A younger colleague and friend texted me after a young mother, eight months pregnant, was brought in with a life-ending, massive head injury from an MVC (a man fleeing police ran into her car). My colleague called OB and the NICU to come down for a crash C-section at the door to try to save the baby.
When EMS rolled through the doors, the OB resident, tears welling in her eyes, placed a towel over the mother's distorted face and did the section in less than a minute.
The baby was lifeless and blue. The NICU doc intubated, and with no palpable heartbeat, my friend began chest compressions. The baby was not pinking up, and with no appreciable heartbeat, a dark cloud of failure and death crept across the trauma bay, with unspoken looks and heads shaking.
Then my friend recounted, “Life just poured in.” Suddenly, in that dark, chaotic tragedy, there was a small, warm light that touched everyone in the room. “It was like witnessing a miracle! Has that ever happened to you?” he asked.
“No,” I texted, “not that one.” But many experiences in my career have produced that numinous encounter in me and others. Early in my career, I thought these occurrences were anomalous, so thin and ethereal that one did not speak of them, when life, without expecting it and without believing it could happen, just pours into a moment. Now I am no longer convinced these experiences are rare.
Magic in a World of Science
I believe life just pours into a moment in many different, discreet ways in a substantial number of emergency patients, but only when one has the right frame of mind, asks the right questions, and by chance or fortitude just happens to be present. It is a little bit like light. Light is almost always there to some degree, so obvious that it appears simple. But light is also unimaginably complex and mysterious; we just fail to acknowledge and marvel over it because it is so ordinary.
I admit this is a personal viewpoint, one not readily provable by a contemporary scientific method. It is a way of life in which I choose to believe. I want to see sacred beauty born from unimaginable suffering (I imagine a little confirmation bias helps). But a phenomenon's lack of measurability in the emergency department does not make its reality any more questionable. The joy of music and art is hardly measurable, and it's almost completely unintelligible why they even exist among humans, but their reality is not questionable, not only among individuals but in every culture through history.
The best of art and science are events born of inspiration. The study of these kinds of moments is called phenomenology, personal experiences one could call metaphysical, mystical, spiritual, or religious that become objective when confirmed by the experiences of multitudes of others.
If someone was a pure materialist, he could say this is all an individual brain acting in ways we don't yet understand. This is a respectable hypothesis, but if one were looking for material data, then the weight of all of history, the rituals of every culture, and the beliefs of the majority of people on the planet have opposing viewpoints.
We in emergency medicine don't speak much of religion or communal spiritual experience and its impact on healers and those who are helped by them. We don't speak at all about why hospitals were started in the first place or how our western American culture would look for the orphaned, poor, homeless, foreigner, prisoner, and mentally ill if we didn't believe in a benevolent higher being. And if you needed more data about a nation with no place for divine phenomenon, you could study Marxism. But with our current cultural climate, another tense discussion and probable disagreement about the value of religion in medicine is just way too fatiguing.
Miracles: All or Nothing
I believe that we emergency physicians might be able to talk about the liminal experience that we all share (even if it is just our brain) when unbeknownst to us, life unexpectantly just pours in, something happens for which current reasonable explanation goes dumb. To even speak of it requires metaphor, a leap of light to express the inexpressible. It is not unreasonable for a scientist to speak of this; it is a transrational journey to touch a knowledge that is suprarational.
A famous quote, often attributed to Albert Einstein, says, “There are two ways to live your life. One, as though nothing is a miracle. The other, as though everything is.” We are compelled to approximate truth by the scientific method, but a rational truth alone is not enough to sustain us. We are also called to pursue goodness and marvel at a sacred beauty, to convert disasters from bad luck or tragedy into communally shared experiences, even a story, painting, or song of courage.
During a weary time for the world, this is worth talking about because these life-just-poured-in experiences offer hope and faith and at times give birth to acts of mercy and love. Working, and even yearning, to want the pouring in of life with each patient encounter moves us from professional scientific craftsmen to those who are called to heal.
This, my friends, is what makes emergency medicine phenomenal.
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Dr. Mosleyis an emergency physician in Wichita, KS.