One of my dirty little secrets is that I do, on occasion, think about some deep things in life. That's probably the reason why, finding myself with time on my hands and having seen all the Marx Brothers movies, I decided last year to enter a distance-learning program in religious studies. I thought about all the things I could have done that might be useful to my career get an MBA, for example and then chose something completely opposite.
I've never been a great fan of shows of faith in the workplace. Frankly, those physicians and paramedics I've known who wore their religion on their sleeves drove me crazy. At times I've felt that if I had to see one more "WWJD" bracelet, I was going to scream (especially because I was pretty sure that Jesus would not vote the same way a lot of these believers did). They would strut about with that perpetually happy demeanor that comes with absolute faith in well, something. I wanted to install subcutaneous Valium pumps in the lot of them. But I've learned that having a strong belief system, an unalterable sense of place and purpose, may be the way to go.
How do the great questions of theology apply to EMS? The place to start is to consider what theology actually is. It's the quest to express a faith in a coherent and consistent fashion. As opposed to philosophy, which assumes nothing, theology assumes the existence of certain principles of faith and builds upon them.
A central question of theology is the existence of God. (Technically, this is not a theological question Judeo/Christian/Islamic faith systems assume as much but it's a place to start.) There are all kinds of ways to prove the existence of God. None are complete, and, ultimately, the existence of the divine cannot be definitively proven or disproven. It becomes an article of faith.
But the implications of a lack of belief in God, or at least some sort of essence, plan, or order that we might call God, are staggering. If there is no order or plan, then our existence is truly random. We're an accident of the universe; there's no particular reason; and there's no particular road to follow. In this case, it's hard to see why we do EMS, or why we do anything at all. The fact that we're in EMS, that we do care for others and help them in their time of need and that we get some feeling of satisfaction from this exercise implies that within all of us lies a concept suggesting that what we do is part of a greater scheme.
You may call it God if you wish; you can call it simply an impulse of DNA. But recognizing the fact that what we do comes from a sense of order and plan helps to place the daily frustrations of EMS work in a bit of perspective. I won't say that to do EMS is to do God's work (I think even the most pious saint would have a hard time seeing God as integral to Daytona Bike Week), but it does imply a certain set of innate beliefs.
One of the most gut-wrenching issues facing theologians is the question of theodicy, or the problem of evil. How does an all-powerful, benevolent God allow evil to enter the world? Admittedly, we don't ask this question when the drunk gets rolled under a bridge. We do, however, when the four-year-old child is killed in an auto accident or in a clear case of child abuse.
Theology offers some different views. Evil may be a form of divine retribution, a form of education, an opportunity to testify to a faith tradition. Evil may exist only as the absence of the good or may exist only in comparison to the good. If the act of creation requires destruction, then evil may be an inevitable part of the fabric of the universe. Evil may simply be a random act of injustice to which we respond with a plaintive cry of pain. No answer will ever be fully satisfactory. Sacred texts indicate quite clearly that despite our cries of protest, we can never fully comprehend the divine essence, plan, or order of things. But daring to think about this question places our EMS experiences in perspective, helps us to cope with immense tragedy and senseless loss and integrates these feelings into the broader scope of thought.
What about the claims of different faith traditions that God speaks to us through the process of revelation? Like the existence of God, such beliefs cannot be definitively proven or disproven. Revelation is an intensely personal experience and what records we have of it are filtered through the mind of man and the context of the times. But for us in emergency work, there seems to be no shame in acknowledging that the flash of insight on patient care, the association you've finally made between theory and action or the overwhelming wave of compassion, sorrow, anger or exhaustion may be a moment of revelation. It gives some comfort to know that the spark of the divine lies within you, ready to speak when you're willing to hear, ready to help you see that what you do means something greater than itself.
Theology also deals with the more concrete. What are the practical implications of saying and believing that man is created in the image of God? Both body and soul are created in the divine image; both have divine qualities and are worthy of respect and dignity; both are tools to be used in the service of God. The idea that man is made in the image of the divine implies that harm or injustice done to man is also inflicted upon the divine. As such, it is incumbent upon us to display esteem for all persons, both in their physical person and their mental and emotional being. To show disrespect before a reflection of God is to disrespect the divinity himself. It's admittedly hard to show this respect to some of our "clients," but holding this theologic view mandates certain behaviors during individual patient encounters,
Personally, I'm still learning where I stand. I'm certain I'm not in step with those who take the relatively easy way of blind faith rather than the more difficult (but more satisfying) route of faith augmented by reason. Still, I can't help wondering if they know something I don't. I'd encourage you to look into your own faith traditions and discover how they view these great issues in life. Don't accept any statement that begins with "because " and ends with, " says so" as an answer. It's for you to decide. Regardless of the conclusions you reach, thinking about the big questions of life within your practice of prehospital care may well change your perspective and improve the way you view patients, colleagues and the world as a whole.
"This program has been brought to you by the House of David."Julius (Groucho) Marx, Animal Crackers, 1930.