Asking Hard Questions Before You Need Hard Answers

In November of 2021, at 35 years old, I was diagnosed with stage 4 colon cancer and told that the likelihood of surviving for 5 years was less than 50%. Would I see my youngest, who had just turned one, start kindergarten? Would my children be OK without me? Would my husband ever find happiness again?

A million questions raced through my head, but the one that didn’t was “why me?” I would love to brag that my own personal resilience was responsible, but in reality it was that I had spent most of my adult life working as a chaplain and encountering hundreds of people who found themselves seeking answers in the midst of a crisis.

Most people don’t have to think too much about the question of why humans suffer because they don’t encounter suffering at such close proximity every day of their lives. EMS crews see everything, from the results of poor decisions to the relentless march of incurable illness, and bearing witness to that level of suffering over and over can take a toll.

When tragedy struck my family, the thing that helped me survive and grow was a strong understanding, or at least some solid theories, about why bad things happen.

Is There a Greater Purpose?

Theologians, wisdom thinkers, poets, and philosophers have reflected on the question of suffering for thousands of years. We come up with our own ideas that work for us, but these theories are often untested until the moment of crisis. If everything happens for a reason, for example, what’s the reason a young mom gets cancer, or a child falls into a pool, or for the accident that kills everybody but the drunk driver? What’s the reason for loss, or violence, or recklessness? If there is a purpose for this, what might that be?

Life in EMS brings us into direct contact with some of the ugliest, messiest, most unpredictable events in people’s lives. It’s easy to offer platitudes when bad things happen at a distance, but harder to really believe them when our job shoves us into somebody else’s worst day every day. The ongoing stress of EMS life—long hours, few breaks, scared or belligerent patients—is challenging even without throwing on the existential burden of grieving for the pain of this world.

My own cancer experience, and my work talking to other people who had their philosophical rug pulled out from under them, suggests that one thing that helps is to ask those tough questions before you need the answer. Like running drills for mass casualty events, or practicing clinical skills on a dummy, first responders are all about preparedness.

It’s better to have the training and not need it than to have no procedure to follow when you do. I don’t think we can ever fully prepare for the enormity of our work in emergency medicine, but here are a few things that helped me make sense of all the tragedy I encounter in this role helping the helpers, and in my life.

First, think about some of the difficult situations you have seen before. What thoughts, ideas, quotes, or comments were helpful to you? What reactions did you have—what were the feelings, questions, or worries that came up? Sifting through your own experiences is like doing a diagnostic—did you feel good or bad about how you came through the tough calls?

Second, reflect on why you do this job. What is your purpose? What difference do you make in the world? We may not know why something happened, but we can often reassure ourselves in difficult times that we have a calling or that our presence meant something in the grand scheme of things. Believe it or not, most people don’t think at all about why they’re doing what they’re doing in their lives, but having a good grasp of your own “why” can help you to work through some of the other questions that arise in crisis.

Third, know and cultivate your resources. That’s not just EAP and peer support, but it also means spending time with people that make you feel safe, calm, and loved, engaging in activities that promote your physical, emotional, and spiritual well-being, staying connected to the world outside of your workplace, and most importantly practicing using those resources when you have little bumps in the road will help you know where to turn if you find yourself in need of more support.

Confront the Hard Questions

Lastly, and maybe most importantly, it means engaging tough questions for yourself without fear or shame of what the answer might be. A lot of people I know can’t bring themselves to ask big questions because if their answers start to stray too far from things they were taught from their parents, faith communities, or culture, they feel like they are being a bit blasphemous. Some people just feel like they aren’t qualified to even ask such questions, let alone answer them, because they don’t have any kind of training in philosophy, theology, counseling, or whatever.

You may not be an expert at unlocking the secrets of the universe, but you are an expert in your own life experience. It’s OK to ask hard questions even if the answers might be different from what you were taught, and it’s okay to ask hard questions even if you don’t have experience or expertise. In fact, it’s not just okay but vital to being a caregiver.

I have seen clinicians with ten years of training and decades of experience crumble under the weight of this work because they were too fearful to even approach the difficult questions. We get stronger muscles by exercising them, and we get a stronger spiritual, moral, and ethical compass by pushing the limits of our assumptions and beliefs. Sometimes we come around to where we started with a deeper, more nuanced understanding. And even if you come to a completely new understanding, what matters is that your understanding works for you.

Growing in your Beliefs

I personally go back and forth between several answers, and for me mostly what helps is being fine with the ambiguity of not knowing why suffering happens. I’m just one person, and I do my best with the cards I’ve been dealt. But I do know that wrestling with the questions before something really bad happened to me helped me devote more of my energy to fighting cancer than to wondering why I was fighting cancer, and I think that did make a difference for me. And maybe spending a little time thinking about your answer, or whether you need an answer, will help you recover if and when you get that one call that shakes your foundation.

I can’t say that being diagnosed with advanced cancer at age 35 didn’t shake me deeply; in many ways I am still wrestling with it even though I have been cancer free now for over a year. But that crisis didn’t crumble my foundation, and in some ways even helped me grow in my own beliefs. It takes bravery to confront hard questions, but one thing I know for sure is that there is no shortage of bravery in EMS.

Rev. Gwen Powell, MS, MDiv, BCC, is an Episcopal priest, chaplain, and well-being liaison serving the employees of Allina Health EMS and the Minneapolis-Saint Paul International Airport Police Department, where she supports first responder mental health through relationship building, education, and well-being initiatives. She is founder of the Health Education Resource Operation (H.E.R.O.), an organization committed to educating public safety professionals on caring for themselves and one another, and providing networking and learning opportunities for other public safety chaplains.