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Thomas was the apostle who did not believe Jesus had been resurrected. According to the Bible, (John 20:24-29) he was not convinced until he actually saw and felt the scars of Jesus.

Since then, anyone who refuses to believe something without direct physical proof is called a Doubting Thomas. And, therefore, an asthmatic that refuses to believe he has asthma is rightfully dubbed a Doubting Thomas.

Believe it or not, I've seen my fair share of these folks in my 11 years as an RT. It's neat, because they will come into the ER for an unrelated reason, the doctor will listen to them and order a breathing treatment, and then I enter the patient's room thinking I'm going to do another breathing treatment just because the doctor didn't know what else to do.

Just recently I had a pudgy, balding male named Carl, mid 30s, lying supine on the ER bed. He appeared to be breathing normally. I gave him my usual line, "Hi. I'm Rick from Respiratory Therapy. Are you having trouble breathing?"

"No," he said, "I feel fine."

"Okay, so why am I giving you a breathing treatment," I think to myself. Then I say, "How come you came to the ER tonight?"

"Um... because I was just not feeling right. I also have a little chest pain."

I pulled my stethoscope from my lab coat and pressed the bell on the patient's anterior chest. I hear wheezes. "Can you please sit up so I can listen to your back?" I listen to his back. "You definitely have wheezes in there. Do you have asthma?"

"Not that I know."

I hand the patient a nebulizer that I had already filled with one amp of albuterol.

"What's this for?"  The patient looked at me awkwardly.

"This is for people with breathing trouble," I said, "The doctor thinks it might help you breathe better."

"Well, I'll take it, but I'm not having trouble breathing."

I plug the nebulizer tubing to the flowmeter and the neb sputters to life, releasing its cool white mist into the room, and hand it to the patient who spends several minutes inhaling the mist. 

I stand coolly by until the nebulizer sputters, a tell-tale sign that it's finished. I turn off the flowmeter, and pluck the nebulizer from the patient's mouth. "So, how do you feel now?"

"You know what?" he said, taking in a deep breath and smiling, "I think I feel great. Wow! I don't think I've ever felt this good in my life."

Ah, and that last sentence -- "I have never felt this good in my life"-- following a bronchodilator breathing treatment -- is a tell-tale sign of a Doubting Thomas asthmatic.

"I bet you've been short-of-breath for days and you didn't even know it."  If you ever hear an RT or doctor ask this question, you know he is thinking Doubting Thomas.

"Actually," the patient said, "I've had this regular cough for years, especially after exercising.  It got so bad I had to quit exercising a few months ago.  I just thought being a little short-of-breath was a normal part of aging."