Spirituality in EMS

The relationship between EMS providers and patients is a unique one in the practice of medicine and spirituality, for some, is part of that connection

The dawn was like no other, distinguished not by a rescue gone right, but by the view from the end of a steel cable a hundred feet above Tennessee’s Roaring River. Paramedic Chris Masiongale marveled at smoldering sunlight piercing summer mist as he and Sean Buckley, a 23-year-old medic with the 50th Medical Company of the 8thBattalion, 101st Airborne, were hoisted toward the UH-60 Blackhawk, a helicopter whose military exploits overshadow its peacetime role as a medevac platform.

It had been a long night for Chris and his fellow responders. The search for hikers Ralph Hayes and his son, Joel, near the intersection of Jackson, Putnam and Overton counties in north-central Tennessee started six hours earlier. Both men were found on the riverbank suffering from tib/fib fractures and hypothermia. Rough terrain complicated conventional transport, so Chris’s supervisor called the MAST (Military Assistance, Safety, Traffic) unit at Fort Campbell on the Kentucky border for assistance. After airlifting the injured to a local hospital, the soldiers returned to pick up Masiongale and Leon Harris, another rescuer.

As the Blackhawk hovered above, Buckley was lowered to the ground by a starboard-side winch. The Army medic advised Masiongale and Harris he could take only one of them at a time. The 29-year-old Masiongale, who’d never been in a helicopter, reluctantly agreed to go first.

Buckley and Masiongale sat facing each other on the penetrator, a three-legged lifting device resembling a blunt, inverted grappling hook. Sean’s legs straddled Chris’s torso in a minimalist arrangement requiring a mutual embrace for support. Superficial shoulder straps added psychological, more than functional, protection.

The 10-by-15-foot rock that was their launch pad receded beneath the medics’ boots as the shriek of two General Electric 1,890-horsepower turboshafts overwhelmed the whine of the winch. At the treetops seconds later, Chris lauded the panorama afforded by the gentle rotation of the penetrator. “What a beautiful view,” he said. Sean didn’t respond. To Chris, he seemed preoccupied.

What is spirituality? My dictionary defines it as “religious devotion or piety; the rights, jurisdiction, tithes, etc. belonging to the church or to an ecclesiastic.” Most of the EMS providers I interviewed for this article disagreed that spirituality is necessarily linked to religion or houses of worship. “The side of personality that’s all good,” “the ability to connect to yourself and loved ones,” “the way you frame your world” and “how you live your life” are concepts of spirituality asserted by prehospital practitioners during eight hours of discussion. However, secular views weren’t the only sentiments expressed. “Showing your faith,” “going to church” and “belief in God” are other definitions of spirituality voiced by our colleagues. It seems there is no more of an EMS consensus on spirituality than on ambulance configuration.

Why, then, tackle a topic as subjective as spirituality? There are no practical exams to evaluate spiritual skills. The word isn’t even mentioned in any of my textbooks. According to my state’s prehospital protocols, spirituality is less of a concern than application of MAST suits, packaging of avulsed teeth and transportation of dead snakes. Is spirituality a subject best relinquished to clerics?

I might have settled for that outcome had I not read a story by commentator Robert Krulwich about Richard Feynman, an American physicist who helped develop the atomic bomb. Feynman was at the bedside of his terminally ill wife when she died of Hodgkin’s disease. According to Krulwich, Feynman noticed the clock on the wall of his wife’s hospital room stopped at 9:21 p.m., the precise time of her death. The physicist saw no significance in that; the clock had been broken and fixed before. He reasoned someone had jostled the fragile timepiece, causing it to malfunction again.

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