring.
I saw Alex’s daughter sobbing uncontrollably. Her world had just
collapsed. My thoughts turned to Zoyi.
I didn’t want to add to Olga’s mounting anxiety. Yet, it didn’t feel
right to hide it from her either.
“Alex.”
I hesitated. My whole body shook. Then I added, “In his sleep.”

T h e M a s k o f S u r v i v a l · 115
CHAPTER NINE:
The Mask of Survival
Eugene
The city lights blurred through the windshield like a watercolor left
in the rain, and Eugene suddenly realized that his carefree youth
had vanished, replaced by the frightening sense that he was now “the
sick man” whose survival depended on devices, tubes, and a body
he no longer trusted. He remembered when they used to drive like
this at night for fun, windows down, old Russian pop songs “White
Roses” on the radio, the two of them arguing over which bakery had
the best late-night pastries. Now, Olga was driving him to the sleep
center, and the sound of his own words, brittle and uncertain, almost
brought him to tears.
Through the silence in the car, Eugene stared ahead. “Do you remember
you asked me if I recall anything from the night I collapsed? It was mostly
blank. But if I really think about it . . . I remember a white corridor, just
like in the movies. I was walking through it, and I thought, ‘I don’t
want to be here. I love my wife. My little girl.’ And I turned around.”
He noticed tears slowly trailing down Olga’s face.
Inside, Eugene followed Robert, the technician, into a small
presentation room just off the hallway. The walls were lined with
116 · B RE AT HL E S S
posters of sleep cycles, airflow patterns, and oxygen levels. Bundles
of wires, sensors, and an assortment of CPAP masks lay on the table.
In the background, a monitor gleamed softly.
Eugene smiled at the bulky, strong man who offered him a seat.
Suddenly, he noticed a grey plastic box with a big hose wrapped
around it, attached to a clear oval mask.
He paused, feeling a chill settle in his stomach. That machine
reminded him of the one beside his father’s bed, the very one his
father constantly complained about. Claustrophobia, skin irritation,
and air in his stomach. His father used to say he’d rather die than
sleep with the machine.
He hoped to avoid that ordeal.
Eugene glanced at the bundle of wires. “All that’s going on me?” he
asked, his voice tinged with disbelief.
“Not all of it, but yes, quite a bit,” Robert chuckled. “Sensors on your scalp,
forehead, under your nose, chest, abdomen, and legs. We’ll track your
brainwaves, heart rate, oxygen levels, breathing, and muscle activity.”
He held up a strap. “This one goes around your chest to measure how
hard you’re working to breathe.“ Then he picked up a pulse oximeter.
“And this little guy clips on your finger to monitor oxygen.”
Eugene exhaled slowly. “And I’m supposed to sleep like that?”
“You’d be surprised,” Robert reassured. “Most people doze off within
the first hour. We just need a few solid hours of clean data.”
Eugene crossed his arms. “I’m a light sleeper. Cameras, wires . . . It’s
hard to imagine relaxing.”
T h e M a s k o f S u r v i v a l · 117
“There’s a camera and a mic to monitor your sleep. It’s nothing invasive.
We’re just observing position changes, snoring, and pauses in breathing.
My job is to keep you safe and ensure we capture the data we need.”
Eugene glanced at his hands, then back up. “So, what are you really
trying to find?”
“We’re monitoring for any disruptions in your breathing, whether it’s
an airway collapse or your brain failing to send the signal. If your
oxygen levels drop or your heart rate changes, we’ll detect it. This
information will assist your doctor in determining what’s happening
and how best to treat it.”
Eugene nodded slowly. “Okay.”
“Great,” Robert said. “Let’s get you to your room and wired up. Try
to rest.”
The sleep center room didn’t resemble a typical medical facility. There
were no harsh lights. No white walls.
Instead, it reminded Eugene of the hotels he used to stay at on
business trips. Soft lighting enhanced the neutral tones. A large bed
with crisp linens awaited, and even a faux-wood nightstand with a
reading lamp completed the scene.
Only the discreet camera in the corner and the tangle of wires coiled
on the bedside table revealed its purpose.
He looked around and exhaled. “Strange,” he said. “Feels more like
a Marriott than a hospital.”
The sleep tech attached a small forest of wires across his chest, legs,
face, and scalp. Additional leads monitored his heart. A camera would
118 · B RE AT HL E S S
record his every movement. Oxygen saturation, airflow, respiratory
effort, brain activity—all of it captured.
When the lights went out, Eugene didn’t feel afraid. Instead, he felt
oddly calm. For the first time in a long time, someone would be
watching. Tonight, his sleep would be measured and judged.
Eugene lay still, the ceiling fading into darkness. The wires tugged
lightly at his skin. His mind did what it always did when there was
nowhere else to go.
It moved backward.
He saw himself again as a boy in Russia. Heavy. Awkward. Teased.
Ignored. Left out. Olga had been different even then. Brighter. Sharper.
Confident. She had protected him.
That version of himself embarrassed him now. For years, he had tried
to erase that boy.
America had given him the chance to rewrite everything. He
transformed his body. His smile. He learned how to speak. How to
win. College. Work. Money. Confidence that looked real enough to
fool even him.
When he went back to Russia years later, he wanted Olga to see it.
To see him.
But she was already moving on. Busy. Married.
Still, he kept his inner eye on her. Always watching.
When he heard from mutual friends that her marriage was falling apart,
he felt not triumph, but permission.
T h e M a s k o f S u r v i v a l · 119
He showed up again. He saw it in her eyes. Surprise. Respect. Or
maybe destiny. She became his goal. His direction. Proof, in a way.
Winning her felt like winning life itself. Then, without noticing when it
happened, he stopped chasing. The dream moved into his house, slept
beside him, bore his child. Zoyi. A miracle. The evidence of love made
solid. Maybe that was when he let go of himself.
The weight returned. Gradually. Comfortably.
He told himself it was normal. Family life. Success. Stability. No more
battles to fight.
Until his body turned traitor.
Now here he was, wired to machines, waiting for answers he dreaded.
Dependent. The sick man.
Don’t let this be the end, he told himself. I turned around once. I can
do it again.
* * *
The next morning, Olga arrived just after sunrise to pick him up.
“Well? Did you sleep?” she asked softly.
“Barely,” Eugene murmured as he buckled his seatbelt. “I felt it again.”
Olga turned toward him, her concern shifting swiftly to panic.
“Felt what?”
Eugene rubbed his chest. “The device they implanted. The defibrillator.
A little electric shock here. Like being kicked from the inside. Maybe
120 · B RE AT HL E S S
once, maybe twice. But I didn’t panic. I almost wanted it to happen, so
they could see it. So someone could finally understand what’s going on.”
He stole a quick glance in her direction.
From his angle, he saw the blood drain from Olga’s face, leaving
her skin pale, almost translucent. Her jaw tightened, muscles in her
cheeks circling in tense waves as if grinding down some invisible
resistance. Fear tightened every contour of her expression.
“The tech mentioned the doctor will review everything today. Looks
like they got what they needed.”
* * *
Just after lunch, Eugene’s phone rang. The number was unfamiliar.
Yet, something urged him to answer.
“Hello?”
“Hi, is this Eugene?” a melodic voice asked. “This is Amanda from
the sleep center. Dr. Alison Kole reviewed your study and would like
to set up a Zoom call this afternoon, if possible.”
“Sure,” Eugene replied. “What time?”
“She’s available at 4:30. I’ll send you the link.”
As soon as the call ended, Eugene exhaled. The news had been
postponed. For a moment, that felt like relief.
By 4:28, he sat at the kitchen table with a glass of water and a blank
notepad. Olga stood nearby, close enough to see the screen.
T h e M a s k o f S u r v i v a l · 121
The screen flickered to life.
“Hi, Eugene.” Dr. Alison Kole’s bright, open smile invited conversation
even before she spoke.
Eugene noticed a cozy, dimly lit office. Shelves behind her were lined
with thick textbooks and a scattering of small souvenirs from patients.
On one side, CPAP masks stood on mannequins. He cringed at the sight.
Her voice was warm and friendly. “Nice meeting you. I’ve had a
chance to review your results. Let me explain what we found and
where we go from here.”
“Okay,” Eugene said, gripping the glass tightly.
“You have obstructive sleep apnea. It’s moderate to severe. During
sleep, your airway collapses, halting your breathing dozens of times
each hour. These interruptions lead to oxygen drops and spikes in
your heart rate.”
Eugene lowered his chin.
“We also monitored your heart rhythm.” She turned to another screen.
Her dark hair fell in soft waves, brushing gently against her cheeks.
“Fluctuations appeared, especially in the early morning hours. That’s
when apnea is at its worst.”
She paused. The information needed to sink in.
“Why does it feel worse in the morning?”
“Because you have more REM sleep during that period. Your muscles
are in their most relaxed state,” the doctor explained.
122 · B RE AT HL E S S
“There’s growing evidence that obstructive sleep apnea can trigger
atrial fibrillation. For someone like you, with a history of ventricular
fibrillation, these connections can be life-threatening.”
“So . . . the apnea might’ve triggered my cardiac arrest?” Eugene
asked slowly, seeking clarity.
“It’s a strong possibility,” she replied. “Sleep apnea places a huge
stress on your cardiovascular system. Oxygen drops. Adrenaline
floods your body. Blood pressure rises. The rhythm falters.”
A long silence stretched between them.
“We need to treat the apnea,” Dr. Kole said gently. “The gold standard
is CPAP therapy. It uses air pressure to keep your airway open at night.
It’s noninvasive. It can be life-changing.”
“My father had one,” Eugene said. “The mask. The noise. He couldn’t
use it.”
Dr. Kole nodded. “It takes a little time to get comfortable with the
machine, but we’ll support you through it. The next step is a titration
night, where we calibrate the machine to find the exact pressure that
eliminates your apneas.”
“And after that?”
“Then we begin treatment. Our goal is to give your heart a chance
to recover and rest. By controlling the apnea, we reduce the risk of
future cardiac events.”
Eugene looked at Olga, and her eyes said it all. I told you. It had been
her idea that treating his sleep apnea could ease his heart troubles.
He felt gratitude and irritation at the same time.
T h e M a s k o f S u r v i v a l · 123
Eugene exhaled, releasing a breath he hadn’t realized he was holding.
“I can try,” he said. “But I’m not sure I can.”
As the screen went dark, Eugene stayed in his chair. He stared
at nothing.
He didn’t move.
Just sat there, the silence filling the room with a new fear.
Eugene’s parents had both tried using CPAP. They gave up after a
few weeks. Instead of helping each other, they just argued about
who snored louder, as if that solved anything. Eugene felt himself
slipping into that same story of being old and weak, hooked up
to machines.
Across the room, Olga was already making a list. Pressure settings.
Mask options. Follow-up dates for his CPAP treatment. Meanwhile,
she navigated the insurance portal, preparing the paperwork to
ensure the service would be covered.
Eugene admired her for it. He even envied her ability to act. He, on
the other hand, felt paralyzed, as if everything were simply happening
to him, without his consent.
“I’ll go if you want me to do the titration study,” he said, shaking his
head, “but I don’t see the point. I’m not using that mask. I won’t sleep
with a machine strapped to my face.”
Olga frowned and reached for her phone. “I’m calling the insurance,”
she said. “Every time I see the mailman, I’m terrified there will be
another enormous bill. This treatment is expensive. I’m struggling
to get it preauthorized and covered.”
124 · B RE AT HL E S S
Eugene knew she was fighting for his life again. This time, it
was with an insurance company. It had become her second fulltime
job.
He watched her pace the room, phone pressed to her ear, her voice
sharp and clipped as she argued with a representative. Initially, he
thought it was mere frustration with bureaucracy. Then he realized it
ran deeper. This was not anger for its own sake; it was fear.
Fear of losing him.
Fear of raising Zoyi alone.
Fear of standing by herself in a country that still did not always feel
like home.
What struck him most was that fear never froze her. It didn’t shrink
her. Instead, he saw a side of Olga he hadn’t fully understood before—
how fear, in her, turned into fuel.
In that moment, Eugene felt not only love but something heavier and
rarer. It was a deep recognition of her strength; the way she moved
forward when he could not.
He thought, Is this what love looks like?
* * *
Olga spent her mornings on hold with the insurance card pressed
between her fingers. First, it was approval for the sleep study. Then,
the CPAP titration. Each call was a loop of explaining Eugene’s
condition to a new voice, reciting his birthdate, his diagnosis, the
same desperate timeline.
T h e M a s k o f S u r v i v a l · 125
She faxed what they asked. Then faxed it again. The office needed
to prove, on paper, that a man with a heart device firing every
morning deserved to breathe at night. Over this endless activity, Olga
developed a new philosophy.
She told Eugene, “First of all, there is a human being on the other
end of the line, once you get to that human being after a labyrinth
of automated responses. You have to treat this person with respect
by asking his or her name. If you cannot find your desired results,
it is a great idea to ask to be connected with a supervisor. But you
have to stay calm. Life is a game; do not get lost in the intensity of it.”
For Eugene, the system felt inhuman. It was as if some unnamed
authority was deciding whether Zoyi would grow up with a father
or without one.
Eugene leaned back in the chair. He paused his typing on the laptop
and rubbed his eyes.
He said, “You remember, back in Russia, medicine was free. We went
to these polyclinics, all painted that same dull, light green. Sometimes
the doctor would come right to my apartment. Unbutton the coat, cold
stethoscope on your chest. Quick prescription . . . done.”
“But my mom! She never waited for doctors.” Olga shook her head,
a half-smile forming. “She had her own plan. Mustard plasters on
my back were so hot I’d wake up red and burning. Or she’d make
me breathe over a pot of boiled potatoes with a towel over my head
until my cheeks stung.”
He chuckled softly and continued. “It wasn’t all bad. I got to stay
home, curl up on the couch, and watch those old Soviet comedies
all day. No school in the morning. In the afternoon, my friends
would come by after classes. It almost felt . . . sweet.”
126 · B RE AT HL E S S
“Well . . .” She shrugged. “There was always the brutality of it, too. But
my mom would say, ‘Natural, chemical-free,’ like that made it better.”
He glanced at the stack of insurance forms on the table. “Sounds a lot
simpler than this mess,” he said. “Understandable and predictable.
And sometimes, I remember it like a luxury.”
* * *
Eugene stood in the sleep center room, a lump in his throat, clutching
a bag of night necessities. It looked like a hotel room, except for the
CPAP machine glowing on the side table. Tonight, they would force
air into him while he slept.
Robert Miller explained gently, “Tonight’s a titration. We’ll start with
low pressure and gradually increase it through the night.“ He paused,
letting the information settle. ”The goal is to find the pressure that
keeps your airway open without disturbing your sleep.”
Eugene nodded. The words barely registered.
Robert continued, “I understand how you feel. I use CPAP too. I was
devastated when I first found out I had sleep apnea and that I’d have
to wear a mask at night. Before CPAP, I’d come home and crash on the
couch by 7 p.m. Now? I coach my kids’ soccer and softball practices.
I’m truly involved in their lives. My day feels like it has more hours.”
He smiled, revealing perfectly white teeth. “I used to drink six cups of
coffee a day. Honestly, I wanted it on an IV drip,” he laughed. “Now I
have one small cup in the morning, and I’m fresh as a daisy all day.”
Eugene brushed his teeth and sat on the bed. Familiar wires were
attached to his scalp, chest, and legs. But this time, something new
awaited him: the mask.
T h e M a s k o f S u r v i v a l · 127
First came the nasal pillows, two soft prongs that nestled just inside
his nostrils. The moment the machine turned on, Eugene flinched.
The air pushed in with dry, relentless pressure, like a cold gust forced
straight into his sinuses. It didn’t feel like breathing. It felt like being
inflated like a balloon.
His nose burned. Inside his nostrils, a tightness took hold. A strange,
pressurized tension spread across his face. It felt as if his whole skull
was resisting.
“I can’t wear this one,” he muttered, pulling it off. “It feels like it’s
drilling into my head.”
Robert set the nasal mask gently on the table. Lines etched at the
corners of his eyes told stories of years spent working face-to-face with
people. He helped them make choices that often felt overwhelming.
“I get it,” he said, his voice warm and steady. “It’s strange at first. But
once we find the right fit, and you actually sleep in it . . . You’ll feel like
yourself again. You’ll have energy. You’ll enjoy your day. Here—try
this one. It sits all on the outside, nothing pressing in.”
Eugene put on a small, rigid plastic piece that sat snugly over the
bridge of his nose. He lasted only a few minutes, trying to focus on his
breathing. But every inhale felt unnatural. It was as if he was working
against the machine instead of with it. The pressure was steady, yet
it didn’t feel supportive. It felt mechanical, imposed.
A faint sting began to spread just under his nose where the mask
pressed into his skin. The seal felt tight, compressed. The edges
started to itch, then burn. Dry plastic rubbed against delicate skin.
“It’s starting to hurt,” he said, his voice muffled. “Right here under
my nose.”
128 · B RE AT HL E S S
Robert stood beside Eugene, waiting.
“No problem. We will find you the best match, and you will feel
yourself again,” encouraged Robert. He brought a much bigger mask
that covered both the mouth and nose. Eugene put it on. It felt like a
fighter pilot’s gear—bulky and tight.
His head barely moved, the straps digging deep into his cheeks. When
he spoke, his voice echoed back.
“This is . . . a lot,” he said. “It’s like I’m being held down.”
Robert adjusted the straps and dimmed the lights. “I understand
exactly how you feel. This is a very new experience. Take your time.
Focus on your breathing. Try to relax and think about waves. We’ll
be monitoring all night.”
Eugene lay back. The machine hissed beside him. He turned, and the
mask shifted. Air leaked into his eye.
He closed his eyes. Then, he opened them.
Sleep was impossible.
Eugene hated the mask, the pressure, and the straps. It made him
feel like a patient, not a man. Half the night, he lay awake. Adjusting.
Resisting. Counting the seconds until morning.
Would Olga want to sleep next to an astronaut? he wondered.
When he finally opened his eyes and sat on the bed, the habitual
click from the shocker was absent. It had started his day for several
weeks now.
T h e M a s k o f S u r v i v a l · 129
His heart had stayed quiet.
He sat on the edge of the bed, mask in hand, staring at it like it was
a miracle. What if this really was the thing saving him?
What if this awful, claustrophobic mask was the reason he’d be there
to walk Zoyi to school next fall? The reason he’d make it to his next
birthday? To her graduation?
He thought of his youth, of how carefree it had been. He never
imagined his body could betray him like this. Back then, he had
believed strength was endless, that time was generous. Now, those
worry-free days felt sealed in another life. He wasn’t equipped for
this cascade of challenges, this constant negotiation with doctors,
machines, and his failing health.
He wasn’t sure he could wear it again, but he wasn’t sure he could
survive without it either.

Fi g h t f o r L o v e a n d B r e a t h · 131
CHAPTER TEN:
Fight for Love
and Breath
Olga
Olga never imagined love would look like this. Her life had narrowed
into a single mission: to keep Eugene alive. Watching him fight for
every breath, she realized their entire world now depended on a
machine he could barely tolerate.
She took a deep breath and took solace in her home, a mix of European
charm and city sharpness, blurring the view of Manhattan’s serrated
skyline. The dozen sticky notes with wellness ideas were stuck to
the fridge like a detective board. The living room was spacious and
curated with elegance. Dimming light spilled over soft cream walls
and books stacked in towers beside linen-draped armchairs
A ceramic bowl with fresh fruits sat untouched on the kitchen counter.
Beside it, a row of amber glass jars held dried herbs and obscure
superfoods she’d ordered on impulse. The bananas gave off a faint,
cloying sweetness, just past ripe. Olga noticed it and turned away.
As a child, bananas had been a dream. Now, she could have them
whenever she wanted. And yet, she didn’t.
132 · B RE AT HL E S S
The large black-and-white photograph captured a rainy Nevsky
Prospect at night. Glistening cobblestones, blurred headlights, and
silhouettes of strangers hurrying under umbrellas decorated the wall
above the sofa. On a small shelf by the window, white bone porcelain
teacups bloomed like open tulips. Their pale curves mirrored in the
soft shimmer of the antique silver tray behind them. Olga’s mom
had bought them for her at the Royal Porcelain Factory store in St.
Petersburg. Olga liked to transfer all her Russian memories to her
new life.
She sat curled in the corner of the velvet couch, legs tucked beneath a
cashmere blanket, her phone casting a gentle glow in the dim hush of
early evening. After a long afternoon spent working on a school project,
Zoyi was initially thrilled to create a presentation board showcasing
highlights from an imaginary trip to Italy. With careful precision,
she cut out the Coliseum from a printed picture, her tongue peeking
out in concentration, and pressed it onto the board with a glue stick.
When they came upon a picture of Pisa’s leaning tower, Zoyi glanced
up. “Why is it leaning?” she inquired.
Olga paused. “Sometimes things don’t stand the way they’re
supposed to.”
“Can we stop now?” Zoyi asked, already sliding off the chair.
“Just one more,” Olga said, reaching for the glue.
Zoyi had lost interest. After Olga put her to bed, she tackled most of
the project on her own.
Olga turned to the internet, diving into late-night support threads
for tips and comments. This had become her evening routine since
the accident.
Fi g h t f o r L o v e a n d B r e a t h · 133
Eventually, she discovered an online community dedicated solely to
surviving CPAP. It was created by a woman who had once faced the
same struggles. She transformed it into a haven of practical advice
and genuine encouragement.
Real stories. Small victories. Hacks passed from one exhausted
stranger to another. Mask liners. Hose holders. Nasal sprays. A
pressure adapter that softened the airflow. Olga took notes.
Later, she watched a short video by a sleep specialist. It explained that
wearing the machine while awake—during TV or reading—could
teach the brain that the mask was not a threat.
Eugene was still gasping awake at night, fraying her nerves. In online
support groups, strangers shared their long struggles and small
breakthroughs. Again and again, a CPAP coach from Brooklyn kept
coming up.
Over the next several days, the insurance battle was raging. Olga
called daily. Held for an hour. Argued. Pleaded. Asked for a supervisor.
Recorded the names of all insurance representatives.
“It’s not cosmetic,” she snapped, her patience worn thin. “He had a
cardiac arrest.”
She faxed the sleep study. Highlighted it. Circled it. She called the
case managers again. Wrote emails. Asked the cardiologist for a letter.
“I’m not waiting three weeks,” she insisted to Eugene. “You need
this now.”
Eugene slouched in his office chair, the glow from several screens
casting a pale light on his face. Olga caught his eyes. They were softer
than she was used to seeing. A half-smile of gratitude played on his
lips, a sentiment he had never put into words.
134 · B RE AT HL E S S
By week’s end, she had secured a case number for the Durable Medical
Equipment company.
When approval came, Olga proudly handed Eugene the paper and
said, “They said yes. You’ll have your machine.”
“This is love. You keep fighting for my life,” Eugene said with a smile.
By the end of the week, the CPAP machine had arrived. It came with
virtual instructions and a link to a YouTube video with cheerful
background music. Eugene barely watched it. He pulled the mask away
from his face like it was made of fire. “I’m not doing this,” he said. “I
can’t breathe in it.”
That’s when Teresa, a CPAP coach from Brooklyn Olga had found,
showed up.
She stepped into their apartment with a kind smile. Neatly pressed
charcoal scrubs, embroidered with Sleep Better NYC, hugged her
frame. In her hand, she held an iPad bearing the same logo.
“Eugene, let me ask you something. What would you gain from a
good night’s sleep?”
Silence.
“What would you lose if you don’t?”
Silence again.
“Let’s start simple,” she said, adjusting the tubing on the machine.
“This device warms the air between sixty-eight and seventy degrees.
It feels more comfortable, especially in the winter. You want your
breathing to feel natural, not clinical.”
Fi g h t f o r L o v e a n d B r e a t h · 135
She tapped the screen of the machine. “In the sleep center, they used
a standard CPAP. It had a fixed pressure all night. If the tech saw
you needed more air, he had to manually raise the level right then
and there. But the one you’ve got now is an APAP. It adjusts the
pressure automatically. If your airway starts to close, it’ll give you
a little more. If you’re breathing easily, it’ll back off so you’re more
comfortable. It’s like having a smart version of CPAP that changes
with you through the night.”
She pointed to the settings. “We’ll set the pressure to ramp slowly.
Start at four, then gradually increase to ten over thirty minutes.
This gives your body time to fall asleep while the pressure is still
gentle. You won’t even notice the shift.”
Eugene crossed his arms. “Feels like I’m being choked.”
Teresa nodded empathetically. “That’s normal in the beginning.
Here’s the trick: wear the mask during the day while you do
something you like. What do you enjoy?” She adjusted her long,
dark hair without breaking eye contact.
“Work is my hobby,” Eugene said. He had a passion for anything
with technology.
“You need to find ways to forget it’s even there. Retrain your brain
to link the mask with comfort, with something familiar. Not fear.”
Teresa opened her iPad. “This is a liner you will put over the
silicone of the mask to prevent contact with your skin. Instead
of this rubbery touch, you will feel softness. I remember you
mentioned feeling strangled with a hose. Look at the hose holder.
It allows you to turn around without being in contact with a
hose. You can even put lining on the hose itself to eliminate that
rubbery feeling.”
136 · B RE AT HL E S S
Teresa scrolled down and revealed another device. “That insert will
level the pressure of the machine,” she explained. “You won’t feel
as much resistance when breathing against the air.”
“I feel like an old man,” Eugene mumbled. “Hooked up to machines
just to sleep. It’s depressing.”
“You’re not old,” Olga said. “You’re healing. That’s different. This
is part of the journey. And you don’t want to gamble with your
health again after a cardiac arrest that only three percent of
people survive.”
“Teresa, tell us, what are the other options in that journey?” Eugene
asked, a hint of sarcasm in his voice. “Or can we only travel by this
machine through life?”
“This is a great question for your sleep doctor. While I can’t provide
a specific answer for you, I can outline the available options.”
Olga listened carefully. She recalled Dr. Sokolina’s discussions with
patients about sleep apnea and the dental approach to managing it.
She had explored many options online.
Olga assured Teresa, “We’re not going to treat it as medical advice.
Instead, we’ll focus on your personal experience, given your many
years as a Sleep Coach.”
Teresa replied, “Usually, a dental device would be the next step
with a dentist qualified to treat sleep apnea. Alternatively, there
might be a referral to an ENT for hypoglossal nerve stimulation.
Those are not the only options. Depending on the level of your
obstruction and where your airway gets blocked, you can try
positional therapy. Sleeping in a certain position can lower the
chance of airway collapse.”
Fi g h t f o r L o v e a n d B r e a t h · 137
Olga glanced at Eugene. He sat with his lips parted, breathing as if
air still wasn’t enough, even now, even during the day. His face had
settled into something closed and immovable. She saw it clearly:
every word Teresa said was already rejected.
Like a fish thrown onto sand, Olga thought, and made a
mental note.
Teresa continued listing options. “Nutritional counseling leading
to weight loss, either through medication or calorie restriction.
Evaluation of your nose and soft palate with an ENT. You could
work with an oral surgeon for maxillomandibular advancement
surgery, or with an orthodontist on upper jaw expansion. Another
possibility is working with a myofunctional therapist on breathing
and tongue position.”
She paused. “I have to say, there are many options for you to explore
once you feel better. But remember this—sleep apnea is a lifelong
condition. No single treatment fits for a lifetime.”
She glanced from Eugene to Olga, then continued.
“I know this sounds like a lot. Consider exploring this option now,
using the different tricks I offered. It’s your safe choice. As your
insurance company mentioned, you need to use the machine for
twenty-one days, four hours each night.”
Eugene glanced at the kitchen clock on the oven. “I’m going to pick
up Zoyi from school.”
Once Eugene left, Olga turned to Teresa. “Please,” she said, “tell me
what our next step is.”
Teresa tucked a strand of her long, dark hair behind her ear.
138 · B RE AT HL E S S
“Some people find a lot of interest in wearables. Eugene likes
technology, and he might find it exciting to monitor his progress
on his phone. Heart rate, pulse, and amount of REM he is getting. I
know some devices that measure Apnea-Hypopnea Index. That is the
level of breathing deficiency the patient has. If he has fun following
his own accountability, it might be a great idea.”
“I will follow up in four weeks.” Teresa put the iPad in her bag, smiled,
and gently closed the door.
* * *
Eugene returned with Zoyi. The tension hit Olga instantly.
Zoyi tossed her backpack in the hallway and dashed to her room,
shoes still on.
“Zoyi,” Olga called after her. “Shoes off. Slippers.”
It was a rule from Olga’s own childhood, one she kept without
exception. No outside dirt in the house. No germs allowed.
“What happened?” Olga asked, lowering her voice.
“Why is she always alone?” Eugene asked. “I asked her about her friends.
I wanted to stay with her on the school playground. But she got in the
car and wanted to go home.”
Olga found it unusual to see Zoyi sprinting to her room.
“Why doesn’t she have any friends?” Eugene pressed, his brow
furrowed. “We played outside with so many people when we
were kids.”
Fi g h t f o r L o v e a n d B r e a t h · 139
“I think there are some rules in America that we have to learn,” Olga
said. “Kids make friends here differently. She doesn’t play any sports
like soccer or softball. I’m not friends with any parents. I asked the
teacher, and she suggested I write an email to all the moms in the class,
but it yielded no results. Nonworking moms were busy scheduling
endless activities for their kids, while working moms were just busy
in general. I realized I would never find Zoyi a friend until I became
friends with a mom of her classmate.”
Eugene sighed. “Rules? For kids, making friends? I never had rules
like that. When I was growing up, no parents were involved at all.”
“I approached our neighbor, Natasha,” Olga went on. “She doesn’t have
an official job, but she works full time to organize Max’s life like a
general commanding troops. She explained it to me. Max’s weekdays
are a carefully coordinated jigsaw puzzle. After school, they sprint
to soccer practice, then piano lessons, then dash to the robotics club.
Her family calendar is a mosaic of color-coded activities.”
Eugene shook his head. “That’s . . . intense.” He paused, reflecting.
“My after-school plan was to disappear until dinner. No one cared
what I was doing.”
“She told me she has obligations to her husband, emphasizing the
need to raise a well-rounded child. In our neighborhood, playdates
aren’t just casual gatherings. They’re orchestrated social events. Kids
hop from one to the next, learning networking from an early age.”
“That’s wild,” Eugene said, leaning back. “Networking? At eight
years old?”
“I remembered my own time after school in the Soviet Union,” Olga
said with a small laugh. “Jumping from roofs and playing with
treasures from the garbage.”
140 · B RE AT HL E S S
“That sounds a lot more fun,” Eugene muttered.
“I tried to do it the American way,” Olga continued. “I asked Natasha,
‘Can Max and Zoyi play Lego from four fifteen until five o’clock on
Wednesday in three weeks, and eat freshly baked cookies from five
until five fifteen?’”
Eugene raised an eyebrow. “You needed three weeks to schedule Legos?”
“Natasha said, ‘I’ll reply to your email and send you a list of products I
consider unhealthy for Max.’”
Eugene stared. “And . . . you’re still friends with her?”
Olga was taken aback by the change. She couldn’t recall the last time
they had such an extended conversation about Zoyi.
“You also have obligations to your husband to raise a well-rounded
child?!” he said, half joking, half asking.
“No, Eugene, our child is our shared project. I’m glad you’ve started
to notice.”
He flashed a crooked smile, then looked away.
* * *
The next morning, she noticed Eugene’s lips were open again. “I am
wondering,” she said, “can you breathe through your nose? I noticed
you always slept with your mouth open before. Maybe that’s why you
find it so difficult with the machine.”
Olga noticed Eugene trying to sit with a mask on his face at certain
times during the day. He scrolled on his phone and ordered all the little
Fi g h t f o r L o v e a n d B r e a t h · 141
tricks Teresa recommended. According to Olga, Eugene was making
some progress.
Sleeping next to the machine was never easy, with its constant wind, the
uneven hiss of air, and the faint scent of plastic. It wasn’t restful—more
like a nightly disturbance—but Olga stayed. She felt obligated to be
there, to listen for changes in his breath, to ensure everything would be
alright. The bed had become a place of monitoring, not rest. Not love.
She couldn’t remember the last time it felt romantic. The very idea
of romance seemed foreign now, like a forgotten language. She
had become the caretaker. Always alert. Exhausted. Watching over
everything but rarely being seen herself.
Still, something had shifted in Eugene. Since he began using the
machine, he seemed more alive. More present. His energy had returned,
if only in flashes. He even made a few jokes, playful remarks about her
outfit when she dressed up for something as routine as meeting Zoyi’s
teacher or going to the grocery store. Olga had always loved dressing
up. It didn’t matter if the event was simple. It made her feel like herself.
One brief and unexpected moment, Eugene leaned in and kissed her
on the neck. It felt tender, almost like an invitation to reconnect. For
a second, it caught her off guard. Then, the feeling vanished as quickly
as it came. Fleeting and light, like the wings of a butterfly, it barely
survived the thick pull of everything surrounding them.
* * *
Four weeks slipped by before Teresa finally scheduled the follow-up
appointment on Zoom.
When she appeared on the screen, she asked Eugene, “How’s it going
with your machine?”
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He said, “I truly hate it.”
Teresa was supportive. “Let’s concentrate on wins,” she said. “What
changed since you started using the machine?”
“I don’t get morning shocks from the defibrillator in my chest. I do
not drink more than one cup of coffee, and I am not sleepy,” Eugene
replied, crunching on his Doritos.
“What would you lose if you did not use the machine?” Teresa
pressed on.
“My heart, right?” Eugene smiled, savoring the irony in those words.
Olga listened intently to the conversation. “Please let Teresa know
that I’ve scheduled your ENT consultation.”
Eugene glanced at the screen. “Teresa, do you think seeing the ENT
will just make the machine easier to use, or could it actually fix the
sleep apnea?”
Teresa’s eyes darted between them, her answer forming. But just as
she was about to speak, the Zoom window froze.
T h r o u g h t h e N a r r o w P a ss a g e · 143
CHAPTER ELEVEN:
Through the
Narrow Passage
Olga
Olga watched the man her life depended on crumble as his body
turned foreign. She didn’t step back. Instead, an urgent need surged
within her—to breathe her strength into him.
That feeling accompanied her as she stepped through the door of
the ENT clinic, a place that resembled a boutique spa more than a
medical office, with its pristine white walls, backlit glass panels, and
minimalist furniture in soft grays and browns.
Eugene whispered, “I never liked doctors or any medical attention,”
avoiding Olga’s gaze.
A gentle diffuser released a crisp aroma of peppermint and tea tree
oil, just enough to mask the sharper scent of disinfectant without
pretending it wasn’t a clinic. It brought Olga a flashback to childhood
clinics in Russia, but this one was more pristine, colder, with no
chipped linoleum or faint smell of boiled buckwheat from the
staff lounge.
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“Now . . .” he continued. “I have this deep fear that something
unpredictable could happen with my body. I won’t have any control
over it. It’s such a conflicting feeling. I don’t even like myself for it.”
Soft instrumental music played in the background, featuring a
slow piano rhythm and the faint sound of water droplets. The front
desk was sleek, equipped with a touch-screen, and there wasn’t a
clipboard in sight. Olga signed in using her phone. She then took a
seat beside Eugene on a low leather couch that looked too elegant
to be practical.
Olga gave a soft, resigned sigh. “Enormous depth,” she said. “But we
have to swim in those waters—this is all we’ve got.”
Eugene exhaled heavily as he sat, the fast food bag still in his hand. The
greasy scent of fries and artificial cheese clashed with the sterile calm
of the room. He had insisted on stopping “just for something quick”
and “I need to relax a little” on the way. Olga didn’t say anything.
He had been gaining weight steadily since the cardiac episode. Partly,
it was because he’d stopped moving, scared to push his body. Partly,
it was because he had started reaching more and more for comfort
in food. Chips, takeout, creamy pastas—these filled the silence in his
day and dulled the constant panic in his chest. He used to be broad
and strong. Now, he was just big. Heavier, slower, more irritable. The
extra weight showed in his swollen fingers, his rounded face, and
the way he shifted constantly, trying to find a comfortable position.
The assistant ushered them into the exam room.
A cartoon poster on the wall depicted a cheerful child, with arrows
pointing to adenoids, tonsils, turbinates, and sinuses. Something
about the child’s rounded cheeks, bright eyes, and the faint shadows
beneath them reminded Olga of Zoyi.
T h r o u g h t h e N a r r o w P a ss a g e · 145
The air carried a sharp undertone of antiseptic laced with something
oddly sweet, like cherry-flavored throat spray.
The door opened with a gentle sound. Dr. Chernobilsky entered
with precise movements, clad in a crisp lavender shirt. His attentive
brown eyes were watchful, curious. He crossed the room without
haste, offering a firm yet unhurried handshake first to Eugene, then
to Olga.
Dr. Chernobilsky settled into the chair across from them, folding
his hands loosely in his lap. His careful brown eyes moved between
them, attentive but without pressure.
“So,” he said, with real interest, “what’s brought you in today?”
Eugene shifted in his seat, casting a brief glance at Olga before speaking.
“I’ve been having trouble with my CPAP machine. I can’t seem to get
comfortable with it—feels like I’m fighting it all night.” He gave a small
shrug, as if downplaying the frustration behind the words.
Olga, holding her phone, leaned forward. “And there’s more,” she
said, flipping it open to the note she’d prepared. “Chronic sinus
infection. Postnasal drip. He’s always congested. He has allergies.
Asthma.” She paused, glancing at Eugene. “And he’s always slept with
his mouth open.”
Then, she turned to Dr. Chernobilsky. “Could all this be part of why
he can’t tolerate the CPAP?” she asked.
Dr. Chernobilsky nodded slowly, his gaze returning to Eugene. “All
right. Let’s start there.” He stood, wheeling a small tray closer. The
instruments—slender metal forceps, gleaming mirrors—caught the
light, and the thin black cord of the nasoendoscope curled like a
sleeping snake.
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“I’m going to take a closer look,” he said calmly. “It shouldn’t hurt.
Just a little pressure, maybe some watering of the eyes.”
Olga’s jaw clenched. She watched him draw up a small spray bottle
and mist a numbing solution into Eugene’s nostrils. The sharp
medicinal scent made her own eyes sting. She wanted to tell him
to stop, to give Eugene a break. But Eugene sat perfectly still, jaw
set, his gaze fixed somewhere on the far wall.
The doctor guided the scope forward with slow, deliberate precision.
Her molars pressed together, a faint pulse starting at her temples. She
wanted to shield him, to push the cold metal away. Eugene bore it with
the stillness of a man who’d long accepted discomfort as part of living.
After a pause, Dr. Chernobilsky withdrew the scope.
Eugene flashed her a sidelong smile. It was the kind that said, “See?
Told you I could take it.”
“I see quite a bit of inflammation,” the doctor remarked. “There’s
swelling in the turbinates, and the mucosa appears irritated. I’m also
noticing signs of chronic congestion.” He quickly noted this on the
chart on his computer. “It’s no wonder you’re struggling with CPAP.
Airflow through your nose is significantly reduced at the moment.”
Olga exhaled slowly. Relief washed over her; it was finally over. Yet,
unease lingered. Her suspicions were confirmed.
The doctor nodded once and rolled closer on his stool. “Let’s talk
options,” he said, turning to Eugene. “Since you’re not happy
with your CPAP, I can suggest another possibility—hypoglossal
nerve stimulation.”
Eugene leaned forward, his brow tightening. “What’s that?”
T h r o u g h t h e N a r r o w P a ss a g e · 147
Dr. Chernobilsky pointed to a model on his desk, “Hypoglossal nerve
stimulation is a treatment for sleep apnea. The hypoglossal nerve
controls the muscles of your tongue. If we stimulate it gently while
you sleep, the tongue moves slightly forward, which keeps your airway
from collapsing. The system works automatically—you’d have a small
electrode placed on that nerve and a pulse generator implanted in your
chest, a bit like a pacemaker. Before we consider it, we’d do a test under
light sedation to make sure you don’t have something called concentric
collapse, which would make the therapy ineffective.”
Olga tilted her head. “So . . . no more CPAP?”
“In many cases, yes,” the doctor said. “You’d still need a sleep study
to fine-tune the stimulation, but you wouldn’t have to wear the mask
nightly. You’d just switch it on.”
Eugene’s mouth twitched. “Sounds . . . easier. But that’s another
surgery. Another gadget in my chest, next to my defibrillator.”
Dr. Chernobilsky gave a small, understanding nod. “True. Surgery
always comes with its own considerations. Yet, for some patients,
the comfort and compliance outweigh the downsides.”
Eugene shifted in his seat. “I have some questions for you. Why do I
keep waking up feeling like my throat’s clogged?”
Olga leaned forward. “And the postnasal drip,” she added quickly. “I
smell it all the time. And it’s not roses.” She wrinkled her nose, making
Eugene smirk.
The doctor smiled faintly. “Yes, the drip can be linked to swelling and
narrowing in the nasal passage, often from chronic inflammation.
Allergies are a common culprit. If we control the allergic response,
we can often reduce that swelling without surgery. That might mean
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antihistamines, steroid nasal sprays, or allergy immunotherapy. But
if medication isn’t enough, there’s another option: inferior turbinate
reduction—ITR. It’s a straightforward procedure that shrinks the
turbinate so air can move more freely.”
Olga pulled a folded page from her bag, the numbers highlighted. “I
read that about sixty-three percent of people who undergo surgery
for a deviated septum or nasal obstruction report significant
improvements afterward. Is that true?”
“That’s accurate,” Dr. Chernobilsky said. “For many patients, the
benefits last for years. Less congestion. Fewer sinus infections. Even
reduced snoring.”
Eugene raised an eyebrow. “But you also mentioned my septum.”
“Right,” the doctor nodded. “Yours is deviated. But this is common.
Eighty percent of people have a deviated septum, according to the
research, but for thirty percent, it leads to nasal flow obstruction.
If we only do turbinate surgery without fixing the septum, you may
get partial relief. Septoplasty and turbinate reduction are often done
together for the best results.”
Olga glanced at her phone, scanning her notes. “And the valve issue?”
she asked.
“Yes, you have some narrowing in your nasal valve,” Chernobilsky
explained. “We can correct that surgically by reshaping or reinforcing
the area so airflow isn’t restricted. It’s like opening the front door
wider so air can actually get in.”
“That would make CPAP easier?” Eugene asked.
“It should,” the doctor replied. “Anything that reduces resistance
through your nose can make it more comfortable.”
T h r o u g h t h e N a r r o w P a ss a g e · 149
Olga hesitated. “What are the possible complications?”
The doctor’s tone grew more cautious. “Empty nose syndrome. It’s
rare, but it can happen. If too much turbinate tissue is removed,
some people feel like they can’t get enough air, even though the
nasal passage is open. It’s all about balance. You want to improve
airflow without removing too much.”
Eugene leaned back, weighing the words. “So . . . this could help me
use the machine better. Or—”
“—or it could be one more step toward not needing it at all,”
Olga concluded.
Dr. Chernobilsky let the thought hang in the room. “That,” he finally
said, “depends on how your airway behaves after surgery. No one
can promise it will cure the apnea, but it might just change the game
for you.”
Olga glanced at Eugene. “And you also want to check the nasal valve?
Maybe even allergies?”
“Yes,” Dr. Chernobilsky replied. “If swelling is due to an allergen,
we can manage that medically. I’d like you to see an allergologist
before we commit to surgery. But there’s more we could address. For
example, your uvula and palate.”
Eugene tilted his head. “My palate? What’s wrong with it?”
“You have a long uvula,” the doctor said. “That can contribute to
snoring and partial blockage. But it’s rarely just the uvula.”
Olga’s eyebrows lifted slightly. “UPPP?” she asked. “That old surgery
where they simply cut everything out?”
150 · B RE AT HL E S S
Chernobilsky nodded.
“Uvulopalatopharyngoplasty was the standard years ago. Very aggressive.
A lot of tissue was removed. Painful recovery. Even later doctors did
with lasers or radiofrequency. Often . . . disappointing results.”
“So, what’s different now?” Eugene inquired.
“We’ve learned that sleep apnea isn’t a single-spot problem,” the doctor
said. “In sixty to ninety percent of patients, the airway collapses at
multiple levels. The nose, the soft palate, the tongue base, sometimes
even the voice box. Treating only one area rarely solves it.”
Eugene folded his arms.
“Modern surgery focuses less on cutting tissue away and more on
repositioning and stabilizing muscles, helping the airway hold its
shape during sleep rather than just shrinking parts of it. The goal is
function, not destruction.”
Eugene leaned forward. “What kind of problems are we talking about?”
“With older techniques, people could end up with swallowing
problems, chronic dryness, voice changes,” Dr. Chernobilsky said.
“Newer approaches have fewer complications. Yet, surgery is still
just one piece of the puzzle, not the whole answer.”
Olga typed on her phone. “So, if you fix the nose and the palate, that
should solve it?”
Dr. Chernobilsky lifted a finger. “Not necessarily. Research shows
that the airway collapses during sleep because of the tongue falling
back. Even if we improve your nasal airway and palate, if the tongue
isn’t addressed, you could still have obstruction.”
T h r o u g h t h e N a r r o w P a ss a g e · 151
Eugene exhaled sharply. “So sleep is a team effort—nose, palate, tongue.”
“Exactly,” the doctor said. “We can improve your comfort with CPAP,
maybe even reduce your need for it. But if the collapse is mostly tonguebased,
we’ll need to consider treatments for that too.”
Olga looked at Eugene. “Sounds like the nose work is one piece of the
puzzle,” she said. “Not the whole thing.”
Olga crossed her arms, still processing what she’d just heard. “So, it’s
not just about fixing the uvula or the palate. The tongue has to be
a priority?”
“Exactly,” Dr. Chernobilsky said, leaning back on his stool. “If we don’t
address the tongue’s position during sleep, we’re only solving part of
the problem. Reshaping the palate and opening the nasal passages will
help. But it won’t stop the tongue from falling back.”
Olga tilted her head. “Is it possible to do something with the tongue?
Perhaps reshape it or prevent it from blocking the airway when
Eugene sleeps?”
The doctor smiled slightly. “We can’t reshape the tongue itself, but we
can reposition the structures that support it. One option is genioglossus
advancement. This involves moving forward the part of the lower
jawbone where the tongue muscle attaches. It brings the tongue base
forward, making it less likely to collapse.”
Eugene’s eyebrows shot up. “You move bones for that?”
“There’s also hyoid suspension,” Chernobilsky continued. “This
involves repositioning a small bone in the neck to open the airway.
Both are more invasive procedures. We only consider them when
other treatments fail. They’re not first-line options.”
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Olga glanced at Eugene. “What’s the most conservative step?”
“The most conservative step,” the doctor explained, “is to try an oral
appliance. It holds the lower jaw slightly forward during sleep, moving
the tongue base with it. Sometimes, that’s enough to prevent collapse.”
Eugene gave a skeptical half-smile. “And here I thought we were just
talking about fixing my nose.”
“Well,” Olga said, “he’s used those nasal sprays before. They open up
his nostrils, but he still breathes through his mouth.”
Chernobilsky nodded knowingly. “That’s not unusual. Mouth breathing
can become a deeply ingrained habit, even after the nose is clear.
Sometimes with myofunctional therapy, sometimes with breathing
exercises—usually a combination of both. The key is learning to breathe
through your nose during the day. It can feel uncomfortable at first. It
takes conscious effort.”
Eugene rubbed his jaw, processing the stack of options. “So, fix the
nose, maybe the palate, maybe use an appliance, maybe . . .” He let out
a short, humorless laugh. “Move my bones.”
Olga shot him a look. “Let’s start with the easier ones first.”
Eugene’s shoulders eased as the doctor wrapped up. He reached for
Olga’s hand, giving it a light squeeze before rising from the chair.
“Thank you, Doctor,” he said warmly. “We’ll talk it over and get back
to you about the next step.”
Dr. Chernobilsky nodded. “Take your time. Let me know if you
have questions.”
Out in the corridor, Eugene’s pace was lighter, almost perky. By the time
they’d reached the car, he was already talking about dinner.
T h r o u g h t h e N a r r o w P a ss a g e · 153
* * *
Later that evening, when the house was quiet, Olga stepped into the
kitchen and dialed Dr. Sokolina. “Can you make a sleep appliance
for Eugene?” she asked without preamble. Olga lowered her voice.
“Things are . . . changing between us. For the better. I don’t want to
lose this momentum.”
“How did the appointment with the ENT go?”
“Well, he suggested certain medications to open up his nose, discussed
different surgical options, and referred us to an allergologist. He said
the medications do open up his nostrils, but . . . well, Eugene’s had
this long-developed habit of mouth breathing. It’s a tough one to
break because he believes it is the correct way.”
“You make such interesting observations! You’re learning a lot in your
Instagram Reels school!” Dr. Sokolina remarked with a smile.
Olga’s voice softened. “I have two pieces of news to share. Which one
should I start with?”
Dr. Sokolina let out a deep sigh. “Given the recent dark mosaic of
events, start with the lighter shade.”
“It’s not the life I dreamed about,“ Olga added after a pause, her tone
more contemplative now. “But I’m on that path, and I’m learning
so much about myself and about us. Maybe that knowledge is just
as important.”
“On a darker color now . . . I don’t know what to do with Zoyi.”

W h e n B r e a t h B e c o m e s L e g a c y · 155
CHAPTER TWELVE:
When Breath
Becomes Legacy
Olga
Olga had faced the nightmares and daylight terror of losing Eugene in
his sleep. She truly thought she was losing her mind the moment she
suspected her daughter might have inherited the same silent troubles.
If she stopped moving, the thoughts would consume her whole.
The daily home routine was the only constant she could still control.
She closed the laptop with a soft click and began tidying the kitchen
out of habit. On the counter, Zoyi’s purple folder lay open, one corner
already curling. Olga reached for it, intending to slip the loose papers
back in.
That’s when she spotted it.
A sheet of white printer paper, folded in half, was tucked between
two worksheets. Her name was typed at the top in neat, black ink.
“Dear Olga, I’d appreciate the opportunity to speak with you briefly
after school one day this week regarding Zoyi’s recent work and
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classroom participation. Nothing urgent, just a few observations I’d
like to share and discuss together.”
It was signed simply, “Mrs. Teller.”
Olga read it twice. The teacher had written the note, not sent an
official email.
Her first instinct was to brush it off. Teachers always had comments.
Yet, something in the wording caught her: “recent work,” “classroom
participation.” The teacher chose the phrasing to sound gentle,
not casual.
* * *
Olga remembered the classroom smell. A mix of Elmer’s glue, dry
markers, and old crayons. A laminated alphabet strip ran across
the top of the chalkboard. Children’s artwork, some chaotic, some
meticulous, lined the walls. Zoyi had been led to the after-care room
so she wouldn’t overhear the conversation between her mother and
the teacher. She didn’t cry or protest. Just walked away. But with
that deep, knowing look children give when they feel left out of
something important. Olga sat in the too-small chair, her knees
pressed awkwardly beneath the low table, clutching her purse with
white knuckles.
Across from her sat Ms. Teller, Zoyi’s second-grade teacher. Her face
was gentle. Yet, the practiced tone in her voice made Olga wonder.
How many parents had heard the same explanation before?
“I want to start by saying Zoyi is very bright. She has a vivid
imagination and a strong vocabulary for her age. But . . .”—a pause—
“she’s become increasingly disruptive in class.”
W h e n B r e a t h B e c o m e s L e g a c y · 157
Olga’s heart skipped a beat. Moya devochka. My baby girl.
“She calls out constantly. She interrupts my lessons, refuses to follow
directions, and often leaves her seat without permission. I’ve also
noticed she struggles to make friends. The other children have
started avoiding her. She doesn’t seem to pick up on social cues,
and when she plays, it’s very intense, like she has to control every
part of the game.”
Olga didn’t know where to look. Her face burned with a mix of
shame, defensiveness, and disbelief. I am not a good mother. Teachers
never complained about me to my mom, she thought.
“She’s not doing it on purpose,” Olga hurried to say. Her jaw locked.
The pulsation of her heart throbbed in her temples.
She craved understanding, not judgments.
She’s just a child, she thought fiercely. School is hard. I don’t want her
to feel inadequate. Maybe we should transfer her to another school.
This place has no personal approach, and Zoyi is unique.
“I understand your frustration,” Ms. Teller said gently. “But it would
be valuable to meet with the social worker.”
Olga drew in a sharp breath. “Zoyi’s father just had a major cardiac
accident,” she said. “She’s responding to that in her own way.”
“I’m sorry to hear that, but given the circumstances, I recommend
the meeting even more,” the teacher said.
“Thank you. I will discuss it with my husband.” Olga stood abruptly,
her chair scraping across the floor, and left the classroom without
waiting for a reply.
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Olga picked Zoyi up from where she was waiting for the meeting to
finish. She noticed that Zoyi sat quietly in a corner while the other
kids played games.
On the drive home, trouble began.
“Can we get McDonald’s?” Zoyi asked from the back seat. Her forehead
pressed against the cold window.
“No, sweetheart. We have soup at home,” Olga replied, her tone light
and reassuring. “I made it with those little noodles you like.”
“I don’t want soup!” Zoyi’s voice turned sharp. “I’m hungry now. I
don’t want your stupid Russian food!”
“You’ll eat in fifteen minutes.”
“No! You never listen to me! You never let me eat what I want! I want
normal American food!”
The words hit harder than Olga expected, but she kept her hands
tight on the wheel, her voice even. “I am listening. I’m just making a
choice that’s good for your health.”
Zoyi screamed the rest of the way home.
Her daughter dropped her coat on the floor and kicked off her shoes in
the hallway. Olga stooped to pick them up. She watched her daughter
stomp toward her room with a familiar tilt to her walk, so much like
Eugene’s. The same eyes that lit up when they were excited. The same
eyes that flared when they didn’t get their way.
Olga began to reflect on her dream of having a child. Painful memories
from her first marriage surfaced—the constant attempts to conceive
and the crushing disappointment each time her period arrived. She
W h e n B r e a t h B e c o m e s L e g a c y · 159
had made endless visits to OB-GYNs and fertility specialists, always
searching for answers, yet finding none.
In the middle of that exhausting fight, her first marriage simply
fell apart. It dissolved over time. She was left with unanswered
questions and hidden grief.
When she later married Eugene, things felt different. She became
pregnant, but the scars from that long struggle never completely
disappeared. The memory of longing for Zoyi, even before she existed,
remained vivid and alive.
The house was quiet, save for the soft clicking of Eugene’s keyboard.
He sat at the dining table, eyes locked on the screen, blue light
reflecting off his glasses. A second monitor displayed a half-finished
presentation. He didn’t even notice them come in.
Olga picked up the phone and called Dr. Sokolina.
“Do you think I should have Zoyi evaluated by the social worker?”
“Yes, you should have her evaluated,” replied Dr. Sokolina. “But you
know her best. Ultimately, you’ll decide what’s right for her.”
Olga exhaled, her fingers tightening around the phone. She hadn’t
realized how much she needed that support.
“She’s not like other kids,” she whispered. “They’re calling her a
disruptor,” Olga said. “A problem.”
“She’s a bright child,” Dr. Sokolina replied.
“They say she doesn’t have friends. That she takes over everything.
She’s controlling. Now, they want her tested.”
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Dr. Sokolina paused, considering her response.
“Well,” she said gently, “do you think it’s possible they’re seeing
something that calls for comprehension? Not judgment, but . . .
understanding?”
Olga sighed. “In Soviet schools, no one had ADHD. No evaluations.
There was no such thing. We all sat in rows. Nobody cared if you
had big emotions or needed help focusing. The teachers barked at
you. Gave you nicknames. Called you ‘stupid’ or ‘fat’ in front of the
whole class.”
Dr. Sokolina agreed, “And how did it feel to be a small part of a huge
mechanism? To be the same, equal to everyone else?”
“Horrible,” Olga admitted. “But we survived. No one ever asked if
we were okay.”
“That’s the difference,” Dr. Sokolina said. “Now they ask.”
Olga could almost taste the bitterness she felt.
“Maybe it’s not about labeling her,” Dr. Sokolina continued. “It’s about
helping her. And you. Understanding how her mind works. You don’t
have to agree to medication or anything right now. Just . . . meet with
the social worker. Hear her out. Then decide.”
Olga hesitated. Her heart was still heavy.
“I just don’t want Zoyi to be seen as broken. Eugene is already in
that shape.”
“She’s not,” Dr. Sokolina said. “She’s just not built for a box that small.
Let’s discover her true shape and build around that.”
W h e n B r e a t h B e c o m e s L e g a c y · 161
* * *
Olga felt like she might explode. Eugene was fighting for breath every
night, and Zoyi was suffering at school. The pressure of it all was
becoming unbearable. Olga felt like she was standing in the middle,
holding both ends of a rope that was tightening around her chest.
She picked up her phone and dove into articles about ADHD.
She was determined to be ready for the upcoming meeting with the
school social worker.
At first, it seemed harmless—almost beautiful.
Children full of energy. Curiosity. Movement.
She imagined Zoyi pacing the living room, explaining her homework
with fervor.
Then Olga continued reading.
Some children struggle to sit still, even when everyone else seems calm.
Their bodies shift, feet bounce, and fingers drum on tables.
Olga exhaled sharply.
How many times had she whispered, “Zoyi, sit still. Please.”?
She had even demonstrated how she was taught to sit in Soviet school:
back straight, one arm neatly over the other. Eyes fixed on the teacher.
No turning of the head.
Disciplina.
The word rose in her mind. It was a command.
She continued to read.
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Their attention wanders from an overload of interest. They care about
everything at once. The sound of a fan. A bird outside the window. A
flash of color on someone’s shirt.
Olga saw Zoyi again at the kitchen table, beginning her math
homework with enthusiasm, only to abandon it halfway through
because she suddenly needed to draw a dragon. Or inquire about
volcanoes. Or construct a tower out of books.
Olga had always referred to it as imagination.
She had often been captivated by Zoyi’s quick reactions and sharp
observations. Olga believed this stemmed from the games her child
played on the iPad, demanding such swift responses.
As she read, she thought the characteristic described Zoyi. Like
children with ADHD, Zoyi interrupted conversations. The information
indicated this wasn’t out of rudeness. It was because these children’s
thoughts came so fast they feared they would forget them.
Zoyi had a habit of finishing sentences for others. She often blurted
out answers, jumped ahead in stories, or shouted during group
activities at school. Conversations began with her without waiting
for permission.
This was a constant source of arguments in Eugene’s parents’ house.
Olga’s mother-in-law often insisted, “You need to teach her good
manners from an early age.”
Olga observed that at school, these children’s desks were a mess,
unorganized, and they often forgot homework or couldn’t follow
multistep instructions. Emotions burned hot. A small frustration
could lead to a loud outburst or bring tears. Feelings were
overwhelming to them.
W h e n B r e a t h B e c o m e s L e g a c y · 163
Olga recalled a conversation with her mother-in-law. “Zoyi can cry
over the smallest argument,” she had said, “and scream because she
is sensitive.”
Of course, her mother-in-law’s unsolicited advice was clear: “You, as
her mother, must explain to her what is right and wrong.”
She thought about how Zoyi craved stimulation, novelty, and
movement. Sitting too long or waiting in line was torture for
the child. She needed engagement most of the time, something
creative or hands-on. Often, she would enter a focused state and
shock everyone with her depth of knowledge and imagination. This
ADHD description fits Zoyi.
The teacher’s complaints echoed in Olga’s mind, but she suspected
the real issue was boredom. Zoyi wasn’t challenged in class, and
it showed. More than once, Olga had caught herself wishing she
could send her daughter to a private school, somewhere with a more
personalized approach, where Zoyi’s uniqueness might be seen as
a strength rather than a disruption.
Now, that was impossible.
She was not working, and Eugene was technically building a startup,
but in reality going from doctor to doctor.
Dengi. Money . . . that was another constant, sharp needle in
Olga’s consciousness.
Her eyes widened as she read that ADHD children can be the center
of attention—funny, animated, magnetic, but friendships could be
tricky. As described, Zoyi’s impulsivity and emotional reactivity
sometimes lead to misunderstandings or hurt feelings. Zoyi was
definitely “extra” and didn’t know what to do with herself.
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All of it was true. It sounded like Zoyi. As Olga read through the
descriptions, nothing seemed amiss. These were the very traits she
cherished. Positive features, not symptoms. Zoyi was a miracle in
Olga’s life. She had struggled for so long to bring her into the world.
Olga scheduled her meeting with a social worker.
* * *
The social worker’s office was small but well curated. A calming
diffuser released a faint citrus scent into the room. Picture books
about feelings lined neatly on a shelf. Olga sat with her hands in her
lap. Her back was straight, every muscle like a tight rope.
Ms. Ramirez, the social worker, greeted her with a calm smile and
warm eyes. Her tone was gentle. “Thank you for coming, Olga.”
Olga said, her voice clipped, “The teacher mentioned Zoyi should be
evaluated. But no one explained what that really means.”
Ms. Ramirez reached for a folder and opened it slowly. “We’re
recommending a full ADHD evaluation. It includes parent and
teacher questionnaires, cognitive and academic testing, classroom
observations, and a clinical interview. We examine attention span,
emotional regulation, impulse control, and working memory. All
those pieces affect learning and behavior.”
Olga listened in silence, her jaw tense. Then, she asked the question
that had haunted her for days. “But why? Why Zoyi? She’s smart, gifted,
even. Not lazy or disinterested. She just . . . doesn’t fit their mold.”
Ms. Ramirez nodded slowly. It was as if she had heard this story
many times before.
W h e n B r e a t h B e c o m e s L e g a c y · 165
“We also review her developmental history. We rule out anything
that might mimic ADHD, such as anxiety, sleep issues, or
sensory differences.”
Something lit up in Olga’s mind like a blinking light bulb. Sleep.
Like Eugene?
Olga felt a thin stream of cold sweat running down her back. Suddenly,
she was too warm.
Before she could form the question, Ms. Ramirez continued
speaking. “You’re absolutely right. Zoyi is bright. Exceptionally so.
That’s not uncommon for children with ADHD. Their brains are
wired to notice everything, think fast, and feel deeply. But without
the right support, all that potential can become tangled. Focus
becomes difficult. Following rules, staying on track. It’s exhausting
for them.”
Olga swallowed hard. Budushchee. “So, what does that mean for
her future?”
“It means that without proper support, Zoyi might struggle with
the structure of traditional education. Especially in standardized
environments. She may do brilliantly in creative settings but freeze
during timed tests. Executive dysfunction—difficulty with planning,
organizing, completing multistep tasks—can affect her ability to
succeed on standardized exams like the SAT. And those are still the
gatekeepers to good colleges.”
A weight settled in Olga’s chest.
She had seen it in Zoyi—the lightning-fast imagination, the intense
emotions, the way she asked questions even adults couldn’t answer.
Olga had always viewed it as genius, the kind that set Zoyi apart. As
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an immigrant mother, she had already pictured Zoyi’s future with
crystal clarity: Ivy League, medical school, a clean, prestigious path.
Olga looked away, blinking rapidly. “So if I don’t do this . . . if I don’t
test her . . .”
The social worker answered, firm notes in her voice. “She could fall
further behind. Or lose confidence. Start believing what others say.
That she’s too much, loud, and scattered. And that kind of belief? It’s
harder to unlearn than anything else.”
Olga sat still. The pressure of the moment was tremendous.
She had fought fiercely to bring Zoyi into the world. Now, she realized
another battle awaited her. She would have to fight just as hard to
ensure the world saw her daughter for what she truly was—brilliant,
yes, but also different.
Right there in the social worker’s office, Olga opened her phone and
started a new note titled “Zoyi.” She typed: “anxiety, sleep, sensory
issues . . .” Then she added a few question marks. She was trying to
unlock a code. Ne slomat. Not break Zoyi.
* * *
That night, Olga was not able to sleep. She played out different
scenarios in her mind. The machine was making its hissing sound,
but she was able to get into a state of drowsiness. Once, she opened
her eyes and saw Eugene sitting upright on the edge of the bed with
the mask clutched in his hand like a weapon he no longer had the
strength to wield.
“I might die, but I’m done,” he said, his voice raw. “I can’t live like this.”
W h e n B r e a t h B e c o m e s L e g a c y · 167
Olga blinked in the darkness, her heart sinking. Silence enveloped
her. She had heard the same phrase more than once, but now his
voice carried a certain desperation, a higher note she hadn’t sensed
before. She glanced at the clock. It was 3:15 a.m. Eugene had used the
CPAP for four hours.
She remembered that the insurance company had explained he
needed to wear it for at least four hours each night for twenty-one
days, or they would take it away. He had already passed that test; time
to look for other treatment options.
Without a word, she rose, clutching her pillow, and quietly walked
down the hallway to Zoyi’s room.
Zoyi’s bedroom glowed with a soft, constant light. Olga kept it on
because Zoyi feared the dark. A gentle vanilla scent wafted from the
fresh linen. The room, with its lavender walls and neatly arranged
toys, was an expression of Olga’s love. It was designed for her daughter
to feel safe and warm.
Zoyi lay asleep, curled awkwardly on her knees and elbows, her
bottom raised in the air like a toddler who had collapsed mid-crawl.
Her face was turned to the side, lips parted, breathing heavily through
her mouth. Her chest rose and fell with each labored breath, straining
as if the air had to be pulled in.
Without opening her eyes, she suddenly pushed herself upright. Still
caught in sleep, she mumbled something strange and unintelligible.
Olga paused, thinking for a moment that Zoyi had woken up. But
the child’s gaze was unfocused. Her movements were disconnected
from reality.
Then, just as suddenly, she dropped back onto the bed, this time flat.
Her mouth stayed open. Her breathing was fast and shallow. Her chest
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rose and fell with effort. Moments later, she began kicking her legs,
twitching and shifting as if fleeing from something inside a dream.
Olga stood frozen in the doorway, a cold sweat washing over her.
“What is this?” she whispered. “Is this normal sleep?”
She grabbed her phone and hit record.
After that moment, Olga couldn’t sleep. Her mind circled endlessly
around Eugene’s nightly struggle to breathe. She couldn’t shake what
she had seen in Zoyi.
She had a degree in biology from St. Petersburg University and
had always been passionate about genetics. Now, she couldn’t stop
wondering—Will Zoyi repeat Eugene’s health destiny?
Even the thought made Olga’s anxiety spike. To calm herself, she
opened her phone and started a new entry in the “Zoyi” section of
her notes. She typed: “mouth breathing, open mouth, sleeping on
knees and elbows, loud breathing, almost snoring.”
After placing her phone on the side table, she stared at the ceiling.
Her mind raced once more.
How do I stop this?
Who do I talk to?
How do I make sure Zoyi doesn’t end up like Eugene?
B e f o r e I t ’ s T o o L a t e · 169
CHAPTER THIRTEEN:
Before It’s Too Late
Dr. Sokolina
By the time I sat down across from Inna at Bouley Botanical,
something deep inside me had already shifted. Alex’s death and
Eugene’s sickness had altered how I viewed every patient who walked
through my door.
Stepping into the misty light of the restaurant felt almost surreal.
Walls adorned with fresh herbs, the soft scent of lavender and Thai
basil, and the shimmer of vertical gardens surrounded us. Normally,
this elegance marked our once-a-year ritual, but tonight, the beauty
only made the grief between us feel sharper.
Finally, after a brief silence, I began gently. “Inna, what did the doctors
say about Alex’s passing?”
Inna’s expression shifted subtly. It was as if the memory of that night
had come rushing back.
“SDC—Sudden Cardiac Death,” Inna’s voice trembled slightly. “It
was such a peaceful evening before everything happened. He was
fine. He had cooked stuffed peppers for our Sunday lunch together.
The casserole was still on the stove in the kitchen that night. Then
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his girlfriend called me. ‘Alex is not breathing.’ I told her to call 9-1-1
and ran to his apartment.”
She blinked fast now. “He was so heavy. I moved him from the bed to
the floor. I did the compressions. Then they came. EMS. They made
us step back. They worked on him for a long time. Took him to the
hospital. I came to his bedroom—there was a lot of blood on the floor.
And then . . . nothing. Gone.”
My thoughts turned to Eugene right away. His weight gain. His loud
snoring. His collapse. His ventricular fibrillation. I read in an article
Olga sent to me that the survival rate after this kind of episode was
three percent. Eugene was extremely lucky. Alex was not . . . Could
that tragic loss have been prevented?
Now, sitting across from my friend, I felt the bitter contrast. A
beautiful, fragrant evening with meticulously plated meals . . . and
the cold, brutal finality of life. I chewed slowly. The food was tasteless.
I lean back in my chair, my eyes on Inna, her silhouette soft against
the glow of the interior amber lights. “I’ve been taking so many
courses on dental sleep medicine lately,” I began, “And the more I
learn, the more I realize it isn’t something you just add to a practice
and move on.”
I paused. “It keeps pulling me back to orthodontics. To growth. To
structure. The mystery of why teeth and jaws behave the way they do.”
“Maybe you see it differently,” Inna said, locking her gaze with mine.
“Because your first dental education was in Russia?”
“Maybe,” I smiled. Years have passed, yet I still remember the elation.
Seeing my name on the list of students accepted to medical school in
St. Petersburg was unforgettable.
B e f o r e I t ’ s T o o L a t e · 17 1
Inna leaned forward. “That was a huge win.”
“My parents were terrified,” I said. “They begged me not to challenge
myself like that. It was widely known Jewish applicants faced
strict, unofficial quotas. Education was free, but controlled by the
government. Getting in felt like winning a small, silent war. It was a
prize and a victory all at once.”
“In Russia,” I continued, “medical and dental students studied
the same subjects for the first three years. Anatomy, physiology,
pathology—all together. But dentistry itself . . .” I hesitated. “Primitive.
We placed metal crowns in school. Sometimes we did terrible root
canals without proper instruments or medications.”
Inna’s brows arched. “Stone age?”
“Our teachers showed us photographs of American root canals,” I
said with a laugh. “To me, they existed somewhere between a dream
and a fairy tale. Aesthetic reconstruction? It didn’t exist. Worse
still, nothing was integrated. No one spoke about how specialties
connected, or how one system affected another inside dentistry.”
“And then America,” Inna said.
“Yes. In the United States, training felt definitive,” I said. “It wasn’t
just a repetition of my Russian education. It was something entirely
new. From the first years, I treated patients. It was like learning to
think with my hands.”
Inna smiled. “That’s a great line.”
“My general practice residency was especially pivotal,” I continued. “I
tasted every flavor of dentistry. But sampling wasn’t enough. I didn’t
want to fix little pieces of the mouth. I wanted to build the whole
structure by my own design.”
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She studied me. Her eyes were searching, thoughtful. “That sounds
like you.”
“The idea of a bombed-out mouth,” I said slowly, “damaged by fear,
neglect, trauma—it gave me a strange thrill. Transforming it into
something clean and beautiful with my own hands felt powerful. I
could do that work day and night.”
Inna remained silent.
“It wasn’t just technical, more psychological for me,” I added. “Behind
every broken smile was shame, self-doubt, avoidance. I could relate.
Guiding patients through that transformation—from bad breath and
embarrassment to eating, kissing, confidence—felt sacred.”
She nodded.
“Mouth holds pain and power,” I said.
“I was hungry for more,” I continued. “I chased knowledge wherever
I could find it. I shadowed professors. Bothered mentors. Attended
every lecture.”
“And still not satisfied?”
“The more I learned,” I said, “the more I realized I didn’t know the
secret I truly wanted. How to mimic nature. How to take a destroyed
mouth and bring it back to the way nature intended it to function.
Not just look good but be durable.”
Inna tilted her head. “That’s when occlusion came in?”
“Yes,” I said. “I studied full mouth rehabilitation. Learned occlusal
design by reading the language of the bite. Lines on the front teeth.
Dots on the back molars. We revealed them with carbon paper, thin
as tissue, pressed between teeth.”
B e f o r e I t ’ s T o o L a t e · 173
“Incisors guarding molars,” Inna remarked.
“Anterior guidance,” I said with a smile. “Teeth sharing the load. Each
contact checked and rechecked until balance.”
“And yet . . .” she urged gently.
“And yet,” I said, “even with ideal schemes, I saw failures. Teeth
fractured. Restorations broken.”
“Because . . .”
“I didn’t like working on crooked teeth,” I said. “Restoration demands
precision. Crooked foundations distort force lines. When forces are
wrong, nothing lasts.”
Inna leaned in slightly. “So, you asked why teeth were crooked in
the first place.”
“Yes,” I said. “I had never seen mouths like that in Natural History
museums. Teeth might be worn, imperfect, but never crowded like
I saw daily in patients.”
“That frustration pushed me into orthodontics,” I said. It was a
residency for practicing dentists. There, amidst cephalometric analysis
and jaw tracings, I discovered the airway and sleep connection.
Inna smiled. “That moment.”
“When we move teeth, we change arches,” I said. “And if we change
arches, we alter the space beneath the nose and tongue. That space—
the airway—is everything.”
“When we expand a child’s arch,” I continued, “we give them room
to breathe. Room for the tongue. Room for tonsils not to collide. The
face grows differently. Everything responds. Three-dimensional.”
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“Did they cover extractions in orthodontics?” Inna inquired.
I exhaled. “I began questioning everything. Girls’ sutures fuse at
twelve or thirteen, while boys’ fuse a bit later. Families want braces
once. Teeth don’t fit, so we remove them.”
“And the results?”
“They haunted me,” I said. “Tiny smiles on large faces. Black circles
under the eyes. No room for the tongue. Something was wrong.”
“Dental sleep is complicated,” I continued. “There are real obstacles:
medical billing, navigating insurance, and the biggest challenge of
all—working alongside physicians who don’t always understand what
we do or why it matters.”
Inna raised her brow. “Of course there are. You’re crossing into
medicine. Doctors don’t exactly love sharing the sandbox with
dentists. I remember your stories when you tried to explain to
primary care doctors the connection between periodontal and
cardiovascular diseases. They looked at you like you came from
Mars and are not fully mentally stable.”
I smiled, “Inna, I remember your campaign to send letters to ENT.
You argued that orthodontic expansion, or Phase One orthodontic
treatment, could reduce the need for tonsillectomy. By increasing
palatal width, you said, we lessen the chance of airway collapse. At
least we keep trying!”
I continued. “Also. With dental codes, everything is predictable.
Electronic submission, estimates, everything calculated. But medical
billing? It’s chaos. Dozens of plans. Surprise denials. Zero clarity.”
“So why not just do fee-for-service?” she asked, slicing her mushroom.
“You’re not exactly running a Medicaid clinic.”
B e f o r e I t ’ s T o o L a t e · 175
“I could,” I admitted. “It’s cleaner that way. But if you don’t accept
insurance, physicians hesitate to refer. They don’t want to deal with
angry patients expecting coverage.”
Inna chuckled dryly. “No one wants to deal with angry patients. That’s
the universal language of healthcare.”
I smiled and leaned in, passion rising in my voice. “But don’t you
find it strange how so many kids need braces now? Allergies, blocked
noses, and mouth breathing are everywhere.”
She looked at me, doubtful. “You’re not the first to notice,” she said.
“But you’re not going to fix the world alone.”
“And the extractions,” I added, pushing forward. “Four premolars
gone. Every single patient I’ve seen with that treatment has TMJ
issues—bruxism, headaches, fatigue. It makes me wonder . . . was
it the anatomy that caused it all, or the treatment? Chicken or egg?”
Inna sighed and set down her fork. “Maria, you’re asking the right
questions. But do you know how hard it is to change a system?
These doctors you want to collaborate with? Most don’t even read
your notes. And the patients? Half of them won’t wear an appliance
as prescribed. Meanwhile, parents and kids want orthodontic
treatment to be fast. Once and done. Like surgery. Magic
wand. Unicorn.”
I laughed at that. She wasn’t wrong.
“Dental Sleep feels like the missing piece of my practice,” I said. “In my
work and in my life, there are so many signs. I should start listening.”
“Catch-22,” Inna said with a smile. “You want to help people. But the
system won’t let you.”
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I nodded, exhaling. “Building a network with physicians? It’s almost
impossible. They still don’t take us seriously. Our education is separate,
as well as insurance and record systems. We can’t even access the
medical records needed to properly support our patients’ insurance
submissions. It’s a massive barrier.”
She raised an eyebrow. “So, just don’t take insurance.”
“It is a philosophical question. I found that sleep is a matter of
necessity. It is not a luxury. Some people can’t afford treatment
without insurance. Healthcare shouldn’t just be for the rich.” I wanted
to set my values in a comfortable way.
“CPAP compliance drops so fast,” I said, leaning forward. “Especially
after the first year. These people aren’t using what’s prescribed to
them. And meanwhile, there’s this wall between medicine and
dentistry that’s stopping collaboration. We need each other, doctors
and dentists, but we act like we’re on different planets.”
I paused, then gave her a look. “Remember that story? The sleep
doctor, the foodie?”
She grinned. “You tried to charm him, didn’t you?”
I laughed. “I did. I sent him a patient, and he prescribed CPAP. The
patient didn’t wear it. So, I invited the doctor to his favorite restaurant.
I spent a week prepping articles, diagrams, and everything to explain
oral appliance therapy. I paid the bill, made the pitch.”
“And?”
“He looked at me and said, ‘I’m not referring to you. I don’t believe in
this treatment modality.’ Meanwhile, half my patients have CPAPs
collecting dust in their closets.”
B e f o r e I t ’ s T o o L a t e · 177
Inna shook her head. “A vicious cycle.”
I sighed. “Do you know the NIH statistics? Twenty-four percent of
men, seventeen percent of women, in the US have sleep apnea. Eightyseven
percent go undiagnosed. That means, at any given time, two
out of ten people sitting in our chairs are suffocating every night and
no one’s noticing. It’s strange to me that the number of Sleep Apnea
in Germany, Poland and Japan is fifty percent of the population. We
have a lot of immigrants from those countries here. Maybe we do not
do screening in a meticulous way like in those countries?”
She fell silent. I noticed a shift in her expression. It was as if she was
already crafting a counterargument.
“I know,” I said softly. “You don’t see it as the best business decision.”
She shrugged. “It’s not that. I just know how hard it is. You’ve always
had big ideas, and some of them work. But this one? It feels like
fighting the whole medical system.”
“I get it,” I said. “But those statistics? They’re not just numbers. They’re
people. People who wake up drained. Struggling. Searching for help.
Dentists might have a front-row seat to these problems. We see
patients several times a year.”
I looked at her. “Let me tell you a story. It’s about Eugene and Olga.”
As I spoke, I watched her listening. Her face changed. She was
connecting the dots. Not only to patients she’d known, but to Alex.
“I remember our daughter’s graduation night,” she said. “We all stayed
in one room—me, Alex, his girlfriend. His snoring was so loud. Like
a freight train. I never understood how she could stand it. During our
marriage, it was unbearable. I used to dread bedtime.”
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“I can’t say for sure about Alex,” I told her, “but Eugene’s episodes
of atrial fibrillation line up with the apneas in his sleep study. It’s
not random.”
“There are so many clues,” I added. “Sometimes I wonder if it’s a disease
of evolution. Our jaws and faces might be shrinking. Perhaps our
airways weren’t meant for this modern world.”
Inna narrowed her eyes. “Dickens wrote about it. Pickwick Papers.
Everyone thought it was just about weight back then.”
“And maybe it was. But some of the worst cases I encounter aren’t
overweight at all.”
“Same,” she replied. “I’ve seen it too.”
“And Eugene?” I added. “He says he feels better with CPAP, but he hates
using it. I think it’s because he can’t breathe through his nose. Maybe
it’s blocked sinuses or a stuffed nose.”
Inna’s face lit up. “That’s smart. You should tell them.” She paused,
considering. “I would recommend ENT visits for Zoyi as well.”
We sat quietly, letting the silence envelop us.
It was an unforgettable evening from every angle. One of those rare
nights that changes how you see everything.
Inna’s words lingered with me long after I left. The stories, the grief,
the freight train that used to sleep beside her.
Now I saw it in Eugene, the same rhythm and danger. I realized I did
not want to just treat teeth separately anymore without connecting
the dental story to overall health and the whole body.
B e f o r e I t ’ s T o o L a t e · 179
* * *
I was driving home along the West Side Highway, the wet pavement
glistening beneath my headlights like a trail of scattered glass. To my
left, the George Washington Bridge emerged from the darkness, its
arches blinking white against the deep black of the Hudson.
I thought of Dr. Richard Beistle. He was a teacher who tried to change
the system. Yet, he was always met with the same response: “This is
how it’s always been done.”
It was Dr. Michelle Weddle who said to me, “If you want to
understand why people destroy their mouths and how to stop it,
you have to learn dental sleep.” She had created the ASAP Airway,
Sleep and Pediatrics Pathway, an online mini‑residency designed
specifically to train dentists on identifying, diagnosing, preventing,
and treating childhood sleep‑disordered breathing. Her words stuck
with me.
It was many years ago that I signed up for the mini-residency in
dental sleep medicine at Tufts. That’s where it all snapped into place.
I examined sleep studies. Pages filled with drops in oxygen and surges
in heart rate.
Patients weren’t resting. They were running marathons all night,
fighting for air. The REM stage of sleep remained elusive.
They never sank into deep sleep. It’s the stage where the body releases
hormones to repair tissue and regulate hunger and weight.
No wonder they woke up exhausted, plagued by memory loss, mood
swings, and hormonal chaos. It was no coincidence that these same
patients disrupted my restoration.
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And that’s when it struck me.
This is how I could protect what I built. Not just crowns or aesthetic
smiles. Lives.
But here’s the truth I need to tell: even after taking the course, I didn’t
rush to treat anyone.
My interest was genuine. Yet, the barriers were enormous.
Dental sleep medicine is not a skill you can pick up during a study
course. It isn’t only knowledge, but the entire system.
Medical billing.
Physician collaboration.
Diagnostics.
Staff training.
Equipment.
Referrals.
Every part must work in harmony.
I kept asking myself:
How could I step into that responsibility before it was too late?
T h e R e t u r n o f T o u c h · 181
CHAPTER FOURTEEN:
The Return of Touch
Dr. Sokolina
I sensed it before the doorbell rang. The morning would not be calm.
A cold, pointy awareness nagged at me. I couldn’t understand why.
It was the Friday after Thanksgiving. The wind outside felt sharp and
hollow. The last of the leaves had been blown off the trees. Somewhere
in the distance, I could smell wood burning—someone’s fireplace
or maybe the neighbor’s backyard grill. I was working from home
that day, wrapped in a long sweater and seated at the kitchen island.
The kitchen was my favorite room in the house. The light overhead
was soft and golden. A sea salt grapefruit diffuser gave the air a
pleasant energy. I liked how clear the counters were, no clutter. Beside
the espresso machine, a pot of ginger-lemon water was steeping. My
morning tradition.
As strange as it sounds, doctors spend just as much time behind the
scenes as they do seeing patients. They review charts, check lab bills
and insurance claims, log procedures, and write treatment plans.
That morning, I was deep into analyzing a particularly complex case
from the week. Suddenly, the doorbell rang.
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Pale, with dark circles around her eyes, and obvious exhaustion,
Olga stood there in a wool coat. She didn’t say anything at first,
just looked at me as if she were about to cry. She appeared not to
have slept, with that anxious edge I usually recognize in worried
mothers who have been wrestling with racing thoughts all night.
I invited her in. “Tapochki?” I noticed she was wearing her slippers.
She must have been in a real hurry to visit me.
It’s a cherished Russian tradition from childhood. We come in from
outside, remove our shoes, and slip into cozy slippers.
I nodded toward the stool by the island. “How about a cappuccino
with oat milk?”
In Russia, kitchens weren’t just kitchens. They were the country’s
psychotherapy offices. We didn’t have therapists. We had friends,
warm tea, and small kitchens. Bedrooms were often shared with
children, and doors rarely closed. The kitchen was the only room
where you could talk freely, cry, and confess.
So even now, in America, my kitchen holds that same energy. It’s
where the real conversations unfold.
She shook her head.
“My lemon-ginger water?”
“I don’t think I even have an immune system left,” she mumbled.
Her voice was dry with exhaustion.
I poured the drink anyway and slid it toward her. The freshness from
the diffuser mingled with the ginger spice, creating a soothing aroma.
But Olga did not touch the cup. She was shaking.
T h e R e t u r n o f T o u c h · 183
“You didn’t sleep,” I said gently.
I looked down at Olga’s hands. I remembered them well, how careful
she used to be with them. The first time I noticed was when she came
to my office. Her nails were immaculate, finished with a glossy coat of
polish. I had complimented her.
She had smiled then, just a little. “It’s a Russian manicure,” she said with
pride. “I drive two hours to Brooklyn to get it done. Russian women
can’t live without it.”
I was stunned. “Two hours? What’s so special about it?”
“It takes four hours,” she remarked.
“Four hours? For two hands? That’s two hours per hand! Even heart
transplants are quicker these days. What could possibly take that long?”
She laughed. “You’ll never understand until you try it. It’s a super sacred
magic. A special way of removing every cuticle, shaping every edge.
When it’s done, you feel like a woman again.”
Something nostalgic in her tone stuck with me. That devotion to her
own beauty.
But now, those hands looked different. Weak. Ungroomed. Her fingers
clenched tightly around the phone, knuckles slightly red. She caught
me glancing and said, in a flat, drained voice:
“No time. No energy. Manicures are out of the question.”
She looked up. “Eugene tore the CPAP off again. He said he’d rather
die than wear it. I moved to Zoyi’s room just to get some peace . . . and
that’s when I saw it.”
She took out her phone. With a quick tap, she hit play.
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I leaned in. The screen showed Zoyi tossing in her bed, mouth open,
breathing erratically, her tiny jaw slack. That pointed feeling from
earlier returned.
“What do you see?” she asked, her voice cracking.
I didn’t respond immediately.
“I see Eugene,” she whispered. “And the same scary future.”
Her pupils were huge, full of panic, as if she had just seen a ghost. Her
hands began to shake, and soon her whole body followed. Tears slid
down her cheeks without warning. Her lips barely moved. “She’s going
to repeat everything. The mouth breathing. The fatigue. The heart.”
I reached across the counter and clasped her hand.
“Wait, Olga. Breathe. Don’t spiral. This might be the clue you were
looking for.”
“But I don’t know where to start. I searched online for sleep doctors,
orthodontics, myofunctional therapy, ENT. It’s overwhelming.”
“Well, sounds like you already have a plan,” I said softly. “We’ll figure
it out. She’s still young. There’s time to change the trajectory.”
Olga wiped her eyes and added, “And Eugene . . . he’s worse. He won’t
wear the CPAP. But I trust you. You have to make an appliance for
him. Please.”
For years, I attended courses on the subject, but mostly what I did was
educate my patients. I told myself the system was too complicated,
that I didn’t want the added responsibility.
Some stories stayed with me.
T h e R e t u r n o f T o u c h · 185
Federal investigators later discovered that the engineers involved
in two major New York–area commuter train crashes suffered
from undiagnosed obstructive sleep apnea. One crash occurred in
Hoboken, the other in Brooklyn. In both incidents, the men had
fallen asleep at the controls.
Sleep apnea does that. It steals oxygen, fragments sleep, and leaves
the brain drained, even after a full night in bed.
The National Transportation Safety Board pointed to lax screening as
the culprit. This disease doesn’t just cause snoring. It leads to severe
daytime fatigue and sudden sleep episodes.
And if sleep apnea could bring down a train, what might it do to a
driver? To a pilot?
That filled me with fear.
What if my treatment didn’t fully address sleep apnea? What if
something terrible happened anyway?
But growing up was inevitable.
The moment had arrived. The signs were unmistakable in nearly a
quarter of the patients who entered my practice: broken teeth, evident
mouth breathing, and snoring. Now Eugene. Alex. Zoyi.
I said with a deep sigh, “I’ll make the appliance for Eugene, but we’ll
have to repeat the sleep study to be sure it’s really helping him.”
* * *
I scheduled him early, before any patients, so I could give him my full
attention. He looked more than tired. His skin had a gray cast. His lips
had that faint glossy sheen I often see in people who keep their mouths
186 · B RE AT HL E S S
slightly open, as if always needing more air. When I sat him back in the
chair and asked him to breathe through his nose, he shook his head.
“It’s always clogged,” he said. “I can’t even remember the last time I
used my nose. I adapted. I use my mouth now.”
As I examined his mouth, I noticed signs that worried me more. His
gums were red and swollen, bleeding with even my gentle touch.
“Eugene,” I said carefully, “before we even talk about your appliance,
I need to tell you that your gum health is not good. Bleeding gums
are not just about bad breath or loose teeth. You have pockets around
your teeth, and bacteria have a perfect hiding place there. These are
not good bacteria. Their byproducts can affect your whole health. The
inflammation can worsen your heart condition. It’s all connected.”
He sighed, rubbing his face. “Great. Another thing to worry about.”
“No,” I replied. “We can make it better. We’ll examine your microbiome
and work on reducing inflammation from a gum standpoint.”
Eugene rubbed his forehead, his voice hoarse. “Somehow, I didn’t
have these problems when I was young. Why does everything keep
happening to me now, all of a sudden?”
“Eugene,” I said gently, “your mouth has its own little ecosystem,
what we call the microbiome. Think of it like a garden. Some plants
are healthy and protect the soil. But weeds can take over if the
balance shifts.
Right now, your gums are full of weeds. They cause bleeding and
inflammation. But these weeds don’t just stay in your mouth. They
spread seeds through your bloodstream, making it harder for your
heart to stay healthy.
T h e R e t u r n o f T o u c h · 187
What we’ll do is test your garden, see exactly which weeds are growing,
and then help the good plants take back control. When that balance
is restored, the gums will stop bleeding, inflammation will drop,
and your whole body will benefit. A healthy mouth is one of the
foundations of longevity.”
We took a scan and bite registration. I was especially careful, knowing
how sensitive he was. If an appliance isn’t comfortable from the start,
most patients never get used to it. I measured a balanced jaw position.
It opened the airway while minimizing strain on the joint.
Mouth breathing could ruin any therapy.
“You can wear this and breathe through your mouth,” I told him. “But
it’s like trying to row a boat with holes in it. We have to train your body
to keep your mouth closed.” I continued, “I know you visited an ENT.
His therapy could help, as well as nasal hygiene, tape, and maybe a saline
spray. At first, it may feel uncomfortable because your body isn’t used
to holding a little more carbon dioxide. But with practice, it adapts.”
He nodded, yet there was hesitation.
“I’m not asking you to suffer,” I added. “I’m trying to help you breathe
and live. I’ve seen many examples of people like you get better. Not
overnight but slowly. Once the brain feels safe at night, the whole
body heals differently. Patrick McKeown and Dan Brule talked about
it all the time. James Nestor wrote the whole book Breath about it.”
* * *
Several weeks passed, and we found ourselves meeting in my office
once more.
Eugene sat in the chair, his fingers clenched around his phone. He
watched as I unwrapped the box. I’d chosen the smallest device. It
188 · B RE AT HL E S S
was one I trusted for patients with periodontal concerns. Less bulky,
easier to adjust, and gentle on the gums.
“Let me show you how it works first,” I said, holding up the two pieces
like puzzle parts. “This is the lower; this is the upper. It’s designed to
bring your lower jaw slightly forward while you sleep. Just enough to
keep your airway open without locking your bite.”
He nodded, though reluctantly.
I slid the lower piece in first, applying light pressure and checking the
fit. Then came the upper. He gagged slightly, out of habit. His body
still hadn’t learned that breathing through the nose was safe.
“Try closing,” I suggested.
He did. Slowly. The appliance clicked together. I checked the bite. The
contact points were solid.
“How does it feel?” I asked. “Do you feel tension in your jaw?” I touched
his cheek gently, right next to the temple.
“Strange, but not much tension,” he mumbled. “It’s like I’m wearing
a tiny helmet inside my mouth.”
I smiled. “That’s a fitting description.”
I handed him the mirror. He glanced at his reflection, then turned
back to me, uncertain.
“Now watch this,” I said, opening a little box with elastics and showing
Eugene different devices to open his nostrils at night. “You’ll use this
tape at night, just around the lips. Not to suffocate but to remind your
body that the mouth is closed and it’s time to breathe through the nose.”
T h e R e t u r n o f T o u c h · 189
“Like therapy for my mouth and nose at the same time?” he asked.
“Yes. Therapy to train your airway to stay open. To give you back a
deep sleep.” I paused. “But you have to use it every night. Even if it
feels weird. You’re retraining your brain and your body.”
He nodded slowly. “I’ll try.”
Making Eugene’s appliance felt personal. His case was too close
to everything I had just lived through. The memory of Alex, the
concern about Zoyi’s future, the helplessness in Olga’s voice, it was
all there, putting pressure on me. That’s when I knew: I had to build
a department focused on sleep and airway care.
I had been reaching out to anyone I could, practitioners in dental
sleep medicine, mentors, peers, hoping someone would guide me
through the next step. Some were hesitant, guarded, as if protecting
trade secrets. Others were just overwhelmed themselves, trying to
figure it out as they went. Eventually, I found my mentor in dental
sleep: Dr. Barry Chase.
We met at a seminar on facial development. I still remember his style—
elegant in a suit and tie, a crisp shirt framing eyes that seemed so
curious about the world. His voice held confidence. It was shaped by
wisdom and burnished by experience.
“How long have you been practicing?” he inquired.
“Around fifteen years,” I replied. “But I’m trying to grasp the mysteries
of sleep.”
Dr. Chase extended an invitation for me to visit his practice.
He had run a successful general dental practice for twenty-five years,
then sold it to focus solely on sleep. He wasn’t practicing dental sleep
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medicine; he built a system for how it should be done. A practice
based on clarity, compassion, and structure.
“Come observe,” he said. “You’ll grasp it more clearly in person.”
When I arrived at his sleep practice a few days later, I expected
another busy dental office.
From the moment I stepped inside, I sensed the difference. It wasn’t
chaotic like so many practices I’d seen. Everything moved with the
precision of an orchestra.
“Everyone here has a role,” he said, catching my eye as I surveyed
the room.
It was true. Everyone knew their part.
“I built the system to support the doctor–patient relationship,” he
said. “This allows me to focus on listening to the patient.”
A dedicated business department handled the financial side, so the
doctor could focus purely on patients.
I watched those first conversations unfold between Dr. Chase
and the patient. They were deep and human. The flow of care
was seamless.
Dr. Chase revealed the inner workings of his team.
The medical liaison team tirelessly educated physicians about the
role of dentistry in treating sleep apnea.
The billing department managed the intricate world of
medical billing.
T h e R e t u r n o f T o u c h · 191
Team leaders reported to a central coordinator.
Then I noticed the Key Performance Indicators graphs pinned on
the walls of the business office. Numbers, patterns, and metrics
filled the space.
“You can’t grow what you don’t measure,” he said.
It was a system, not just a practice—a well-oiled machine. Instantly,
I saw my mistake. I had been trying to control everything myself,
wearing every hat at once.
“That’s the hardest part,” he said, as if he could read my mind.
I realized it’s the same mistake many young business owners
face. Your own creation, your office, feels so precious that you
can’t let go. You convince yourself that if you loosen your grip,
everything will fall apart. But that very thought keeps you
from growing.
I turned to him and asked, “How could I practice like that? I love
the aesthetic and orthodontic parts. But how do I find the people
to create this kind of smooth, aligned care?”
He treated me like a colleague. Not a competitor.
“Eighty percent of sleep apnea patients are still undiagnosed,” he
said. “Every dentist has the chance to find their portion of that
eighty percent. Right now, it’s an elite group doing this work. Soon,
I hope it won’t be. The world needs more of us.”
At that moment, an urge surged within me. I wanted to create my
own version of a sleep department. Not just for the people I love,
but for every patient who needed that kind of care.
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* * *
At home, I sank into my favorite chair, my retreat for organizing
my thoughts. I liked its subtle leather aroma. Its earthy brown color
matched so well with Butterfly, the artwork I got from one of my
patients. I think it carries transformative energy, and the wings of
those creatures remind me that change is possible. Always.
I called Olga. On the other end, her voice was unusually energetic.
“He doesn’t like his appliance,“ Olga said, “but something
else happened.”
Olga let out a small breath, continuing. “Last night . . . it was so
unexpected. Surpriz. Eugene put Dirty Dancing on, prepared
champagne, and paired it with black caviar. It was something I had
not experienced for a long time. I couldn’t believe it. I thought, maybe,
finally, things were changing.”
She lowered her voice. “Blízost. I recently came across some research
on that delicate topic,” she said. “It’s amazing how much emotional
and physical well-being can be linked to healthy sleep.”
Olga paused. Her breath caught slightly as she spoke into the phone.
I noticed a vulnerability she hadn’t shared before.
“For so long, I thought Eugene didn’t care anymore . . . lyubóv . . . love,
intím . . . intimacy that we’d lost everything between us,” she said,
her voice thick with emotion.
“I used to try, to start, you know? I’d put on those movies we used
to love, like Ghost or Dirty Dancing, hoping something would spark
again. I’d look for those little signs between us, like the way Patrick
T h e R e t u r n o f T o u c h · 193
Swayze and Demi Moore had that unspoken connection. But after
Zoyi was born, it was like Eugene just . . . withdrew. He would leave
me sitting there, my attempts unnoticed, my signals ignored.”
I listened intently, sensing the depth of Olga’s frustration. “I
understand,” I replied, taking a deep breath.
“Yesterday, his hands held my face. His eyes traced every line, every
detail, as if trying to memorize me. The intensity left me breathless.”
She sighed, her voice barely above a whisper. “That moment . . . I
didn’t know whether to reach out or pull away.”

Di e t o f D e si r e · 195
CHAPTER FIFTEEN:
Diet of Desire
Olga
Olga woke slowly and turned toward Eugene, expecting the familiar
stillness of his sleep as the morning light filtered through the curtains.
She held her breath for a moment, unsure if she had imagined it. But
no. There it was, an unmistakable spark of desire beneath the sheets.
A sign of vitality she had not seen in years.
Olga thought about that special period from Thanksgiving to the
Christmas Holidays, that anticipation of magic, and even unrealistic
expectations. Novogodniaya Noch, that time when dreams come true.
Eugene moved, his eyes blinking open, unaware of the realization
that had passed through her. She looked away, her heart racing,
the discomfort of the moment settling in. It was subtle, almost
imperceptible, but it was there. She hadn’t seen him like that in so long.
Olga looked around the room. The CPAP machine sat on the table,
its mask discarded, left there hours ago when Eugene had removed
it. The box from the appliance stood open on the side table, empty.
Eugene had torn off the CPAP mask during the night, but the oral
appliance Dr. Sokolina made for him was still in his mouth. Olga
felt satisfaction at the sight. For once, no snoring kept her awake.
196 · B RE AT HL E S S
No rasping sound irritated her nerves. Deeper still, she hung onto
the thought that with the appliance, his airway held open; his heart
remained safer.
As relief washed over her, a needle of doubt pricked her thoughts.
What if this fragile balance didn’t hold?
She couldn’t help but reflect on their conversation from the previous
night. Just moments ago, she had finished putting Zoyi to bed. The
routine had become a challenge. Yet, she was determined to manage.
Sometimes, Olga felt as if she were living two lives at once. On one
hand, she was a detective of her household. Her eyes were sharp,
Notes open, gathering every clue that might explain her family’s
troubles. The dark circles under Zoyi’s eyes, her bed-wetting, her
behavior at home and in school—each detail felt like a piece of a case
file. Eugene’s stubborn refusal of the mask and lack of desire for any
physical activity added to the puzzle.
On the other hand, she was an explorer, a Darwin of her own
household. She didn’t collect seeds or shells, but fragments of
knowledge—scientific articles bookmarked at midnight, podcasts
replayed on her morning walks, and testimonials. Each was a
specimen in her growing collection, a way to map the invisible
forces shaping her family’s fate.
Her mission was to trace the hidden connections until a pattern
revealed itself.
Olga was constantly reading and finding new remedies or solutions to
make her loved one healthier. That was her detective search and life
journey at the same time. She knew that Eugene was unhappy about
that last find. Olga read the article about the simultaneous use of
CPAP and oral appliance for sleep apnea, called combination therapy.
Di e t o f D e si r e · 197
“You do not have to use both at the same time. But according to
the research, you need to use something at night. You can start
with CPAP and use the appliance afterward or start with both and
remove the CPAP once you feel you have had enough. According
to this article, it will have the best results for your blood pressure.”
Eugene tightened his lips but followed.
Olga sensed a slight shift in the right direction.
Now, she wanted to focus on Zoyi. She had been filling her notes
with observations, just as she had for Eugene, pages of thoughts after
podcasts, quotes from books, routines, bedtime strategies for children
from experts like Dr. Shareen Lim and Sharon Moore. The school
had whispered ADHD, but Olga wasn’t convinced. The open-mouth
breathing, the teeth grinding, the dark circles under her daughter’s
eyes told her intuition a different story.
So she had scheduled a first appointment with Dr. Funke Brown, a
pediatric sleep specialist. This time, she needed Eugene beside her.
* * *
The screen flickered on, revealing Dr. Funke Brown. She sat in a cozy
office, a soft light glowing to one side. Her voice was warm, confident.
She asked questions with genuine curiosity. Olga sensed this doctor
had encountered similar situations before. She knew the answers
Olga sought.
Olga entered the meeting filled with questions and doubts. She was
unsure if she was overreacting or missing something crucial.
Dr. Brown asked, “What brought you to me?” and really listened.
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Olga had sent Dr. Brown a brief video of Zoyi sleeping. Her lips were
parted, and her breath was raspy and uneven.
Dr. Brown leaned forward slightly. “What have you been observing
with Zoyi?”
Olga noticed her dark hair, neatly swept up into braids.
She hesitated, then began. “She’s constantly moving. She can’t sit
still in the classroom or really listen to the teacher. And . . . she has
trouble making friends. Zoyi is eight and recently started wetting
the bed. She has been out of diapers since she was one year old.”
Dr. Brown nodded, urging her to go on.
“She’s also so small,” Olga added softly. “The smallest girl in her class.
The school is already suggesting ADHD, but . . .” She pressed her hands
together, searching for words. “My gut tells me there’s more. I need to
look deeper.”
Dr. Brown’s voice was calm and reassuring, like someone who had
already helped many families navigate this uncertain terrain. “I hear
you. And you’re right to trust that instinct. Let’s explore this together.”
Dr. Brown didn’t dismiss her. She nodded, gently guiding the
conversation. She asked the right questions about Zoyi’s nightmares
and anxiety, her swollen tonsils, and night sweats. Every answer
made Olga feel seen. Not dramatic or paranoid. Just a mother
paying attention.
Dr. Brown spoke about what she had observed on a video: the pauses,
the effortful breathing, the restless tossing. She also pointed out
another red flag. Bedwetting at age eight could be linked to sleepdisordered
breathing.
Di e t o f D e si r e · 199
Dr. Brown leaned forward slightly. “We’ll start with a home sleep
study. It’s noninvasive and easy to set up, but it will give us crucial
information about her breathing and sleep stages. I’d also like her
to have an ENT evaluation to check her tonsils, adenoids, and nasal
passages. Sometimes obstruction in those areas plays a big role.”
Olga nodded, grateful for the clarity.
“And if it is sleep apnea?” she asked.
“Then we talk,” Dr. Brown replied, her voice firm and confident.
“We usually begin with a conservative approach, exploring airway
development, myofunctional therapy, and orthodontic options first.
Our goal is to help her breathe, grow, and sleep better. We need to
create the conditions that allow her body and brain the rest they
need to thrive.”
Eugene rubbed his face, his voice weary. “I hope this helps her at
school . . . and in the long run.”
* * *
Several weeks passed by. The home sleep study turned out simpler
than Olga had feared. Eugene, to Olga’s relief, figured out the setup
and paired the sensor with his phone through Bluetooth. The app
confirmed it was ready to record the night.
He had his own way of explaining it to Zoyi, framing the device as a
tiny piece of space technology. His fascination with gadgets seemed
to spill over into her and turned the test into an adventure. Zoyi
slipped the small ring-shaped sensor onto her finger without protest.
She even decided to treat it as part of her science project, eager to see
what kind of “secret data” it might reveal about her sleep.
200 · B RE AT HL E S S
* * *
In just a few days, Olga was eager to review the sleep data. She was
also keen to discuss the treatment strategy.
As she waited for Dr. Brown on the computer monitor, Olga looked
around the room and felt the pleasant anticipation of the holiday
spirit. She was proud of the room decor with the silver shimmer of
the menorah by the window, the playful colors of dreidels scattered
nearby, and the elegant row of nutcrackers, nestled in a bed of long
pine needles, lining the fireplace shelf. She liked the aroma of a freshly
cut Christmas tree and mandarins the most, which reminded her of
her own childhood.
Dr. Brown appeared on the screen, her wide-framed glasses catching
the light. Behind her, multiple diplomas adorned the wall.
“She did great with the study,” Dr. Brown began, pulling up a chart
on the shared screen. “There were several obstructive events, enough
to give us a clear diagnosis of moderate sleep apnea.”
Olga felt her facial muscles tighten. “So this . . . this explains it? The
lack of growth, the trouble focusing?”
Dr. Funke Brown clicked to the next page of the report. “Zoyi’s
apnea-hypopnea index, or AHI, is six.”
Olga squinted slightly. “That doesn’t sound . . . too bad? I mean, six
out of . . . what’s normal, again? For adults, I thought under five is
considered fine?”
Dr. Brown nodded slowly. “You’re right, that’s true for adults. An AHI
of under five in adults is usually considered within normal range. But
children are different. Their brains and bodies are still developing.
Di e t o f D e si r e · 201
Even a few interruptions in breathing per hour can cause significant
disruption in their sleep architecture.”
She paused.
“For kids, we start getting concerned at an AHI of just one. Anything
above that is abnormal. So a six? That’s moderate obstructive sleep
apnea in a child.”
Olga’s eyebrows lifted. Moya dochenka. Ny poor daughter. “Same as
my husband? She is repeating his story? What should I do?”
“No. Zoyi is very young, and there are many things you can do to
prevent the consequences,” Dr. Brown said gently. “This isn’t just
about noise or restlessness. Every apnea or hypopnea event pulls
her out of deep sleep, disrupting memory consolidation, emotional
regulation, immune function, and even growth hormone release.
When this happens dozens of times each night, her body feels as if
it’s under stress, night after night.”
Olga glanced down at her notes, then looked back at the screen. “The
school already brought up ADHD. They asked me to consider testing.
I understand that after the test, they will offer medications. But I
just . . . I needed to understand what was going on in her body first.
I couldn’t jump into meds without looking deeper.”
Dr. Brown nodded, her expression thoughtful. “It makes sense to
look at sleep first. Sleep-disordered breathing can mimic ADHD in
children. When a child isn’t getting deep, restorative sleep, they can
be restless, inattentive, even impulsive. It often looks like ADHD. But
the root cause is exhaustion.”
“So, you think we should hold off on the ADHD evaluation?”
Olga inquired.
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“I think the first step is addressing her sleep,” Dr. Brown replied. “Let’s
see how much it improves once her body is getting the rest it needs.
If there are still concerns afterward, then an ADHD evaluation can
be very helpful. This way, you’ll know it’s not just her body crying
out for air and sleep.”
Eugene, who had been quiet until now, rubbed his eyes. “So, we could
avoid putting her on meds if sleep is really the problem?”
“Exactly,” Dr. Brown said. “One step at a time. Let’s give her the chance
to breathe. Let her rest first.”
Olga’s mouth was dry. She sipped her lemon water with ginger. “We
also saw a pediatric ENT, Dr. David McIntosh, last month. He noted
her tonsils are enlarged but didn’t recommend rushing into surgery.
Instead, he suggested seeing an allergologist. He mentioned the
swelling might be linked to inflammation. I wasn’t sure what he
meant by that.”
“That’s a great next step,” Dr. Brown replied. “Tonsils and adenoids are
part of the immune system, so they often react to allergens, whether
it’s dust mites, pollen, or even certain foods. If Zoyi has underlying
allergies, they could be keeping that tissue chronically inflamed.
Treating the allergy might reduce the size of the tonsils, sometimes
enough to avoid surgery altogether.”
Olga nodded slowly. “So it might not just be anatomy. Maybe her
immune system is reacting to something.” She sighed. “What now?”
she asked. “What would be the next steps? Does she need CPAP
like Eugene?”
“We didn’t need to rush to surgery or CPAP now,” Dr. Brown said. “Her
tonsils are enlarged, yes, but they might not be the only problem. Before
considering removal, I wanted to try a few conservative strategies.”
Di e t o f D e si r e · 203
The doctor brought a slide to the screen. It read: Functional
Treatment Pathway.
“I want to consider myofunctional therapy to retrain her oral and
facial muscles. Nasal hygiene could help reduce inflammation. An
orthodontic evaluation might explore the arch expansion.”
Olga leaned closer to the screen. “Expansion like with a palate expander?”
“Exactly,” Dr. Brown nodded. “To create more room for the tongue,
improve nasal airflow, and promote proper growth. The earlier
we start, the more we can influence development. And if we do
need surgery down the line, it would be part of a stronger, more
functional foundation.”
Olga added, “I read in several books that functions need to be
addressed first before cutting any structures. Strengthen the airway,
retrain the muscles, support proper growth—and then reassess.
Surgery should be the last resort, not the first line of treatment. They
usually emphasize that point.”
Olga met Dr. Brown’s eyes. “I listened to a lot of podcasts. They all
talked about developing the airway at a very young age. It might even
be too late for Zoyi. We should have started at age two.” She bit her
lip. “But what if none of this works?”
Dr. Brown’s voice didn’t waver. “Then we reassessed. But you wouldn’t
be losing time. You’d be building strength and awareness. Everything
we do now serves her long term.”
Olga glanced at her phone. The note she had typed the night before
glowed back at her: “What if it’s not ADHD? What if it’s sleep?”
That was another clue Olga had discovered.
204 · B RE AT HL E S S
* * *
After researching breathing therapy for kids, Olga began teaching
Zoyi how to wash her nose.
“We spray a little here, inside the nose,” she explained patiently. She
directed the saline spray toward the middle of Zoyi’s nose. “You’re
so good at brushing your teeth, but now you have to clean your nose
too. It’s just as important.”
To make it less intimidating, they read Myo and His Nose by Nerissa
Bogan together. Olga wished to look like one of those effortless moms
she saw on her phone screen, but the reality was far more complicated.
Zoyi could read on her own now, yet Olga cherished these quiet,
shared moments at the end of the day.
The white bathroom counter was cluttered with tissues, cotton balls,
and the slim blue bottle of Xlear saline spray. Olga crouched to meet
Zoyi’s gaze. Her voice dropped, as if she were proposing a secret game.
“Ready to see who can blow the cotton ball the farthest?” she asked,
placing one gently on the counter.
Zoyi wrinkled her nose, shaking her head. “I don’t like it when things
go in my nose.”
“I know, sweetheart,” Olga said softly, brushing a strand of hair from her
daughter’s cheek. “But look—Myo does it too.” She flipped open the book
and turned it toward Zoyi. The cheerful illustrations came into view.
Zoyi leaned in, curiosity softening her resistance.
“Watch,” Olga instructed, setting her cotton ball before her. “Take a
big breath in . . . and blow!”
Her puff of air sent the cotton rolling across the counter.
Di e t o f D e si r e · 205
Zoyi giggled despite herself. She pinched her nose and gave a tentative
blow. The cotton ball wobbled forward a few inches.
Along with their new bedtime routine, Olga began adding small
changes to Zoyi’s bedroom itself. She replaced the harsh overhead
light with a dimmable one, softening the room into something calmer,
guided by what she had read in Sharon Moore’s book. She kept the
temperature just below seventy, having learned that a cooler room
invites deeper sleep.
And then came the Myotape.
Following the advice of Dr. Brown and Patrick McKeown, she began
placing it gently around Zoyi’s lips at night. Olga was hesitant to seal
them shut. Yet, she wanted to remind the lips to rest closed, to let
breathing return to the nose. Zoyi could still open her mouth if she
needed to. But more and more often, she didn’t.
It was a small thing. Yet in sleep, small things become everything.
* * *
After completing her evening rituals, Olga returned to her computer,
eager to continue her research. She enjoyed reading through the
information she had gathered from her CPAP community and various
doctors, hoping to find the best solution for her family.
Olga noticed Eugene washing the plates before placing them in
the dishwasher. A warm sensation spread through her heart as she
watched him.
Outside, a delivery truck eased to a stop near the house.
Her body tensed without her noticing at first.
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Pochta? Too late for the mail, she thought, her jaw tightening.
She remained perfectly still until it moved on.
It was dark outside, with a strong wind whispering through the trees.
Olga craved some ambience. She reached for her favorite candles
and lit them. The sweet, tingling aroma of coconut cashmere spread
around like a cozy cloud. It filled the room with warmth.
“Thanks for doing the dishes,” she said.
He nodded without looking up. She returned to her screen.
For four months now, she hadn’t worked.
Every appointment, prescription, and medical bill shadowed her
through the day, relentlessly.
Money was tight, but it wasn’t only about money. The question
returned again and again: Should she go back to work? Or was her
real work here, holding this fragile system together?
That thought always left a cold knot in her stomach.
Sighing, she avoided the questions and started scrolling through
research. She stumbled on something that was very personal and
uncomfortable, but it offered explanations to questions that had
burned inside her for years.
Sleep apnea. Erectile dysfunction.
Men with sleep apnea were far more likely to struggle with
intimacy. As oxygen levels dropped at night, blood flow suffered
and hormones shifted.
Di e t o f D e si r e · 207
Olga leaned back in her chair. Before, she hadn’t realized how deeply
sleep apnea could infiltrate a life. It touched things no one talked
about out loud.
Eugene stood behind her, eyes fixed on the computer screen.
Olga turned around. “Yeah, I’ve been researching some things . . .
about sleep apnea. I came across something surprising that I didn’t
know before. Maybe we could talk about it.”
Olga saw his eyes darken. The crease between his brows tightened. He
was already bracing himself, unsure if he wanted to hear the answer.
Still, he asked, “What did you discover?”
Olga paused for a beat, gathering her thoughts. “I was reading about
the connection between sleep apnea and . . . the things it can affect
that we don’t usually discuss.”
She noticed his chewing muscles tighten as he processed the words.
Quickly, she rushed to explain.
“I don’t know how to say this without hurting you,” she continued.
“But it made me wonder . . . if some of what’s been happening between
us isn’t about us at all.”
Her words hung in the air. Eugene’s body became rigid, his eyes
drifting away. She sensed his discomfort. Still, she pushed forward.
“I’ve been thinking a lot about us,” she continued, her voice shaking
slightly now. “About everything we’ve been through, and how things
have changed. I’ve missed being close to you, Eugene. Blizost. Not just
physically, but . . . emotionally. I don’t need anything more than for
you to be here with me, present with me like you used to be. But . . .
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I don’t know if it’s me or if it’s just your body. And I don’t know how
to fix it. I don’t know if you’ve lost interest in me, or if it’s something
beyond your control.”
Eugene stood quietly, his facial expression darkened with a depth
of pain. He didn’t speak, but his face said enough, his lips pressed
tight, his muscles tensed as he absorbed her words. It was like he
didn’t want to look at her but couldn’t turn away.
“I just . . .” Olga’s voice faltered. “I’ve missed everything, Eugene. I
don’t even know where we’re supposed to go from here. It’s like I’ve
been waiting for you to reach out, to show me that spark we once
had. But I can’t tell anymore if it’s still there, or if . . . if it’s gone.
And I’m afraid. I’m afraid it’s because you can’t . . .”
She squeezed her eyes shut briefly, as though the vulnerability of the
moment was too much. “But what’s harder than that, is living with
the silence. V molchanii. Not knowing. Pretending everything is fine
when . . . I feel like we’re both stuck.”
Eugene’s face softened. His lips didn’t move, but his eyes spoke
volumes. He wanted to say something, to explain. Yet the words felt
trapped inside. All he could do was stand there, simmering.
Olga reached out for his hand, a tear slipping down her cheek as she
looked at him. “We don’t have to rush through this . . .”
Eugene pulled his hand back.
“I hate sleeping with the CPAP,” Eugene said, slamming his hand on
the table. “I hate going from doctor to doctor. I’m drained by all these
different treatments you keep finding for me. I feel so weak, so out
of sync with my body. I don’t want to do it, but I do it for you and
for Zoyi.” He paused, frustration mounting. “But nothing seems to
be enough for you.”
Di e t o f D e si r e · 209
Eugene’s painful words cut deep into Olga.
“Every time I think we’re done,” he said, still not looking at her,
“there’s something else. Another problem or conversation, a new way
I’m failing.”
Olga wanted to explain how important it was for her to feel desirable,
to have a physical connection. She missed touch in any form. It was
like a tightrope, holding her from falling into somewhere. She felt
like an acrobat in a circus without a safety net. The words got stuck
in her throat as she watched the flame, swaying in unison with the
gusts of wind.
Eugene turned and headed to the bedroom. Meanwhile, Olga drifted
into the kitchen, her eyes catching the flickering lights around Ded
Moroz. She had brought this childhood version of Santa Claus
from Russia.
Olga opened the fridge, Eugene’s words still echoing in her mind:
“Nothing seems to be enough for you.” Was that truly how he saw her?
She knew what she wanted. The tenderness hidden beneath the
struggle. The man who once reached for her without hesitation. A
presence that had once been enough to hold her world together. She
longed for that again.
Her hand found a mandarin. At once, the memory rose like perfume.
In her youth, New Year’s celebrations in Russia always arrived with
these small suns, tucked into thin netted bags. Their black diamond
stickers bore curling yellow letters, spelling the staccato, melodic
word “Morocco.” She remembered how easily the peel gave way.
Bright citrus scent filled cramped kitchens. The skin tasted tart.
Inside, a sharp sour mixed with sweetness. A reminder that patience
was always rewarded.
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Olga remained with the fridge door open, the mandarin still cool in
her palm and found herself drifting toward thoughts of the holiday
dinners. Vkusnenkoye. What would she set on the table then? Red
caviar crowned with black, shimmering under the light.
She smiled to herself, remembering her first New Year’s celebration
in America. Zhizn udalas. Life, then, had felt generous. Almost
theatrical in its abundance.
Her eyes moved over the shelves: rows of Eugene’s silver energy drink
cans, Zoyi’s bright juice bottles and cartoon yogurt tubes, and the
boxes of frozen waffles stacked neatly in the corner.
They seemed like a complete map of their lives, illuminated in
processed light.
She stood motionless, her hand resting on the door, staring into
what now felt like a crime scene. Holodilnik. Cold against her skin.
Convenience disguised as care. Habits passed off as love.
If she didn’t act now, Zoyi would become Eugene—a child raised
on artificial coloring and packaging. An adult trapped in the same
relentless cycle of modern life.
Her jaw and neck muscles tightened. The mandarin warmed gradually
in her hand.
She stared into what now looked like a shrine to everything she was
afraid to change. The room was filled with artificial promises. Olga
imagined clearing them out. A surge of rebellion rose in her chest.
Would Eugene see it as an attack?
Would Zoyi cry over what she didn’t yet understand?
Di e t o f D e si r e · 211
Would their love survive a war over what went on their plates?
What if Eugene lost weight?
Would his heart grow stronger?
Would his sleep settle, free from choking interruptions?
She thought of Nutrition and Physical Degeneration, of warnings
written generations ago, and of The Dental Diet, drawing a straight
line between the mouth, the gut, and the brain.
What if the future wasn’t in another prescription? What if it was in
the refrigerator?
She closed the door quietly.
Darkness.

T h e L a n g u a g e o f F o o d · 213
CHAPTER SIXTEEN:
The Language of Food
Olga
Olga’s head was exploding with the conundrum of how to change
a menu built on childhood memories, traditions, and finances
according to the doctor’s warnings. Then Eugene walked in
with flowers.
He carefully set the mimosas on the table in front of Olga. Bright
yellow, fluffy blooms added a splash of color to the room. Their sweet,
citrusy scent mingled with the cozy atmosphere of the winter evening.
He caught her eye. For a moment, just giving her the flowers felt like
a small, silly way of saying, “I am awake.”
Olga smiled. “Mimosas, huh? You always know how to brighten the
evening.” She sighed, a hint of longing in her voice. “It’s so difficult
to find them here in the US.”
While Eugene went out for a few grocery items, Olga completed her
regular ritual with Zoyi—nose cleaning, teeth brushing, reading
a book, and taping Zoyi’s mouth. She was much happier now that
Eugene had taken responsibility for cleaning the kitchen and doing
the grocery shopping without needing a reminder. A new rhythm
at home. It felt good.
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He gave a half-smile and shrugged. “Well, you deserve something
nice . . . but . . . I was thinking . . .”
Olga raised an eyebrow, sensing his hesitation. “What is it?” she asked.
He shifted his weight, eyes drifting down to the flowers.
He met her gaze with a teasing expression. Yet, beneath it, Olga
caught a flicker of the nervous schoolboy.
“You know, in the old days, the flowers we gave on March 8 always
had a little something extra. A wink, a smile . . . maybe a surprise,”
he added with a teasing note in his voice.
She laughed. “Surprise?”
Eugene leaned closer, a small twinkle in his eye. “Well, it wasn’t just
the flowers. It was more . . . about a moment. Fun. Something that . . .
reminded us of what we used to have. Do you remember how we’d
steal little moments back when we were in school? Just for fun?”
Olga’s eyes sparkled with the memory.
“I do remember.” She met his eyes and smiled, as if the memory of
their youthful connection was still fresh. “We were always a little
mischievous, weren’t we?”
That specific bitter aroma of the flowers transported Olga back to
her days in Soviet schools. March 8, International Women’s Day,
celebrated femininity. February 23 was when girls honored the boys.
These days required secret preparations, whispered plans, surprises
tucked into pockets. They smelled of spring, waiting just beyond the
frost. Olga was nostalgic.
“Ice cream?” Eugene suddenly suggested, a smile spreading across
his face.
T h e L a n g u a g e o f F o o d · 215
Olga laughed softly. “From the supermarket. During class.”
They had run away from school for it. The thick sweetness coated her
mouth, lingering.
“Morozhenoe,” he added. His gaze drifted upward.
“Eskimo,” she corrected him, teasing. Thin chocolate cracked under
their teeth. The sweet-bitter taste melted too fast on wooden sticks.
Eugene nodded, leaning back slightly while keeping his gaze locked
on hers. “Maybe we could bring back March 8, just for tonight?”
Olga noticed something soft and woolen cradled in his hands.
“My scarf?” she said, surprised. “I can’t believe you still have it. That
was ages ago!”
There it appeared, a ghost from the past, crafted with wooden needles
in a simple garter stitch, light green like the first shoots of spring.
Olga breathed in its natural lanolin scent, comforting and earthy.
The ends curled slightly from use, loved, wrapped, and rewrapped
on many cold mornings.
Eugene smiled.
Olga continued, “I remember not having anything to give you when you
left for the States. I thought we’d never see each other again. I knitted
it for my domestic skills lesson when I was no older than Zoyi is now.”
“I found it truly precious,” Eugene said, his voice warm with memory.
“It had your smell, and I would breathe it in whenever I felt lonely
and nostalgic during my first years after moving to the US. I even
216 · B RE AT HL E S S
took it with me to college as my talisman. Everyone wore scarves
with the college logo, but I wore yours.” He paused, a bittersweet
smile on his lips. “I visited my parents today and found it in my
old boxes.”
Olga felt something stir within her, an enveloping tenderness toward
Eugene. Tears streamed down her cheeks. She wasn’t sad or happy.
It was a release, a letting go of the tension she had held inside for so
many months.
* * *
Olga sat in the car, waiting for Zoyi outside her school. She usually
arrived early to be the first one in the line of cars next to the school
door. At the same time, those thirty minutes were her thinking time
away from home, her own time. She was analyzing the allergist’s
appointment and the dilemma she was facing after that. She glanced
at the notes she’d typed into her phone: “Gluten, milk.”
Words begin forming around the idea of what they could mean for
Eugene and Zoyi. The results of the skin prick tests were both a
relief and a new set of challenges. Gluten, milk . . . those were the
triggers. No surprises there. The allergist had suggested reducing
inflammation, adding medications, and the importance of changing
their diet. It all felt like an overwhelming mountain to climb.
Olga made a note in her phone. “We are what we eat.”
Food was a vital pleasure in life. It intertwined with every
possible memory.
She touched the steering wheel, her fingers cold against the warmth
of the leather. She needed to align her thoughts. The allergist had
T h e L a n g u a g e o f F o o d · 217
recommended a shift to anti-inflammatory foods: more vegetables,
less dairy. A focus on foods that didn’t trigger the immune response.
How do I change everything? she thought. Where do I start?
Her thoughts drifted back to the details of the test. She recalled
explaining it to Zoyi.
She couldn’t help but smile at the thought of Zoyi’s face. The way she
wrinkled her nose at the prickling sensation was endearing. Then, she
laughed at the small distractions they tried to offer her.
The allergist would place tiny drops on their skin, then gently touch
those spots with a small needle. Zoyi was fine with the drops, but
the needle frightened her. She kept moving her hand, which might
explain why the allergist didn’t identify any real allergens.
Olga recalled how the tiny pricks had raised bumps on their skin. Each
mark was a testament to where the allergens had triggered reactions.
Eugene’s results were standard—gluten, milk, and tree nuts. Eugene
had not been happy about the appointment; every muscle in his
body had shown that. Olga had specifically asked for a follow-up
appointment on Zoom. That was much easier for her to arrange.
Thank God for telemedicine. She hoped that would ease some of
Eugene’s resistance. The Zoom format was less difficult to manage,
and he wouldn’t have to leave the house.
Her mind shifted again, away from the tests, back to simpler memories.
Moloko. The word “milk” swam in her mind like a sweet childhood
dream. She remembered the way she and Eugene would grab those
triangle-shaped paper containers with the pink letters on them,
remove the small triangle, and sip the sweet, creamy milk inside. It
was a daily ritual, something they shared after school, walking home
218 · B RE AT HL E S S
together, and laughing about the small things. The milk was always
sweeter after a long school day.
Olga used to take a long gulp before tearing into the sweet sourdough
bread. They got it at a tiny Soviet bakery with only three items inside,
but an amazing smell of freshly baked bread. They ripped off chunks
with their hands. The fresh bread was alive in their fingers, the airy
pieces breaking apart in the most satisfying way. It was soft, almost
delicate, and always so full of flavor.
Now this was an allergen making Eugene’s nose swell up so much that
he couldn’t breathe?
Here she was, questioning if she could ever remove that same comfort
from him, from both of them. Milk had been a part of their lives. Now,
it felt like an obstacle, a roadblock to healing.
She couldn’t help but ponder the options the allergist discussed. “We
can try shots,” the allergist had said.
“Or perhaps sublingual drops.”
The allergist offered allergy shots and sublingual immunotherapy
(SLIT) for Eugene, especially for his gluten, dairy, and tree nut
sensitivities. Both aimed to gradually retrain his immune system. It
sounded like a long-term solution, but Olga hesitated. Would Eugene
even agree? He always rejected the injections, but perhaps drops
under the tongue would meet less resistance.
Then there were the medications.
“If sprays fail, we escalate.”
Start with antihistamines and nasal sprays. If they fail, consider oral
corticosteroids or leukotriene modifiers.
T h e L a n g u a g e o f F o o d · 219
More medications, Olga thought. She hadn’t wanted to go down that
path, but maybe it was necessary if it would help Eugene breathe
easier. She just hoped it wasn’t another band-aid solution that masked
the real problem.
“But it can help retrain his immune system,” the doctor had said, his
voice reassuring. “Reduce reactivity, even lower inflammation over
time. Especially when paired with dietary changes.”
The gluten and dairy-free options were clear, but Olga wasn’t sure
where to begin. Food had always been her way to comfort Eugene. It
was also how she rewarded Zoyi.
Even pleasure has become a challenge now.
“I’m not taking anything away,” the allergologist said gently. “I’m
helping you understand what’s triggering your system. Food can be
medicine or it can be noise your body can’t handle.”
“And the reflux?” Olga asked. “You said it might be connected?”
“Yes. Your chronic sinus issues and postnasal drip might be linked
to gastrointestinal inflammation. A referral to a gastroenterologist
is the next best step.”
The visit to a gastroenterologist was inevitable, especially with the
way his sinuses were reacting. But Eugene wasn’t thrilled. Another
doctor. More tests.
For Zoyi, whose test results had been more uncertain, the allergist
suggested a blood test to pinpoint specific allergens. Olga worried that
Zoyi’s fear of needles might complicate things. Maybe it could wait.
Olga glimpsed her daughter in an unexpected way.
220 · B RE AT HL E S S
Zoyi used to always be alone. All the other kids were holding hands,
and her perfect child wasn’t part of the crowd. Today, though, she
saw a dramatic change. Zoyi was holding hands with two other
students—a boy and a girl. Just like that, she ran to Olga’s car and
exclaimed, “Can we have a playdate now?”
Olga really wanted to say yes. But she had learned the rules of Zoyi’s
school the hard way. You had to arrange all after-school activities
with the other child’s mom well in advance. Kids these days were
busier than adults. Moms had tight, minute-based schedules for
soccer, chess, music, dance, and homework. A playdate couldn’t
just be offered on the spur of the moment.
Olga truly wanted Zoyi to have friends. She longed for her to run
around the playground, to enjoy unstructured time. Through games
and interactions, Zoyi could learn about herself. But it was a different
time now.
She nodded, “Of course, I’ll write an email to their parents. We’ll
schedule a playdate very soon.”
Zoyi pleaded, “Please, please, now. I want it now. We have to film
our TikTok reel!”
Olga was relieved when Zoyi’s friends hurried to their parents or
caregivers, and the situation resolved on its own.
Zoyi climbed into the car, her disappointment evident.
“Bye, Lunch Queen!” a boy shouted from a passing car.
Zoyi lit up for a moment. But as soon as she slid into the seat, her
expression darkened again.
Olga asked gently, “Lunch queen? What is that, Zoyi?”
T h e L a n g u a g e o f F o o d · 221
Zoyi giggled, shaking her head. “It just means everyone wanted to
sit at my table today.”
“Why?” Olga asked with a smile.
“I shared my lunch. Then, I told a funny story.”
“Wow,” Olga exclaimed.
Zoyi grinned. “Yeah. I ruled the table,” she said, her voice full of pride.
“I decided who got to sit with me.” Then she crossed her arms, her
voice tightening just a little. “Papa packed me a secret lunch today,”
she said. “Not your weird one.”
Olga raised an eyebrow. “My weird one?”
“The one that smells,” Zoyi said, rolling her eyes. “And that dark bread.
Everyone keeps asking what it is.”
Olga paused, her hand resting on the steering wheel. “You didn’t
want it today?”
Zoyi shrugged. “I just wanted my lunch to look like everyone else’s.”
Olga felt a nudge inside. “You asked Papa to pack it?”
“No,” Zoyi said, brightening again. “He surprised me! He said I
deserved something fun.” She smiled. “And it came in a real yellow
and red box, not foil or plastic wrap like always.”
Olga glanced at her, lips tightening.
Zoyi nodded. “Yeah. Cool. Fun.”
If food is how we show love, how do you take it away without becoming
the villain?
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Olga smiled, but only on the surface. Predatel.
Inside, the burn of betrayal rose slowly in her chest. A shiny box
and salt—how easily they replaced everything she had been trying
to build.
She remained silent for the rest of the drive. Her mind was already
at work.
Olga prepared soup for Zoyi. She was confident, though, that Zoyi
would not touch it now.
Net. Guilt wouldn’t work. Control would only backfire. She needed
to be smarter.
They weren’t fighting fast food. They were grappling with identity.
Wrestling with memory. Battling loneliness.
Olga scheduled a visit for Eugene with a gastroenterologist.
C r a v i n g s a n d C r o ss r o a d s · 223
CHAPTER SEVENTEEN:
Cravings and Crossroads
Dr. Sokolina
Olga had clearly been preparing for this evening. The moment I
walked in, I could feel it in the air. The careful lighting, the comforting
smells from the kitchen, the way she’d set the table just elegantly
perfect. She had not forgotten anything: placemats, napkins, tall,
thin wine glasses, even artful napkin rings. Olga had invited me to
a homemade dinner to discuss my Galapagos discoveries. Yet, I got
the feeling something else played on her mind.
I slipped off my coat and fur hat. Shapka.
“I’m so happy to see you,” Olga said, wrapping me in a warm hug.
“Your hair looks so straight.”
“I blow-dried it for the occasion,” I said.
“You don’t like it curly?” she asked, curious.
“Curly feels too disorganized,” I replied.
“It looks redder under this light,” Olga observed.
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“I love adding color to the blackness.”
Olga smiled, delighted as the moment came together.
She poured the wine with a kind of ceremonial calm. Yet, I could
see the tension in her shoulders. Her eyes searched mine as she set
the glass down.
“I’d love to hear about your Galapagos discoveries. I used to read about
Darwin. Multiple scientists reached the same conclusions, as if the
ideas were floating in the air, waiting to be found.”
“Where are Eugene and Zoyi?” I asked, scanning the room. The silence
was unusual.
Olga smiled. “Eugene took her ice skating with friends.”
“That’s new,” I remarked. “Will he skate?”
Olga rolled her eyes and shrugged. “I don’t think so,” she said. “He
was very good as a kid. Now, I think he’s embarrassed. The weight.”
“Still,” I said, “this feels meaningful. He’s more active. More involved
with Zoyi.”
Olga took a deep breath and lowered her eyes. “It’s not easy. But I
want to hear about your trip.”
“It was extraordinary,” I said. “To witness natural selection, adaptability,
and genetic variation—not as theories, but alive in front of me.”
I smiled. “Sorry if I sound like I’m lecturing. I just like putting these
thoughts into words. Sometimes, it feels like I’m back there again.
You’re one of the few people curious enough to listen.”
C r a v i n g s a n d C r o ss r o a d s · 225
I continued, “The islands are close together, yet each is its own
world. Different plants. Unique landscapes for each island. The same
species evolve in completely distinct ways, depending on what they
eat and what they need to survive. You can see how life changes
with the environment.”
I paused. “I was thinking about Eugene,” I said. “About how his body
had adapted and compensated. We are not so different from the
animals of the Galápagos. We adapt, too—sometimes at a cost.”
“We are what we eat,” I murmured, almost as if speaking to myself.
Olga smiled. “I had the same thought, too.”
I continued, “I appreciate your home-cooking approach. It may be
repetitive, but you’ve transformed it into something more profound—a
form of daily self-care.”
“Let’s go back to Galapagos,” Olga said.
“Everyone knows about the finches. But seeing them in person? It’s
something else. The ones that eat hard seeds have short, thick beaks.
They crack through the shells with ease. Just a few islands away,
though, the finches that feed from inside flowers have developed long,
delicate beaks, slender as tweezers. Same bird. They probably flew to
the island from the mainland after the islands formed. Completely
different survival tools.”
Olga nodded, her expression distant yet engaged. I could see her
picturing it.
“There are the turtles, too,” I added. “They started out genetically
identical. But some live on lush, flat islands, where food is everywhere.
They developed shorter legs and thinner shells. Others inhabit rugged
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terrain, where they climb and often go without food. They evolved
long legs and larger bodies to store nutrients and reach what they need.”
I noticed Olga lean forward slightly. She took a slow, deep breath.
She was letting it in—the idea that our bodies are listening to our
environments more than we realize.
“But what stayed with me the most were the black iguanas. I met the
marine iguanas on the volcanic islands,” I said. “They’re black, not the
usual brown or green. They live where there’s barely any vegetation,
just lava rock and sea. So the ones who adapted learned to swim.
They dive into the ocean and eat seaweed. On land, marine iguanas
breathe like typical reptiles, taking slow breaths every thirty seconds
to a few minutes, depending on activity and temperature. But the
black iguanas, they can hold their breath for up to forty minutes.”
I said thoughtfully, “They slow their heart rate dramatically while
diving to conserve oxygen, sometimes to just a few beats per minute.
This helps them forage for algae on submerged rocks without
surfacing too often. They became something their ancestors couldn’t
have imagined.”
I took a moment. “It made me think about Eugene. He needs to
inhale so often. His body never quite trusts the air will be enough.
Sometimes, I wonder if it’s his own way of adapting to a modern
rhythm of life that changed faster than our bodies could keep up with.
Perhaps the breathing patterns we see today are just the aftermath
of that shift.
It is possible that sleep apnea is the price we pay for those adaptations.
Just a thought.”
I inhaled deeply, letting the last image of the Galapagos settle, the
black marine iguanas disappearing into volcanic water, the power
C r a v i n g s a n d C r o ss r o a d s · 227
of necessity shaping biology over time. The silence around the table
felt thoughtful. Olga was still turning it over in her mind, I could tell.
“Survival isn’t always about convenience. Sometimes it grows out of
hardship and scarcity. I think the puzzle you are trying to solve is
not just health failure, but a reflection of evolution.”
“I can’t stop thinking about us,” I said, looking straight into Olga’s eyes.
“The human body, how flexible it is. We change in response to our
surroundings. The food we’re given, the stress we live under, even the
cultural habits we’re born into. Just like the animals on those islands,
our survival depends on how we respond. And not just physically, but
emotionally, behaviorally. Sometimes, survival means understanding
what no longer serves us. It means learning to change course.”
I drew a slow breath. “And Zoyi. Notice how quickly her attention
sharpens around the iPad. Her nervous system syncs effortlessly to its
pace. That’s adaptation to a louder, faster world. But our schools and
the rules that govern them haven’t adapted in the same way. That’s
where the collision happens.”
Olga looked down at her hands. “Maybe evolution doesn’t care if
we’re comfortable,” she said. “It only cares that we survive long
enough to pass something on. Even if what we pass on makes the
next generation struggle.”
She looked up at me. “Even if it costs Eugene and Zoyi their sleep.”
Olga smiled, and with an inviting gesture toward the food. “Let me
introduce the meal I made. I got recipes from the book Eat Better,
Sleep Better by Marie St-Onge and Kat Craddock, editor of my favorite
magazine, Savour.”
Olga pointed to the salad and began a restaurant-style description.
“Vibrant green edamame, crunchy shredded carrots, and red cabbage.
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Sesame oil, freshly grated ginger, a touch of rice vinegar, and a whisper
of maple syrup. Scallions, sesame seeds, and cilantro or mint.”
“Krasota. You prepared such an exquisite dinner in my honor!” I said,
touched by her care.
Olga beamed with pride over her culinary creation.
“You know,” Olga said slowly, “when Eugene was in college and just
after, his best memories were wrapped around fast food. He’d talk
about it like it was part of his identity. Chips while watching TV.
Soda when he was tired. He used to say McDonald’s felt like a reward.
After a hard day, that’s where he’d go. It made him feel taken care of.”
I listened carefully, not interrupting. Her voice was even. Yet
underneath it, I sensed something deeper—frustration or mourning
for what had taken root in him before she could ever reach him.
“I’m sure you’re familiar with that style,” she added. “So convenient,
engineered to feel good. It’s like it was made to be irresistible.”
I met her gaze, “Yes. I’ve seen it over and over again. Food becomes
more than fuel. Privichka. It becomes a comfort. A way to soothe. To
reward. It weaves itself into memory, identity, even love.”
Then I paused. This moment mattered.
“Breaking that pattern isn’t just about nutrition. It’s about rewriting
the story of what it means to feel good. To feel safe and calm. That
takes time. And yes, adaptation.”
Olga gave a small smile, her eyes drifting for a moment into memory.
“Exactly. And now . . . it’s not just Eugene anymore. I see it in Zoyi,
too. When we go grocery shopping, she always gravitates toward the
C r a v i n g s a n d C r o ss r o a d s · 229
cereal boxes with the toys or puzzles inside. It’s like the packaging is
more important than the food. The color, the characters, and hidden
prizes. It’s brilliant marketing. They’ve figured out how to sell not
just taste, but excitement.”
I nodded, already knowing where this was going. I’d seen it countless
times. Parents trying to teach healthy patterns while fighting a system
designed to hijack attention and emotion.
Olga continued, her voice tightening with conviction. “It’s so clever,
and it’s not just about flavor. They can pack everything into that box
to make it irresistible.”
I leaned in slightly. “Michael Moss talks about that in his book, Salt
Sugar Fat: How the Food Giants Hooked Us, doesn’t he? How the food
industry manipulates salt, sugar, and fat to create products that light
up the brain like a slot machine.”
Olga nodded. “Exactly. The bliss point. That perfect ratio where you
don’t even want to stop eating.” Smart scientists figured it out. Then
there’s shelf life, texture, smell—all engineered.
This is not food anymore. It’s a machine, designed to keep us reaching
for the same things, over and over.
Olga narrowed her eyes, absorbing the information. Then she shook
her head in frustration.
“And it’s not just them,” she added, her voice tinged with regret. “I’m
noticing it in myself, too. I crave those same foods: fast food, soda,
something crunchy like chips. When I’m tired and overwhelmed,
it’s become a reflex.”
I watched her for a moment. Guilt and fear were etched into
her expression.
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“Breaking that cycle is hard,” I said. “Food isn’t just about nutrition.
It’s intertwined with comfort, memories, and a sense of safety. The
pull is emotional. But once you recognize it and speak it aloud, that’s
where real change begins. Understanding comes first.”
She glanced down at her plate.
“I just don’t want Zoyi to grow up thinking food is only about rewards,
sugar, and bright boxes.” Her fingers tapped anxiously at the edge
of the table. “Even when I try to shop differently, I feel the pull.
It’s everywhere.”
I reached across the table, letting my hand rest briefly beside hers.
“Your thoughtful approach is already a gift to her,” I said. “The fact
that you’re seeing and naming it means she’s going to grow up with
something most kids don’t get—a mother who doesn’t just feed,
but thinks.”
She nodded, her mind clearly still spinning, and leaned in again.
“I’ve been reading Dr. Robert Lustig’s Fat Chance and Metabolical.
He breaks it down so clearly. Fructose isn’t just empty calories but a
metabolic poison. It disrupts insulin and leptin, rewires hormones,
and interferes with the signals that tell us we’re full. I’m starting to
think Eugene’s depression and fatigue are all tied to sugar.”
I felt a lot of respect for Olga and said, “You are a great investigator.
Putting pieces together. You’re right. Fructose affects more than
weight. It disrupts the entire endocrine system, and it is linked to
nonalcoholic fatty liver disease, insulin resistance, even anxiety.
People think it’s harmless because it’s in fruit juice. But in processed
form, fructose becomes one of the most potent disruptors we face,
especially when consumed day after day, year after year. Sugar alters
brain chemistry, hormone function, even liver and heart health.”
C r a v i n g s a n d C r o ss r o a d s · 231
I sighed. “Sweetness is deeply embedded in our food culture. Yes,
it’s addictive. The food industry knows exactly what they’re doing.”
Olga leaned forward, her voice low but edged with urgency. “Eugene’s
been relying on fast food, soda, and chips for comfort. I see it. He’s
not just struggling with reflux or asthma. It’s his energy. His moods.
The food is doing the opposite of what he hopes for.”
I set my wine glass down gently. “You’re right. Sugar creates a
physiological loop—cravings, crashes, and mood swings. Emotionally,
it becomes a coping mechanism, but like any addiction, the longer it
goes unaddressed, the harder it becomes to detach. Especially when
it’s wrapped up in love, nostalgia, or even just daily rewards. That’s
why small, thoughtful changes are so powerful—not just swapping
ingredients, but rewiring the meaning of food itself.”
Olga served her main dish. With pride, she announced, “Let me
introduce you to pan-seared halibut with barley-artichoke risotto.”
The halibut looked perfect. It sat over the thick risotto—creamy,
warm, a little earthy. It was a conversation between the ocean and
the garden.
“It’s not just Eugene anymore,” she said, her face clouded with
sadness. “Zoyi’s picking it up too. We’ve tried using McDonald’s
or pizza as rewards for good grades, treats when she behaves. This
is how everyone here was raised. It’s so hard to undo.”
She paused, saying nothing.
“My mother and I used to argue about soup,” Olga finally admitted.
“Before any games, she insisted I eat it.”
She drew in a slow breath.
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“She made it every week. Vegetables. Roots. Herbs. A real broth. Back
then, I hated it. Everything about it felt like a chore, something to
endure before I could finally rest.”
Her gaze dropped.
“And now, I find myself making the same soup for Zoyi. I hope she’ll
eat it.”
She shook her head, almost embarrassed.
“I used to think I’d be different. A better parent. Yet, when everything
feels unstable, I reach for the only thing I ever knew.”
She didn’t lift her gaze.
“I want her to feel nourished. Even if she doesn’t understand it yet.”
“That’s how it starts,” I said. “Food corporations hook them early.
Bright colors. Shiny boxes. Sugar highs. But you’re seeing it now.
That means you can break it. Protect her before it becomes a
lifelong struggle.”
“So,” she began, her voice edged with emotion, “I had Eugene see a
gastroenterologist. They did the endoscopy. While they found signs
of acid reflux, there wasn’t a clear cause. No ulcer or hernia. Just . . .
inflammation.”
I nodded. I wanted her to keep going. This had been building inside
her for days.
“His asthma still comes and goes,” she continued, her fingers twisting
the corner of her napkin. She stretched her neck, first to the left, then
to the right.
C r a v i n g s a n d C r o ss r o a d s · 233
“Sometimes he breathes fine. Other times, it flares up. You’ve
mentioned before that his teeth are burned from acid. He still has
that constant postnasal drip. He says it feels like something’s stuck
in his throat. But no one can tell me exactly what’s wrong.”
She was trying so hard to hold it together. I recognized that look. It
was familiar in so many women—caregivers, wives, and mothers—
trying to piece together medical confusion with intuition and love.
“The doctor mentioned it might be laryngopharyngeal reflux,” she
continued. “He explained that while gastro-esophageal reflux
disease typically causes heartburn, laryngopharyngeal reflux”—
LPR—“climbs higher, reaching the throat and voice box. Eugene’s
symptoms align more with LPR, especially the sore throat and that
strange pressure in his chest after eating. They offered him proton
pump inhibitors and histamine receptor blockers, but honestly, I’m
unsure. It feels like just another band-aid.”
I took a slow breath before speaking, choosing my words carefully. “LPR
is tricky,” I said. “I read about it. It’s not always obvious. The symptoms
you’re describing—like something stuck in the throat, postnasal drip,
even asthma—can all stem from acid irritation. And if it’s reaching the
upper airways, it makes sense that he’s struggling. Sinus congestion,
chronic inflammation, fatigue . . . they’re all part of the same chain.”
I paused. She absorbed that.
“His mouth tells part of the story, that is true,” I added gently. “The
enamel erosion. Strange defects on one side of several teeth, of
unknown origin. The dryness. We see this in silent reflux cases. The
acid doesn’t have to feel like a burn to do damage.”
Olga nodded, but worry clouded her expression. She wasn’t seeking
answers from me. She needed validation. She wanted to know that
what she sensed and feared wasn’t just in her head.
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“Surely, I’m not overreacting or being irrational, am I?”
I lean forward, offering what I can: my full attention and support.
“Sometimes it’s not one big diagnosis,” I said. “It’s a series of small,
misaligned pieces. When we start to put them together, we begin to
see the pattern. You’re not alone in your constant search. I’m thinking
about Eugene and your family all the time.”
“Thank you. I just don’t trust all that packaged food in the stores. I
think, too many things hidden on the labels. And fast food or readymade
meals . . . they’ll never feel good enough for my family. When I
cook, even if it’s the same dishes again and again, at least I know every
ingredient. It’s my way of giving them something real, made with love.”
Just then, the front door creaked open. Zoyi and Eugene came in,
cheeks pink from the cold. Their coats smelled of winter air and pine,
with a hint of something sweet—hot chocolate?
“Great session,” Eugene said, pulling off his jacket with a vigor I hadn’t
seen in months. His skin held a fresh pink tint. His eyes lit with a
spark that had long been missing. Even his posture seemed straighter.
“But I’m starved.”
I watched him move toward the table, instinctively seeking food. Olga’s
tone shifted, tender yet tight. “Will you eat with us?” she asked Zoyi.
“I’m not hungry,” Zoyi mumbled.
Olga’s eyes narrowed slightly. She caught a fine dusting of
marshmallow powder on her daughter’s lips. She didn’t say anything.
She turned to Eugene, gesturing toward the plate she’d carefully
prepared. “I made this just for you. Gluten-free, dairy-free. Exactly
like we talked about.”
C r a v i n g s a n d C r o ss r o a d s · 235
Eugene sank into the chair, offering a weary smile.
“I know. It looks great,” he replied, lacking enthusiasm. “Thanks.”
Olga’s gaze was fixed on him.
He chewed slowly, cutting everything into small pieces. It was more
like someone picking at hospital food than enjoying a carefully
prepared meal.
I sensed her irritation. She had tried—adjusting recipes, reading labels,
rethinking every ingredient. Still, his eyes searched for something
this meal could not give him.
I was caught in the middle of an everyday battle.
She had been trying to nourish him. But for Eugene, food was never
just nutrition.
It was rebellion and memory. Something deeper. Harder to reach
with kale or gluten-free bread.
And as I watched her watching him, I knew. This was the struggle
between willpower and meaning.
I observed them across the table. The tension between them was subtle,
present in every gesture. Olga had prepared a beautiful, carefully
thought-out meal. Eugene, though clearly appreciative, seemed like
a man caught between old comforts and unfamiliar rules.
Olga stopped biting her lips and said, “I’ve been following the diet
based on allergologist recommendations and all those books.” She
rearranged her fork and knife around her plate, parallel to each other.
“But Eugene? He’s still grabbing soda, snacking on cookies, eating fast
food when I’m not looking. I see it.”
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She exhaled loudly. “I hear you choking at night. I lie there, listening.
I’m scared you’ll stop breathing again.”
I was embarrassed. Witnessing the internal tension was the last thing
I wanted.
Eugene didn’t argue. He shifted in his chair, eyes fixed on the plate.
His face turned red. Small drops of sweat appeared on his forehead.
“I’m so tired of everything being a problem.” Eugene flinched.
He paused. “It’s just . . . at night, I really crave something crunchy and
sweet. That’s when it’s the worst.” Another pause. “That’s when I miss
it the most. It makes me feel relaxed.” He exhaled slowly. “I want to do
better. I really do. I know the weight’s part of it. I just . . . I don’t know
if I can fix everything fast enough.”
I stayed silent. Inside, I really wanted to help.
Olga’s voice cracked, just slightly.
“We’ve done so much. The oral appliance, nasal sprays, even the
breathing exercises. Yet, you’re still waking up many times at night,
drained. I know the extra weight is pressing on your airway. We have
to try something else.”
I paused briefly, then spoke.
“You’re both doing so much already,” I said. “And none of this is easy.”
I looked at Eugene. “The cravings, the exhaustion, the feeling that
you’re always fighting yourself—it’s not a lack of discipline. It’s your
body talking to you. Weight does matter when it comes to breathing
at night. Even with appliances and sprays, there can still be pressure
that makes it harder for air to move the way it should.”
C r a v i n g s a n d C r o ss r o a d s · 237
Eugene looked up, his eyes filled with expectation.
“You know, weight doesn’t always show up where we think.
Sometimes it changes things from the inside first, even in the
tongue, and that can affect breathing before anything else does.
Your body has learned to live in emergency mode. That’s what
metabolic imbalance looks like from the inside.”
He nodded, rubbing his jaw. “It’s like a loop I can’t break.”
Olga pushed her chair back, the legs scraping sharply against
the floor. She opened the fridge and retrieved the dessert. “Easy
stonefruit sorbet.”
It was winter, yet she magically teleported me into summer. Peaches,
silky and light, melted quickly on the tongue. It was like eating
sunlight in spoonfuls.
“There’s something you could consider,” I suggested gently. “It’s called
Glucagon-like Peptide, GLP-1.”
I observed Eugene’s face for a moment, then continued.
“It’s something your body already makes after you eat. It tells your
brain, ‘You’re full,’ and slows things down so you don’t feel like you’re
constantly chasing food.” I paused. “The medication just strengthens
that signal. You feel full fast and do not feel hunger. Interestingly,” I
added, “people on these medications often breathe better at night too.
Fewer interruptions. Not just weight loss, but better sleep.”
Olga leaned in.
I continued, “But it’s a tool, not a miracle. It works best when paired
with real lifestyle changes. Food. Movement.”
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Olga raised a brow, her voice protective. “Another medication?
We’re already juggling so much. Plus, I heard it’s not even covered
by insurance. I don’t want to just hide the symptoms.”
“I hear you,” I said. “And I agree. Medication alone isn’t the answer.
But used thoughtfully, it can help Eugene’s body become more
responsive again. It opens a window for real change, especially when
combined with movement to protect muscle.”
Eugene looked away. “I used to play tennis. Now, I don’t even
recognize what drains me.”
“That’s common,” I said. “When muscle goes, energy follows. Even
small movements matter. Gentle strength work, walking—anything
to keep the metabolism functional.”
I saw Olga watching him carefully. Her jaw had tightened, a familiar
sign. “I watched a video today,” she said. “I think I should start
myofunctional therapy for Zoyi. But the more I think about it,
the more I believe it could help all of us.” She met Eugene’s eyes.
“It’s like physical therapy, but for breathing and the tongue,” she
explained. “It teaches where the tongue should rest, how the lips
stay closed at night, how the muscles work together. Not a quick
fix, but a retraining.”
Eugene gave a half-smile, a blend of affection and resistance. “You’re
always looking for the unicorn, Olga. That magical thing that’ll fix
it all.”
She didn’t move. “Maybe. But sometimes the long road is the way.
I’m not trying to control everything. I want to help you breathe . . .
and live.”
No one spoke.
C r a v i n g s a n d C r o ss r o a d s · 239
From Zoyi’s room drifted the familiar sounds of her iPad playing
a video.
Eugene pushed his chair back abruptly and stood. “I’m going to play
with Zoyi,” he said, already moving away.
Olga stayed where she was. Her eyes were fixed on the table. Her face
was tense, brows drawn so tightly together I could almost see the
number eleven between them.
I stood as well. “Thank you for a beautiful, delicious dinner,” I said.
“You’re doing everything you can.”
I hugged her. I needed to leave.
The house was elegant and cozy, full of light. Yet, something felt dark
and fragile.
I’ve learned that real change doesn’t start with recommendations. It
starts when a person decides they’re ready.
Would they try the medication? Would they commit to the therapy? Or
would fear and fatigue keep them circling the same well-worn path?

T h e Hi d d e n F l a m e · 241
CHAPTER EIGHTEEN:
The Hidden Flame
Eugene
It came back and startled him so vividly like a scene spliced into the
reel of his mind without warning. He hadn’t thought of that moment
in years. Or decades. The Petersburg school courtyard was dim, grey,
with that milky Northern twilight that never fully turned to dark in
the summer. The smoke of the neighboring factory was in the air. They
were playing Romashke with their classmates in seventh grade, that
silly teenage game. Spin the bottle, make a wish, or kiss.
He remembered her eyes before anything else—the frozen panic
within them. Olga had pulled him aside just before the game began.
“If it points to me,” she whispered, her voice barely audible, “just . . .
don’t kiss me in front of them.”
Of course, he nodded. He would’ve agreed to anything she said. She
could’ve told him to jump off the fifth-floor ledge, and he might have
considered it. If she had promised to watch.
Later, as he walked her home, they stood side by side in the elevator.
The steel walls vibrated constantly, transferring their rhythm to
the iron gate doors. An ammonia-like smell rose from the floor,
242 · B RE AT HL E S S
unmistakably human. When the doors closed, he kissed her quickly.
A peck on the cheek. Nothing more. But it made her eyes widen, her
face turning crimson. The moment the doors opened, she ran. She
didn’t speak to him for days.
For him, though, it was a victory. That night, a wave of tenderness
washed over him. His underwear and sheets were left wet with a
warm, steady love that made his chest hurt.
He recalled another memory. It was fuzzier, half-dreamed.
His last evening before leaving Russia. Everyone spoke as if it were
the end of time.
“You’ll forget me in America,” Olga said with a deep sigh. “I don’t
think we’ll ever see each other again.”
As if America could erase everything that came before.
He remembered the dark hallway of Olga’s apartment. The slightly
torn pink wallpaper, adorned with golden flower bouquets, caught his
eye. In the next room, the indistinct dialogue of her parents watching
TV drifted through the air.
They kissed. She allowed it, or perhaps she simply didn’t stop him.
He touched her then, the way boys do when they don’t yet know
what they’re doing but feel every motion as sacred. Her skin was
warm under his fingers, more alive. The surprise of wetness. The soft
resistance of her hair. The immediate response to his gentlest move.
He didn’t even know what to make of it at the time. But that moment
became a hidden flame he carried through college. His own strange,
private Viagra. Stronger than any fantasy.
And now?
T h e Hi d d e n F l a m e · 243
Now he couldn’t rely on even that.
His body betrayed him.
Or perhaps it was his mind.
He could still want; that wasn’t the problem. Sometimes, even the
scent of Olga’s shampoo or the curve of her collarbone could ignite
a warmth deep in his belly. But then she would sigh, or glance at his
stomach, or make a passing comment, and the entire surge would
collapse like a house of cards.
He hated that. Hated how fragile he’d become. It was as if his desire
had turned into a trembling animal, spooked too easily. Just a look,
a word, and it vanished. No return.
It wasn’t just her.
He tried to find the right moment. When Zoyi was finally asleep.
When Olga wasn’t overwhelmed. When he wasn’t half-dead from
work. It was like chasing a rare eclipse.
The moment never came, and then the absence grew like mold. The
longer they didn’t do it, the more alien it became. You stop doing it.
Then, you stop wanting to do it.
Or was it just that way for men?
It became a cycle he couldn’t find a way to break.
However now, after the heart scare, the near-death experience, he
promised himself change. He wanted to wake up transformed—
confident, brimming with desires, ready to turn wishes into reality.
He noticed Olga. She was giving it her all.
244 · B RE AT HL E S S
Her subtle touches. Her soft pajamas, or the absence of them. Her
efforts to make eye contact again, to laugh like before.
And he wanted to respond. Desperately so.
But the fear was there too, like a splinter lodged too deeply to
pull out. He worried his body might betray him again, leading to
disappointment. That he would become unwanted. Unworthy.
What scared him most wasn’t failure. It was the thought that maybe
he was no longer the boy in the elevator. That version of himself—
brave, tender, full of possibility—was lost forever.
Still . . . the doctor called it a second chance.
Maybe it wasn’t too late to find him again.
He awoke with a start.
The kind of hardness he hadn’t felt in . . . he didn’t even know how
long. This wasn’t the hazy, half-there swelling he’d learned to ignore.
It was real, undeniable fullness.
He lay still, afraid to move, fearing it might dissolve like a mirage.
A small part of him wondered if it had been a dream. Something
warm, soft, vaguely tinted with old summers. A memory with no
clear edges.
He glanced at Olga sleeping beside him. Her breath came slow and
deep, and one of her arms was tucked under the pillow. For a fleeting
second, the idea passed through him that he could reach out, slide
closer, try.
He didn’t. Memories of what had happened before held him back.
T h e Hi d d e n F l a m e · 245
That slow, shattering humiliation of almost. Moments when he felt
the desire, took a step toward her, began to kiss her. He even sensed
her responding. Then, like a switch, it vanished mid-motion. Worse
was the look on Olga’s face afterward—not pity, but confusion.
Disappointment wrapped in concern.
He turned onto his back, staring at the ceiling. The erection had
already begun to fade, taking with it the illusion that maybe things
were going back to normal. The feeling of strength, of aliveness,
slipped from him like water between fingers.
He needed help. That much was clear.
Even more strange, he realized he didn’t want to wait for Olga to notice.
He didn’t want her to research the options, book the appointment,
send him links, and roll her eyes when he didn’t respond.
He didn’t want this to be yet another one of her wild ideas. He
was tired of being dragged into them, laced with mild sarcasm
and resentment.
This felt different.
He longed to feel like himself again—a man with desire, not just a
father or a provider. Rising from bed, he made coffee. Then, he sat
at the table with his laptop and sent an email to his new primary
care provider.
When the receptionist called back and asked why he needed the
appointment, he hesitated for just a second. Then he said, “I think I
need to talk to the doctor about . . . men’s health.”
For the first time in a long time, Eugene felt he had taken a step
toward truly living.
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* * *
A clinical scent, disinfectant and paper, sharp and dry, hung in the
air. Eugene sat on the edge of the table. He had filled out the form,
ticked the box that said “erectile concerns,” and now he was waiting,
shirt slightly damp under the arms, fingers digging into the vinyl.
When Dr. DeFeo entered, a neat white lab coat framed the dark scrubs
beneath. He greeted him with a warm smile. After glancing at the
computer forms, he looked directly at him.
“So,” he said gently, “you’ve been experiencing some difficulty
with erections?”
Eugene nodded, his jaw tight. “Yeah. I thought it was stress. But . . .
recently . . . You heard about my heart adventure.”
“Your wife performed CPR after your cardiac arrest,” he said. “She
brought you back . . . a pure miracle of love. It’s already a legend in
medical circles. Of course, I know.”
He leaned closer. “You’re not the only one dealing with this, Eugene.
One in three men your age experiences some form of erectile
dysfunction. Sometimes it’s physical—vascular issues, hormones,
medications. Other times, it’s psychological. Relationship
strain, stress, performance anxiety. Usually, it’s a mix.” Eugene
nodded again.
Dr. DeFeo continued, “Let’s talk about strategy. First, we’ll take a
two-step approach.”
Eugene noticed simple wooden-bead bracelets stacked on the
physician’s wrist. They were small tokens of grounding in the chaos
of clinical life.
T h e Hi d d e n F l a m e · 247
“But long-term, I want to run bloodwork to understand the hormone
signals in your body. It all begins in the pituitary gland, the control
center in your brain. This gland releases signals that instruct your
testes to produce testosterone. If that signal is weak, or if the raw
materials—what we call precursors—are running low, testosterone
drops. And when testosterone is low, energy, mood, muscle, and
sexual function all suffer.”
Eugene’s mouth was dry. Anxiety had stolen every drop of saliva.
The doctor continued: “Testosterone doesn’t just appear out of
nowhere; it follows a chain of signals. First, the brain releases a
chemical called gonadotropin-releasing hormone. That travels to
the pituitary gland. Think of it like your body’s control tower. It
then sends out two messengers: luteinizing hormone and folliclestimulating
hormone.”
All those medical terms made Eugene feel nauseous.
“Luteinizing hormone is the one that knocks on the door of your
testes and says, ‘Make testosterone.’ Meanwhile, follicle-stimulating
hormone takes a different role. It focuses more on sperm production.
Yet, it also helps keep the whole system balanced.”
If any part of that chain of signals is disrupted, the brain, the
pituitary gland, or the testes, testosterone levels can drop. That’s
why bloodwork is so important. We want to check not just your
testosterone but also those signaling hormones, so we can see where
the issue begins.”
Eugene gritted his teeth.
“Sleep apnea, for example, can really throw off testosterone levels,”
Dr. DeFeo added.
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“The second thing we can check is testosterone levels. Low
testosterone can impact sexual desire, energy, mood, even sleep.
It doesn’t always cause Erectile Dysfunction or ED, but it can
contribute. If your levels are low, we might consider testosterone
replacement therapy. That’s a longer conversation—we’d look at
bloodwork first and talk about risks like prostate growth, red blood
cell count, and long-term heart health.”
Eugene swallowed hard. “Would that . . . make me feel like
myself again?”
“It might,” he said. “Low testosterone, or what we call androgen
deficiency, is common in men over forty. It’s not just about sexual
function. Hormones influence mood, energy, concentration, sleep,
and even how your body holds onto muscle and fat. Have you noticed
any other changes lately? Fatigue? Irritability?”
He chuckled softly. “I thought that was just . . . fatherhood and stress.
And getting older.”
The doctor smiled. “It could be all of that. But it might also be
hormonal. We won’t know until we test. I’d like to run a total
testosterone panel, along with Sex Hormone Binding Globulin and
free testosterone levels. Ideally, we do that first thing in the morning,
when levels peak. If your numbers come back low or borderline, we’ll
repeat the test to confirm.”
Eugene let his eyes close for a moment.
“And if it’s low?” he asked.
“Then we discuss treatment options. Testosterone replacement therapy—
TRT—can come in many forms: daily gels, weekly injections, or even
longer-acting pellets implanted under the skin every few months.”
T h e Hi d d e n F l a m e · 249
He paused, then added, “But I want to be very clear. TRT is a serious
medical therapy. It’s not about turning you into a muscle-bound
teenager again but hopefully about restoring balance. And it has
both benefits and risks.”
Eugene leaned forward, listening with an intensity he usually reserved
for business meetings.
“The benefits,” DeFeo continued, “can be profound—improved libido,
more stable mood, increased muscle mass, better stamina. But the
risks are real too. Testosterone can raise your red blood cell count,
which increases the risk of blood clots. Due to your Atrial fibrillation,
it could be dangerous. Testosterone can worsen sleep apnea. And
there’s ongoing debate about its effects on heart health, especially in
men with underlying cardiovascular conditions like yours.”
Eugene gulped.
“And the prostate?” He had scoured countless articles online.
“Good question. TRT doesn’t cause prostate cancer, but it can
accelerate growth if cancer is already present. That’s why we screen
your prostate-specific antigen—PSA—levels before and during
therapy. If you experience any urinary symptoms—like waking at
night or a slow stream—we’d evaluate that as well.”
Eugene sighed. Helplessness rose in his chest.
“What if I start and then feel weird?” he asked. “I read I might have
mood swings, or . . . aggression?”
The doctor shook his head. “That’s usually more myth than reality.
When dosed appropriately and monitored closely, TRT shouldn’t
cause mood instability. But everyone reacts differently.”
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“It can worsen sleep apnea,” the doctor added.
Eugene crossed his arms over his chest. His voice was clipped,
defensive. “I use my sleep apnea treatment every night,” he shot
back. The idea that he wasn’t already doing enough was something
he wanted to push away.
He looked down at his hands. He just wanted to feel again. To be
strong—not in the gym poster way, but in the present-in-his-ownbody
way.
“This is . . . a lot,” Eugene finally admitted.
“It is,” Dr. DeFeo agreed. “But it’s part of the bigger picture. We start
low and slow. We follow up closely. You won’t be alone in this. We
will be looking at your full health. Heart, hormones, mind. And
relationships. Not just chasing erections.”
“For now, a medication like Viagra can help right away.” The doctor’s
careful eyes seemed to pierce straight into Eugene’s heart.
“Sildenafil, commonly known as Viagra, works by increasing blood
flow to the penis. Take it thirty to sixty minutes before sexual activity.
Remember, Viagra doesn’t create desire. Don’t expect an erection just
from taking the medication. But with the right mental and physical
stimulation, it can help you maintain one.”
At least that part made sense.
“Side effects can include headaches, flushing, and a stuffy nose. If you
have chest pain or take nitrates, it’s not recommended. However, I
don’t see anything in your chart that would rule it out.” He made a
note on the computer. “Are you currently taking any medications for
chest pain? Nitrates, like nitroglycerin? Just to confirm.”
T h e Hi d d e n F l a m e · 251
“No. They gave me beta blockers to slow my heart rate, and I’m on an
anticoagulant. No chest pain since.”
“That’s good,” he remarked.
Eugene leaned in, curiosity etched on his face. “Is Viagra even safe
for someone like me?”
Dr. DeFeo didn’t answer right away. He leaned back, pondering.
“Let me be very clear,” he said.
“Viagra—sildenafil—can be used safely in men with heart conditions,
including those with pacemakers, if certain conditions are met. You
are not on nitrates, and your arrhythmia is currently managed.
That’s essential. The danger with sildenafil is primarily in people
using nitrates or those who are very unstable. Recent heart attacks,
uncontrolled angina, or untreated arrhythmias pose significant risks.”
He paused, allowing him a moment to process.
“In your case,” he continued, “you’ve had your event, been evaluated,
and your pacemaker is functioning. That’s not an automatic
disqualification. But precautions are necessary. We’ll check your
resting blood pressure today. Viagra can lower it a bit. I want to see
your most recent echo and stress test results. If those are reassuring,
I can safely prescribe a low starting dose.”
Eugene looked down at his hands. “What if . . . something happens
during sex? I don’t want to scare my wife. Or myself.”
“That’s a valid concern,” Dr. DeFeo said, his voice gentle. “But the
truth is, sex itself isn’t much more demanding than climbing two
flights of stairs. If you can do that without chest pain or shortness of
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breath, you can usually have sex safely. And the pacemaker is there
to protect you. Think of it as your backup rhythm section.”
Eugene let out a nervous laugh.
“Plus,” he added, “Viagra doesn’t work instantly or involuntarily. You
take it, and then stimulation has to follow. This way, you can always
monitor how you feel. If you ever experience chest pain, dizziness, or
a racing heart, you stop immediately. You don’t push through. But
most men don’t experience that.”
Eugene exhaled slowly. The knot in his chest began to loosen.
“So . . . you’d be at ease prescribing it?”
“Yes,” the doctor said. “We’ll start with a low dose—twenty-five
milligrams. We’ll see how you respond. I’ll give you clear instructions:
take it on an empty stomach, avoid alcohol, and not more than once
a day. I’ll also want a follow-up in two weeks. Fair?”
“Fair,” Eugene replied.
Then Eugene hesitated. “It’s strange,” he said. “I didn’t think I’d feel
this much about a pill.”
Dr. DeFeo smiled. “It’s not strange. This isn’t about performance.
You’re trying to take your life back. Intimacy, confidence, your sense
of self. That’s never just physical.”
Eugene nodded, tilting his chin in acknowledgment.
He took a deep breath and exhaled slowly. “Let’s do the bloodwork.”
The doctor nodded, tapping his screen thoughtfully. “Good. We’ll
start there. And Eugene . . .”
T h e Hi d d e n F l a m e · 253
Dr. DeFeo leaned back slightly, and looked Eugene in the eyes, before
changing the topic. “There’s one more thing I want to mention,” he
said. “Not a prescription or a blood test, something I recommend
more often than people come with intimacy issues.”
Eugene raised an eyebrow. “What is it?”
“Couples therapy.”
He blinked. “You think we need . . . marriage counseling?”
Dr. DeFeo gave a gentle smile and raised a hand slightly. “I didn’t say
marriage counseling. I said couples therapy. This isn’t just for people
on the brink of divorce, despite what TV shows make us believe. It’s
often for couples who want to understand each other better, reconnect,
and create an atmosphere where intimacy can grow again.”
Eugene looked unconvinced. “I don’t know. Olga and I, we’re not the
talking-about-feelings type. We’re busy. And therapy’s . . . slow. Isn’t it?”
“I understand the hesitation,” he said. “But let me explain what
it actually is. This way, you’re not left imagining couches and
blame games.”
Eugene gave a half-smile. “That’s exactly what I was imagining.”
Dr. DeFeo offered a gentle smile, then continued.
“Couples therapy is led by a trained professional, someone neutral,
who helps you both explore your communication, habits, and
assumptions. Over time, we all build patterns in our relationships.
Sometimes these patterns are invisible and defensive. One partner
feels rejected. The other feels pressured. No one’s wrong, but the
emotional space becomes unsafe.”
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Eugene looked away for a moment.
The doctor continued, “In the case of sexual challenges, like what
you’re experiencing, therapy can help remove the pressure from
performance. It shifts the focus to connection. You both learn how
to talk about sex without shame or fear. You practice curiosity instead
of criticism. You relearn how to be close, not just physically, but
emotionally. Emotionally safe.”
The doctor paused, studying Eugene’s face.
“I’ve seen men who’ve had no physical problem, but they shut down
from just one moment of judgment or miscommunication. Others
had real medical issues, but tension in the relationship turned the
situation into a prison, not the diagnosis.”
Eugene ran a hand across the back of his neck. “So . . . we’re going to
spend an hour a week analyzing everything I do wrong?”
“No,” Dr. DeFeo replied. “The aim is for both of you to rediscover how
to become allies once more.”
The word caught him by surprise, warm and unexpected. Allies. Not
opponents or strangers passing in the house hallway, but partners
in something.
Eugene took a breath. “What do people even say in those sessions?”
“It depends,” he said. “You talk about what’s hard to say at home. Fears.
Expectations. What intimacy used to feel like. What you miss and
wish the other knew. The therapist helps translate things. So they
don’t land like criticism.”
The doctor added, “Sometimes, you discover it’s not about sex at all.
It’s more about trust, or timing, or grief stored deep inside.”
T h e Hi d d e n F l a m e · 255
Eugene thought, Could sex therapy really do that? I just want that
foggy light in her eyes again, like when she first came to America and
desire was effortless. I long to feel in control of my body and to give
Olga what she needs.
“I can give you a few names,” he offered. “You can go once and see
how it feels. No commitment. But if you want to rebuild this part of
your relationship, I really believe this helps more than anything else.
Meds included.”
Eugene took a deep breath, still processing it. Perhaps the most
surprising revelation was uncovering a part of himself long buried
beneath sarcasm, logistics, and fear.
As Eugene stepped outside the building, the cool wind hit his face
like a wake-up call. The Viagra prescription was folded neatly in his
pocket. He clutched the lab order for testosterone testing in his hand.
But his mind wasn’t on either of them.
It rested on Olga.
How would she respond if he told her? Would she be relieved, or
would she blame herself? Or worse. Would she look at him with that
brief, involuntary flinch she had during those last failed attempts, as
if something tender had been bruised?
He was unsure, yet eager to discover the truth.
He drove home in silence, ignoring the news waiting on his Bluetooth.
The sky was a dull slate gray. The air smelled like wet pavement. A
snowstorm was coming. Passing Dunkin Donuts, he felt a strong
urge to stop.
The smell of fried sugar and coffee hit him, almost pulling the wheel
from his hands. For a moment, he pictured Zoyi’s face lit up with joy
256 · B RE AT HL E S S
over a box of powdered munchkins. They would watch snowflakes whirl
and vanish against the ground. It would feel normal. Sweet, even happy.
However, the thought twisted quickly into guilt. Giving in would feel
like betrayal, undoing every one of Olga’s rules and sacrifices. She’d
see the pink square box, catch the smell, and her disappointment
would fall on him heavier than any snowstorm.
He tightened his grip on the wheel. No. It felt like cheating.
* * *
At home, Olga sat at the kitchen table, flipping through something on
her iPad. She was researching again, from the look of it.
Eugene tossed his keys into the bowl by the door.
Olga looked up. Without any greeting, she said, “I want to take Zoyi
to see an orthodontist. Maybe you will want to see one as well.”
Eugene blinked. “What?”
“I’ve been reading,” she said quickly, her words like stones skipping
across water. Her mouth breathing, the restless sleep, the tantrums . . .
It’s not ADHD. It might be connected to her jaw, her tongue, even her
airway. There’s this orthodontist, Dr. Mew, who—”
“Wait, wait,” he interrupted. “We’re not diving into some strange
new therapy from Instagram videos. If she needs help, we’ll see the
pediatrician. A real doctor.”
“I’m telling you,” she said, her voice sharpening, “there’s something in
her face. Something . . . not growing right. It’s the same look I see in
old pictures of you.”
He froze.
T h e Hi d d e n F l a m e · 257
A chill moved through him. “What’s that supposed to mean?”
She’s blaming me now for Zoyi, too, he thought. As if her problems are
stamped in my genes, as if every mistake in this house comes back to
me. My fault she grinds her teeth, my fault she wakes up screaming?
His jaw locked, heat rising in his chest. It had become unbearable. I
can’t listen to this anymore. I won’t carry the weight of every crack in
this family on my shoulders.
He opened his mouth. Silence. Nothing came out.
Then she said, in a voice barely above a whisper, “What if this didn’t
start with you, Eugene? What if it began before you even realized
there was a problem?”
The words floated in the air, heavy and strange.
He remembered something. An old, yellowing photograph of his
father in Russia. Asleep in an armchair after work, the TV flickering
with Soviet news. Mouth open, head tilted back. It had always been
a joke in the family. But now . . .
Something in his gut tightened. It was as if the floor tilted, just enough
to make him grab the counter.
Before he could speak, Olga turned the iPad toward him.
On the screen, a grainy 3D scan of a child’s skull appeared, annotated
in red. Arrows highlighted the narrow dental arches, a high vaulted
palate, and reduced airway space.
“This,” she said, “is what I want to understand. I think we’re missing
something big.”

T h e A r r o ws P o i n t B o t h W a y s · 259
CHAPTER NINETEEN:
The Arrows Point
Both Ways
Dr. Sokolina
As I sat in my car next to my office, waiting for Zoyi and Olga to
arrive, my thoughts kept circling back to Eugene. The answer wasn’t
in Eugene alone.
The chill of February clung to the windshield, with frost creeping
around the edges like delicate lace. I cherished this East Coast
phenomenon, where melting snow and sudden freezes transformed
tree branches into magical glass sculptures that shimmered like
diamonds. A thin sun hovered over the parking lot, pale and weak,
casting long shadows over the bare trees. Valentine’s Day cards
had begun to appear in shop windows, hearts cut from red foil
glowing against the gray skies. An enticing chocolate aroma hung
invisibly in the air.
Olga slid into the seat beside me, and Zoyi climbed into the
back. A rush of sharp, minty air accompanied them. We sat there,
discussing Zoyi’s upcoming orthodontic consultation with Dr.
Michelle Weddle.
260 · B RE AT HL E S S
“Buckle up for our adventure together,” I said, glancing back at Zoyi.
Zoyi smiled up at me. “Can I show you my loose tooth?” She
leaned in, examining me closely. “Your eyes are yellow, with a black
flower inside.”
Her smile was open and bright, full of innocence. Yet, I saw a deeper
story. She was eight. Her upper jaw still held a full row of baby teeth—
small, pearly, and tightly packed together. There were no natural gaps
between them, no space for the adult teeth waiting to erupt.
“I would be happy to meet your loose tooth,” I said. “I always thought
my eyes were brown. But I have to admit, you’re a great spy, Zoyi. You
notice everything.”
Zoyi’s smile, while undeniably adorable, was just a touch off-center.
On either side of her mouth, dark corridors appeared between
her teeth and cheeks, hinting at a narrow upper jaw. The crossbite
revealed itself subtly as her back lower teeth edged outward, clashing
where they should have nestled inside.
“I don’t see her permanent tooth,” Olga said, her voice edged
with concern.
Zoyi’s smile was shaped by function and environment, not just
genetics. Her mouth did its best with limited space.
Her smile held beauty, yet there was urgency too.
“Those hearts are everywhere,” Olga said. “Like the whole world is
celebrating Eugene’s heart story.” She reached into her bag and pulled
out a crumpled Valentine’s card that Zoyi had made. A pink heart,
awkwardly folded, with jagged scissors edges. Inside, a scribbled
drawing of the three of them—Zoyi, Eugene, and Olga—holding
T h e A r r o ws P o i n t B o t h W a y s · 261
hands. She had drawn stars above their heads and what looked like
a dog with wings below them.
“You look like a giant in that picture,” I said, turning to Olga, expecting
to share a laugh. Instead, I noticed the heavy shadows beneath her
eyes. Puffy, blue-tinged bags told me Olga’s story.
“I see the subtle suggestion of a dog in this picture,” I guessed.
Zoyi’s head popped up immediately. “I need a dog!” she screamed, her
voice bouncing around the car with unfiltered excitement. Her curly
blond hair cascaded over her shoulders, visible in my front mirror.
“What about a giant without any energy?“ Olga sighed. “I got the
hint too, but I am dead tired. I can’t even remember the last time
I truly slept.” She paused, her voice weary. “I’m doing all sorts of
thinking, scrolling, researching at night, but I just can’t force myself
to sleep.”
I glanced again at the Valentine’s card, taking in the bright pink heart.
“We didn’t have Valentine’s Day where I grew up,” I remarked.
Olga looked at me. “True.”
“Love followed different rules,” I said. “February 23 was Defender of
the Motherland Day. Every boy was a zashchitnik rodiny.”
Zoyi frowned, puzzled. “What does that mean?”
“Protector,” I said, “even the small ones.”
“And in March,” I continued, “we celebrated International Women’s
Day. It focused on working women. Strength. Not so much romance.”
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Olga offered a faint smile. “That doesn’t sound very romantic.”
“Somehow,” I said. “It was.”
She shot me a curious glance.
“In February, girls chose who they wanted to give a gift to,” I said.
“Then March came, and they waited. Would the boys give one back?”
Zoyi leaned forward between the seats. Her curiosity was palpable.
“Do you have to wait two weeks to know who likes you?”
“Yes,” I said, smiling. “The choice was easy. Waiting was the hard part.”
Olga gave a slow nod.
“I remember the cold knot of anxiety in my chest,” I added. “I
wondered if anyone liked me enough to choose me back.”
“And?” Olga inquired.
“And somehow,” I said, “there was something sweet about it. Just
different. It was a game of balance. Showing yourself as hard to get,
while being friendly enough to invite attention. A tightrope of pride
and desire. This is how I think about it now.”
Zoyi let out a giggle.
“I know that here in America you have to give gifts and cards to every
person in a class to show love and to feel included,” I added. Then, I
looked back at Zoyi’s drawing. Three figures holding hands.
“I know this may sound strange,” I said, pausing for a moment, “but
I’ve been thinking about Ethiopia.”
Olga turned toward me. “Ethiopia?”
T h e A r r o ws P o i n t B o t h W a y s · 263
“I don’t even know why,” I hurriedly said. “It’s like my phone keeps
sending me reels. Villages. Children. Faces I can’t stop looking at.”
I paused, searching for words. “Have you seen them?” I asked. “The
kids in those remote areas. Broad jaws. Straight teeth. No braces.”
She shook her head. I continued.
“In Ethiopia, people still chew food grown in their own fields. They
look . . . rested. Like they sleep through the night with their mouths
closed.” I exhaled. “Or maybe it’s just the rhythm of their lives. They
don’t seem breathless.”
I didn’t expect it. Ethiopia. There was a touch of something
almost supernatural. “Wow,” I said with a short laugh.
“Sovpadenie. Serendipity.”
Olga looked at me. I said, “I’ve been planning to go there,
to continue my research.”
Her eyes grew wide.
“It’s one of the few places left where you can still observe something
close to prehistoric life,” I said. “Before modern civilization
rearranged everything.”
I paused, carefully choosing my words.
“Parents still chew food for their children,” I added. “They pass their
microbiomes directly. It’s not ideal. Just . . . different.”
Olga nodded slowly. “I sterilized everything when Zoyi was born,”
she said. “Every surface. Every object she ever touched. I bought
a portable sterilizer. Even my parents-in-law had to wear special
T-shirts before touching her for the first year of her life.”
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* * *
We arrived at Dr. Weddle’s office. It looked like a playground, with
small colorful chairs, a big picture of a hot air balloon, and a fun tree.
A few children played with the games scattered about in the waiting
room. Olga and Zoyi had already gone through the initial evaluation.
Pictures and X-rays had been taken. Today was the conversation
about treatment options. I noticed tension in Zoyi.
I am always amazed by how smart kids are. Adults often
underestimate children’s ability to grasp a situation. Zoyi had
witnessed Eugene’s challenges with treatment. Now, she was
imagining a similar journey for herself. How could she not
be nervous?
I leaned toward Zoyi, smiling as gently as I could. Her brows knit
with uncertainty as she looked up at me. She was trying to be brave.
“You know,” I said, “when I was just five years old, I began wearing
something in my mouth to make me beautiful.”
Her eyes widened.
“In those days, back where I grew up—in the Soviet Union—we
didn’t have fun, colorful appliances or soft materials. The doctors
used this strange white stuff called plaster to take impressions of
my teeth. You know, like the plaster you use in school art class to
make sculptures.”
Olga joined in, “Remember when Papa ordered that imprint of
your hand and his together for my New Year’s gift? The one where
you mix powder and liquid, put your hand into it, and once you
take it out, the material hardens? We framed it and hung it on
the wall.”
T h e A r r o ws P o i n t B o t h W a y s · 265
I smiled and continued, “Exactly. Now imagine that, but inside your
mouth. A big metal spoon filled with what felt like chalky pudding.
Cold and a little weird. Then it started to warm up . . . and harden!”
Zoyi’s eyes grew round.
“I remember sitting there, thinking, What if they can’t get it out?
What if I’m stuck forever and turn into a statue?” I laughed. She did
too, just a little.
“But the doctor was like a sculptor. He tapped with a chisel, gently
breaking the mold apart, piece by piece. Then they glued it back
together like a puzzle. This became the model for my retainer. It
wasn’t painful at all. Just weird at first.”
Zoyi leaned forward. Her eyes, eyebrows raised, locked onto mine.
“That retainer had a small wire designed to push my teeth forward,
encouraging my jaw to grow. It wasn’t very comfortable for the first
couple days but after that I got used to it.”
I paused for a moment, remembering. “As a child, I made the same
wish every New Year: ‘Can I just wake up beautiful, without all this
treatment? Can it happen overnight, like magic?’ But my mom always
told me, ‘You have to be beautiful. Otherwise, you won’t find love.’
Later, I learned it wasn’t true. Love isn’t about appearance.”
Zoyi blinked slowly. Her face relaxed.
Dr. Weddle’s assistant invited us to her consultation room.
After Olga introduced me as her friend and boss who was helping her
with Zoyi’s issues, Dr. Weddle greeted us and started her explanation,
tapping the screen to show Zoyi’s X-ray and profile photos.
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I had known Dr. Weddle for years. She welcomed us with the same
bright warmth I had always admired. Endlessly curious, she was the
kind of clinician who stayed ahead of the curve. Her long dark hair
framed deep, sparkling brown eyes that lit up with every new idea. Her
energy was unmistakable. She was someone who truly loves what they do.
“There are several treatment modalities we can use,” she began, “but
the main goal right now is to encourage the growth of Zoyi’s upper
arch while she’s still developing. Equally important is fostering healthy
myofunctional habits, such as training the tongue, lips, and breathing
to function as they should.”
Olga tilted her chin slightly downward, her eyes scanning the images.
“Let’s discuss noncustom options,” she explained. “We typically use
systems like the MyoBrace, Myomunchee, and Pre-ortho. These are
soft, prefabricated arches that don’t require molds or lab work. They
apply gentle pressure to help the upper jaw grow wider, but more
importantly, they serve as a guide for habit correction. They’re designed
to prevent the lips and cheeks from pushing in on the teeth during
swallowing and to train the tongue to rest on the roof of the mouth.”
“So, they’re kind of like coaches?” Olga asked, tilting her head.
“Exactly,” the doctor smiled. “They don’t force anything, just guide.
These appliances encourage nose breathing and gently advance the
lower jaw. This helps open up the airway.”
She tapped the screen, bringing up another image. “Now, if we feel
Zoyi needs more individualized support, we can move to a custom
appliance called ALF—advanced lightwire functional appliance.”
“Advanced lightwire functional appliance. ALF?” Olga echoed,
curiosity piqued.
T h e A r r o ws P o i n t B o t h W a y s · 267
“Yes. ALF is a very light wire appliance we make specifically for each
child. It sits behind the teeth, so it’s hardly noticeable. Instead of
forcing teeth into place, it gently encourages the jaw and face to grow
as they’re meant to.”
As I listened, I couldn’t help but marvel at how far orthodontics had
progressed. This wasn’t just about straightening teeth for a prettier
smile. It was about breathing and growth.
“Does it expand the palate, too?” Olga inquired.
“It does, but in a more nuanced way,” Dr. Weddle said. “Traditional
expanders widen the upper jaw using orthodontic force. In contrast,
ALF gently encourages growth and balance. It works well with
craniosacral therapy or osteopathic support, communicating with
the nervous system through the fascia. Subtle, but powerful.”
Olga’s eyes widened. “That sounds . . . almost holistic.”
“It is,” she nodded. “ALF isn’t only about moving teeth. This treatment
supports the whole structure, including breathing, posture, tongue
position, and even facial symmetry. The approach is a bit more
complex. Yet, for certain children, especially those with very narrow
arches or asymmetry, it’s worth considering.”
She sat back and offered a reassuring smile. “We can begin with
the noncustom appliance. It’s a more economical option. This will
give us a chance to see how Zoyi adapts. If she responds well and
we see the progress we want, then together we can decide whether
to move forward with a more customized approach like ALF
or expander.”
“Wait,” Olga said, raising her hand slightly. “So, the cheeks and lips
can actually make the teeth more crowded?”
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“Exactly,” Dr. Weddle said, smiling. “When we swallow the wrong way,
the muscles around the mouth push inward. Over time, this pressure
narrows the arch. We want Zoyi to start swallowing correctly, with
her tongue pressing gently against the roof of her mouth. This creates
outward pressure, stimulating the palate to grow.”
“So, these appliances . . . they help train her tongue?” Olga inquired.
“Yes,” Dr. Weddle said. “They help keep the tongue in the right place
and also guide the lower jaw forward. This opens the airway. It’s all
connected—breathing, posture, jaw growth. With consistent use, the
appliances work with her natural growth patterns.”
Olga appeared deep in thought. “And what’s the plan for her long
term?” she asked. “I mean . . . what are the steps?”
Questions for Dr. Weddle crowded my mind, one after another. But
this wasn’t my office. I planned to ask her later. For now, I stayed still
and listened.
Dr. Weddle nodded, impressed by Olga’s focus.
“We’ll follow the protocol, which has four stages. The first is habit
correction. We teach Zoyi to breathe through her nose, rest her
tongue on the palate, swallow properly, and keep her lips sealed when
she’s not speaking or eating. This phase is the foundation. Without
it, nothing else will hold.”
She offered a brief pause.
Listening to Dr. Weddle outline the four stages, I felt the pieces
clicking into place. Habit correction, airway, growth, retention, the
map was so clear. It had taken me years after dental school to make
sense of what I was seeing in my patients, patterns that now felt
suddenly and unmistakably logical.
T h e A r r o ws P o i n t B o t h W a y s · 269
“Then we move to arch development. Since she’s still young, we have
time to work with her growth. The appliances guide the upper jaw to
widen, creating room for all the permanent teeth to come in.”
Olga tilted her head. “So you’re using the time she’s still growing? Is
she ready emotionally, or is it her body that’s prepared?”
“Her body is ready,” the doctor said. “That’s the key. Gentle guidance
during the right developmental stage is much more effective. It’s more
comfortable, too.”
Olga took a breath. “What comes after that?”
“The third stage,” Dr. Weddle said, “is dental alignment. Once her
permanent teeth begin to erupt, we’ll shift to the next step, which
helps guide the teeth into their natural positions—without needing
braces yet in many cases.”
“And the final phase?” Olga inquired.
“Retention,” she said. “We want to ensure the results hold. If we do
the first three stages well and keep her breathing and function stable,
this part is usually straightforward.”
“How would she sleep with such a big piece in her mouth?” Olga
wondered aloud.
“Children usually adjust surprisingly quickly,” the doctor said. “The
appliance is designed to sit comfortably, and most kids stop noticing
it after just a few nights. Mouth tape can help, but first, I want an ENT
to ensure Zoyi can breathe well through her nose. If her nasal airway
is clear, we can place a small piece of tape near the lips as a gentle
reminder to keep them together. It doesn’t seal the mouth shut—
she can still open it if she needs to. With the help of myofunctional
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therapy, her lips will gradually become stronger, and she’ll learn to
keep them closed on her own.”
“I’m very concerned,” Olga said. “Zoyi is eight, and she’s the smallest
in her class. She hasn’t even lost her front teeth yet.”
“We hope that once Zoyi’s nose breathing is established through
myofunctional therapy, along with the use of these appliances, she’ll
begin to sleep better without interruption. This improvement will
stimulate her growth hormone, promoting her overall growth.”
Olga looked worried. “What if this appliance doesn’t expand her
upper jaw?” She paused, concern etched on her face. “I’ve noticed
that her teeth don’t have much space between them.”
“If progress stalls after four months, we have another option: Phase
1 orthodontics. This approach can involve removable or fixed
appliances. Clear aligners are also an option for expansion.”
“What if her lower jaw doesn’t move forward or expand?” Olga inquired.
“There are orthodontic appliances that can move the jaw forward,
stimulating the growth of the lower jaw. Yet, the best instrument is
Zoyi’s tongue. If she keeps her tongue on the roof of her mouth most
of the day, it will help her lower jaw find a better position.”
“I listen to a lot of podcasts and read that article in the New York
Times,” Olga said. “I think Zoyi is tongue-tied. I didn’t breastfeed her;
she didn’t like it. But I don’t want her to have any surgical procedures.”
Dr. Weddle, pressing her fingertips together, continued, “I suggest you
start with myofunctional therapy. This process allows us to evaluate
whether Zoyi needs her tongue tie released. It takes two to four
months to prepare the tongue muscles to stay in a certain position.
This ensures they don’t return to the original place.”
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Olga asked Dr. Weddle, “Does Zoyi need to have her four teeth
removed like her father did? There’s not enough space in her mouth
for all her teeth.”
Dr. Weddle said, “It’s important to start taking care of it. Now is the
time. Not too early, but not too late. The suture in the middle of the
jaw becomes calcified around puberty, at age thirteen to fourteen for
girls and fourteen to fifteen for boys. We still have time to work on
her growth. I would suggest Zoyi see an osteopath or a craniosacral
therapist. That can really help with her expansion process.”
As I listened, my mind turned to the adults I had treated over the years,
teeth straightened, bites corrected, but still struggling. No one had
ever shown them how to swallow with their tongue on the roof of the
mouth or breathe through their nose. I had been taught to manage
what I could see, the symptoms, not the reasons hidden underneath.
Sitting here, watching Zoyi’s case unfold, I thought about how different
their lives might have been if someone had started here, at the root.
“I believe it will be effective,” Dr. Weddle said, adjusting her glasses.
Her tone was confident. “However, I recommend you visit an allergist
as well. This will address the underlying cause of her swollen tonsils
and nasal obstruction. It will help us understand if there are any
additional factors contributing to her difficulty with breathing.”
“We already did. I’m creatively working to eliminate everything she
enjoys . . .”
Zoyi pulled a frightening face.
Olga hesitated. Her fingers tightened slightly around the strap of her
bag. “Can I ask you something else, Dr. Weddle?”
“Of course,” she said, glancing up from the chart. Her fingers moved
swiftly over the keyboard.
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“I’ve been wondering if I should take Zoyi for an ADHD evaluation.
Her teacher mentioned she’s often distracted and fidgety in class. But
now, with everything you’ve explained about her breathing, tongue
posture, and sleep, I’m not sure. Should I wait?”
Dr. Weddle continued, her voice compassionate and deeply reassuring.
“It’s a good question, and you’re not the only parent facing this. Often,
what looks like inattention or restlessness can be related to poor sleep
or low oxygen levels at night. These are things we’re addressing now.
I’d recommend we start with this foundational work first. Let’s help
her breathe better, sleep well, and use her mouth the way it’s meant
to. You can always revisit the evaluation if needed. But we may see
significant changes once her breathing improves.”
Dr. Weddle rose and opened a drawer, retrieving a bright blue
appliance. “I believe we have just the right size for Zoyi,” she said.
“Would you like to try it today?”
Olga glanced at her daughter, who gave a small, cautious nod. Dr.
Weddle smiled. She handed the appliance to Zoyi.
She turned it over in her hands, her fingers gently tracing the smooth
outer shell. Then she explored the inside. “There are little bumps
inside,” she said, with the curiosity of a little scientist.
“Yes,” Dr. Weddle replied with a warm smile. “Those are intentional.
Notice the bumps along the roof of the appliance? They guide your
tongue to rest in the correct position—right up on the roof of your
mouth. This encourages your palate to grow wide and strong.”
Dr. Weddle slipped on gloves, cleaned the appliance, and handed it
to Zoyi. She placed it inside her mouth.
“Can you feel those little ridges on the cheek side as well? They’re
along the outer part, near your lips.”
T h e A r r o ws P o i n t B o t h W a y s · 273
She nodded.
“Those bumps remind your cheeks and lips to stay relaxed,” she said.
“Many kids push with their lips without realizing it. This helps your
tongue handle the swallowing.”
Zoyi blinked thoughtfully. She experimented with a pretend swallow.
“It feels like the retainer is bossing my mouth around,” Zoyi said.
“Exactly. You’re very smart,” Dr. Weddle said with a smile. “It’s helping
your mouth learn the right way to work. This ensures your teeth grow
as they should. Breathing at night becomes easier.”
As Zoyi practiced opening and closing her mouth with the Myobrace in
place, her reflection beamed back from the mirror. Nearby, Olga stood
by the door, clutching the instruction packet Dr. Weddle had given her.
“Dr. Weddle,” Olga began, her voice tinged with something deeper
than routine curiosity. “Can I ask you one last question? It’s about
my husband.”
Dr. Weddle glanced up from the chart, giving a small nod as she set
it aside. “Of course.”
Olga stepped closer, her tone hushed. “He had four premolars extracted
when he was a teenager. And now . . . he can’t tolerate his CPAP
consistently. He’s not wearing his oral appliance every night either.
I keep waking up in the middle of the night, hearing him snore or
holding my breath, waiting for him to breathe again. I’m worried. I’ve
been wondering . . . is there anything else we can do? Something more
permanent. A way to reverse what was done?”
Dr. Weddle’s expression turned thoughtful. Slowly, she nodded.
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“You’re not the first person to ask that,” she said. “Sometimes, revisiting
earlier orthodontic treatment is possible. But such a decision demands
a careful evaluation.”
She paused.
“Sometimes, we attempt to reopen spaces and expand the upper jaw
once more. It’s not simple. It takes time. Yet, it can restore room for
the tongue and improve breathing.”
Olga exhaled slowly. “That’s exactly what I suspected. His jaw is so
narrow, there’s no space. His tongue always sits low when he talks,
and he clenches at night.”
Dr. Weddle gave a nod.
“I can refer you to a colleague who specializes in working with adults
using skeletal expansion devices like MARPE. For some patients, this
can widen the upper jaw and enhance nasal breathing.”
Olga raised her eyebrows. “That works for grown men?”
“In the right case, yes,” Dr. Weddle said. “When the jaw relationship is
more severe, the other option is orthognathic surgery. It’s jaw surgery
to reposition the bones and open the airway.”
Olga glanced down briefly, then met her eyes again. “Would it help
him breathe better?”
Dr. Weddle nodded. “In some cases, yes. Opening the jaw can provide
the airway with more space. However, it’s a significant decision that
requires careful evaluation by a surgical orthodontic team. What
matters is that you’re asking the right questions.”
What struck me most was the diversity of choices. It wasn’t just CPAP
or ENT surgery. There were paths to truly change the structure, to
T h e A r r o ws P o i n t B o t h W a y s · 275
reclaim space, balance, and breath. I appreciated that patients could
be offered more than a single box to fit into.
She offered a small, grateful smile. “I just want to find an option that
helps him breathe without interruptions. Not just survive the night.”
“I understand,” Dr. Weddle said gently. “Let me give you the names
of a specialist I trust.”
Olga glanced back at Zoyi, who was now cheerfully chatting with the
assistant, the blue appliance still snug in her mouth.
Olga gave a small shrug. “I just hope I’m doing the right thing for
Zoyi, helping her grow the way she should. But for Eugene . . . maybe
it’s not too late to create more space for him to breathe.”
We left.
“Do you feel overwhelmed?” I asked Olga.
“I wish AI could help us more. An actual plan. Like a real map of the
body: breathing, sleeping, function, food sensitivities, allergies, bite,
posture, sympathetic, parasympathetic modalities. Each specialist
sees their corner. But no one sees the whole.”
“My friend is working to incorporate AI in Dental Sleep Medicine,”
I said, smiling.
We climbed into my car, and I turned up the heat.
Olga looked at me. “Zoyi recently asked me what love is,” she said. I
told her it’s when someone pays attention.“
“The way you fight for Zoyi and Eugene,” I said, “that’s love in action.”
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Zoyi frowned slightly, then her eyes lit up. “No, I meant . . . a different
kind of love. The kind where someone wants to be with you all the
time. They lick your face the second you come home.”
“I probably pay too much attention. I feel empty inside.” Olga sighed.
“I listen to all the podcasts. Follow hundreds of experts. I just worry
so much about Eugene.”
A gust of wind swept across the parking lot, swirling dead leaves
into a little dance. February always feels like a slow exhale of winter.
“I think he should consider reversing his orthodontic treatment,”
Olga said, her voice resolute. “Reopen the spaces. Give the tongue
room. Rebuild what was taken. Maybe then he won’t be tethered to
machines every night for the rest of his life.”
I noticed she kept massaging her temples and face, moving her
head slowly from side to side. Then my attention shifted to her hair.
Naturally dark brown, it was usually straight or styled in loose curls.
Now, it had been lightened to blond, but a wide strip of uncolored
brown ran down the center, interrupted by a white streak along
her part.
“I don’t have the money or time for a salon,” she said, catching
my glance.
Was it exhaustion? Or was fear finally taking its toll?
According to Olga, Eugene was struggling. He wasn’t fully
committed to his CPAP and was inconsistent with his appliance.
Eugene seemed trapped in a body shaped by extractions, weight, and
fragmented sleep.
Olga was pulling the family toward healing. Yet, she was drained, too.
T h e A r r o ws P o i n t B o t h W a y s · 277
The signs were there. She was beginning to feel the effects of long,
sleepless nights and constant fears. Maybe something else, too.
Hormonal? Premenopause? Maybe. I sensed something was changing
inside her, though she hadn’t yet understood what it was.
What if the clues she had found weren’t just for them, but for her?
What if the clock was ticking . . . for all three of them?
She had done everything right. Myofunctional therapy for the
whole family was in place. Zoyi’s treatment was underway. A
referral for Eugene was ready, whether for MARPE or possibly
orthognathic surgery.
The pieces were all on the board.
Would they grant her the outcome she fought so fiercely to achieve?
I wasn’t certain.
An uneasy feeling crept over me.

T h e H o p e o f R e b u i l d i n g · 279
CHAPTER TWENTY:
The Hope of Rebuilding
Eugene
Long before Eugene sat in a surgeon’s office, hearing that his bones
might need to be moved so he could breathe, another clue appeared
on Olga’s phone. It was a boy in Ethiopia, drinking from a rain puddle
as if it were the most ordinary thing in the world.
Olga lay sideways on the couch, her legs tucked under a blanket.
She was scrolling through Dr. Sokolina’s Instagram story once more.
“Did you see this one?” she called out to Eugene. “She’s talking about
building the microbiome in Ethiopia.”
Eugene glanced up from his laptop. “Microbiome? What’s that?”
“All the bacteria that live in and on us form our internal ecosystem,”
Olga explained. “They mostly reside in the gut, but also in the mouth.
These bacteria aid in digestion, bolster immunity, and even influence
sleep.” She held up the phone. “Wait, just watch.”
Eugene saw the screen: a young boy with a Kalashnikov slung over
his shoulder, crouched beside a shallow rain puddle, cupping water
in his hands and drinking it. The sight made Eugene nauseous.
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Dr. Sokolina’s voice came through in the background: “I don’t
recommend drinking from a rain pad. I’m showing this to explain
body resilience, not hygiene practice.”
Olga’s mouth dropped open. “He drinks from that and doesn’t die of
dysentery. Meanwhile, I’m wiping every surface Zoyi touches with
antibacterial wipes like a lunatic. Perhaps . . . that’s why she has so
many allergies. If the body does not have something to attack from
outside, it starts to attack something of its own?”
Dr. Sokolina had said something about bad and good bacteria while
checking his gums. The mouth had its own microbiome. When the
balance breaks, harmful bacteria take over and spread inflammation
through the body.
But aloud, he attempted humor, saying, “I just feel bad for that
boy drinking from a rain puddle. We’re not going to teach Zoyi
to do that.”
Olga glanced at the phone once more.
“Of course not,” she said quietly. “But maybe Zoyi’s allergies aren’t
just bad luck. Maybe her immune system never had a chance to learn
what’s normal.”
Eugene rubbed his jaw.
“Normal doesn’t really exist, Olga,” he said. “We live by the rules of
modern society.”
But the thought lingered in his mind. Had he become too sterilized?
Antibiotics had always been his quick solution to any problem.
Now, he wondered, was his immune system reacting to the
wrong things?
T h e H o p e o f R e b u i l d i n g · 281
Spring had finally arrived, bringing with it less bite and more
bloom. Normally, this heralded weeks of allergy fog, sinus pressure,
and tissues stuffed into every pocket. But this year, something felt
different. Perhaps it was the elimination diet Olga had him on—no
dairy, no sugar, no fast food, no fun. Or maybe his body was simply
healthier now, less inflamed and reactive.
He felt . . . clearer.
The sleep wasn’t perfect. He still rotated between CPAP and his oral
appliance like a man choosing weapons before a duel. Sometimes, no
weapon at all. His weight was down. Glucagon-like peptide (GLP-1)
medications were working after several exchanges. His jaw was no
longer clenched all the time.
Thanks to a little blue pill . . . That tiny chemical miracle made him
feel twenty years younger. Yet, memories of that night’s conversation
kept coming back. He remembered it vividly.
They lay tangled in sheets that still held warmth. The room carried
a subtle mix of skin and lavender. He had been experimenting with
the blue pill, seeking just a bit of confidence. It made him feel young
again, a fragile illusion of normalcy. Of wanting and being wanted.
Olga had been neither for it nor against it. He had hoped for more
enthusiasm from her. But maybe that was impossible at her age? Or
given their current life situation?
Afterward, they lay close, almost fused. Her curly hair rested against
his shoulder, and he breathed in its scent.
“Do you understand that you might die?” Olga whispered.
He laughed. “Don’t we all?”
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She turned to him, her head resting on her hand.
“That’s true,” she said. “But you might die tonight. Or the next. Every
night, I listen. If I don’t hear the machine, I panic. If I start hearing
you snoring, I panic more. I wait for your next breath. Those gasps
and pauses terrify me.”
He recalled moving away from Olga.
“What are we going to do without you?” she had asked, her voice
trembling. “How am I supposed to raise Zoyi here, alone?”
He had no answer.
“Loshad,” Olga said, her voice husky. “I feel like a horse pushed through
too many races, still running because it’s expected to, long past the
point of rest. I’m drained. I can’t muster the emotional resources for
this level of fear anymore.” She’d turned slightly closer to him. “I
don’t have the drive I used to. I feel lost.”
Then the words began to come faster. “I’m not well. I’m not stable.
I’m constantly on edge. I snap at Zoyi. Then I hate myself for it. I lie
awake, wondering if this is how children grow up anxious because
their mothers are constantly panicking all the time.”
Her voice cracked. “I don’t feel like a good mother anymore.”
He heard her swallow.
“And what scares me most is this,” she had stressed. “Our moments,
our closeness. It’s supposed to mean life. Love. That we’re still us.”
She had shaken her head. “Instead, every time we’re together like
this, I’m more afraid. I imagine waking up without you. Explaining
your absence to Zoyi.”
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Olga had sobbed. “I imagine a future without you.”
He turned around. “I’m not dead. I feel good. I love you. What more
do you want from me?” He took a sharp breath. “Have you heard
about PTSD? Post traumatic stress disorder? Maybe you need help
from a psychologist.”
She looked at him, her eyes wet and red.
“Out of the two of us, you’re the one who needs a psychologist. I am
not crazy. I just need to know,” she had said, her voice firm despite
everything, “that you’re fighting for your life the way I’m fighting
for this family.”
Eugene shook his head, trying to clear the memory of that night. He
looked at Olga.
He had thought she was beautiful, even if she didn’t feel it lately. She’d
been spending more and more time curled sideways on the couch,
legs tucked under a blanket. She scrolled through Dr. Sokolina’s
stories from Ethiopia, like messages from another planet.
He watched her now. One hand massaged her jaw, while the other
flicked through clips.
She looked sexy, even in that tired way. Her cheekbones were sharp,
hair slightly undone. But she seemed distant. Like something inside
her had gone offline.
Eugene’s eyebrow arched.
“No, I’m serious,” Olga continued. “Zoyi’s body has nothing to fight,
so it starts fighting itself.
Did you see the other episode? The one where the father chews the
meat and gives it to the baby? With saliva and everything?”
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“I missed that one,” Eugene said dryly. “Sounds . . . intimate.”
“I don’t know if it’s good, but it’s definitely different,” Olga muttered.
“I read this article that people with depression and anxiety have
a totally different gut ecosystem. There’s a chance in that society;
they’re literally transferring the right bacteria to the baby. Like . . .
vaccinating them with life.”
She paused. “Remember when I used to judge those parents who
picked up a pacifier from the sidewalk, licked it, and popped it back
in their baby’s mouth? I sterilized everything. Boiled it. Scrubbed it
like I was prepping for surgery.”
Eugene chuckled. “You always question yourself as a parent. You’re
a chronic A+ student, Olga. Do you know where perfectionism
leads you?”
She glanced upward, anticipation already building.
“To a mental institution,” he said, grinning. “You’re racing past all
the wins. Straight into a crash landing.”
“It’s in my blood,” she said, her voice flat. “I can’t and don’t want to
get it out.”
He laughed again. “Just make sure you don’t sterilize Zoyi’s childhood
in the process.”
“Look at this,” she said, tapping the screen to replay a brief clip.
On it, Dr. Sokolina stood beneath the vast Ethiopian sky, holding
a small plate of meat. Just a few rough-cut chunks. No sauce, no
garnish, nothing tenderized. “This is dinner,” the doctor said in the
video. “Chewed twenty times on the right, twenty on the left. My jaw
T h e H o p e o f R e b u i l d i n g · 285
is sore,” she laughed. “But it’s delicious in a different way. Not melting
in your mouth, but real. Alive.”
“She said she couldn’t even chew it all the way,” Olga murmured aloud.
“Had to cut it smaller. The meat’s tough because the cows run. They
move. They aren’t sitting in cages being fattened with corn and soy.”
Eugene glanced up from the laptop, a playful grin on his face. “So . . .
you want me to start chasing my steak around before I eat it?”
“No,” she sighed, “I want you to eat something that makes your jaw
work. Like carrots. Something firm. Not this soft, overcooked, soggy
stuff you eat when I’m not looking. Remember what the myofunctional
therapist said in the video? Chew or grind. You’re grinding your teeth
at night because you’re not chewing during the day.”
“But I’m not growing,” Eugene protested, half-serious. “I don’t need
to build bones.”
“But you have muscles,” Olga replied softly. “And they’re weak. Especially
here,” she added, tapping her own tongue. “You want a stronger airway?
Start with chewing. Want to stop clenching at night? Chew and exercise
your tongue. Better digestion? Better brain power? Same. You chew
because you use your body to eat, not just your stomach.”
Eugene leaned back, watching her. The light from her phone glowed
softly on her cheekbone. “You sound like one of those Instagram
wellness gurus.”
“Maybe that’s not a bad thing,” Olga said, her lips curling into an
almost smile.
“Have you ever thought about going back to school?” he asked, his
voice tinged with hope.
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She did not lift her gaze.
“To become a hygienist, or maybe even a dentist,” he added. “You
already know more than half of them do. You come alive when you
talk about this.”
She blinked slowly. “I don’t know,” she said. “Could be.”
* * *
The week had been heavy with appointments. For the first time,
Eugene felt trapped inside his own anatomy, studying it as if from
the outside.
The day began with a visit to the orthodontist. Next came the oral
surgeon. Finally, in a loud whisper of shame, there was an unplanned
stop at a fast-food drive-thru.
The orthodontist’s office smelled like mint and plastic packaging.
Eugene sat stiffly in the consultation chair. Dr. Karpov, a beautiful
woman with careful eyes, clicked through a digital model of Eugene’s
upper jaw.
“You see this?” Dr. Karpov pointed to the midline of the palate. “This
line is the midpalatal suture, where the two halves of your upper jaw
meet. In childhood, it’s flexible, allowing the jaw to grow. With age,
it becomes more rigid. Yet, sometimes, it can still be opened.”
Eugene nodded, striving to appear as if he understood.
“That’s where MARPE comes in,” Dr. Karpov continued, her Russian
accent adding a gentle touch to each word. “Mini-Implant Assisted
Rapid Palatal Expansion. It’s related to the expanders children wear,
T h e H o p e o f R e b u i l d i n g · 287
but it works differently in an adult. In children, the suture is still
flexible. A traditional expander can open it. MARPE uses miniimplants
to deliver the force more directly to the bone.”
Eugene leaned in.
“We anchor the appliance with four small steel mini-screws directly
into the roof of the mouth. These implants act like handles. When
we activate the device, it applies lateral force to split the suture
gradually. It doesn’t just push the teeth apart. It expands the entire
upper jaw.”
“And this helps me . . . breathe?” Eugene inquired.
Dr. Karpov nodded. “Yes. Expansion can widen the nasal cavity,
creating more room for the tongue. Together, these changes may
improve airflow and stabilize the airway during sleep.”
Eugene stared at his skeletal scan. He imagined air moving through
it like wind in a narrow tunnel.
“Does it hurt?” he asked.
“There’s pressure,” Dr. Karpov said. “Some soreness. A few days of
feeling strange. But the bone responds quickly. Especially when we
guide it gently.”
She paused, then added, “Sometimes the suture is too resistant in
adults. In those cases, an oral and maxillofacial surgeon can assist
by making small cuts in the bone to reduce resistance. It’s called
surgically assisted palatal expansion. There are several techniques,
but the goal is the same: helping the upper jaw widen safely.”
Eugene took a deep breath.
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She continued: “But we’re also learning that how your muscles
respond to that matters just as much. I’d recommend bodywork,
osteopathy, craniosacral therapy, maybe myofascial release, to
relax the surrounding structures. Tight musculature can cause
asymmetrical pull during expansion.”
“So now I get to have more relationships with doctors?” Eugene sighed.
He sounded anything but happy about it.
Dr. Karpov rotated the scan, highlighting Eugene’s narrow palatal vault.
“If we’re dealing with dense bone or a fused midpalatal suture, which
can happen in adults, especially men over twenty-five, we may need
surgical assistance from an oral and maxillofacial surgeon. Sometimes,
we combine MARPE with corticotomies—small cuts in the bone that
help it mobilize more easily. But that depends on your bone density.”
“And if it doesn’t work?” Eugene asked.
“Then we consider the next level—orthognathic surgery,” Dr. Karpov
said. “But MARPE is the first gate. If your anatomy responds well, we
might not need anything more invasive.” She turned from the screen
and looked Eugene directly in the eye. “You’ve been living in a cage.
Small jaws, a narrow airway, not enough room for the structures that
have to work when you sleep. This gives us a chance to open that cage.
To let you breathe.”
Eugene stepped out of Dr. Karpov’s office with new knowledge and a
fear burning somewhere inside him. The idea of MARPE, those four
or more screws anchored into his palate, sounded almost surgical
already. But what bothered him more was the uncertainty.
What if it didn’t work?
What if he endured it all—the pressure, the adjustments, the waiting—
only to find himself strapping a machine to his face every night? Still
T h e H o p e o f R e b u i l d i n g · 289
living tethered to an appliance. Re-titrating. Avoiding the way Olga
pulled away whenever he snored in his sleep.
He sat in his car for a while, the scanned images still etched in his
mind. Dr. Karpov had been honest. Hopeful, but realistic.
She had said this was the first gate. Eugene was tired of gates. He
wanted to break down the whole damn wall.
That night, he booked an appointment with the oral surgeon himself.
No nudging from Olga. It was his own decision, made between the
CPAP and the feeling of silicone resting on his molars.
If MARPE was the opening move, Maxillomandibular Advancement
might be the checkmate. He was ready to solve it all at once, without
devices. He wanted his airway rebuilt. Nights uninterrupted. If that
meant cutting bone and healing for weeks with a swollen jaw and
numb lips, so be it.
For too many years, he had been numb in other ways.
* * *
Later that month, Eugene found himself in the polished exam room
of Dr. Alfi’s surgical practice.
“Here’s where things get real,” Dr. Alfi said with the clarity of someone
who had performed this procedure countless times. He wore medical
scrubs, yet there was an understated elegance about him. He pulled up
Eugene’s airway scan. “You might have some improvement potential
with MARPE. But based on your nasal resistance and posterior
collapse pattern, I don’t think it’ll be enough.”
Eugene’s stomach dropped.
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Dr. Alfi continued, “It may relieve some upper airway obstruction,
but most of your problem is below that, your soft palate, tongue
base, and lateral pharyngeal walls. That’s where Maxillomandibular
Advancement Surgery (MMA) comes in.”
He tapped the screen. “With MMA, we advance both jaws forward.
It’s aggressive, but it’s the most effective surgical solution we have
for Obstructive Sleep Apnea. Still, it’s a commitment—recovery,
numbness, facial changes.”
Eugene exhaled. “What if I go through with MARPE, MMA, and it
still doesn’t fix the apnea?”
Dr. Alfi paused for a moment, choosing his words carefully. “That’s
always the risk. Nothing is one-hundred percent, but we build a case
based on evidence: imaging, sleep study results, and collapsibility
index. And we layer treatments, bodywork, positional therapy,
myofunctional therapy, nasal hygiene. The success is cumulative.”
Eugene stepped out of the office into the bright parking lot. The world
was suddenly too loud for what he had just heard. The air smelled like
spring, but Eugene felt none of it. His legs carried him on autopilot
across the pavement. He moved past rows of cars, each gleaming
under the thin sunlight.
His mind was still inside that exam room, replaying words like cuts,
plates, airway collapse, recovery. He unlocked his car, slid into the
driver’s seat, and shut the door.
Everything fell silent.
The silence hit him. His hands were shaking hard.
He had answers now—or at least options. Bone cuts, expansion
screws, titanium plates. Recovery timelines, and even a list of soft
foods he’d have to eat for several weeks.
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But one thought bothered him. Olga.
He wasn’t sure she believed in this path. Maybe she thought it was
too extreme, or perhaps she was too exhausted to fight for another
solution. Financial burden played a role as well. He was the main
breadwinner. Could he risk it all? Was she burned out or just checked
out emotionally? Perhaps she was fighting her own private battle with
sleep and hormones.
Still, Eugene wasn’t backing down. He wanted something permanent.
He needed a body he could inhabit without machinery.
He reached for his phone, paused, and then typed out a text to Olga:
“Consult went well. MARPE is possible, but MMA might be necessary.
It’s a lot . . . but I want to do this. I want to breathe without wires
and plastic.”
He hit send, tossed the phone into the center console, and leaned back.
Outside, spring was in full bloom. Cherry blossoms scattered across
the sidewalk, delicate and fleeting.
* * *
An hour later, Eugene sat in the parking lot of a gas station. A fast
food bag lay open beside him, fries half-gone, salt clinging to his
fingertips. He stared blankly at the steering wheel, chewing slowly.
The burger rested heavy in his hand. Equal parts comfort and guilt.
He knew he had betrayed Olga’s effort. He understood the salt and
fat were detrimental to his weight and his heart, especially now. Yet,
every doctor’s visit felt like proof that something inside him was
failing, and he needed some way to relax.
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None of the appointments, the scans or consultations, brought him
anything that felt like a reward at home. It was his health, yes. His
life on the line, yes, but some childish part of him still longed for
praise, for admiration, for someone to say you’re doing so well,
like in childhood, when you endured something hard and your
mother wrapped you in a hug, or rewarded you with a treat for
good behavior.
Olga didn’t do that now. Something in her had dimmed. She was
simply . . . indifferent. Faded. Always drained.
Many times, he had asked himself: Who am I doing all this for? For
me? For her? For Zoyi?
He still didn’t have a clear answer.
So the fries were his rebellion against kale, protein shakes and slowchewed
turkey slices; against the discipline that had brought him no
comfort or praise. He hadn’t felt satisfied in days.
His phone buzzed. A sinking feeling gripped him. He knew exactly
what kind of call this would be. The screen indicated:
CARDIOLOGY CENTER – Hackensack Hospital.
He stared at it for a beat. Then he answered, “Hello?”
“Hi, Eugene, this is Diane from Dr. Reno’s office,” came the calm,
professional voice. “The doctor reviewed your monitor report. He’d
like to see you this week, preferably sooner rather than later.”
Eugene’s chest tightened. The burger remained in his hand.
“Is something wrong?” he inquired.
T h e H o p e o f R e b u i l d i n g · 293
“He’s seeing an increase in atrial fibrillation episodes,” she said. “He’d
like to discuss the possibility of an ablation procedure. Would you
be available Thursday morning?”
* * *
The laptop screen blinked on Thursday. Eugene slipped into the
bedroom and closed the door behind him. The room looked neater
than it had in months before his accident. Pillows were aligned in a
perfect row. The bedspread was smoothed without a single wrinkle.
No socks curled like abandoned creatures on the floor. Olga had
been sleeping here again since his surgery. Her presence left a kind
of order he liked so much.
He sat on the edge of the bed, angling the laptop away from the
hallway. He didn’t want Olga overhearing this conversation. He
wasn’t sure if she’d emotionally checked out or if she was simply
too drained to react anymore, but he didn’t want her burdened by
yet another piece of bad news. Some part of him still needed to feel
like a man who could shield her, not add to her worries.
The doctor appeared on the screen. Eugene noticed multiple
diplomas on the back wall. “Your atrial fibrillation is getting more
frequent,” said Dr. Reno, his electrophysiologist. “And based on
your monitor data, we should seriously discuss catheter ablation.”
Eugene shifted in his seat. “Will it fix it? For good?”
“No guarantees,” the doctor said. “But in patients your age, ablation
has high success, especially if we act before the atria remodel more.”
Eugene hesitated to ask. “I’m trying to fix everything at once—my jaw
and airway, my sleep and weight, my diet. I don’t even know what’s
helping anymore.”
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Dr. Reno regarded him thoughtfully. “Eugene, it’s not about
pinpointing a single cause. We aim to alleviate as many burdens
from your body as we can. Sleep apnea, weight, stress, and sodium
are all potential culprits. Our goal is to extinguish the fire before
it spreads.”
“Could those episodes be related to the fast food I am eating?” Eugene
asked, anxiety lacing his voice.
“It could be part of it,” replied the doctor. “Fast food is very high in
sodium, and that can aggravate the heart.”
Eugene had a shadow idea in his mind about the book Olga was
talking about Salt, Sugar, Fat by Michael Moss, “Olga mentioned
that salt many times, but it feels so good . . . It just . . . feels so good.”
Dr. Reno leaned in a bit closer to the camera and smiled. “I know
exactly what you mean,” he said. “That blend of salt, fat, and sugar
creates a kind of bliss moment. It lights up the brain quickly. That’s
biology. Food scientists have figured it out.”
Eugene exhaled, relieved there was no blame in the doctor’s voice.
“Most of the time, I feel so hopeless around fast food. I just . . .
can’t stop.”
“Change rarely works cold turkey,” Dr. Reno explained. “Especially
with something wired into reward pathways. Try to eliminate it
overnight, and your brain pushes back.”
He paused, then continued. “What works better is renegotiation.
Moderation with intention. Eat what you want once a
week—consciously.”
Eugene’s brow furrowed with skepticism. “Does that actually work?”
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“It does,” Dr. Reno said calmly. “The body is remarkably adaptable.
Change the rhythm, and it recalibrates. Cravings soften. Taste shifts.”
He leaned forward slightly. “And don’t just remove things. Replace
them. You still need pleasure. Bliss doesn’t disappear—it relocates.”
Eugene’s eyebrow arched.
“When people discover other ways to feel satisfied, the old habits start
to lose their power.” Dr. Reno concluded.
“I hate food discipline,” Eugene sighed deeply.
“It’s not about discipline,” Dr. Reno said. “You’re teaching your body
something different. Repeat something new often enough, and it
starts to feel normal.”
“I’m so tired of this,” Eugene said, his voice weary. “I just want one
magic pill that fixes everything.”
Dr. Reno chuckled softly. “So would I. I’d prescribe it to myself first.
But it doesn’t exist.”
* * *
When he entered the living room and saw Olga sprawled on the couch,
her eyes half-open, scrolling through an Instagram feed as if it held
the secrets of the universe, he felt a new ache. Not medical. Emotional.
She was absent.
So, when Zoyi came bouncing in with her Myobrace case and said,
“Mama, can we do our myo exercises before dinner?” Eugene was
taken aback.
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“I’ll do them too,” he said, setting his phone down. “Let’s all do
it together.”
Olga blinked, startled.
“Really?” she asked.
He nodded, striving to sound casual. “Figure I can’t fix my bones
right now. But maybe I can start with muscles.”
His body had whispered before it broke in that tragic heart accident,
and he hadn’t listened. This time, he would be attuned.
If he could train his tongue to rise again, perhaps Olga’s spirit
would follow.
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CHAPTER T WENT Y-ONE:
The Pattern Was
Reaching Further
Olga
Hope required effort that morning.
The snow at the end of March felt like a setback. But Olga chose to read
it differently. She imagined cooking a delicious breakfast at home.
Bundling the family up. Telling herself that fresh air and movement
might restore something that had been slipping away inside her.
Only later would she realize that the clue she’d been chasing wasn’t
in Eugene at all.
The morning was crisp, the snow covering the ground glistening
under the early sunlight on a beautiful Saturday morning. It was
unusual to have so much snow at the end of March. Just when she
thought spring was here, nature had taken a step back into winter.
Olga missed the snow here in the US, that white majesty symbolizing
a new beginning. She loved waking up in the morning to see the
magical white branches. The absence of any human activity made
it peaceful.
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Olga felt drained of energy lately. Something was shifting within her
body—jaw pain, constant tension, and waking up with a headache
nearly every morning. She knew she needed help, but even seeking
it required energy she scarcely had.
She hoped the unexpected snow would lift her spirits.
She came up with a great plan: they would take a hike together,
something they hadn’t done in ages. The fresh air and exercise would
be good for all of them. It was a slow way to get Eugene into physical
activity, something he needed to do to build muscle strength in
addition to his Glucagon Like Peptide (GLP-1) medication, to avoid
losing muscle mass.
Olga wasn’t much of a hiker herself. Yet, she was on a mission. She
wanted to help Eugene and set an example for Zoyi.
She pondered ways to make the hike more enjoyable for both Zoyi
and Eugene.
“I’ve got an idea,” she said. “Let’s head to the park with the hill for
sliding. Instead of driving, why don’t we walk up? I’ll bring a plastic
sled for Zoyi to slide down.”
Eugene raised an eyebrow, clearly not enthusiastic about the walking
part. He grumbled. “That’s a long way up.”
Olga smiled and leaned in closer. Today, she felt unusually light.
“I’ll make your favorite gluten-free blintzes for breakfast,” she said,
“with homemade strawberry jam, no sugar added. A perfect start
to the day.”
Eugene’s face lit up at the mention of breakfast. “Blintzes, huh?” He
grinned. “Alright, you’ve convinced me.”
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Olga smiled over her cup. “What did you love most about winter as
a child?”
“Snowball fights,” Eugene said without hesitation. “I loved them. My
gloves would get so wet my fingers froze into unbendable sticks.” He
spread his fingers wide, showing them to Zoyi.
She laughed softly.
Olga looked up dreamily to the ceiling. “I really liked making
snowwomen. Not just snowmen. We usually built both, with branches
for arms. I felt so accomplished rolling it. Sometimes we even gave
them scarves or hats.”
Eugene chuckled. “I was very competitive with snowball fights. We
even built snow forts and battled from behind the walls. Defending
them was half the fun.”
Olga shook her head. “Oh yes! You always had to win.”
Eugene sighed, “And look at me now. Do not ever grow old, Zoyi!”
“You are young, Papa,” Zoyi protested.
“I don’t know why, but we had ice on our hill almost all winter.
We’d put water on the slide and let it freeze. Gorka. Nothing can be
compared to sliding down that hill,” Olga said, a smile dancing on
her lips as she remembered the fun. “I did it standing up, lying down,
sitting. I was a champion at sliding.”
Eugene chuckled. “A champion, huh? I remember how fearless you
were.” He shook his head and leaned back in his chair. “You’ll show
your super skills to Zoyi today?”
Olga’s eyes sparkled with excitement. “Oh, I’m sure she’ll love it. I
used to race down that hill every chance I got.”
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Eugene laughed again, though a shadow lingered in his voice. “I
actually . . . broke my front tooth doing it.” His fingers brushed his
teeth absentmindedly, as if the pain still remained.
Olga smiled and gave him a playful nudge. “You were always so
reckless with your teeth. Never used to keep your lips together as
a child. Zoyi was the same way, remember? She’d leave her mouth
open all the time until we started her treatment.”
Eugene nodded, his thoughts drifting for a moment. “Yeah, that’s true.
As a kid, you don’t really think about that. Teeth aren’t something
you focus on.”
“Until they break,” Olga teased, a small smile playing on her lips. “That’s
why we’re taking care of Zoyi now. It’ll be better for her in the long run.”
“I wasn’t able to breathe through my nose for some reason all through
my childhood,” Eugene said, his voice growing warm as he reflected
on those years. “Kids can be brutal. They’d make fun of me because
I always had my mouth open and my front tooth was broken. They’d
call me names, and it really stuck with me. I hope Zoyi never has to
go through something like that.”
“I am the cotton ball champion,” Zoyi declared. She took a deep breath
through her nose and exhaled with a loud whoosh.
“This is your superpower!” Eugene exclaimed, his voice brimming
with pride.
Olga smiled, her thoughts drifting to Zoyi and the changes time had
brought. “That broken front tooth,” she mused, “was the reason you
got your braces soon after arriving in the States, right?”
Eugene nodded. “Yeah, it was. I had this dream inside me to return,
to smile with an American smile, and to show it to you and all those
terrible people from my class.”
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“Why did they take out your teeth if you just wanted to fix your front
tooth?” Olga asked.
Eugene laughed, a teasing glint in his eyes. “It’s a long story. I went
to the dentist with my parents, and he explained that just putting
a crown on my tooth wouldn’t make it look right. He suggested
straightening all my teeth first and referred me to an orthodontist.
The orthodontist checked and told my parents that my jaws didn’t
meet in a way that allowed my lips to close comfortably. If we wanted
straight teeth and relaxed lips, four teeth would have to be removed,
plus my wisdom teeth. He thought it was the only way. So, I ended
up in braces for two years while I was in college.”
“Best contraception,” Eugene joked with a mischievous smile. Then
he added, “But, hey, I wanted to impress you.”
Olga smiled at his words. “Ha! You definitely succeeded.”
Eugene’s face softened, a nostalgic smile playing on his lips. “Once the
braces were off, the dentist put veneers on my teeth. And voilà, I went
to St. Petersburg and stole your heart.” He flashed her a confident grin.
Olga noticed that Zoyi was clearly absorbed in the story. For her, it
was a precious moment of connection, seeing her father talk so openly
about his childhood struggles.
* * *
During the snow adventure, Zoyi energetically skipped ahead,
leaving Eugene and Olga to walk side by side. As they began the
ascent, Eugene reached for her hand. At first, it felt like a romantic
gesture, a beautiful moment for them to savor the serenity of the
snowy landscape. The snow crunched beneath their feet, sending little
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sparkles into the sunlight with every step. The crisp air was refreshing,
but Eugene’s heavy breaths were clearly labored as they climbed the
hill. He breathed through his mouth, each inhale ragged and quick,
as if the effort of the hike was too much for him.
Olga, walking beside him, noticed his posture. His shoulders were
hunched forward, and his breath came in shallow gasps. She gently
touched his shoulder, trying to guide him into a better position.
“Eugene, you need to open your chest more. You’re still holding that
tension,” she said softly, hoping her words wouldn’t fall on deaf ears.
He shot her a quick glance, clearly irritated. “I’m fine, Olga. Just tired,”
he muttered. His words were abrupt.
Concern crossed Olga’s eyes, but she kept her voice calm and hopeful.
“I’ve been reading this book. It’s about breathing efficiently to improve
your health, and really changed my perspective. You know, if you
breathe through your nose instead of your mouth, you’ll use oxygen
more efficiently.”
Eugene gave a short laugh, shaking his head as he continued his
ascent. His breath was still rapid. “You think changing how I breathe
is going to make a difference in how I feel right now?”
Olga smiled, her idealistic nature shining through. “Yes! It’s more than
just breathing; it’s about breathing in a way that supports your whole
body. The book talks about something called the Body Oxygen Level
Test. It’s a way to measure how efficiently you use oxygen, and I’ve been
trying the exercises to help increase my breathing capacity. The author
even cured his own asthma through breathwork and got much fitter.”
Eugene wiped his brow and sighed. “I’m just trying to get to the top
of this hill without passing out,” he said. “I don’t need a magic breath
cure right now.”
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Olga ignored the sarcasm in his voice and continued. “It’s not about
magic, Eugene. More about opening your body’s potential. You have
this magical force inside you, and you can use it through your breath.
Another book talks about releasing your intuition with breathing,
using it to tap into your inner strength. Shestoe chuvstvo. You can
use it for your business!”
Eugene’s frustration mounted. His breathing became heavy and
shallow. “I don’t have time for any of this,” he snapped. “I’m just
trying to breathe without feeling like I’m going to keel over.”
Olga, sensing his frustration yet remaining determined, gently placed
her hand on his shoulder once more. “I know you’re drained, but
you’re still breathing through your mouth,” she said softly. “You’re
not letting your body work the way it’s supposed to. We can do this
together. Just try breathing through your nose for a bit. It will help
with your energy and focus, and possibly posture.”
Eugene clenched his jaw, eyes fixed on Zoyi. She had skipped
far ahead, moving with effortless energy. His stomach growled.
“Fine,” he muttered, rolling his eyes. “I’ll try it. But if we don’t
get some food soon, I’m going to pass out from hunger, not from
oxygen deprivation.”
As the elevation increased, the air grew thinner. Eugene’s pace
began to slow. His grip tightened on her hand, not in affection but
in frustration.
“You’re doing great, Eugene,” Olga said, trying to keep his spirits
up, though she felt just as strained. She squeezed her fists in her
soft, feathered mittens, a gift her mother had sent from Russia. The
pressure in her chest tightened as she tried to stay calm on the outside.
“Catch me, Daddy!” Zoyi screamed, urging them to hurry.
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Eugene had always been stubborn, particularly about his health.
As they continued, Eugene’s irritation grew. His breathing
became heavier.
“Let’s check your app,” she suggested. Olga had given Eugene an Oura
ring for Valentine’s Day. She hoped that seeing his accomplishments
would motivate him.
Eugene shot her a glance. “I don’t need an app to tell me I’m out
of shape.”
“I’m fine,” he added, casting a glance at Zoyi ahead of them. She
was already out of earshot, hopping between the snowbanks with
an energy Eugene could only dream of. “But this is a lot harder
than I thought. It’s like my legs are made of stone.” He removed
his trapper hat and ran a hand through his hair. “Olga,” he finally
said, his voice clipped, “let’s just go to McDonald’s when we’re
done. I’ve earned it.”
Olga chuckled, her smile crooked. “McDonald’s, really?”
“You don’t understand,” Eugene huffed. “This isn’t fun for me. I lack
Zoyi’s energy. I don’t want to be stuck here all day.”
Zoyi, though distant, caught the mention of McDonald’s. She
screamed, “I want a Big Mac, French fries, and ice cream!”
Olga gritted her teeth but didn’t want to get into an argument. “We’ll
have lunch at home. I made chicken soup for Zoyi and barley-feta
cheese salad for us.” Olga was proud of her balanced recipes, which
she had taken from the book Eat Better, Sleep Better.
“This is fantastic,” Eugene said. “But we need a little pleasure in life.”
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Olga sighed. “How about we meet in the middle? We’ll get one
portion of French fries, and then we’ll make a homemade dessert
with Zoyi.”
* * *
That lunch was serene. Olga seized the moment to share an idea
with Eugene.
“Zoyi is doing well with her appliance. She’s like you, keeps breathing
through her mouth most of the time and doesn’t keep her tongue
on the roof of her mouth. She has enough space on her palate, but
her tongue might not be strong enough. I know body work can be
added to Myofunctional therapy to make it easier, but we’ve worked
on habit-breaking with Myobrace, which already provides some
mild expansion. Now, I think her palate is wide enough to fit her
tongue with the help of the Myofunctional therapy. Dr. Weddle
mentioned that.”
“I can sense more troubles are coming,” Eugene quipped, his voice
laced with a touch of sarcasm.
Olga paused for a moment. “She also recommended that we have an
evaluation by Dr. Siegal for a tongue tie. But anyway, Myofunctional
therapy will need to prepare Zoyi for the tongue tie release. We can
make a decision after that.”
“Olga, you are unstoppable.”
“It was just the two of us who did those exercises with Myobrace,” Olga
said, glancing at Eugene. “I think Zoyi will be happier if you join us.
It’s on Zoom. I’ve scheduled our session. I really find it very holistic.”
Olga made a cute, pleading face.
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Olga showed Eugene the book about sleep disorders and breathing
for children she had brought from Dr. Weddle’s office. She handed
it to Eugene. “You remember Zoyi was evaluated for ADHD, but the
symptoms of that condition are almost the same as sleep-disordered
breathing. As I started addressing her sleep and diet, her school
behavior improved so much. She stopped bedwetting. She’s not as
anxious. And her allergies are better.”
Olga flipped through the book and showed Eugene a page. “I love
how this book begins,” she said.
Eugene looked at it and nodded. “It says, ‘Conversation between
grandparents: What’s happening to kids these days? It seems like
every one of them has behavioral problems, allergies, ADHD . . .’”
He paused, then looked at her. “It’s not about the kids, it’s about me.”
Olga gave him a warm smile.
“I used to have such a hard time focusing. My memory was terrible.
It’s much better now, but I still hate all those treatments you put me
through.” Eugene sighed, yet the corner of his mouth lifted.
Olga squeezed his hand gently. “It’s wonderful that you’re feeling
better. We’d really love for you to join us for the Myofunctional
session on Monday. What do you think?”
* * *
Olga, Eugene, and Zoyi sat in front of the computer screen. In front
of them lay a small bag filled with various exercise equipment.
Zoyi was excited about the activity they were all involved in. “I’m
going to show you, Daddy, how to keep your tongue in the right spot.
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Can you go to the supermarket and buy us this much ice cream after?”
Zoyi said, showing an oversized portion with her hands.
Olga clenched her jaw. Her efforts to fight against the industry seemed
futile. Even her neck and shoulders were tense now.
Just then, the therapist Nicole appeared on the screen with a very
friendly smile. “This is so wonderful to see the whole family! From
my experience, I’ve learned that if you do it as a family, your results
will be much better. First of all, I would like to present the goals of
Myofunctional therapy in general.”
The therapist continued, “I will do a little recap for Eugene. You will
learn to breathe through your nose day and night. Keep your lips
together. Hold your tongue on the roof of your mouth. Swallow with
just your tongue, without any movement of your cheeks or lips. Our
course is approximately twelve sessions. I don’t want you to feel like
you’ll stay in this therapy forever. In the first half, we’ll focus on
strengthening the muscles of your tongue, lips, cheeks, and soft palate.
In the second part, we will apply what we’ve learned to drinking and
eating in a way that keeps your muscles toned. This way, you’ll be
exercising constantly while you swallow. You swallow your saliva
about nine hundred times a day.”
Zoyi was growing bored. She started playing with the contents of the
supply bag, constructing a tower.
Nicole educated them with enthusiasm. “We will have two types of
exercises. Active exercises—you need to do them three times a day for
five minutes. Try to make it a competition. It’ll be fun. And passive
exercises—you can do them while driving, watching a movie, or while
Zoyi is playing with her toys.”
The therapist started showing Zoyi how to unblock her nose by
holding one nostril. After that Zoyi had to make as many steps as
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possible while holding her breath as long as she could.. The therapist
told her to breathe only through her nose after that.
“I have an idea,” the therapist said. “Let’s play ‘Tug of War with
Buttons’ with your dad.”
Zoyi knew the game. She turned to Eugene and explained, “Daddy,
you put this button in your mouth, and I put one in mine. We see
whose lips are stronger.”
Olga noticed Eugene’s lips turning white from the effort. He was
trying hard to resist Zoyi. Then, he relaxed. He let her win the battle.
Zoyi beamed. “I’m stronger than you, Daddy,” she sang with delight.
Nicole smiled. “Now let’s play with clicks,” she added. “Make a click
with your tongue, and I’ll judge who can do it louder.”
Zoyi’s click was loud and sharp. In contrast, Eugene’s tongue produced
a soft flipping sound.
“Your tongue is like a dolphin,” Zoyi laughed.
“Why?” he inquired.
“It’s flipping,” she said with pride. “Mine is solid.”
“Eugene, try using the back of your tongue,” Nicole encouraged.
“Create suction, then release it. Practice will make you better.”
After all the exercises were done, Zoyi hurried into her room. The
therapist continued explaining to Olga and Eugene.
“I think this therapy will be great for you, Eugene,” the myofunctional
therapist said. “If your tongue can stay on the roof of your mouth
during the day, you’ll breathe through your nose while keeping your
T h e P a t t e r n W a s R e a c h i n g F u r t h e r · 309
lips together. Hopefully, at night, your tongue will remain slightly
suctioned to your palate, instead of falling into your airway. Nose
breathing will be beneficial with any treatment strategy you choose
to control your apnea.”
“What about me?” asked Olga. “I’ve noticed that my chewing muscles
are so tense. I wake up at night because my jaw is clenched. During
the day, I do this too, and my neck feels tight as well.”
“Are you falling apart just like me?” Eugene quipped, a sarcastic smile
playing on his lips.
“For you, Olga, it will be great as well,” the therapist replied. “Your
tongue will provide another point of support for the jaw joint. You’ll
also notice some beauty benefits. If your tongue stays high, your hyoid
bone will also move up.” She pointed to the area under her own chin
on the screen. “This is where your hyoid bone is located. Your muscles
under the jaw will tighten, improving the appearance of a double
chin. Plus, if you swallow without tensing the muscles around your
mouth, you’ll have fewer wrinkles.”
Eugene joked, “If I make my tongue and lips stronger, will I become
a better kisser?”
Olga raised her eyebrows, choosing to ignore Eugene’s sarcasm.
“Based on your professional experience, should we consider a tongue
tie release for Zoyi?”
“I know Dr. Weddle referred you to Dr. Siegal,” the therapist said. “It
would be best if you visit him after four sessions. Zoyi needs to hold
her tongue in proper suction before that procedure.”
Olga turned to Eugene. “You have a tongue tie too, Eugene. Perhaps
you could join us for that visit?”
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Eugene grimaced at her.
“I know this can be overwhelming with information,” the therapist
continued, “but I just want to add this for your situation with TMJ,
and for both of you as well.” “We will work on your posture during our
sessions. A lot of people with sleep apnea have forward head posture.
There are many theories as to why this happens. Maybe it’s because
the body is adapting to breathe better in that position with a narrow
airway. Or perhaps it’s the result of fascia tension. The tongue is the
beginning of that complicated fascial system, which ends at the big
toe. Very often, people with fascia tension end up with spine problems,
or hip and knee joint replacements. Besides tongue tie release, which
will help decrease fascia tension, it might also be helpful to work with
a physical therapist, osteopath, or craniosacral therapist.”
“That’s a lot,” Olga replied.
“You don’t have to do it all at once,” the therapist reassured her. “Start
your research, and once you think it’s the right time and direction, I
can refer you to specialists.”
“I have to praise you, Olga,” Nicole said. “You’ve laid a solid foundation
for a good airway for Zoyi. You’re definitely helping Eugene with
his treatment.”
Olga sat beside Eugene, mimicking the myofunctional exercises,
but her jaw pulsed with tension and a dull ache crawled across her
temples. She barely heard the therapist’s words. Some mornings she
woke with a sliver of hope, but most days she felt like she was dragging
her body through fog. Her cycle was a mystery now.
Was this perimenopause? Or something worse? She’d been reading
about pelvic floor dysfunction, posture, how the temporomandibular
joint might be connected to all of it. Perhaps she needed a sleep study.
T h e P a t t e r n W a s R e a c h i n g F u r t h e r · 311
Maybe she was the one who couldn’t breathe at night. Her weight
had crept up, her energy vanished, her skin felt foreign. Something
is wrong with me, she thought.
* * *
Deep inside, Olga no longer felt a sparkle—she couldn’t remember the
last time she’d laughed for real. Who had she become? A caregiver? A
shadow? She used to feel sharp, curious, so sure she’d be a biologist,
a scientist. She and Eugene used to dream together, but now even
when he spoke of her starting a new career, it felt like someone else’s
fantasy. She couldn’t imagine getting through the week, let alone
building something new.
Possibly hormone therapy could help, or perhaps physical therapy.
Something had to change.
Sometimes, when the body became a riddle and science fell silent,
the answers didn’t come from another test or therapy.
She found herself drifting backward. Olga hadn’t thought about her
first husband in years. That chapter of her life had closed, leaving no
lingering regret.
Then the university WhatsApp group appeared—a twenty-year
reunion thread. Names and faces rose from a time capsule.
At first, she stayed silent, just watching. Later, the atmosphere seeped
in. She caught herself reacting to the old jokes, the teasing, the
familiar tones.
Once, she had been the most admired girl in that room. She was
married to the most successful boy.
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Then a message appeared from him. He wanted to know about her
American life. Olga sensed his interest, and she enjoyed it.
She didn’t miss him. She missed the confident Olga of the past, the
part of her identity he had helped shape—the girl who felt beautiful,
polished, admired. Free from caregiving and endless responsibilities.
Olga opened her phone and, almost without realizing it, began
searching for flights. Maybe she just needed a break. A chance to
breathe somewhere she wasn’t always holding everything together.
Dom. For a moment, she let herself imagine stepping off the plane and
taking in the smell of her childhood room. Then, she could almost
feel her mother’s arms around her. Just last night she had a long
conversation with her mom.
Olga understood that Russia wasn’t the same country anymore. The
news had made that clear. Borders had hardened. Flights vanished
overnight. Once people left, they didn’t return easily.
It could even be a one-way trip. Yet, part of her wanted to go.
The thought of leaving Zoyi made her chest tighten. Telling Eugene?
That brought a cold sweat.
He wouldn’t understand. To him, it would seem like weakness.
Like betrayal.
And the messages . . . He had always been envious of her past. Fear
of causing him pain made her hesitate.
Something inside her whispered, stubborn and exhausted: If I don’t
go now, I might disappear entirely.
She glanced at her phone and began searching for tickets.
T h e S h a p e o f T e n si o n · 313
CHAPTER T WENT Y-T WO:
The Shape of Tension
Olga
When Olga stopped working and became the family’s anchor, each
part of her had been poured into others. She didn’t know a single
sentence the next morning from her daughter could undo her more
than all the sleepless nights.
She had parked on the street next to the school, unbuckled her
seatbelt, and got out of the car to help Zoyi. She was ready to hold
her daughter’s hand, walk her past the familiar red brick building,
and share their usual morning goodbye with a hug and a kiss. As she
opened the car door for Zoyi, the girl stopped her.
“No, Mom. I don’t want you to walk me to school. I’ll go with my friends.”
Olga blinked, surprised. She looked around. The cherry tree by
the sidewalk was in full bloom, its light pink petals blanketing the
pavement like soft spring snow. Zoyi had already slung her backpack
over one shoulder and was running toward a tall girl with long red
hair. The backpack bounced rhythmically with each stride. Her
laughter trailed behind her like a song.
Devastated, Olga was left standing alone.
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Back home, she scooped coffee grounds into the small cezve and
added a pinch of cardamom, just enough to wake the memory of
something warm and distant. As the coffee began to foam in the
cezve, the rich aroma began to fill the room, citrusy and spiced,
cutting through the dull fog inside her head. It pulled her back to the
kitchen in St. Petersburg, where her mother used to make coffee in a
battered but beloved copper cezve. Back then, the fragrance carried
a sense of being abroad, of faraway places waiting beyond their small
apartment. Now she was abroad, and the same aroma only sharpened
her loneliness.
She poured the coffee into her favorite cup. It was white, tulip-shaped,
made from bone porcelain. Her mom had bought it at the Lomonosov
Royal Porcelain factory store and sent it here.
Then, with a sigh, she stepped into Zoyi’s room.
The room, once bursting with color and games, had grown strangely
still. Stuffed animals sat neatly lined up along the edge of the couch.
Their button eyes stared into nowhere, waiting to be loved or, most
likely, left behind. A few days earlier, Zoyi had gently arranged them
herself and declared, “I think I’m too old for these now.”
The little princess bed had been pushed to the corner, awaiting its fate
on Facebook Marketplace. In its place stood a sleek white vanity with
a mirror and a glowing ring light. A new chapter. This was where Zoyi
now filmed videos she didn’t want Olga to see yet.
Secrets, identity, and growth. A new page now. Was it like that for my mom?
Time slipped from her hands like petals in the wind, leaving a sharp
ache of vanishing moments.
Olga began to prepare for a medical consultation online. She opened
the window. The air was thick with the scent of pollen and the early
T h e S h a p e o f T e n si o n · 315
warmth of summer heat. A season of change filled the room with
sweet inevitability.
She looked at the new mirror, staring at her reflection. Her face looked
foreign. Puffy under the eyes, dark circles. The very same features she
was concerned about in Zoyi, but now Zoyi’s eyes look better. Olga
felt that she had absorbed her illnesses after putting so much effort
into caring for her.
A strange tightness around her jaw was constantly there. Her left eyelid
was twitching without warning. She opened her mouth and let her
jaw hang for a moment, then slowly closed it. The ache never left. She
massaged her cheeks with habitual movements. Morning to night,
night to morning, a steel band of pressure looped around her temples
and clamped the back of her skull. The headaches that used to be only
in the morning had become a constant soundtrack, dull, pulsing.
Olga understood that she should make an appointment to her Primary
Care Physician and share her concerns with him, but Eugene’s heart
situation had decreased her trust in traditional medicine. She noticed
so many limitations in this philosophy; she wanted to be her own
knowledgeable health advocate.
Dr. Yohei Takada appeared on the screen, calm with an open smile.
Stylish orange glasses framed his face.
Olga discovered PRI, the Postural Restoration Institute, during a
late-night Instagram scroll. She was lost in a sea of wellness hashtags.
People there described exactly what she felt: whole body tension
and pain that no MRI could explain. Intrigued, she messaged Dr.
Yohei Takada, whom she had once met at a community event. They
arranged an introductory telemedicine visit.
Dr. Takada did not rush. His patient, even tone gave Olga room to
express herself.
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“Start from the beginning,” he said. “What is your body trying to say?”
“I already did the sleep study. No apnea. Just upper airway resistance
syndrome. Sounds harmless, right?” Olga let out a dry laugh. “But I
still wake up gasping. I think it’s real and not my imagination or fear
for my husband. My jaw goes into spasm. I look in the mirror in the
morning and see deep wrinkles between my eyebrows, like I’ve been
worried all night. I feel so tired in the morning.”
She rubbed her temple, eyes flicking down at her notes. “It’s not
just my jaw anymore. My neck feels like it’s made of steel wire. My
shoulders are so tense; it’s like I’ve been carrying a backpack full of
bricks for years. And my hips, God, my hips, they lock up. It’s like
my spine is stuck in some kind of silent cramp. I even notice that I
clench my glutes all the time.”
“That happens when people are trying to stabilize the body,” Dr.
Takada explained.
Olga looked up, her brow furrowed. “I can’t even describe it. I feel like
a map of micro spasms. My muscles have forgotten how to shut off.
Even when I sleep, it’s like my body is bracing for something. Every
nerve is on high alert.”
She offered a weary smile. “And now my feet have decided to join the
fun. Some mornings, I get out of bed and limp like a seventy-yearold.
The pads under my toes burn, as if someone has shoved glass
shards beneath my skin. I Googled it, of course—sesamoid bone
inflammation. Whatever that means.”
She paused. “My balance feels off. I get these little stumbles, like the
floor moves beneath me. And my eyes, letters blur, sometimes I see
halos. I used to read for hours. Now I squint after twenty minutes.”
Dr. Takada gave a slight nod.
T h e S h a p e o f T e n si o n · 317
“I know I’m not crazy,” Olga continued. “Something is wrong. I’m tired
of being told it’s just stress. Yes, my life is dramatic—my husband, my
daughter—but now I need help.”
“I’ve had these strange moments several times,” she continued slowly,
her fingers circling the rim of her cup. “It happened on the bus more
than once. The bus would make an abrupt stop, and I’d lose my
footing. Fall. Other people would reach out and grab the handrails.
But my body just didn’t know where it was. My eyes couldn’t agree on
where the ground was. I remember one time my husband caught me
just before I hit the floor. Another time it was a friend. They thought
I fainted. But I didn’t. I just lost orientation. Like my brain wasn’t
wired fast enough to react.”
She looked up at Dr. Takada, her voice softer now. “It always felt like my
eyes weren’t working together. Just for a second. Long enough to fall.”
Dr. Takada nodded slowly, jotting something down. “That’s important,”
he remarked. “That moment between seeing and responding—it’s
something we need to explore.”
Olga leaned back in her chair. The scent of cardamom lingered in the air.
Dr. Takada leaned forward. “What you’re doing at night isn’t
clenching. We might call it guarding. Your entire system is on high
alert, even in sleep. You’re holding your breath, tightening your hips,
your feet, your diaphragm. It’s a full-body silent scream.”
Olga blinked. “That’s exactly how it feels,” she whispered. “Like I’m
trapped inside a freeze.”
“Being human is hard work,” Dr. Takada said gently. “We are the only
species that stands upright on two feet. We hold our eyes level with
the horizon and maintain a stable center of gravity. That is not easy.”
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Olga gave a nod.
“But here is where it gets tricky,” he continued. “Your body will do
whatever it must to keep your eyes level and your feet grounded. It
might twist, tilt, or tighten in the wrong places. You may appear
upright from the outside, but inside, you are compensating.”
He gestured gently toward her jaw. “That’s where the teeth come in.
Your bite and clenching. Your nervous system is trying to stabilize
you from the top down. The bottom, your foundation, may not be
doing its job.”
Olga tilted her head. “I read something like that in the Postural
Restoration Institute philosophy.”
“You need to reset your foundation,” Dr. Takada said gently. “Not
only the jaw. We start with the feet, the hips, and the diaphragm.
Everything is connected by fascia. One tensegrity chain. If one part
tightens, the others follow.”
Olga wrote it down slowly, murmuring, “Fascia chain. Feet, hips,
diaphragm.” She glanced up. “But how?”
“We have several areas to address. First is breathing,” Dr. Takada
said. “Deep, slow, through your nose. It tones your pelvic floor and
balances your nervous system. You don’t need more breath; you need
less. Slower, lighter, quieter. That is strength.”
Olga frowned. “Less breath? That’s backwards.”
“I know,” he smiled. “But it works. And your circadian rhythm matters.
Wake up and get sunlight right away, or use blue light glasses if it
is dark or cloudy. At night, switch to orange lenses like mine to
block stimulation from screens. You want your brain to feel sleepy,
not excited.”
T h e S h a p e o f T e n si o n · 319
Olga nodded, scribbling. “Mouth closed. Nose open. Got it.”
She paused, considering. “What about food? Could that be part
of it?”
“It always is,” Dr. Takada remarked. “Inflammation speaks. You might
be reacting to common allergens—gluten, dairy, perhaps even eggs.
What does your diet look like?”
“We already try to eat clean,” Olga said. “Avoiding gluten and dairy.
Eggs maybe. We are watching Zoyi too. Sometimes, she gets a
stuffy nose.”
Dr. Takada opened a drawer. He pulled out a small dental appliance.
“This is what we call a Mandibular Occipital Occlusal Orthotic,”
he said, showing it to Olga. “It’s not just to protect your teeth. It
reminds your nervous system that it is safe. It helps reposition your
jaw just enough to take pressure off the joint,” he continued. “But
more than that, it sends a message. You don’t have to clench. You
are not in danger.”
Olga looked up, her eyes wide. “It looks like my husband’s oral
appliance,” she said. Then, with a hint of hope, she asked, “Do you
think that small guard could help calm my nervous system?”
“Exactly,” Dr. Takada said. “It’s like a permission slip for your whole
body to stop guarding. The nervous system first, then everything
else follows.”
Olga sighed, tucking her curly blond hair behind her ear. “I just want
to feel like myself again,” she said. “Like I belong inside my body.”
“You will,” Dr. Takada said gently. “Let’s begin with an assessment
in my office.”
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* * *
They met in Dr. Yohei Takada’s clinic for evaluation. Yohei’s office
was nothing like a medical clinic. It looked more like a yoga studio,
with the scent of rubber mats and climbing steps. No white coats
or harsh lights. Instead, warm wooden floors met soft gray walls, a
single potted plant sat in the corner soaking in the morning light. A
yoga mat was rolled out on one side. Resistance bands hung neatly
from pegs. In the center, a narrow treatment table stood like an island.
“Shoes off,” Yohei said, gesturing warmly. “Socks too.”
Olga looked at him, surprised. She slipped off her shoes and socks.
Her bare feet touched the floor, cool and unfamiliar. Immediately,
she felt the sting in the balls of her feet. A deep, bruised ache. It had
become a constant part of her days.
Yohei crouched beside her. “Just stand,” he urged. “Don’t think
too much.”
Olga stood in silence. Her body reacted instinctively. Shoulders pulled
forward. Her left hip drifted slightly ahead of the right. Toes clawed
the mat for stability.
They began the PRI evaluation. Yohei first tested her breathing patterns.
He placed one hand gently on Olga’s belly and the other on her chest.
“Breathe in through your nose. Slow. Now exhale, as if you’re fogging
a mirror.”
Olga tried. Her chest rose, but her belly barely moved. The tension
felt like a wall inside her.
Yohei shook his head gently. “You’re breathing up here,” he said,
tapping her clavicles. “That’s emergency breathing. Your diaphragm
T h e S h a p e o f T e n si o n · 321
isn’t driving the breath; your neck and shoulders are doing all the
work. No wonder everything hurts.”
Next came positioning. Olga lay on the table. One leg bent. The
other straight.
“Let’s not rush,” he urged.
Head tilted slightly, he stepped back. A composed half-smile rested
on his face. His dark eyes were attentive, taking in every detail.
“See here,” he said, motioning gently. “Your rib cage. One side opens
more than the other.”
Olga turned her head, following his gaze.
“And your right glute,” he added, tapping lightly near her hip. “It’s not
really joining the conversation.”
She exhaled softly.
“Your left foot is doing too much work,” he continued, calm and
matter-of-fact. “It flattens to help you stay upright.” He paused, then
gave a small nod. “Nothing is random,” he said. “The body always
finds a way. When one part forgets, another compensates.” His voice
stayed even, almost meditative. “We just have to remind the system
how to share the load again.”
“You’re adapting,” Yohei said, noticing the concern in Olga’s eyes.
“But now you’re stuck.”
He handed her a small balloon. “We’re going to reintroduce your
diaphragm,” he said. “Blow into this slowly at the end of your exhale.
It’s not about the lungs. I want to retrain your core.”
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Olga felt absurd. There she was, lying on her back with her knees
up, blowing into a balloon like a child. As she exhaled fully, her ribs
dropped, and her lower back pressed gently into the table.
Olga got up. Her feet were heavier. She felt her heels touch the floor
beneath her. She chuckled. “Feels strange.”
“We call it grounded,” Dr. Takada said, smiling.
Olga’s eyes welled suddenly, unexpectedly. She couldn’t quite
understand why.
“It’s a start,” Yohei said, resting a gentle hand on her shoulder. “The
body remembers how to heal.”
After the PRI evaluation, Yohei dimmed the lights slightly. He
poured warm water into two ceramic cups. Handing one to Olga,
he watched as she settled back on the small couch. Her feet were
tucked beneath her, and the warmth of the exercises still buzzed
in her muscles.
“I know that was a lot,” Yohei said, settling into the chair opposite
her. “How are you feeling?”
“Tired,” Olga admitted. “But it’s a different kind of tired. It’s like my
body finally got the signal that I can rest. Just a little.”
Yohei smiled gently. “Good. That’s the nervous system starting to
downshift. You’ve been living in a state of defense, high alert, for a
long time. Everything we saw today confirms that. Your left hip is
overworking to stabilize you. Meanwhile, your right glute isn’t doing
its job. Your diaphragm isn’t coordinating with your pelvic floor, which
is probably why you feel that tightness and urgency. And your feet?
They’ve been overcompensating for poor feedback from your center.”
T h e S h a p e o f T e n si o n · 323
Olga stared into her cup. “I knew something was wrong. But I thought
it was just in my head. That maybe I was weak. Or dramatic.”
“You’re not weak,” Yohei said firmly. “Your body learned that tension
was safe. Now, we just have to teach it another way.”
He leaned forward and opened his notebook. “Here’s what I propose.
We go in stages. First, we retrain your breathing to calm you and
create internal stability. Every breath should recruit your diaphragm,
not your neck. We’ll use balloon breathing, low exhale holds, and
exercises that train your ribs to expand to the sides.”
Olga nodded slowly. “So I won’t feel like I’m suffocating all the time.”
“Exactly,” Yohei said. “Next, we’ll do integration. I’ll give you daily
home exercises. Things you can do in ten minutes. PRI repositioning
drills, some wall-supported hip lifts, heel activations. Light work, but
very specific.”
“What about my balance? And my vision?”
“The body shifts into an extension pattern,” Yohei said. “Ribs flare, the
pelvis tips forward, and the head moves out in front of the shoulders.
Your neck tightens to keep you balanced. Your jaw starts to clench,
stabilizing the skull. Your eyes strain to keep the world level.”
He paused. “It’s often a visual compensation. When your eyes can’t
coordinate properly, especially if one is dominant, you subtly push
your head forward to stabilize vision and balance. It’s subconscious.
Over time, it becomes structural.”
“Sounds complicated,” Olga remarked, offering a half-smile.
“It’s precise,” Yohei corrected gently. “And we’ll go slow. We’ll also
support your sleep. You’ll need a dentist who can make a Mandibular
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Occipital Occlusal Orthotic. Wear it consistently at first. It will give
your jaw and cranial nerves a break. Morning light is critical. If you
can’t get outside within thirty minutes of waking, use your blue light
glasses. At night, wear orange glasses an hour before bed. No screens
in bed.”
“I’m trying,” Olga said. “But I get so tired I just scroll. It’s the only
time I feel like myself.”
“Then we won’t take that away,” Yohei said. “We’ll try a different
approach. Screens with glasses, maybe regular journaling with pen
and notebook as well. Let’s add some wind-down breathing.”
He paused. “You’re doing a lot,” he added gently. “Now, your body
just needs time to trust that it’s safe enough to soften.”
Olga’s throat tightened. She blinked hard. “And if it doesn’t?”
“It will,” Yohei said, making a small circular motion with his hand.
“Right now, your jaw is trying to do the job of your feet, hips, and
diaphragm. It’s clenching to create a sense of safety your body isn’t
getting elsewhere. But it’s not designed to be that kind of anchor.
That’s why you’re in pain. Your jaw joint is overfiring. Your cranial
nerves are on alert. Your brainstem thinks you’re in danger even
when you’re not.”
Olga blinked. “So, how does the guard tell my body I’m safe?”
“In a way, yes,” Yohei said. “It interrupts that survival loop. When
you wear the guard, it keeps your lower jaw slightly suspended and
prevents full clenching. This changes the input to your nervous system.
Your neck can finally let go. Your pelvis can stop counterbalancing
your bite. Even your eye muscles can recalibrate, because they’re
deeply connected to jaw position through the cranial system.”
T h e S h a p e o f T e n si o n · 325
Olga frowned, intrigued. “So my jaw affects my hips and my eyes?”
“Yes,” Yohei said. “You are one unit, Olga. PRI teaches that everything
is connected. The diaphragm, pelvis, jaw, feet, and vision. Your body
has been compensating for years. This device isn’t fixing everything,
but it’s the first domino. It shifts you out of defense mode, and then
we can build real support.”
“Do I have to wear the guard all the time?”
“For now, yes,” Yohei said. “Especially while you’re learning the new
patterns. Later, we can reassess. Think of it as training wheels. A
reminder to let go.”
“And if I take it out?” she asked, her voice tinged with caution.
Yohei smiled. “Then we observe what changes. The goal is not
dependence; it’s awareness. Your healing begins here.”
“I remember Dr. Sokolina taking that course from the PRI institute
with Dr. Hruska in your office,” Olga said. “She was deeply impressed
by its depth. She will make the guard.”
“That’s excellent,” Yohei replied. “I can join the appointment and see
firsthand how your body responds as she fits it.”
Her body felt lighter leaving Yohei’s office. Her heart, however,
did not.
Later, as she scrolled through the WhatsApp chat, Olga noticed a
brief message from her ex-husband.
His message read, “I want to know how you’re doing. It would be
great if you came to the class reunion. I know you think it’s scary
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here, but it’s not. I want to see your family pictures, your daughter.
She looks as beautiful as you are, I think.”
Olga wasn’t sure if continuing the conversation was a mistake. Yet,
she felt an overwhelming need for it, like gasping for air after being
submerged too long. It wasn’t him she needed, but the version of
herself that existed back then. Or so she kept telling herself.
A strange, treacherous tug stirred in her chest. It was a pull to home.
She knew it was dangerous in every direction.
F a u l t Li n e · 327
CHAPTER T WENT Y-THREE:
Fault Line
Olga
Olga accompanied Eugene to the cardiology appointment, even
though she had no energy left for it. Only guilt carried her forward.
She knew the conversation she had been avoiding could no longer
wait. He would never understand it.
Outside, the asphalt wavered in the summer heat. Inside the clinic,
the air-conditioning was sharp, almost cold. The vinyl chairs stuck
faintly to the back of Olga’s palms. A reminder of how long they’d
been waiting.
Olga dressed this morning without thought, pulling on black leggings,
a loose T-shirt, and her worn Birkenstocks. She had paused for a
moment at the closet, her eyes drifting over the bright summer
dresses hanging untouched. Once they had meant something, an
occasion and a flame within. Now she had no place to wear them here,
she thought with a dull regret.
Lately, that was how she moved through life—on autopilot. Eugene
asked, and she followed.
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Her once-beautiful blond hair hung heavy. She hadn’t touched a blow
dryer in what felt like a lifetime. Even the small ritual of smoothing
on moisturizer in the mornings had fallen away. The bottles sat
untouched on her vanity, a thin film of dust gathering on their caps.
She had no energy for it anymore.
It struck her bitterly because skincare had been her first act of
discipline, almost a family law.
Her mother’s voice still echoed: “You must start early, at nine
years old. If you wait any longer, it will be too late. Your face
will be full of wrinkles, and with so many wrinkles, you will not
get married.”
In Russia, where she lived, homemade remedies took the place of
imported creams or fancy serums. She remembered mixing honey
with egg yolk, slicing cucumbers to press against her skin. It had once
been so important. Now, she didn’t care anymore.
The row of perfume bottles on the dresser, once her treasures, each
glass vial like a jewel, standing proudly in its box, also gathered
dust. Her mother had never allowed her to touch the sacred bottle of
Climat in the blue box during Olga’s childhood; it had been bought
on the black market, smuggled in by sailors from France.
Once she moved to America, she chose scents that pleased her.
Sometimes it was a light citrus or a sweet fruity note. Always delicate,
never heavy. She remembered Zoyi’s curiosity. Her daughter would
lift the caps and experiment with a mist of scent.
A flat-screen on the wall of the cardiologist’s waiting room scrolled
an endless loop of nutrition advice: low salt, more vegetables, daily
exercise. Olga sat next to Eugene. Her shoulders were drawn inward,
her eyes fixed on the screen.
F a u l t Li n e · 329
When the nurse finally called his name, they were led into the
cardiology suite. It was small and cool, with blinds half-drawn against
the glaring summer heat. On the desk sat a silver flat computer screen
and a stack of reports, neatly clipped together. It included Eugene’s
Holter monitor data, his echocardiogram, and the bloodwork he had
done last week. The ECG printouts were still faintly pink, curling at
the edges.
Dr. Reno, clad in a white coat over green scrubs, hurried in. His
poignant blue eyes met theirs. “Eugene, we’ve reviewed all of your
monitoring and preprocedure tests. The arrhythmias are consistent,
and the ablation is the best next step.”
Eugene leaned forward as Dr. Reno opened a computer image of
a heart. A tiny catheter snaked into its chambers. “The abnormal
electrical pathways are here,” he pointed to the left atrium. “During
the ablation, we’ll use either radiofrequency energy or cryotherapy
to scar this tissue. That scar will block the faulty signals.” He smiled,
reassuring. “Your preprocedure labs and echo are fine. Structurally,
your heart is sound. That’s good news.”
Eugene nodded once more, this time with a tentative smile. “So, after
this, I’ll have a normal rhythm?”
“That’s the goal,” Dr. Reno said, folding his hands. His long, precise
fingers moved with a pianist’s control. “The success rate is high. But
you should know there are risks: bleeding, infection, and damage to
nearby structures. They’re rare, but real.”
Eugene shifted slightly. His jaw tightened.
Dr. Reno continued, “You’ll be admitted early on the day of the
procedure. Catheters will be placed through your groin vein and
guided to the heart under fluoroscopy. You’ll be sedated. The
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procedure usually takes two to four hours. Afterward, you’ll need
to lie flat for several hours to prevent bleeding. Most patients go
home the next day.”
He glanced at them both. “Do you have questions?”
Eugene exhaled. “No . . . I understand.” He glanced at Olga, seeking
reassurance, but she said nothing.
As they stepped back out into the punishing summer heat, Eugene
asked, “What do you think?”
The question hung in the air.
“They scheduled my ablation in two weeks,” Eugene added.
As they stepped out of the lobby, the automatic doors parted with
a soft sigh, releasing them into the thick late-afternoon heat. Olga
hurried a half-step behind Eugene, her eyes fixed on the lines of the
parking lot. Each numbered space blurred like a countdown. Now
or never. She had rehearsed the words for weeks—in the kitchen,
during sleepless nights.
Eugene moved slowly, still drained from the appointment.
Olga watched him, her heart tightening with a mix of guilt and
determination. She slid into the passenger seat. The leather felt cool
against her back.
“I need to spend some time in Russia.”
Eugene turned to her, stunned, as if she had slapped him. “What are
you talking about?”
Eugene blinked, as if he hadn’t heard her right. His face turned bright
red. “Olga . . . I don’t understand. I’m doing everything you asked. I
F a u l t Li n e · 331
stopped eating fast food. I’m almost eating clean. You said I needed
to change—I did.” His voice cracked. “And now you tell me this?”
She turned to face Eugene. “I’ll wait until your procedure is done.
I won’t take Zoyi with me. It’s not safe with the war so close. But I
can’t stay here. My head . . . my heart . . . I don’t feel good here. My
mental health is—” she paused, searching for words, “—suffering.”
Eugene’s face went pale again. “A psychologist could help. A doctor.
We can figure this out. Don’t do something you’ll regret.” His hand
trembled on the wheel. “You’re scaring me, Olga. Are you saying
you’ll leave me . . . and leave our life here?”
“I’m saying I can’t breathe here anymore,” she replied, her voice quiet,
almost cold.
“And Zoyi? Do you realize what you’re saying? You can’t just take
her away—”
“I told you,” Olga interrupted. “I won’t take her. I get it, it’s dangerous.”
Eugene pressed his palms to his face, then let them fall. He stared
at her. “If you want to see your mom so badly, we’ll go together. We
can meet in Estonia, in Armenia, anywhere safe. Zoyi’s on vacation.
We can make it work. Please.”
Olga shook her head, her jaw set with determination. “No. I want to
go by myself. This is my decision.”
They drove home without another word between them and the day
continued in silence. Olga was following her routine with Zoyi’s pick
up, dinner, moving like a mechanical toy. She noticed that Eugene
tried to work but then left. Several hours later, he returned. He brought
a heavy smell of pizza with him and a huge bouquet of red roses.
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His face was pale and swollen, as if he had been crying.
Zoyi inhaled the scent of the roses, her fingers brushing the thorns
with fearless ease. “I’ve had so many needles,” she declared with pride.
“These don’t hurt at all.”
Eugene didn’t open his computer that evening. Instead, he cleaned up
after dinner. He called Zoyi to check on her myofunctional routine.
Then, they played a cotton ball competition in the bathroom.
Once Zoyi was asleep, he joined Olga in the living room, sinking into
the chair across from her.
“I know I wasn’t an ideal husband,” he whispered, his voice breaking.
“I regret it. I promise I will change. But I can’t lose you. You’re the
love of my life.” He paused, searching her eyes. “Just tell me—why?
Why this decision?”
Olga lay on the sofa, gazing out the window at the rugged
Manhattan skyline.
She began slowly, as if peeling back layers. “It’s not sudden, Eugene.
Not a hot-spark moment. I’ve been thinking about it for a long time.
I imagine my life here . . . always as your shadow. As Zoyi’s caretaker.
As an immigrant with no voice. My accent marks me, makes me
foreign to everyone. I try to learn the rules, but by the time I use them,
there are new ones I never knew existed. It’s a game I can’t win. This
endless climbing, rushing, stressing—”
Her eyes became moist. “I’m losing my vision. My balance. Even my
memory. It feels like a constant fog pressing against me. And still, I
have to run. Always run. I’m tired, Eugene. So tired. I don’t want to
do it anymore.”
Eugene inhaled deeply and rubbed his face.
F a u l t Li n e · 333
“We never really talk about my work,” he said, looking away. “Maybe
that’s part of the problem. Remember when I told you about that huge
error at the company before I started mine?”
Olga shrugged slightly.
“I went home that night and couldn’t sleep. I kept thinking how
something so small could turn into something so expensive. I started
sketching a tool. Software that could flag risks early. Automate reports.
So less depends on someone being perfect at two in the morning.”
He glanced at her briefly.
“You remember that time. You called it my blue-light years.”
A weary smile crossed his face.
“I didn’t want to work for anyone else anymore. I wanted control.
Svoyu kompaniu. My own project. My rules.”
His voice grew tense.
“I know I wasn’t there. Weekends, vacations—I missed all of it. In
my head, I kept thinking, just a little more. One big client, and we’ll
finally be safe. I wanted that more than anything.”
He gulped.
“Then a fintech firm started circling. I told myself, just one more push.
Keep going.”
A moment’s pause.
“And then . . . after my incident . . . everything sped up.”
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His fingers trembled slightly.
“They made an offer. An upfront payout. Not crazy money, but lifechanging.
A multiyear contract. I thought . . . ‘Finally, I can build
the life you always deserved.’”
He glanced down at the floor.
“The bills are covered now.”
A long silence.
“For the first time in years,” he said, almost in a whisper, “we can
breathe financially.”
His jaw tightened.
“I’m an immigrant just like you. No safety net. No rich parents. I didn’t
know how to live balanced. I only knew how to build your dreams.”
A breath.
“I killed myself building this, so we would be safe.”
Olga shook her head slowly. “I know you did everything for us.
Spasibo,” she said, her voice thin. “You’re saying the right things.
They land where they should. But it’s too late.”
A pause.
“I still can’t breathe here.”
Eugene stood abruptly. His eyes flicked to the wall where their
ketubah hung in a dark wooden frame. The parchment seemed to
F a u l t Li n e · 335
glow in the dim light, the curvy Hebrew letters bowing their heads
in solemn agreement. He pointed to the Jewish marriage contract
with a shaking finger.
“We are a family. We made a vow. You might never come back. Don’t
you understand? You’ve heard the stories, people disappear, jailed
on invented charges. Do you remember that movie East-West we
watched together? That’s the reality. You need to talk to Dr. Sokolina.
You can’t . . . You can’t just vanish into that fog. Zoyi is a little girl;
she needs you. I need you. You are my core. I wouldn’t even be alive
if you hadn’t saved me.” Eugene’s voice cracked. “You are the love
of my life, Olga. Nothing matters more than that. Don’t you see? I
can’t lose you.”
She shook her head, whispering through her sobs. “I love you, Eugene,
and I love Zoyi more than anything. But I don’t love myself here.”
He swallowed hard, trying to steady his trembling voice. “Listen . . .
this weekend, Zoyi and I are starting a project together. She’s excited—
it’s for school. She wanted to surprise you. We’ll go to the Museum
of Natural History. It will be good for her, good for us. It will remind
you that there is still joy here.”
Olga nodded faintly, though her eyes were already distant. “I’ll go
with you to Manhattan,” she said softly. “But while you and Zoyi
are at the museum, I’ll ask if Dr. Sokolina can meet me nearby.” She
paused, then added, “Let’s not ruin the surprise you are preparing
with Zoyi.”
“Do you want to go to bed?” Eugene asked, kneeling beside the couch.
Olga tugged the cashmere blanket over her head.
“Let me carry you to bed,” he offered, hope threading through his voice.
336 · B RE AT HL E S S
“I want to stay here for now,” she replied, her voice muffled beneath
the blanket.
Eugene rose with a moan, his footsteps heavy as he walked away.
Olga slipped the blanket back and gazed at the ever-blinking
Manhattan skyline.
Something inside me is changing, and it’s not my heart.
B e f o r e t h e Tw o Li n e s · 337
CHAPTER T WENT Y-FOUR:
Before the Two Lines
Dr. Sokolina
The moment I heard Olga’s voice on the phone, I knew she wasn’t
suggesting just a casual walk. It was a clear, warm Saturday morning
when we met near the Swedish Cottage Marionette Theater. Central
Park buzzed with children’s laughter, bicyclists, joggers, and the
aroma of street vendor coffee. The invitation had caught me off
guard, but the desperation in Olga’s tone told me it was serious.
Even before she spoke, I sensed a weariness in her that a stranger
might overlook, but I knew Olga well. I noticed how she held her
bag, how her eyes drifted over the trees without truly seeing them.
As we strolled along the winding path toward Belvedere Castle,
past the blooming roses of Shakespeare Garden, she finally spoke.
“Eugene and Zoyi are at the Museum of Natural History today,” Olga
said, half-smiling. “They’re working on some kind of science project
together. Honestly, I don’t even know what the project is exactly.”
I raised an eyebrow, amused. “You didn’t ask?”
“I did,” she said, with a small laugh. “But their answers were vague.
Something about ‘career pathways’ and ‘evolution.’ Zoyi mentioned
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they needed to see the Hall of Human Origins to talk about it. I don’t
quite get why the museum was necessary to discuss careers, but . . .
they seem so invested.”
She looked outside of the park, where the sun was now casting golden
halos on skyscrapers. Her expression brightened.
“After everything with Eugene’s heart, they’ve really bonded. It’s
strange. That terrifying moment somehow pulled them together.
She used to keep him at arm’s length. He was the rule-maker, the
reminder to put the pencils away. But now, she’s the one who reminds
him to wear his sleep mask. Inside jokes. Shared snacks. She even sits
next to him on the couch while he is working.”
We started walking, slowly at first, through the winding paths just
east of the Great Lawn. We got a little lost in the dense ramble of
trees and crossed one of those curved stone bridges where time feels
suspended. It was the kind of walk that invites confessions. Finally,
we climbed the steps to the castle and looked down at the turtle pond.
The city felt miles away.
“I told Eugene yesterday. I’m going to Russia.”
I paused my steps for a moment.
“For how long?” I asked, hesitating slightly.
“I don’t know,” she said. “I’ll buy a one-way ticket. After his ablation.”
The turtles sunned themselves in the pond below. Olga leaned on the
railing, watching them with a far-off look.
“Rasstroilsia. He was very upset, devastated, even,” she said. “He really
asked me to change my decision.”
B e f o r e t h e Tw o Li n e s · 339
“And what did you say?”
“Ne mogu. I told him I needed something I couldn’t get here. I said
I’ve become this caretaker-machine, this manager of health plans
and symptom trackers. That I barely remember who I was before we
became a family.”
I listened. She didn’t cry. It seemed she had made peace with the
idea long ago.
“What about Zoyi? Is she going with you?”
“Zoyi’s not coming with me to Russia,” she said, her voice husky. “Yes,
she has a vacation coming up. Technically, she could join me, finally
meet her Russian family in real life, not just on Zoom. But the truth
is . . . I want her to stay here.”
She looked up, her voice firm. “The political situation in Russia isn’t
stable. Her life is here now, in the US. Her school and friends . . . And
Eugene . . . I don’t want to leave him alone.”
Olga took a deep breath. Her words came sharper. “I know everyone,
including you, might think I’m crazy. A terrible mom. An awful wife.
But I just can’t take it anymore. I’m losing my mind.”
Her shoulders sagged. “I’m tired of feeling like I’m always behind the
wheel of a failing bus,” she continued. “His CPAP, his oral appliance,
his weight goals, my cycle, my headaches, my tight hips, Zoyi’s
myofunctional therapy, and orthodontic treatment—it never ends.
And now Eugene will have his ablation in two weeks.”
“Tell me about the ablation. What did the doctor say? How will this
help Eugene?” I wanted to steer the conversation elsewhere.
“You know, I didn’t even know what ablation was at first,” she
continued. “I thought it was some sort of burn . . . and in a way, it is.
340 · B RE AT HL E S S
They go into the heart, usually through a vein in the groin. Threading
catheters up into the left atrium, they use heat or freezing to destroy
the tiny areas of tissue that misfire and trigger atrial fibrillation.”
I was taken aback as I looked at her.
Olga continued, “It’s more like reprogramming. They target the faulty
electrical pathways, aiming to isolate the pulmonary veins, as that’s
typically where the arrhythmia begins. Once those circuits are cut
off, the heart stops short-circuiting.”
“I remember the last time doctors touched his heart after the accident.
Tough stuff,” I said with compassion. “You guys got through a lot.”
Olga’s expression shifted. “I could see it in his face when the irregular
beats started. He’d go pale, hold his breath. When he gets scared, I
am scared.”
“Do they say it’s a permanent solution?”
She shrugged. “Sometimes it works on the first try. Other times,
people need a second attempt. The goal is to reduce the atrial
fibrillation burden. Make the episodes shorter, less frequent, or stop
them altogether. For Eugene, just knowing his heart has a better
rhythm again will give him back something. Confidence, perhaps.”
“What about his sleep apnea treatment?” I inquired.
“If he skips his CPAP or oral appliance, if he neglects managing his
weight and triggers, it can all return.”
“Living in constant fear is exhausting, I understand,” I said to Olga.
We exited the park through the Merchant’s Gate. The Maine
monument stood before us, its golden sculpture of a woman riding
a seahorse rising like an ancient warning.
B e f o r e t h e Tw o Li n e s · 341
“I know I sound dramatic, irresponsible,” she said. “I’ve been trying
to explain this to myself. Recently, I joined the group chat for the
twentieth-year St. Petersburg University reunion. We’ve been sharing
photos from our twenties. I look at my face in those pictures . . . and
I don’t recognize myself. Not just physically. Inside.”
Before we reached the café at Columbus Circle, I made a quick excuse
to duck into a nearby pharmacy. I didn’t tell her what I was buying.
But intuitively, I already suspected something.
We sat at a sun-drenched table with white cast iron chairs. We ordered
jasmine tea and some crispy, light avocado toast on gluten-free bread.
As we enjoyed our snack, I noticed the fatigue in her posture. There
was something like grief or regret, perhaps.
“I used to be so full of movement,” she said. “Ideas. Laughter. Men
would turn their heads when I walked into a room. It wasn’t about
how I looked; it was the fact that I was alive. And now? I’m hollowed
out. I’m not even angry, just . . . done. Done pretending that I’m
holding it all together.”
She stopped for a moment.
“And then I look at Zoyi, pulling away. She used to hang on my
every word. Now, she’s filming videos about secret matters. I feel her
slipping out of my hands. I don’t blame her. She wants freedom. But
I feel like my job is finished. My body’s falling apart. It’s too late to
start again. I can’t fix what’s already breaking.”
I didn’t interrupt. I wanted her to keep going.
“I have to go because I need to remember who I was before I became
everyone else’s life support system. I want to breathe air that
remembers me, to walk streets where I don’t feel like an alien, even
342 · B RE AT HL E S S
if just for a little while. I’m not abandoning my family; I’m trying to
salvage what’s left of me.”
She gazed out the window as if expecting the city to answer her.
“I love Eugene,” she added quietly. “And I adore Zoyi. But that
doesn’t mean I can survive like this. Even machines need to power
down sometimes.”
Outside, the traffic pulsed around Columbus Circle. Tourists
mingled with the blare of sirens and the hum of city noise. The world
didn’t stop.
As we lingered over the last sips of our jasmine tea, the conversation
shifted once more. This time, it returned to her family.
Her voice carried both relief and a touch of melancholy.
“It makes me feel like they’ll manage. Even if I’m in Russia for a while.
Maybe the scaffolding won’t collapse if I step away. Some banks or
corporations do that, I read. They send the manager away to see if
his system survives.”
I nodded slowly, holding back the impulse to question the logistics:
school runs, medical follow-ups, Zoyi’s summer, Eugene’s care. It
all seemed impossibly tangled. But I kept those thoughts to myself.
Something in the way she spoke made it clear she wasn’t seeking
permission or my advice. She had already come to terms with
the complexity.
“I won’t interfere,” I assured her softly. “Even though I have a dozen
questions. No judgment. You clearly know what could heal you better
than anyone else.”
B e f o r e t h e Tw o Li n e s · 343
She let out a breath, as though she’d been holding it, waiting for
someone to finally say those words.
“Thank you,” she murmured softly.
“It’s not about not loving Eugene. I just . . . I don’t love myself anymore.
I’ve become the warden of the house. The health monitor. The one
who tracks Zoyi’s nasal spray and Eugene’s CPAP data. I’ve lost the
part of me that used to be joyful.”
I asked softly, “How are you managing with the MOOO guard? Have
you been able to use it regularly?”
Olga gave a small shrug. “My morning headaches and body tension
improve once I’m wearing it,” she admitted. “But often, I just don’t
have the energy to put it in my mouth.” She paused for a second. “I’m
sure I’m entering menopause.”
“Why do you think so?” I inquired.
“My period had been a mess for several years, and now it’s gone. I feel
dry everywhere. I’m constantly running to the bathroom. My skin . . .
I have acne now. I used to be so upset that I didn’t have that physical
closeness with Eugene. But now, when I have a lot of attention from
him. That way. Every possible moment. My flame is gone. Isn’t that
strange?” She grinned.
She glanced down at her cup.
“Perhaps you need a doctor who specializes in hormone therapy,” I
suggested softly.
She nodded, her gaze fixed on the rim of the porcelain. “I’ve been
reading a lot,” she admitted. “Everything I find . . . it feels like it’s
describing me.”
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We sat across from each other at the small café table, jasmine tea
sending thin curls of steam between us. Olga unlocked her phone
and opened a note titled Hormone Replacement Therapy questions.
“Look,” she said, turning the screen toward me. “Progesterone. They say
it starts dropping years before menopause. I keep wondering if that’s
why I clench so much. Like my jaw is holding the rest of me together.”
She scrolled, her fingers moving swiftly across the screen. She kept
talking, almost to herself.
“They say progesterone calms the nervous system. When it drops,
women get migraines, bruxism, tension. Later, the airway collapses
more easily. That’s why sleep apnea shows up after menopause.” She
hesitated. “I even read that women who transition and artificially
stop estrogen can develop apnea too.”
Her voice lowered.
“I sometimes wake up gasping.”
She continued to scroll.
“And my thyroid gland,” she went on. “I’ve been cold lately. My nails
are brittle. They say thyroid controls everything—metabolism, energy,
brain fog. And stress ruins it. Cortisol messes with everything.”
She let out a sharp breath.
“Everything is intertwined.”
I nodded.
Olga held her phone with a strange intensity. She leaned into it,
hanging on every word.
B e f o r e t h e Tw o Li n e s · 345
“And then all these chemicals,” she said, almost laughing. “Plastics,
cosmetics, fragrances. Xenoestrogens. Even shampoo can confuse
your hormones.”
She looked up at me, searching for contradiction.
“I’m going to find a doctor in Russia,” she said. “Someone who will
run everything. Cortisol, DHEA, thyroid, all of it. I think it’s cheaper
there. I just want to know what’s happening to me.”
“I also watched this documentary about menopause,” Olga said, her
tone apologetic. “They discussed various options. Patches, pills,
creams . . . even pellets.”
She absentmindedly stirred her tea.
“They said patches are more natural because they go through the skin.
Pills, on the other hand, face criticism from some doctors due to clot
risks. Women discussed creams and tiny hormone pellets implanted
under the skin. Everyone had a different story.”
She gave a small, tired shrug. Her fingers traced the edge of the cup.
“And the testing,” she added. “They said you have to do everything.
Bloodwork, mammograms, pap smears. Full panels.” She looked up
at me, almost defensively. “It all sounded so complicated. Like you
have to become your own doctor just to survive it. Eugene says I don’t
need to worry about money here. But I do.“ Her voice softened. ”I just
want someone to look at everything, not pieces.”
I nodded in agreement. “You’ve become a professor of all
medical science.”
She let out a faint laugh. Then, she tapped her phone dark and set it
face down on the table.
346 · B RE AT HL E S S
“There’s a strange phase many of us go through when we read too
much medical literature,” I said carefully. “In medical school, I
diagnosed myself with everything I studied. Every symptom suddenly
felt personal.”
“I am sure something is happening,” I said gently. “Your body is
speaking. Remember? Dr. Takada mentioned that. We just need to
listen carefully, but with moderation.”
Her eyes glistened for a moment. “Tell me, honestly. Do you
think I am going crazy?“ She looked down. “Like those people
who convince themselves they’re sick all the time. Munchausen
or something.”
Her voice cracked. “I just want to feel like myself again.”
“I think you are just super tired,” I said. “But it may be the time you
focus on yourself more. On something that brings you pleasure . . .”
She reached for her tea and took a slow sip. A tired sigh escaped her
lips. Outside, the city shimmered with early summer energy.
I gently slid the pharmacy bag across the table.
“Go pee for me,” I said.
Olga blinked, her brow furrowing. “What?”
“Just take the test. Please.”
She pulled the bag toward her reluctantly, her fingers hesitating at
the folded top. Finally, she opened it and saw the box inside. She
froze. Her lips parted, but no sound came out. The bold letters on
the pregnancy test stared back at her like an accusation.
B e f o r e t h e Tw o Li n e s · 347
“You must be joking,” she whispered. “A pregnancy test?” She laughed
once, short and bitter, before shaking her head. “I cannot be pregnant.
I’m forty-two years old. I’ve always had trouble in that department.
And my periods . . .” she hesitated, her eyes flicking away, “sporadic
for the last four years. You must be kidding.”
She shoved the bag aside.
“You’re heading to the bathroom anyway,” I whispered. “Just do me
a favor.”
Olga sat in silence, her eyes fixed on the unopened box.
She paused, then picked up the bag quietly. She headed to the restroom.
When she returned, she sat down. Her eyes were wide, and her cheeks
were drained of color. She pulled the test from her bag and set it in
silence on the table between us.
Two lines.
“Holy shit,” she whispered, her hands trembling. “I’m pregnant.”
The sounds of the city surged around us. Buses sighed at the curb.
Yellow taxis zipped by. Tourists laughed, and distant music rumbled
low. Yet at our table, the world had changed dramatically.

N e w M a ps · 349
CHAPTER T WENT Y-FIVE:
New Maps
Dr. Sokolina
Some conversations begin long before the first sentence is spoken.
Tonight, Alex’s loss hung in the air between us. It had been a year since
Alex passed. Time doesn’t always dilute significance. Some people
continue living inside us, even when they’re gone.
The moment I stepped into Mission Ceviche, I understood why Inna
had chosen it. Murals of Andean mountains climbed the walls. A
golden bar shimmered with a blue fish mosaic. The air pulsed with
soft Latin rhythms. The bright citrus scent of ají amarillo and fresh
herbs lingered. The table was set with small ceramic bowls, brushed
with deep cobalt blue glazes.
“It still catches me by surprise,” she said quietly as we sat down. “I never
expected him to occupy so much space in my life after we divorced. But
now that he’s gone, it feels like . . . the room he took up is immense.”
I nodded. “I miss him every day.”
We ordered seafood ceviche and yuca fries. The plates arrived vibrant
and citrusy. They were colorful and lightly spiced. Each dish was
arranged like a small piece of art.
350 · B RE AT HL E S S
For a moment, I pictured Alex sitting across from us, tossing out
a sarcastic remark about portion sizes. The thought vanished just
as swiftly.
“I’m changing how I practice to become an airway orthodontist,”
Inna said between bites. “You know,” she said, “I never thought I’d
be saying this, but I’m done with the old orthodontic paradigm.
The whole straight-teeth-at-any-cost model? It doesn’t serve people
anymore and probably never did.”
I smiled. “I’m also restructuring my practice toward dental
sleep medicine.”
She offered a small, knowing nod.
I reached for my phone.
“I want to show you something,” I said, scrolling through my gallery.
“No names. Just tell me what you see.”
She leaned in.
The moment she saw the CBCT slices, her eyes sharpened.
Concentration took over.
“Hmm,” she murmured. “Nasal breathing is restricted.”
She zoomed in, pinching the screen with two fingers.
“And look at this airway—elliptical. I see this pattern a lot when the
tongue falls back.”
A pause.
“Does he have sleep apnea?” she asked, looking up at me. “The airway
is so narrow. Like breathing through a straw.”
N e w M a ps · 351
I swiped to a profile photo. Then, I turned the screen toward her.
“What about posture?”
She tilted her head, examining it closely.
“Oh wow,” she remarked. “That’s some serious forward head posture.”
She glanced up at me, then returned her focus to the screen.
“This brings to mind a girl I saw not long ago. She was eleven. Mild
crowding. Another orthodontist had suggested extracting premolars.”
She gave a slight shake of her head.
“But when you stepped back, it was clear—tilted hips, rotated
shoulders, a subtle spinal curve. Functional scoliosis.”
She tapped the image once more.
“The body reveals everything if you know where to look. The way the
head sits, the eye line, the tension patterns . . .”
Her voice turned reflective.
“Sometimes, I find myself wishing AI would catch up. Imagine the
possibilities: combining posture, airway scans, and inflammation
into one map.”
She glanced my way once more.
“Most of the time, crowding isn’t the problem. It’s the symptom.”
Despite myself, I smiled. “You read bodies like maps,” I said.
352 · B RE AT HL E S S
She gave a slight shrug.
“It’s the only way to see the whole story. Once we start moving the
teeth, the story changes.”
“That was Eugene,” I said, an ironic smile playing on my lips. “Four
teeth removed. Orthodontic philosophy to enhance his smile.”
Inna nodded. “Straight teeth for cosmetic results and cleansability,”
she said. “That’s how I was taught in my orthodontic program.”
“Whenever I think about Alex, one memory always returns,” I said.
“He once told me about taking your daughter shopping at GAP. She
was so decisive. Even at four, she knew exactly what she wanted. That’s
actually the age when airway orthodontists recommend starting
treatment,” I added.
Inna gently lifted her shoulders.
“It’s the most powerful growth window. But starting that early? It can
feel like crossing a line. Like turning childhood into a treatment plan.
Like medicalizing a life before it even begins.”
I took a slow breath. “My mom started my treatment when I was four.
Back in Russia. I hated it.”
“And now Zoyi is going through that treatment,” I added. “She’s eight,
and rather than taking space away, her orthodontist is working to
create it.”
She smiled, understanding immediately.
I nodded. “I like that Zoyi is doing myofunctional therapy at the
same time. Training the tongue, the lips, the breath.”
N e w M a ps · 353
Inna’s eyes lit up. “Exactly. When function changes, structures follow.
Without function,” she added, “orthodontics relapses. I see it all the
time. You can create beautiful arches, but if the tongue doesn’t live
there, the body takes it back. We’re only now rediscovering what
Weston Price noticed a century ago.”
“I’ve been adding a nose-breathing philosophy to my sleep patients’
treatment,” I said. “Almost like hygiene. Nose cleansing the way we
brush teeth. I read that ancient Ayurvedic medicine described it.”
She leaned in slightly.
“Simple things. Keeping the nose open at night. Supporting lip
seal, sometimes even with tape. These can completely change
sleep quality.”
I leaned in close and shared the details of the system I’d been building.
“I send letters to every doctor involved in my patients’ care. Sleep
physicians, ENTs, cardiologists, even psychiatrists. They need to
know what I see. How I can improve their patients’ lives.”
She paused, mid-bite.
“You actually send letters?” she asked.
“Every time,” I said. “And if no one replies, we call.”
She laughed. “You’re running a diplomatic mission.”
“That’s what it feels like,” I admitted. “This field is still new for MDs.
Many of them still think dentists only whisper to teeth.”
She smiled.
354 · B RE AT HL E S S
“But we notice patterns early,” I added. “Sometimes years ahead.”
I told her how saliva testing became my unexpected doorway into
functional medicine. “When patients see that their oral bacteria can
predict sleep apnea, reflux, even colorectal cancer, they stop thinking
it’s just dentistry. Once it looks like bloodwork, patients start listening.
“And what about physicians?” she inquired.
“Some lean in,” I said. “Some don’t. But curiosity is growing. Especially
among cardiologists focused on prevention. Did you know that
plaque in blood vessels can be reversed and is linked to inflammation
in the mouth?”
She nodded slowly, impressed.
“And then,” I said, pausing to sip my kombucha, “there’s insurance.”
She gave a shrug.
“I need separate software just for sleep and TMJ cases,” I said.
“Medical coding, preauthorizations, letters proving CPAP intolerance.
It’s endless.”
“Do they at least cover appliances now?” she inquired.
“More than before,” I said. “Medicare, many PPO plans. Yet, dentists
are almost always out-of-network.”
She winced. “So, you’re juggling translations for two languages
at once.”
“Exactly. Dentistry and medicine don’t just speak different languages,
especially in an insurance world. They use different alphabets.”
N e w M a ps · 355
“And your team takes care of this?” she inquired.
“They have to,” I insisted. “They visit medical offices, educating staff on
the necessary documents to solve patient airway problems. Without
this, everything falls apart.”
She leaned back, shaking her head. “That’s a whole ecosystem.”
“It is,” I nodded with a smile. “But now is the right time to build
that bridge.”
She stirred her drink slowly. “That’s the strange part,” she said. “We’re
the ones seeing it first. Airway, inflammation, posture, all of it. And
we’re still treated like technicians.”
“I know,” I said. “I look at bruxism, abfractions, inflamed gingiva—
and I see breathing. Mouth breathing hides in plain sight for years.
The medical world still underestimates it. Yet, it is the pinnacle of
many problems for kids and adults.”
I traced the rim of my glass. “I used to find it frustrating,” I admitted.
“Now, I don’t.”
She raised an eyebrow and went silent for a moment. Then, with
sadness, she said, “We learned something from loss. Alex . . . his
death opened something, didn’t it?” Inna leaned forward, elbows
on the table, her fingers brushing the condensation off her chicha
morada glass.
I looked down at my plate. “Yeah. It did. But that’s how growth
happens, right? No one grows during vacation. You grow when the
ground falls out. And the other truth?” I said, meeting her gaze.
“Science isn’t a closed book. What we know today, we might laugh
at it in a year. What feels cutting-edge today might look primitive
356 · B RE AT HL E S S
in a year. And that’s okay. That’s how it’s supposed to be. We keep
questioning and evolving.”
She lifted her glass just a bit. “To not knowing everything.”
“To the ones who admit it,” I said, clinking her glass.
H o m e , R e w r i t t e n · 357
CHAPTER T WENT Y-SIX:
Home, Rewritten
Dr. Sokolina
Olga opened the door before I could knock. For a moment, I wondered
if I had stepped into the wrong house. The woman greeting me glowed
in a way I hadn’t seen in years.
The leaves had started turning. Rust and ochre fluttered across the
sidewalks outside Olga’s window. The sycamore in front of her house
stubbornly clung to its green, like a child refusing to go to bed. The
wind carried a gentle October crispness, the kind that makes you
nostalgic without knowing why. Olga had invited me over to meet
the new puppy.
“Your belly looks so beautiful, and that glow! You don’t even need to
turn on the lights in your house in the evening.” I hugged Olga tightly.
“I am so happy to see you!”
Behind Olga, the unmistakable snort of a French bulldog echoed.
Zoyi’s delighted squeal followed as she tried to wrestle a scarf onto
the dog’s squirming body. It made me smile.
“Come in, Maria,” Olga said, her pride shining through. “Lunch is
almost ready. Eugene and Zoyi are setting the table. He’s become
358 · B RE AT HL E S S
quite territorial about meal serving. I always underestimate his ability
to surprise me.”
I stepped inside. The warmth of roasted vegetables embraced me.
Something herbal and savory, maybe tarragon, wafted through the
air like a welcome.
Eugene stood in the kitchen, drizzling dressing over a kale-apple
salad. His focus was intense. “It’s got to look like Ottolenghi,” he
said, half-joking.
Zoyi, tall and radiant, exuded a newfound confidence. She left the
puppy momentarily to grab the bowls.
“Look at what we have in our pantry now,” Olga said. She opened the
doors to reveal lentils, wild rice, and a jar of dried seaweed. Once,
Doritos lived there.
Later, as we sat down to eat slices of roasted salmon and warm
chickpeas with parsley, Olga surveyed the table with satisfaction.
“I’m really glad I stayed,” she said, resting her hand on her belly. “I
needed a reset. I thought it had to happen back in Russia, with my
old doctors, friends, and familiar streets. But the reset was in me.”
“How did you break the news to Eugene?”
Olga smiled. I could see she loved that story.
“So I met them at the entrance of the Museum of Natural History,”
Olga said almost dreamily. “Zoyi ran to me first. She was glowing.
Then I saw Eugene.”
She paused.
H o m e , R e w r i t t e n · 359
“He looked so tired, but the instant he saw me, his entire face lit up.”
We walked down Central Park West afterward. Zoyi held both of
our hands. It was strange. She almost never does that anymore.
But that day, she held us tightly, like she was the adult and we were
the children.
“I remember being so exhausted,” Olga continued. “The moment we
got home, I fell asleep. I kept waking and drifting off again. Their
voices echoed somewhere far away. When I finally woke up, it was
already dark outside. Zoyi was asleep. Eugene was in the kitchen,
washing dishes.”
Olga leaned forward and clasped her hands. “I sat at the kitchen
table. He asked if I wanted tea, offered to prepare something or
order. I said no. Then he sat across from me and asked if I had
seen you.”
Olga smiled faintly. “I didn’t answer. I simply took the test out of my
pocket and placed it on the table.”
I glanced at Eugene. A large smile spread across his face. He watched
Olga intently.
She exhaled. “He looked at the two lines. Then at me. Back and forth.
His eyes . . . they suddenly seemed so big. So green. He stood up and
began pacing the kitchen. Fast. Then he dropped to his knees.”
She looked somewhere far beyond the table. “He hugged my legs and
started crying. Loud sobbing. I had never seen him like that. Like
the terror of that morning when his heart stopped was coming out
of him. Koshmar. I still remember the hot wetness of his tears. The
kitchen felt unbearably warm. I couldn’t breathe. And that lemon dish
soap smell . . . I couldn’t stand it. It had never bothered me before,
360 · B RE AT HL E S S
but then . . . it made my stomach turn. He told me later what he was
thinking at that moment.”
Olga shook her head, then closed her eyes.
Eugene leaned forward and picked up for her. “I told Olga that I
kept seeing that white corridor the day of the accident and always
wondered why I survived.”
Olga swallowed. “And then he looked at me and said, ‘This . . . this
is why I came back.’”
She looked down at her hands. “He said . . .”
Eugene reached across the table, took Olga’s hand, and said, “I stayed
to see the face of my son.”
Olga let out a small laugh. “I told him it might be a girl. That’s when
he smiled and said, very softly, ‘And that would be great, then she’ll
be another version of you.’”
Olga rested her palm over her stomach. “I don’t want to sound
mystical,” she said, lowering her voice. “It felt like life made a decision
for us.” She looked up. “And I stopped looking at flights.”
Zoyi and the puppy joined us in the dining room.
The dog snorted at Zoyi’s feet, eager for a piece of salmon.
Eugene tossed him a small one. Zoyi protested, “Papa, no people
food for Remy!”
“Remy?” I inquired, raising an eyebrow.
“Remy is like in Ratatouille,” Eugene said. “The brave French chef.
This one brings us ‘bacteria’ every day from the streets.”
H o m e , R e w r i t t e n · 361
Olga said, “You know—Susan Maples mentioned that raising a brave
child starts with dirt. So, we walk every night. Even when it’s raining.”
She paused, reflecting. “I feel like I’m raising a different kind of baby
this time,” Olga added. “I know more now. About breath and function.
I want to get everything right from the start.”
She looked down at her plate. “No pacifiers this time. Just
MyoMunchee to prevent mouth breathing, tongue thrusting, and
promote proper jaw development. No squeeze pouches. Hard food
from early on. I read about the American Indian tradition—closing
lips, nose breathing from day one. I already got a nasal aspirator and
some xylitol saline spray. No sniffles will be ignored this time. If he
mouth breathes, we’re going to figure out why.”
Eugene looked up from his plate. “She’s got checklists now. For nose
breathing, for gut health, even the shape of his palate.”
Zoyi grew bored with our scientific discussion. She left with Remy
to her room.
“I want to build him strong. No sippy cups either, just open cups or
straws. That’s from the book by an Australian speech pathologist. You
should see the new baby spoons I found. They’re flat. They encourage
real tongue movement. I want him on solid textures early. That’s from
a pediatric dentist and anthropologist. Meat strips, apple slices. No
more pouches.”
I nodded. “And the bottle for emergencies?”
Olga shrugged. “If I need it. I found one shaped exactly like the
breast. But my goal is a year of breastfeeding. Pumping too, to keep
the supply. I want to give him antibodies. I want his face to grow the
way nature intended. I didn’t know all this with Zoyi.”
362 · B RE AT HL E S S
“And no antibiotics unless it’s absolutely necessary,” Olga added. “We’re
protecting his gut bacteria, an important ecosystem. No plastic toys
or weird fragrances. I want his immune system to build from nature.”
Zoyi was listening from the doorway, holding a small paper in her
hand. “Mama, you forgot to say he’s going to eat dirt too.”
Olga laughed. “That’s right. Another author says exposure builds
bravery. Dirt is good.”
We moved to linen-draped armchairs by the window to enjoy the
Hudson view.
I leaned back in the chair and watched Zoyi put the dog into a fleecelined
carrier with the confidence of a seasoned older sibling.
“She looks different,” I remarked. “Lighter, more open. How is she
doing with the myofunctional therapy and orthodontics?”
Olga smiled, her eyes tracing her daughter’s every movement. “We’ve
completed the active phase of myofunctional therapy.”
“Really?”
“She graduated,” Olga nodded, a smile spreading across her face as
she lifted her chin. “The therapist said her muscle tone is great. No
more lip movement when she eats or drinks. Her cheeks stay still,
tongue stays up, lips closed. She chews so slowly now, on both sides
of her mouth. It’s kind of mesmerizing to watch.”
I smiled. “Maintenance mode, then?”
“Yes. We still do a few exercises together to keep everything strong,
especially when she’s drained or stuffy. But now, the real work is
consistency. Habits.”
H o m e , R e w r i t t e n · 363
“How about ortho?”
“Oh,” Olga grinned. “That’s been a game-changer. The orthodontist
put her in a Twin Block appliance. It’s guiding her jaw forward as
she grows. She wears it most of the day, except during meals. At
night, too.”
“Is she tolerating it?”
“Surprisingly well,” Olga said. “We had a few complaints at first—
pressure, lisping, you know. But within a couple of weeks, she adapted.
And her sleep? Totally different. She used to be so restless. Now she
falls asleep quickly, stays asleep, and wakes up . . . peaceful.”
“She does seem different,” I agreed.
“She’s blossomed,” Olga whispered. “Like a social butterfly. At school,
with her friends, even with strangers. The teacher was quite surprised
by this change. She used to hide behind me, but now she walks into
a room, asking questions and sharing facts. She even taught the dog
to sit in both Russian and English.”
We shared a laugh.
“I just can’t believe how much of her was waiting behind that tired
face. We cleared the fog and met her for the first time.”
I smiled. “I think the power of breath and rest helps. Give the body
what it needs, and the beautiful spirit shows up.”
Olga poured a bit more tea.
“How are your jaws and feet?” I asked gently. “Still tight? Are you still
clenching? Do you feel pain while walking?”
364 · B RE AT HL E S S
Olga nodded. “Some days, yes. But it’s not as sharp. I’ve been wearing
that guard—MOOO—at night. It really helps. Dr. Takada explained
how it gives the nervous system a break, lets everything reset a bit.
I ordered different shoes recommended by the Postural Restoration
Institute. They distribute pressure differently. I have to do my PRI
exercises because my center of gravity changed.”
Olga placed a hand just above her belly and added, “I’ve also been
doing diaphragmatic breathing. You know, deep through the nose,
soft exhale. Dr. Takada said it tones the pelvic floor. I stretch every
day now, according to PRI. Not just yoga poses—real posture work.
A whole system. I didn’t realize how much I was overusing my upper
chest and jaw just to get through the day.”
I smiled, impressed. “And Eugene? How is he doing? I see a difference
in him as well.”
Olga’s eyes brightened. “So much better. He uses his oral appliance
every night now, without me having to say a word. It’s just part of
his routine. He’s finally stable on his GLP-1. After a few rough starts
with nausea, we found the right dose and appropriate medication. It
was a journey of trial and error. Interestingly enough, he doesn’t get
fast food cravings anymore. No more sneaking into the kitchen for
chips in the middle of the night.”
She let out a small laugh. “He used to fall asleep by 8 p.m. like an old
man. Now he actually stays up, reads with Zoyi, and walks the dog
with us. Different man. He’s present. I’m not parenting alone anymore.
His workload is different now, and that helps.”
“Like music to my ears,” I said, smiling.
Olga announced, “I want to become a hygienist. Maybe even a
myofunctional therapist. Once the baby is a little stronger.” Her
H o m e , R e w r i t t e n · 365
eyes sparkled with determination. “I want to help moms like me,
who are drained, who feel lost, but still believe in something better.”
“You can always come back to our practice in a new role,” I offered.
The clatter of a spoon interrupted our conversation.
“I forgot to tell you,” Olga said, turning toward me with a laugh.
“Remember the trip to Museum of Natural History? The many videos
done as a secret? We went to Zoyi’s school last week. Her science
project was about anthropology and jaw growth. She wants to be an
orthodontist now.”
“This is great!” I exclaimed, giving a thumbs up.
“She made a model of a skull with a narrow jaw and one with a broad
one. She talked about tongue posture, nasal breathing, and chewing.
I had tears in my eyes. That little girl who once hated mustard feet
baths is now talking about arch form.”
Eugene approached us with a smile and a raised eyebrow. “She used
to say she wanted to be a dolphin.”
Eugene was pretending to sneak chocolate from the drawer. Zoyi
caught him mid-reach.
“Papa! That’s not part of the plan!”
He winked. “A little rebellion builds resilience.”
Olga looked at her family, which had cracked, but never broken.
Growth is rarely quiet. It arrives like thunder. What follows is light.
I didn’t say much after that. Instead, I watched them. They laughed,
teased each other, and argued over who would do the dishes.
366 · B RE AT HL E S S
In front of me, they were bending into a new shape, one I hardly
recognized. Built from illness and loss, from choices made in the
dark, they somehow, impossibly, still formed into something stronger.
Simple pleasures are just miraculous.
It’s a baby’s crib in the corner. A dog leash by the door. A lunch
prepared by a man who once nearly died. And a girl who wants to
grow jaws or just help people.
The journey never ends. If you’re lucky, it loops back to love, and with
a breath, it begins again.
R e s o u r c e s · 367
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A c k n o w l e d g m e n t s · 373
Acknowledgments
Since I was a little girl in Leningrad, in the former Soviet Union,
I dreamed of writing a book. I told stories to myself long before
I knew how to write or imagined sharing them with others. Life
unfolded into clinical practice, and as the stories I witnessed began
to connect in unexpected ways, I started to see their meaning for a
healthier humanity. Something inside me kept insisting on being
written down. More than anything, this book became an attempt to
preserve moments and people who are no longer here in reality but
remain vividly alive in memory.
This book was shaped by many voices. I want to begin with Terry
Moore. His existential curiosity, kindness, and constant support
helped bring this project into the world. During the uncertainty of
COVID-19, he sketched the earliest table of contents, and his steady
inner fire kept mine alive.
I am deeply grateful to Nouriel Roubini, a visionary thinker with a
rare ability to see through time, who generously opened his home to
ideas and creators. I want to thank Dr. Robert Lustig, whose clarity
on metabolic disease reshaped how I understand modern illness
and nutrition, and Patrick McKeown, whose dedication to breathing
science and tireless advocacy for nasal breathing has influenced
countless lives, including mine. Sandra Kahn, for illuminating the
evolution of the modern jaw and the quiet forces shaping our faces;
374 · B RE AT HL E S S
Nathan Bryan, for revealing the healing language of nitric oxide
and the hidden chemistry of breath and life.
My dear friend Rita brought laughter and a touch of Chagalllike
romance into my life. Egor Sirota, my classmate and a bright
lighthouse since our school years, stands alongside his Olympic
champion wife Maria. Together, they provide warmth and humor
that never fails to lift the spirit. I am deeply grateful to my friends
Olga Cooperman and Igor Frid. Their generous spirit and thoughtful
reading helped shape these pages early on.
I am equally grateful to Dr. Mark Burhenne—@askthedentist—who
helped me find my voice in the digital world; my cousin Gene, who first
introduced me to the idea of universal justice; Dr. Kim Kutsch, founder
of Carifree, a remarkable inventor whose generosity and instinct for
connection uplift so many; and George Sirota, founder of StellaLife,
whose steady presence brings healing and kindness into the world.
To Afrodet, for opening the door to art, the vibrant life of New York,
and a constellation of extraordinary people.
I give thanks to the Harmony Dental team, past and present. Especially
to Dr. Alyona Sverdlov, Maryanna Kit, Marianna Cesse, Dr. Zarui
Chopuryan, and Renata Ablamska, who have shared the weight of
clinical practice with me for many years.
I am grateful to Jean Hanff Korelitz and her BOOKTHEWRITER
community, where I met many extraordinary people who became
part of this journey.
Betsy Agnawal, AARP editor, and Melissa Delaney, Forbes editor, who
helped shape the articles that laid the groundwork for this book.
I am also grateful to the early B-readers. Their reflections helped guide
this book while it was still emerging.
A c k n o w l e d g m e n t s · 375
I am deeply grateful to the editors who helped shape this manuscript
with care and clarity: Eric Koester, John Palisano, Clayton Boyle, and
Carol McKibben.
To the patients whose lives have touched mine—your stories dwell in
the heart of these pages.
I am deeply grateful to those who believed early, when the pages were
still coming together.
Alexander Mestechkin, Alexander Razdolsky, Alison Kole, Anne
Morse, Armine Arustamyan, Barry Wagenberg, Barry Chase, Bella
Kavalerchik, Boris Chernobilsky, Brie Allio, Corina Atanase, David
Federici, David Fieno, David McCarty, Dmitry Rykunov, Emilian
Miron, Eric Koester, Eugenia Glushanok, Funke Afolabi-Brown,
Gene Ku, Georgy Sirota, Herb Frankel, Igor Frid, Inga Klovaite, Inna
Gellerman, Inna Spivak-Cella, James Walton, Jason Tierney, Jessica
Lederhausen, Joseph Gaudio, Julia Sadove-Lopez, Judith Dember-
Paige, Judy Grossman, Kamilla Azbel, Kanako Hayashi, Kathryn
Alderman, Katie Kennedy, Kim Kutsch, Lana Schimmel, Laura Torrado,
Lenore Riegel, Lesley Briskin Belfor, Leonid Sokolin, Liya Brook,
Lina Zeldovich, Luba Kisilyuk, Lyuba Taft, Margaret Dikovitskaya,
Margarita Khorenyan, Marina Liberchuk, Marthe Schulwolf, Maryana
Kit, Michael Birman, Michael DeLuke, Michael DiDomenico, Michal
Niedzielski, Michelle Weddle, Mikhail Shulkin, Miyoki Chan,
Nicole Tobon, Olga Damansky, Olga Goldenberg, Olga Cooperman,
Regina Druz, Samantha Slotnick, Sari Schwartz, Scott Siegel, Sneha
Abraham, Steve Carstensen, Stuart Blumin, Suzy McNamara,
Svetlana Feldman, Svetlana Malakhova, Terry Moore, Terry Osborn,
Tetiana Rubis, Tom Levine, Toni Dolce, Valeriia Barkhatova,
Valerie Cacho, Yaron Davidson, Yelena Razdolskaya, Yelena Yoffe,
Yevgeniy Klebanov, Yohei Takada, Yuliya Sandler, Zarui Chopuryan.
And to my family and friends, who make every story worth telling.
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