Jack Kelly writer
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EMERGENCY SPIRITUALITY
(Spirituality & Health, March 2007)
A melodious bell sends a ripple through the meditation hall,
calling us to shed distraction. As the reverberations die, we
bring our peaceful contemplation to the breath and to the
always unruly mind.
The signal that marks another facet of my life is quite
different: a sudden electronic yodel, an urgent hi-lo alarm,
and a clipped announcement of an emergency in our
community. For more than fifteen years, I have volunteered
as an emergency medical technician with the rescue squad in
the township where I live in rural upstate New York.
Ultimately, spiritual practice is not intended to remove us from
the daily round, but to turn on a light in our life, to wake us
up. This is what matters; now is the time.
How does being an EMT complement the spiritual seeking
that has led me to disciplines like Iyengar yoga and insight
meditation, to the Bhagavad Gita and the Bible? My
emergency work has served as a touchstone that has helped
me to leave behind concepts, imaginings, and abstractions,
and to come face to face with life as it is lived.
#
“Respond for a one-car motor vehicle accident,” the
dispatcher’s voice intones over my portable radio, “person
trapped in the vehicle, State Parkway northbound, just south
of Willis Road.” Our squad is activated by the alarm; no one
waits on duty at the station. In an impromptu choreography,
some of us will man the ambulance and rescue truck, some
will go directly to the scene of the accident.
The calls follow no pattern. I may be sitting at my computer
finishing an article about the history of technology, or lying in
bed under five layers of dreams. I may have just returned
home from another call, or I may not have been out on one
for a week. I might feel dejected or inspired, worried or
elated. I could be mowing the lawn, taking a shower, or, yes,
meditating.
The alarm erases my mood and every mundane thought.
What was I imagining? What concern, petty or profound, filled
my universe? All gone.
I lay down my fork, leave off in mid-sentence, walk quickly to
my car, turn on a flashing blue light, and head for the scene.
I say, “I.” Someone is driving the car, surely. Someone is
deciphering the broken radio transmissions that give updates
on the situation unfolding across town. Someone is reviewing
protocols for treating imagined injuries -- the signs and
symptoms of shock, the steps of cardiopulmonary
resuscitation.
Someone. Yet much of what makes up my daily “I” does not
accompany me on the call. I have no use for pride,
resentment, nostalgia, or regret. The uncertainties and
quibbles and habitual thought loops evaporate. I discard the
well-worn pack of tarot cards, each one a facet of myself: the
Thoughtful Man, the Spiritual Seeker, the Concerned Citizen.
I bring to the scene the mindfulness of the craftsman. The
work is familiar and exacting, a combination of precise
protocols and second-by-second improvisation. Distraction is
everywhere -- flashing strobes; the loud growl of engines,
pumps and generators; the panicky inquiries of a patient’s
family; the sight of twisted metal and broken glass. When I
am sitting in meditation, the most trivial thought can yank my
attention away from my practice. In the chaos of an
emergency, my mind remains clear.
Today it is a young woman pinned behind the steering wheel
of a mangled Camry. She is alert but terrified, her leg broken,
her face veiled with blood from a laceration on her scalp. Our
procedure is always to “remove the vehicle from the patient”
in order to protect against further injury. I climb through a
window into the back seat, check the patient’s pulse and
blood pressure, apply an extrication collar to guard her
cervical spine, and reassure her. Other squad members
systematically dismantle the car with hydraulic tools. We
carefully slide the patient onto a backboard, splint her injured
leg, and load her into our ambulance.
These tasks rivet my attention and bring me wholly into the
present. Utterly consuming, they obliterate my ego. The
process reminds me that the almighty self, with all its moods
and concerns, is transient rather than fixed, a process not an
object. At the focal point of concentration, it disappears.
#
While researching an article about the history of volunteer
rescue squads I asked a young woman what motivated her to
become an EMT. She didn’t bother with the usual
commonplace about wanting to serve her community.
“Whenever I would drive past an accident,” she said, “I
always wanted to be there at the center of things.”
Those who work in emergency services, myself included, are
adrenaline junkies. The eraser that cleans the slate of my
mind at the sound of an alarm is adrenaline. The mechanism
that concentrates my attention in ways that I rarely
experience in my ordinary life derives from the complicated
chemical stew that an emergency sends through my veins.
The resulting emotional clangor has taught me something
about that perennial spiritual vexation, attachment. Thinking
back to my early days as an EMT, I remember the heart-
pounding fear as I raced to a call, the dread of coming upon
a situation for which I was unprepared.
Some who venture into EMS cannot go beyond that fear.
Inevitably, they don’t last. For the rest of us, experience
changes our perception. The rush of alertness becomes
excitement, not dread. It becomes the thrill of the roller
coaster or the ski slope.
My spiritual practice has taught me that emotions arise
ceaselessly. It is the clinging and the labeling that allow them
to take over. I call arousal fear, and it takes the shape of
fear. I feed my anger, and I become my anger.
Looking back, I see that much of the fear I felt en route to a
call, though it was spurred by adrenaline, was shaped by a
sense of self. Can I handle this? Will I be overwhelmed? How
will I look? Letting go of those concerns, focusing on reality
rather than the products of my mind, has allowed me to
release my attachment to fear.
This is not to say that the rush that comes with an alarm is
completely benign. We are not made to live our lives in
emergency mode. Adrenaline is a tricky and dangerous
hormone.
I collaborated on a book called EMS Stress with Dr. Ray
Shelton, an expert in emergency services psychology. Much
of the advice he offers to EMTs and other emergency
responders focuses on the insidious effects of the fight-or-
flight reaction -- the hyperalertness and searing memories
that can hobble us in daily life.
To survive, an EMT must learn how to use emotional arousal
and also how to turn it off. No matter how intense the
experience, we have to let it go as soon as it’s over. We have
to learn detachment. It’s a lesson that transfers readily to
spiritual practice.
#
My metaphysical struggle often takes the form of a wrestling
match with that ferocious and seductive monster, time.
Impatience and regret are the dual stalwarts of suffering. My
inconstant mind clings to the past and gropes blindly toward
the imagined future. I am oblivious to the obvious: that I live
my life wholly in the eternal now.
The word “emergency” derives from a root meaning “to dive”
(thus the merganser, the diving duck). Only, an emergency
dives out, it emerges from the surface of time, springs upon
us.
Consciousness of time forms a background to much of my
training as an EMT. The “golden hour” is the period following
a physical trauma during which the body is best able to
compensate for insult. When a heart fails, the patient’s
chances of survival head south at a rate of 10% a minute. On
the scene, the clock is always ticking.
What does familiarity with emergencies tell me about time’s
complexion? An EMT takes for granted that there are
occasions when hesitation can be fatal and knows that those
occasions can arise at any moment. Crises are
unpredictable; time is relentless and irredeemable. There are
no do-overs for an EMT. The demand for action dives from
the surface of time to confront me.
Emergencies remove the cushion of time that surrounds us in
our ordinary lives. Could that the cushion be, at some deep
level, an illusion? Survivors of wrecks often comment, “It
happened so fast, one minute I was driving along and then . .
.” They thought they would have time to swerve, to jump out
of the way of their fate. Afraid not.
“Watch this next breath as if it’s the last breath you’ll ever
take,” a meditation teacher once said to me. What is living in
the moment but living as if each instant were critical and
irreversible? As if there were no cushion?
#
Many of the lessons I’ve learned in emergency service have
been taught by other EMTs. The historian Shelby Foote has
a character in his novel Shiloh describe soldiers marching
into battle: “All the put-on had gone out of their faces -- they
were left with what God gave them at the beginning.”
When rescuers are called out in the bleak predawn hours, we
do not take time to don our social masks. At the scene of a
bad accident, there is very little put-on in our faces. As a
result, we come to know each other in ways that are different
from how we know our casual friends. We share a sense of
community founded on unavoidable honesty.
We also share a bond with our patients. The torn and sick
persons we encounter are likewise beyond pretense,
stripped to their barest vulnerabilities. We encounter each
other with a wide-open lack of guile. In the process we gain a
taste of the human truth that lies behind all masks.
The conversation of EMTs does not tend toward the spiritual.
It swings from the technical details of a call to firehouse
gossip to black humor. It rarely comes to rest on our central
purpose: alleviating the suffering of our fellow beings.
This instinctive attitude of EMTs aligns with the advice of the
sages. Our activity is “nothing special.” We help, but without
any thought of helping.
“When we do something with a quite simple, clear mind,”
Shunryu Suzuki says in Zen Mind, Beginners Mind, “we have
no notion nor shadows, and our activity is strong and
straightforward.”
#
Before becoming an EMT I had never seen a person die. I
had encountered very few corpses not primped for the
funeral home. Over the years, I have been present with many
persons as they have slipped into eternity. I have observed
how easy it is to die -- the passage is not marked by fanfare
or orchestral crescendo. A life can go out as quietly as a
candle flame.
Our spiritual quest takes place in the shadow of death. It is
the fleeting nature of life that motivates us to dig for meaning,
that makes the search more urgent as we age, that provides
the final measure of the truth of our discoveries. Some yogis
in India embrace a practice that requires them to spend time
in cemeteries, to cultivate an intimacy with the dead.
Memento mori, remember you must die, is the perennial
watchword of wisdom
The experience of being close to a dying person is never
trivial. Early in my career as an EMT I was called to the house
of a neighbor whose 4-month-old son was seriously ill. The
baby had gone into cardiac arrest before I arrived. I took
over resuscitation efforts from the parents and performed
CPR on the infant as the ambulance rocked down country
roads to the hospital. The emergency room staff enacted
their desperate protocols. The doctor pronounced the child
dead. We packed our equipment, called our ambulance back
in service, and headed home. Having already learned to
invest a minimum of emotion in such a call, I shed no tears.
The next day, I began to dwell on this life that had been cut
so short. I probed the incident for meaning. Suddenly, as in a
vision, it appeared to me that the entire fabric of reality had
become a curtain. For a second, I was allowed to lift a corner
of this curtain and gaze behind. What I perceived I can only
describe as an abyss. I was appalled and shaken. I wept
then, all right, and not just for that poor kid in the morgue.
“The death of a child,” is one of the alerts that we include in
our book on emergency service stress, one of those events
that can blindside the most hardened veteran who routinely
shrugs off mayhem and gore. And “stress” in this case is only
a way of talking about events and emotions that touch the
deepest mysteries of being human.
While the memory of that incident has stayed with me, I have
never made sense of it. Nor of the thirty-year-old male who
came to visit his grandmother one weekday morning and
went to an upstairs bathroom and shot himself in the head.
Nor of the calm, stunned grief of the woman who awoke to
find her husband of 59 years dead beside her in bed. Nor of
the girl of nine who unbuckled her seatbelt to retrieve a book
she had dropped at the very instant that her family’s car was
struck head-on -- everyone else walked away from the crash,
but she was killed.
These incidents are not lessons but enigmas. My spiritual
duty is not to solve mysteries, but to stare, unblinking and
always watchful, at the drama of existence.
Like most EMTs, like most volunteers of all stripes, I have
been reluctant to discuss my emergency work, concerned
that such talk would smack of boasting or lurid gossip. To
me, the work is not heroic but humbling. Every time I have
laid aside my ordinary life to attend a rescue call, I have been
rewarded. I have returned home with another little piece of an
enormous jigsaw puzzle. I have been sobered by the
precariousness of our hold on life and health. I have been
moved by the resilience of human beings who face
extraordinary hardship. I have been heartened by the caring
competence of my companions on the squad.
Being an EMT has given me a front-row seat on the tragic
human comedy and has served as a regular, abrupt
reminder to ground my spiritual practice in the sometimes
grim, sometimes hopeful truth of life.
# # #
(Spirituality & Health, March 2007)
A melodious bell sends a ripple through the meditation hall,
calling us to shed distraction. As the reverberations die, we
bring our peaceful contemplation to the breath and to the
always unruly mind.
The signal that marks another facet of my life is quite
different: a sudden electronic yodel, an urgent hi-lo alarm,
and a clipped announcement of an emergency in our
community. For more than fifteen years, I have volunteered
as an emergency medical technician with the rescue squad in
the township where I live in rural upstate New York.
Ultimately, spiritual practice is not intended to remove us from
the daily round, but to turn on a light in our life, to wake us
up. This is what matters; now is the time.
How does being an EMT complement the spiritual seeking
that has led me to disciplines like Iyengar yoga and insight
meditation, to the Bhagavad Gita and the Bible? My
emergency work has served as a touchstone that has helped
me to leave behind concepts, imaginings, and abstractions,
and to come face to face with life as it is lived.
#
“Respond for a one-car motor vehicle accident,” the
dispatcher’s voice intones over my portable radio, “person
trapped in the vehicle, State Parkway northbound, just south
of Willis Road.” Our squad is activated by the alarm; no one
waits on duty at the station. In an impromptu choreography,
some of us will man the ambulance and rescue truck, some
will go directly to the scene of the accident.
The calls follow no pattern. I may be sitting at my computer
finishing an article about the history of technology, or lying in
bed under five layers of dreams. I may have just returned
home from another call, or I may not have been out on one
for a week. I might feel dejected or inspired, worried or
elated. I could be mowing the lawn, taking a shower, or, yes,
meditating.
The alarm erases my mood and every mundane thought.
What was I imagining? What concern, petty or profound, filled
my universe? All gone.
I lay down my fork, leave off in mid-sentence, walk quickly to
my car, turn on a flashing blue light, and head for the scene.
I say, “I.” Someone is driving the car, surely. Someone is
deciphering the broken radio transmissions that give updates
on the situation unfolding across town. Someone is reviewing
protocols for treating imagined injuries -- the signs and
symptoms of shock, the steps of cardiopulmonary
resuscitation.
Someone. Yet much of what makes up my daily “I” does not
accompany me on the call. I have no use for pride,
resentment, nostalgia, or regret. The uncertainties and
quibbles and habitual thought loops evaporate. I discard the
well-worn pack of tarot cards, each one a facet of myself: the
Thoughtful Man, the Spiritual Seeker, the Concerned Citizen.
I bring to the scene the mindfulness of the craftsman. The
work is familiar and exacting, a combination of precise
protocols and second-by-second improvisation. Distraction is
everywhere -- flashing strobes; the loud growl of engines,
pumps and generators; the panicky inquiries of a patient’s
family; the sight of twisted metal and broken glass. When I
am sitting in meditation, the most trivial thought can yank my
attention away from my practice. In the chaos of an
emergency, my mind remains clear.
Today it is a young woman pinned behind the steering wheel
of a mangled Camry. She is alert but terrified, her leg broken,
her face veiled with blood from a laceration on her scalp. Our
procedure is always to “remove the vehicle from the patient”
in order to protect against further injury. I climb through a
window into the back seat, check the patient’s pulse and
blood pressure, apply an extrication collar to guard her
cervical spine, and reassure her. Other squad members
systematically dismantle the car with hydraulic tools. We
carefully slide the patient onto a backboard, splint her injured
leg, and load her into our ambulance.
These tasks rivet my attention and bring me wholly into the
present. Utterly consuming, they obliterate my ego. The
process reminds me that the almighty self, with all its moods
and concerns, is transient rather than fixed, a process not an
object. At the focal point of concentration, it disappears.
#
While researching an article about the history of volunteer
rescue squads I asked a young woman what motivated her to
become an EMT. She didn’t bother with the usual
commonplace about wanting to serve her community.
“Whenever I would drive past an accident,” she said, “I
always wanted to be there at the center of things.”
Those who work in emergency services, myself included, are
adrenaline junkies. The eraser that cleans the slate of my
mind at the sound of an alarm is adrenaline. The mechanism
that concentrates my attention in ways that I rarely
experience in my ordinary life derives from the complicated
chemical stew that an emergency sends through my veins.
The resulting emotional clangor has taught me something
about that perennial spiritual vexation, attachment. Thinking
back to my early days as an EMT, I remember the heart-
pounding fear as I raced to a call, the dread of coming upon
a situation for which I was unprepared.
Some who venture into EMS cannot go beyond that fear.
Inevitably, they don’t last. For the rest of us, experience
changes our perception. The rush of alertness becomes
excitement, not dread. It becomes the thrill of the roller
coaster or the ski slope.
My spiritual practice has taught me that emotions arise
ceaselessly. It is the clinging and the labeling that allow them
to take over. I call arousal fear, and it takes the shape of
fear. I feed my anger, and I become my anger.
Looking back, I see that much of the fear I felt en route to a
call, though it was spurred by adrenaline, was shaped by a
sense of self. Can I handle this? Will I be overwhelmed? How
will I look? Letting go of those concerns, focusing on reality
rather than the products of my mind, has allowed me to
release my attachment to fear.
This is not to say that the rush that comes with an alarm is
completely benign. We are not made to live our lives in
emergency mode. Adrenaline is a tricky and dangerous
hormone.
I collaborated on a book called EMS Stress with Dr. Ray
Shelton, an expert in emergency services psychology. Much
of the advice he offers to EMTs and other emergency
responders focuses on the insidious effects of the fight-or-
flight reaction -- the hyperalertness and searing memories
that can hobble us in daily life.
To survive, an EMT must learn how to use emotional arousal
and also how to turn it off. No matter how intense the
experience, we have to let it go as soon as it’s over. We have
to learn detachment. It’s a lesson that transfers readily to
spiritual practice.
#
My metaphysical struggle often takes the form of a wrestling
match with that ferocious and seductive monster, time.
Impatience and regret are the dual stalwarts of suffering. My
inconstant mind clings to the past and gropes blindly toward
the imagined future. I am oblivious to the obvious: that I live
my life wholly in the eternal now.
The word “emergency” derives from a root meaning “to dive”
(thus the merganser, the diving duck). Only, an emergency
dives out, it emerges from the surface of time, springs upon
us.
Consciousness of time forms a background to much of my
training as an EMT. The “golden hour” is the period following
a physical trauma during which the body is best able to
compensate for insult. When a heart fails, the patient’s
chances of survival head south at a rate of 10% a minute. On
the scene, the clock is always ticking.
What does familiarity with emergencies tell me about time’s
complexion? An EMT takes for granted that there are
occasions when hesitation can be fatal and knows that those
occasions can arise at any moment. Crises are
unpredictable; time is relentless and irredeemable. There are
no do-overs for an EMT. The demand for action dives from
the surface of time to confront me.
Emergencies remove the cushion of time that surrounds us in
our ordinary lives. Could that the cushion be, at some deep
level, an illusion? Survivors of wrecks often comment, “It
happened so fast, one minute I was driving along and then . .
.” They thought they would have time to swerve, to jump out
of the way of their fate. Afraid not.
“Watch this next breath as if it’s the last breath you’ll ever
take,” a meditation teacher once said to me. What is living in
the moment but living as if each instant were critical and
irreversible? As if there were no cushion?
#
Many of the lessons I’ve learned in emergency service have
been taught by other EMTs. The historian Shelby Foote has
a character in his novel Shiloh describe soldiers marching
into battle: “All the put-on had gone out of their faces -- they
were left with what God gave them at the beginning.”
When rescuers are called out in the bleak predawn hours, we
do not take time to don our social masks. At the scene of a
bad accident, there is very little put-on in our faces. As a
result, we come to know each other in ways that are different
from how we know our casual friends. We share a sense of
community founded on unavoidable honesty.
We also share a bond with our patients. The torn and sick
persons we encounter are likewise beyond pretense,
stripped to their barest vulnerabilities. We encounter each
other with a wide-open lack of guile. In the process we gain a
taste of the human truth that lies behind all masks.
The conversation of EMTs does not tend toward the spiritual.
It swings from the technical details of a call to firehouse
gossip to black humor. It rarely comes to rest on our central
purpose: alleviating the suffering of our fellow beings.
This instinctive attitude of EMTs aligns with the advice of the
sages. Our activity is “nothing special.” We help, but without
any thought of helping.
“When we do something with a quite simple, clear mind,”
Shunryu Suzuki says in Zen Mind, Beginners Mind, “we have
no notion nor shadows, and our activity is strong and
straightforward.”
#
Before becoming an EMT I had never seen a person die. I
had encountered very few corpses not primped for the
funeral home. Over the years, I have been present with many
persons as they have slipped into eternity. I have observed
how easy it is to die -- the passage is not marked by fanfare
or orchestral crescendo. A life can go out as quietly as a
candle flame.
Our spiritual quest takes place in the shadow of death. It is
the fleeting nature of life that motivates us to dig for meaning,
that makes the search more urgent as we age, that provides
the final measure of the truth of our discoveries. Some yogis
in India embrace a practice that requires them to spend time
in cemeteries, to cultivate an intimacy with the dead.
Memento mori, remember you must die, is the perennial
watchword of wisdom
The experience of being close to a dying person is never
trivial. Early in my career as an EMT I was called to the house
of a neighbor whose 4-month-old son was seriously ill. The
baby had gone into cardiac arrest before I arrived. I took
over resuscitation efforts from the parents and performed
CPR on the infant as the ambulance rocked down country
roads to the hospital. The emergency room staff enacted
their desperate protocols. The doctor pronounced the child
dead. We packed our equipment, called our ambulance back
in service, and headed home. Having already learned to
invest a minimum of emotion in such a call, I shed no tears.
The next day, I began to dwell on this life that had been cut
so short. I probed the incident for meaning. Suddenly, as in a
vision, it appeared to me that the entire fabric of reality had
become a curtain. For a second, I was allowed to lift a corner
of this curtain and gaze behind. What I perceived I can only
describe as an abyss. I was appalled and shaken. I wept
then, all right, and not just for that poor kid in the morgue.
“The death of a child,” is one of the alerts that we include in
our book on emergency service stress, one of those events
that can blindside the most hardened veteran who routinely
shrugs off mayhem and gore. And “stress” in this case is only
a way of talking about events and emotions that touch the
deepest mysteries of being human.
While the memory of that incident has stayed with me, I have
never made sense of it. Nor of the thirty-year-old male who
came to visit his grandmother one weekday morning and
went to an upstairs bathroom and shot himself in the head.
Nor of the calm, stunned grief of the woman who awoke to
find her husband of 59 years dead beside her in bed. Nor of
the girl of nine who unbuckled her seatbelt to retrieve a book
she had dropped at the very instant that her family’s car was
struck head-on -- everyone else walked away from the crash,
but she was killed.
These incidents are not lessons but enigmas. My spiritual
duty is not to solve mysteries, but to stare, unblinking and
always watchful, at the drama of existence.
Like most EMTs, like most volunteers of all stripes, I have
been reluctant to discuss my emergency work, concerned
that such talk would smack of boasting or lurid gossip. To
me, the work is not heroic but humbling. Every time I have
laid aside my ordinary life to attend a rescue call, I have been
rewarded. I have returned home with another little piece of an
enormous jigsaw puzzle. I have been sobered by the
precariousness of our hold on life and health. I have been
moved by the resilience of human beings who face
extraordinary hardship. I have been heartened by the caring
competence of my companions on the squad.
Being an EMT has given me a front-row seat on the tragic
human comedy and has served as a regular, abrupt
reminder to ground my spiritual practice in the sometimes
grim, sometimes hopeful truth of life.
# # #