In lieu of an abstract, here is a brief excerpt of the content:

• The Color of Breath
• Coreen McGuire (bio), Jane Macnaughton (bio), and Havi Carel (bio)

Breath under the Skin

Pulse oximeters are technological devices that measure oxygen saturation in the blood using a small infrared light beam. Through measuring the rate of light absorption, they record a proxy measure of oxygen levels in the blood. Normally, if your blood oxygen levels were measurably low, you would know it. You would experience corresponding physical symptoms, such as shortness of breath or dizziness. And yet the Covid-19 pandemic has generated significant reports of “happy” or “silent” hypoxia: the previously little-known phenomenon of people with dangerously low blood oxygen levels who nonetheless function without shortness of breath.¹

These cases highlight a central theme emergent from the Life of Breath project: that there is often a mismatch between objective and subjective measures of health, also known as symptom discordance. A person with low oxygen levels in their blood may present with no discomfort, while another with reasonable levels might complain of severe breathlessness.² Symptom discordance also demonstrates the complexity of the sensation of breathlessness and underlines that the way we perceive breathlessness is constructed partly through physiological data but also through our individual context, personal experience, expectations, and individual psychologies.³

The recent uptake of oximeter use has helped to illuminate deeper problems with the ways we attempt to measure breathlessness through technologies. One of the most critical is that the infrared light is less effective on dark skin.⁴ The oximeter tends to overestimate oxygen saturation levels in non-white individuals, with the error degree increasing in correlation with the skin’s darkness.⁵ This is a pointed metaphor for how the pandemic has laid bare the racial and socioeconomic inequities that have tracked morbidity rates—and has shown simultaneously [End Page 233] how systemic racism causes literal suffocation. George Floyd’s cry of “I can’t breathe” echoed Eric Garner’s identical plea in 2014, both of which so vividly express the devaluation of black lives in the United States. This rallying cry for the Black Lives Matter movement has been amplified by both the global growth of the BLM protests and the breathlessness caused by Covid-19, disproportionately affecting black people and other ethnic minorities.⁶

Breath has long functioned as a metaphor.⁷ Now breathlessness is especially potent as a metaphor for the need for freedom from oppression. This is potently captured in Achille Mbembe’s essay “The Universal Right to Breathe,” in which he argues for breath as a key force for unification in a post-Covid-19 world.⁸ Noting the malign influence of capitalism which has “constrained entire segments of the world population, entire races, to a difficult, panting breath and life of oppression,” he insists that to survive this “constriction” we need to “conceive of breathing beyond its purely biological aspect, and instead as that which we hold in common, that which, by definition, eludes all calculation”: the universal right to breathe.

Skin-Deep

This universality is not acknowledged in clinical contexts, certainly. How we understand breath medically is subject to measurement and calculation—and this calculation undermines the universal in both obvious and subtle ways. Ingrained racial bias is not just skin-deep. It is embedded in the technologies behind technologies: that is, in the data itself. The New England Journal of Medicine recently published a list of race-adjusted algorithms to highlight the growing concerns with their uses given the “mounting evidence that race is not a reliable proxy for genetic difference.”⁹ Medical historians Lundy Braun and Coreen McGuire have shown how spirometric technology has historically been wielded to deepen and reinforce racial differences. Braun’s Breathing Race into the Machine revealed that the practice of “correcting” for race in spirometry, the study of lung function, promoted scientific acceptance of difference between racial groups, without due concern to the racial categories employed to organize this data in the first place, or to the way that social conditions and living conditions affect lung function.¹⁰ McGuire’s Measuring Difference, Numbering Normal developed this analysis by demonstrating the use of variable and inconsistent reference classes in spirometry with regard to women and...

中文翻译：

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呼吸的颜色

代替摘要，这里是内容的简短摘录：

• 呼吸的颜色
• Coreen McGuire（生物）、Jane Macnaughton（生物）和 Havi Carel（生物）

皮下呼吸

脉搏血氧仪是一种使用小型红外光束测量血液中氧饱和度的技术设备。通过测量光吸收率，他们记录了血液中氧含量的替代测量值。通常，如果您的血氧水平明显偏低，您就会知道。您会出现相应的身体症状，例如气短或头晕。然而，Covid-19 大流行已经产生了关于“快乐”或“无声”缺氧的重要报告：以前鲜为人知的现象，即血氧水平极低的人仍然可以正常工作而没有呼吸急促。¹

这些案例突出了呼吸生命项目中出现的一个中心主题：客观和主观的健康衡量标准之间经常存在不匹配，也称为症状不一致。血液中含氧量低的人可能不会感到不适，而另一个水平合理的人可能会抱怨严重的呼吸困难。²症状不一致还表明呼吸困难感觉的复杂性，并强调我们感知呼吸困难的方式部分通过生理数据构建，但也通过我们的个人背景、个人经验、期望和个人心理构建。³

最近对血氧仪的使用帮助阐明了我们尝试通过技术测量呼吸困难的方式的更深层次的问题。最关键的因素之一是红外线对深色皮肤的效果较差。⁴血氧仪倾向于高估非白人个体的氧饱和度水平，误差程度与皮肤暗度相关。⁵这是一个尖锐的比喻，说明大流行如何暴露了追踪发病率的种族和社会经济不平等——并同时显示[End Page 233]系统性种族主义如何导致真正的窒息。乔治·弗洛伊德 (George Floyd) 的“我无法呼吸”的呼喊呼应了埃里克·加纳 (Eric Garner) 在 2014 年的相同恳求，两者都如此生动地表达了美国黑人生命的贬值。BLM 抗议活动的全球增长和 Covid-19 造成的呼吸困难加剧了黑人的命也是命运动的号召力，对黑人和其他少数民族产生了不成比例的影响。⁶

呼吸长期以来一直是一种隐喻。⁷现在，呼吸困难作为对摆脱压迫的需要的隐喻尤其有效。这在 Achille Mbembe 的文章“呼吸的普遍权利”中得到了有力的体现，他在文章中认为呼吸是 Covid-19 后世界统一的关键力量。⁸注意到资本主义的恶性影响，它“将世界人口的整个部分、整个种族都限制在艰难、喘息的呼吸和压迫的生活中”，他坚持认为要在这种“限制”中生存下来，我们需要“设想呼吸超越它纯粹是生物学的方面，而是作为我们共同持有的，根据定义，逃避所有计算的东西”：普遍的呼吸权。

肤浅

当然，这种普遍性在临床环境中并未得到承认。我们如何在医学上理解呼吸取决于测量和计算——这种计算以明显和微妙的方式破坏了普遍性。根深蒂固的种族偏见不仅仅是肤浅的。它嵌入在技术背后的技术中：即数据本身。《新英格兰医学杂志》最近发布了一份经过种族调整的算法清单，以强调人们对其使用日益增长的担忧，因为“越来越多的证据表明种族不是遗传差异的可靠代表”。⁹医学历史学家 Lundy Braun 和 Coreen McGuire 展示了肺量测定技术在历史上是如何被用来加深和加强种族差异的。布劳恩的将种族呼吸到机器中揭示了在肺功能研究中对种族进行“校正”的做法促进了对种族群体之间差异的科学接受，而没有对首先用于组织这些数据的种族类别给予应有的关注，或者社会条件和生活条件影响肺功能的方式。¹⁰ McGuire 的Measurement Difference, Numbering Normal通过展示肺量测定法中关于女性和...