I believe in God.
I say that plainly because this essay requires it. Not as a declaration or an invitation or an attempt to persuade anyone of anything. Simply as the starting point. The lens through which nineteen years of ambulance work have been experienced, questioned, tested, and, somehow — despite everything — maintained. Faith, for me, has never been the absence of doubt. It has been the thing that remained after the doubt had done its worst, and in this job, the doubt gets every opportunity to do exactly that.
The ambulance service will test whatever you believe. It will put you in rooms that make belief feel self-evident and rooms that make it feel impossible, sometimes on the same shift. It will show you things that have no clinical explanation, things that have every clinical explanation and still make no sense. It will ask you to hold the hand of a dying stranger while their family prays around you, and it will ask you to stand in a room where a child has died and find somewhere to put that, and neither experience will leave you where it found you.
I have never resolved the contradiction. After nineteen years, I am not sure it can be resolved. What I have learned is how to carry it.
There is a person I have never forgotten. I never will. They were sitting in their chair when we arrived, head resting on their hand, elbow on the arm of the sofa, and a cup of tea on the table beside them. They looked, entirely and completely, like someone who had simply closed their eyes. Not fallen. Not collapsed. Not struggled. Just quietly, in the middle of an ordinary evening, I stopped. The tea was still there. The room was undisturbed. Everything around them was exactly as it would have been if they had been sleeping.
They weren’t sleeping.
In nineteen years of attending deaths, I have seen many things. I have seen what sudden death looks like, what prolonged death looks like, and what violent death looks like. I know the difference between a room where something terrible has happened and a room where something has simply ended. That room was the latter. Whatever had happened had happened gently, in their own chair, in their own home, without pain or panic or the awful struggle that death can sometimes be. If you believe, as I do, in something beyond the clinical explanation, then that room felt like evidence of it. Not proof. Nothing in this job comes with proof, and I have learned to be suspicious of anyone who claims it does.
But evidence is a different thing from proof. Evidence is what you are left holding when the clinical account is complete and accurate and still does not feel like the whole of what happened in the room. There was a quiet grace in that house that had no medical term attached to it, and nineteen years of training have given me no language to dismiss it, nor any to confirm it. I have simply kept it.
I have thought about it many times since. About what it means to go that way. About whether the manner of a death tells us anything about what lies beyond it, or whether that is simply the human mind doing what it always does — reaching for meaning in the places where meaning is hardest to find. I am honest enough to know I cannot tell those two things apart. I am also honest enough to admit I have stopped trying as hard as I once did, because the trying never changed what I felt standing in that doorway.
I don’t have an answer. But I have the image of them, cup of tea beside them, and I am grateful for it in ways I find difficult to explain. Not every death offers that. accurate and
The ones involving children are the ones that test everything. I will not describe specific calls because some things belong only to the people who were there and to the families who lived them. But I have been in rooms where children have died. From illness, from accident, from causes that arrived without warning and without reason and without any framework that makes sense to a person of faith or a person of no faith or anyone in between.
Those rooms are different. The air in them is different. The silence in them is different. And what faith does in those rooms — or tries to do or fails to do — is the most complicated thing I know.
My eye caught the schoolbook lying open on the table. A pencil on top of it. A homework question was half answered, and the sentence stopped partway. The blazer is over the back of the chair. The bag beside it. You do the work with your hands, while the rest of you go somewhere quiet and do not come back for a while.
It wavers. I won’t pretend otherwise. Standing in a room where a child has died, looking at a family whose world has just ended, trying to find the place where belief lives — it wavers. The question that everyone asks in those moments, believer and non-believer alike, is the oldest question there is. Why? Not asked academically. Asked from the gut, from the floor, from wherever you go when nothing makes sense anymore.
Why this child? Why this family? Why this room, tonight, with all of us in it?
I have never had an answer to that question. I have stood in those rooms, and I have not had an answer, and I have done the job regardless, because the job does not wait for answers. You are treated. You support. You do what can be done, and you stay present for what cannot be fixed, and somewhere in the middle of all of it, you find whatever it is that keeps you functional. For me, sometimes, that thing was prayer. Not always conscious. Not always formed into words. Sometimes just a direction – a turning towards something beyond the room that felt, in the absence of anything else, like the only honest response to what I was witnessing.
I have also seen things that sit at the other end entirely. Calls where the outcome defied what the clinical picture was telling us. Patients who had no business surviving what had happened to them and who survived anyway, completely, in ways that left the medical explanation feeling thin. You file those calls somewhere in your mind, return to them occasionally, turn them over, and cannot find the mechanism that accounts for them.
Maybe there is one. Medicine is vast, and human resilience is extraordinary, and the body is capable of things that continue to surprise even the most experienced clinicians.
But sometimes the surprise is large enough that the clinical explanation feels like the smaller story.
In Northern Ireland, faith is not background noise. It is woven into everything — the streets, the history, the way people live, grieve, and make sense of the world. It is in the language people use without thinking. It is in which school a person went to, which way they walk home, and which words they reach for when the worst happens. In nineteen years of attending calls across this place, I have been in rooms of every faith and no faith. I have sat with Catholics and Protestants and people of other traditions entirely, and people who believed in nothing, and people who weren’t sure what they believed but reached for something anyway when the worst happened.
And what strikes me, looking back across all of it, is how consistent that reaching is. Regardless of the tradition, regardless of the theology, regardless of whether the person in front of me had been inside a church in decades, when the moment came, when the fear arrived, or the grief hit, or the situation became too large for ordinary language, people reached out.
They reached for prayer. For ritual. For the comfort of words said in a certain way in a certain order that connected them to something larger than the room they were in. In a place that has spent so long divided over how people pray, I have been repeatedly struck by how identical the reaching looks when it matters. At the edge, the theology falls away. What is left is a person, in a room, asking. I have watched that happen across every line this country has ever drawn, and the lines did not survive contact with the moment.
I have helped families pray at bedsides. I have organised priests and ministers and sat quietly while last rites were administered, and held the space while families said the things you say when someone is dying, and you need them to know that they are loved and that you are there and that whatever comes next, this moment was witnessed. I have done this across nineteen years and across every tradition I encountered, and I have never once thought of it as anything other than the right thing to do.
Whether it felt like a professional duty or something more personal is a question I have sat with. The honest answer is both, depending on the call. There were times when organising a minister or making space for a family’s prayer felt like part of the job — important, necessary, and done with care and respect, but not particularly touching my own faith. And there were times when it was more than that. Times when I was present in those moments not just as a clinician holding a space but as a person who also believed, who also understood the reaching, who was, in some quiet way, doing his own version of it alongside the family.
Those moments are the ones that stay.
I have prayed on calls. Not always out loud. Not always in any form that would be recognisable as prayer to someone watching. But in the middle of situations that exceeded what training and experience could cover, I have found myself turning toward something beyond the room and asking. For help. For guidance. For the right outcome. And when the outcome wasn’t right — when, despite everything, it went the wrong way — I have prayed for something harder to name. Forgiveness, perhaps, though the clinical reality was that I had done everything that could be done. Forgiveness from the families. From the patient.
Some acknowledgement, directed somewhere, that I was sorry for what I couldn’t prevent.
That might sound irrational. In the strictly clinical sense, it probably is. But the job is not strictly clinical. It never has been. It is human work, done by human beings, in the most human moments, and the things that sustain you through it are rarely found in the protocol manual.
There are calls I have never fully explained to myself. The cancer patients, particularly. I remember the stillness of those houses more than anything else — a calm that did not come from the medicine, because the medicine had largely run out of things to offer by then. People carrying an illness that has been named and mapped and treated as far as treatment goes, whose faith in the face of it was among the most humbling things I witnessed in nineteen years. They did not, in my experience, pray that the diagnosis was wrong.
They prayed for peace. For a little more time. For their family to be alright after.
For something to ease the crossing. I sat in those rooms and watched faith do the one thing medicine could not: change the outcome but change the room it was happening in. It did not lengthen a single life I attended to. It changed how the time that was left was lived in, and I have never found a clinical word for what I was looking at.
I don’t know what to do with the children. I have said that honestly, and I mean it honestly. After nineteen years of this work, I am not sure whether I have made peace with those calls or simply learned to function in their presence. Whether I have processed what they mean for a faith like mine, or whether I have — as I suspect — chosen not to look directly at the question because looking directly at it is more than I am ready for. There is a version of faith that has an answer to the death of children. I have heard those answers. I have never fully believed them, not in the room, not in the moment, not standing where I have stood.
What I believe, after all of it, is harder to articulate than a doctrine and more durable than doubt. It is something that has been present in the peaceful room with the cup of tea, in the terrible rooms where children were taken, and in every room in between. It has been tested and wavered and held and sometimes barely held and occasionally felt very far away.
But it has never left entirely.
That might be the most honest thing I can say about faith and nineteen years in the ambulance service. Not that it gave me answers. Not that it made the difficult calls easier, the losses smaller, or the questions quieter. But it remained. In the room with the families. In the direction of the prayer. In the reaching, which I have seen in every tradition and every circumstance and which I have never once seen fail to matter to the person doing it.
Whatever lies beyond the rooms I have stood in, I don’t know.
But I have seen what people reach for when they need something larger than themselves.
And I have reached for it too.
