Anthropological Auscultations

A different kind of deep listening

On Tuesdays I opt for an undershirt, knowing that from 6:00-6:15 my fellow EMT hopefuls will be sticking their hands up my sweater in service of assessing my breathing.

Auscultation.

We are all awkward at this point, often placing the stethoscope’s earpieces in backwards (and then yanking them out and asking… is it backwards?), fumbling with what to do with pens and sphygmomanometers, bodies and hands. No one has yet mimicked or mastered the compassionate act of warming the listening end, or the skillful art of making conversation while preparing to listen to breathing sounds. It’s hard to tell who feels most uncomfortable in this race to collect three sets of vitals on three different humans in the brief period we have to accomplish the task. Sure, I’ve got a lot more experience on my side, but I’m also painfully aware of being the oldest and the smallest.

It’s a tremendous group of people who are pulled together from the far corners of the metro area in service of being better prepared to help. We have little time to socialize and connect, and we’re not facilitated to do so, so I find myself sneaking in quick stitches of community. When someone tells me they feel awkward, I remind them that I’m on their team and that I want literally everyone in the room to be a better EMT than me, for purely selfish reasons.

“Save my life, please.”

With little time to suss out our various proclivities and backstories, I’m left to fill in the mad libby details as I consider this micro culture, why we’re here, and where we’ll all go next when our diaspora commences. We’ve got decent body diversity, which is terrifically relevant given that we need to practice poking and prodding each session, and I imagine we make up as many unobservable spectra. We listen for breathing sounds and hope to hear essentially nothing - healthy breathing is unencumbered and easy to dismiss, but it’s that particular almost-nothing we’re in for. Beyond that, what unifies us is the silly idea that we want to be better at helping people.

I admire my colleagues for arriving at this noble calling decades before I did.

We have a brief lecture in which our guide describes again the marriage of our heart and lungs, the important distinctions of respiration and ventilation. Respiration is cellular exchange of oxygen and carbon dioxide, and ventilation is the movement of air composed of these things in and out. You can have one without the other - lots of movement without gas exchange (see Carbon Monoxide), or exchange without movement (see Anaphylaxis) and we’re reminded that both matter equally, but that the best we can do in the field is ventilate with air that has a higher concentration of oxygen, and then get to help fast.

After our awkward touch-fest, we practice pneumonic mneumonics* which help us figure out what small intervention we can do based on what happened.

OPQRST

Onset. Provocation. Quality. Radiation. Severity. Time.

It’s a methodology for crisis evaluation, and I’m supposed to apply it to scenarios like bee stings and heart attacks - carbon monoxide poisoning and collapsed lungs. And I do. Or, I do in theory and mock practice. But real life I practice with the news in the background, which swirls the practice of triage with the real life American unfurling. Is it our culture that is threatened or our society? Respiration or Ventilation? Anthropology and sociology are different enough that one can get a PhD in either, but we don’t seem to live well without both.

Society is something we will need to work hard to keep together (I’m not sure, I’m an anthropologist). But. Our culture is something we hold dear on a cellular level and transmit on that person-to-person, family of choice to family of choice basis. Culture lives on in pottery and weaving, in poetry and song. In body modifications and burial practices.

(and I think this is the good news.)

While it is absolutely appropriate to feel fear and sadness and anger, to desire hibernation and complete disengagement, I encourage you to consider what small steps and practices you can continue in service of both the cultural practices you treasure and the positive elements of the society you desire. A little ventilation, a little respiration, and oxygenation continues.

My version is EMTing for me (and for you), but also lovingly encouraging the young ones to be brave and bold and encourage their provision of life-saving techniques and skills regardless of the reason.

In a world where anything seems to be possible it’s important to remember.

That anything is possible.