How Jainism Can Inspire EMS Providers to Be Their Best
By: Rihi Jain
“Unit 123 for the assignment.” Dispatch called over the radio.
“Go ahead” I responded.
“You will be going to 123 Main Street for the welfare check.”
“Received and responding”
What does it mean to be a “good” first responder? What does it mean to be a “good” EMT¹? These are the questions I often ask myself, especially as EMS² appreciation week comes to an end (May 21–27, 2023). Am I actually doing right by my patients? Moreover, am I actually following my faith — am I being a “good” Jain?
It was the middle of the night — around 3:00 AM when my unit was dispatched to the call at 123 Main Street. Before we had arrived, we already knew who it was and how the call was going to play out.
This patient was what we called a “frequent flier”. She was a middle-aged obese woman who called 911 at around the same time most nights to be adjusted in her recliner. A few annoyed glances, some yelling by the patient, and a sheet lift later, my partner and I cleared from the call.
The first time I responded to this woman’s home, I couldn’t help but feel angry and annoyed. It was the middle of the night — why wasn’t she asleep like everyone else? Why was she calling 911 to be adjusted in her recliner? She certainly was not having a medical emergency, and she was using a resource that could have been used to help another patient who actually required an ambulance.
Despite all of these questions, I didn’t want to feel this way towards this woman — or any patient. After all, my job was to help people.
Anekantavada, the Jain principle referring to the existence of multiple truths and perspectives, helped me understand the importance of practicing Karuna (compassion) towards all. I realized that my patient felt justified in her behavior — she felt that what she was doing is right, even though as an EMS provider, I may feel it is wrong. Of course, it is not as black and white as right and wrong, but my patient was doing the best that she could given her circumstances.
The next time I responded to her house, I didn’t see the annoying woman who wasted our time every night; I saw a lonely woman who had no other means of interacting with people. She lived alone — no spouse, caretaker, or kids. Even though she had no medical emergency, she did suffer from a number of chronic medical conditions. Despite her foul mouth, the strangers who walked through her front door every night were the only people who kept her company.
After my partner and I had adjusted her positioning on the recliner that night, we fetched a water bottle for her from her refrigerator (with her permission) just in case she would need it later in the night before we cleared.
The next shift, my partner and I were dispatched for a young female with unknown psychiatric problems at the local police department.
It was around 6:30 AM when we arrived and the police officers were in a frenzy because they had been chasing the patient all night. When we finally found her in the basement, she was extremely agitated and continuously screamed at us. All attempts at verbally reasoning with her were futile as it resulted in a spout of cussing and insults. She had not received her prescribed medications for her recently diagnosed mental health illnesses, and was becoming increasingly uncooperative and aggressive — making it dangerous for her to be left alone.
Then, she started to punch and kick. The police officers rushed in to restrain her, as my partner and I secured her to the stretcher. During this process, she continued to kick, kicking me in the thighs, legs, and shins as I buckled the seatbelts around her. When she was finally restrained and secured, she began spitting at us. I quickly put a surgical face mask over her mouth.
Undoubtedly, it becomes significantly more difficult to practice Anekantavada and Karuna when the patient is actively trying to hurt you. How can I practice these ideals with a patient who is actively kicking, biting, spitting, and screaming at me?
To begin answering this question, let’s take a look at the story of Mahävir-Swämi, the 24th Tirthankar³, and the Cow Herder.
Mahävir-Swämi was in deep meditation when a cow herder came by, and asked Mahävir-Swämi to watch his cows while he went to run some errands. Mahävir-Swämi, being in deep meditation, did not reply, but the cow herder walked away, assuming that he had heard him.
When the cow herder returned, the cows were nowhere to be found making him angry as he went out looking for his cows. When he returned to Mahävir-Swämi, miraculously, all of the cows were with Mahävir-Swämi. The cow-herder became even more angry because he thought Mahävir-Swämi was hiding the cows from him, and proceeded to take out his rope to whip Mahävir-Swämi.
Indra Bhagwan, the king of the Heavens, came down to prevent the cow herder from whipping Mahävir-Swämi, explaining that Mahävir-Swämi did not do anything with his cows because he was in deep meditation. The cow herder realized the error of his perspective and repented for his sins. Mahävir-Swämi did not have any reaction or negative feelings towards the cow herder.
Why was Mahävir-Swämi able to hold no krodh (anger) towards the cow herder, despite the fact that the cow herder was going to whip him? Why didn’t Mahävir-Swämi retaliate? It was because Mahävir-Swämi held no anger towards anyone as he was focused on a larger goal: his spiritual journey.
Translating these lessons to the patient care setting, as an EMS provider, I can avoid holding krodh towards patients by focusing on what I am trained to do: to provide compassionate and high-quality care to patients, regardless of their background and circumstance.
That is not to say that one shouldn’t defend him/herself if a patient is kicking, biting, spitting, and screaming at them, however, keeping an internal state of equanimity keeps the external violence (dravya-himsa) from becoming internal violence (bhaav-himsa). In keeping this internal state of equanimity, EMS providers can avoid krodh. Even beyond the EMS provider setting, when one can avoid this krodh, they are able to more effectively practice Anekantavada and Karuna towards others.
This brings us to the question we began with: How can EMS providers do right by their patients? Whether or not the EMS provider is Jain, the universal applicability of Anekantavada, Karuna, and the avoidance of krodh enables providers to come as close to practicing “good” medicine as possible. EMS is undoubtedly a challenging job, however, it is these ideals that truly make a difference in others’ lives — offering a light at the end of the tunnel.
If anything in this article has offended you or gone against the teachings of Bhagwan Mahavir, we sincerely ask for forgiveness. Michhami Dukkadam!
[1]: Emergency Medical Technician
[2]: Emergency Medical Services
[3]: The Tirthankars represent the spiritual leaders and teachers in Jainism who have escaped the cycle of birth and death. There are 24 Tirthankars, with Mahävir-Swämi as the 24th and last Tirthankar.
