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lmost every child I grew up with couldn’t breathe with ease.

Growing up in the smog-infested New York City projects didn't help our bodies develop healthily; but there was always a particular insidiousness to the asthma of my poor, brown peers. I was born and raised in the neglected Manhattan neighborhood of Washington Heights, an area comprised primarily of Puerto Ricans and Dominicans. The Heights is tucked at the tip of Manhattan at the cusp of where the Bronx begins, with the Henry Hudson Highway, polluted Hudson River, and notoriously noxious East River encasing us on all sides of the borough. Our sicknesses -- asthma, chronic malnourishment, lead poisoning (to name a few) -- were often forgotten by city officials or casually written off by our Medicaid doctors. Our families, however, suffered in the turmoil of being constantly at war with our living conditions.

I grew up surrounded by garbage, violence, the crack epidemic, and homelessness. Yet what stuck out to me most in the fray were those inhalers. Even now as an adult, I still clearly envision the methodical pull of multicolored pumps from a jacket or a backpack, and the swift, desperate inhale that accompanied the push of the pump. Many nights I fell asleep to the gentle whirring of my brother's and grandmother’s nebulizer machines. The machines were bulky and gray, and rested on the floor by the foot of their beds. A long tube had a face mask at one end to put over the nose and mouth, while the other end attached to the belly of the machine. The nebulizer siphoned medication into the bronchial tubes of asthmatics. No one I knew could breathe.

New York City doesn’t exactly offer space as its primary currency, but there are certain privileged benefits that are specific to place. Compared to areas like the Upper East Side, neighborhoods like Washington Heights lacked reasonable accommodations and consistent sanitation. Wealthy folks in Manhattan didn't have space either, but they did have access to supermarkets with healthy food, private doctors, balconies up in their luxury towers. This meant more access to fresher air, clean parks, and the financial means to escape cramped Manhattan for spacious areas like the Hamptons. What we had in the Heights were our stoops and dirty jungle gyms, or apartment buildings that were falling apart and neglected by the city; incidentally in these poor areas, we find children with the highest rates of asthma and chronic breathing problems. We could not breathe.

Many Puerto Rican and Dominican families were poor. We slept three people or more in bedrooms designed for one. Uncles slept in the kitchen. My grandmother slept in the living room. I knew of children who didn't have bedrooms at all, but just pretended, as they coughed into the night. Cramped living conditions both in and out of our homes made us ill. My grandmother’s asthma was exacerbated by the lack of space. My mother, brother, and I lived with her for many years in a tiny apartment. It was filled with her constant wheezing and the blaring noise pollution outside on Broadway. Always the sirens and screaming outside, always her labored breathing: this is what I remember.

I also remember my grandmother’s startling calm during her daily asthma attacks. I remember her shaking hands motioning me for her asthma pumps. I remember her body cradled on old rocking chair, taking deep breaths in by an open window that faced out onto one of the loudest avenues in Manhattan. Her cheeks were old, skin mottled and thin like paper, and she was tired. But every day, she’d wake, dress, dab on her lipstick and shuffle outside for walks up Broadway. I remember walking with her as a child. I remember the slow pace of her gait, the struggle to inhale and the determination in her to keep moving. All this despite her chronic illness.

She endured. We endured.

I lost touch with a lot of the kids on my block, especially since I moved to San Francisco several years ago. I still am close with my asthmatic brother. He and I are both athletes as adults, somehow, despite all of the sickness. And my grandmother, who suffered tremendously from asthma attacks when I was a child, is still alive. Despite her multitude of illnesses, including dementia and Parkinson's, she continues to push forward. In the few times a year I return back to Manhattan, I make sure to see her. Even in her frailty, she still remembers me. And she still has the fire in her eyes.

I aspire to live like she lived, waking up every day, knowing our hearts are still beating -- and taking a deep breath in.