Triage and the Burning House
There is a story from 1854 that stays with me. Florence Nightingale arrived at the Barrack Hospital in Scutari during the Crimean War to find soldiers dying from the conditions meant to heal them. The hospital itself was the contagion.
She became famous for her lamp, for walking the wards at night—the Lady with the Lamp, the ministering angel. But what's less remarked upon, what the history books tend to gloss over, is the impossible duality she inhabited. She was both the architect of systematic reform and a woman so depleted that she would never fully recover her health. She was simultaneously taking stock of who could be saved and one of those who needed saving.
"I stand at the altar of the murdered men," she wrote years later, "and while I live I fight their cause." But she was also burning. And she knew it. In her private letters—the ones not meant for public consumption, the ones where the careful composure drops away—she described herself as "worked to death," as having "lost the power of feeling." Yet she continued. Because the soldiers were dying now. Because someone had to reorganise the wards now. Because crisis, in its particular cruelty, does not wait for the rescuer to be well-rested, clear-headed, or properly resourced.
Perhaps you cannot reform a hospital from outside the contagion. And so you enter the wards. You breathe the smoke. You learn to function with your own lungs compromised, because if you wait until you can breathe clearly, everyone inside will already be dead.
This is what it means to stand in the burning house.
The timing, it's almost cruel.
I had laid out my plans the night before. My favourite pen and notebook poised and ready beside my laptop to finally compose the essay I'd been holding in my head for weeks, and finally, finally, I had crossed whatever threshold had kept me circling the starting line. I was ready to begin. Nov 24 was supposed to be Day 1. Day 1 turned out to be me waking into triage.
We are told to put on our oxygen masks first, as if crisis operates on the neat logic of sequence: first this, then that. But what happens when you are the only one who knows where the masks are? When the time it takes to secure your own breath is the time in which everything you're trying to save burns down?
I don’t think that this is not a problem to be solved, rather, a condition to be inhabited. And so we must learn to live inside the paradox. To be both the one burning and the one trying to extinguish the flames. To need rescue while being the rescuer. To witness our own emergency even as we respond to it. This has always been the human condition. We have simply become very good at pretending otherwise.
The French have a term for this—sauveteur-victime—the rescuer-victim. It appears in emergency medicine protocols, a warning about first responders who become casualties themselves. The firefighter who runs into the burning building and doesn't come out. The lifeguard who drowns trying to save the drowning. It's meant as a cautionary category, a failure mode to be avoided through better training, clearer procedures, stronger boundaries.
But perhaps it's not a failure at all? Perhaps it's simply what happens when you love someone, when you're responsible for someone, when their crisis becomes yours not because you chose it but because proximity and care have made separation impossible. Perhaps becoming the rescuer-victim is not a mistake but an inevitability when the people burning are the ones you cannot leave behind.
The philosopher Emmanuel Levinas spent much of his career trying to articulate this. He wrote about how the face of the Other makes a claim on us that precedes our own needs, our own projects, our own self-preservation. "The face opens the primordial discourse whose first word is obligation," he wrote in Totality and Infinity. The Other's vulnerability commands us before we can even ask whether we have the capacity to respond.
It's a beautiful philosophy. It's also, in its way, terrifying.
Because what Levinas is saying—though he wrote it from the safety of decades after his own survival of a Nazi labour camp—is that the Other's need is not a request we can consider and decline. It's a summons that has already claimed us simply by virtue of our having witnessed it. To see someone suffering and to be in a position to help is to be already obligated, already responsible, already implicated. And when the person suffering is someone you love, someone you've cared for, someone whose face you know better than your own—the obligation doesn't feel like philosophy. It feels like gravity. Like something so fundamental that choosing to refuse would be like choosing to stop breathing.
In her memoir The Year of Magical Thinking, Joan Didion tried to hold two incompatible realities simultaneously. Her husband had died suddenly. Her daughter lay in a coma in the ICU. Didion found herself caught between the need to be present for her dying daughter and an irrational belief that her solitude could resurrect her husband.
““I needed to be alone so that he could come back.””
She could not be both the clear-eyed journalist documenting her own unraveling and the grieving woman whose magical thinking kept her from accepting what had happened. The two positions were incompatible. Logic said she had to choose. And yet she was both. The book exists because she was both.
What makes Didion's account so devastating is not just the grief—though the grief is oceanic, bottomless. It's the precision with which she documents the mind's attempt to negotiate impossibility. She describes her magical thinking not from a place of recovery. No, she was not from the safe distance of having survived it, but from inside it. Even as she knows it's irrational. Even as she can see herself believing something that cannot be true. She is both lost in the woods and drawing a map of the woods. Both drowning and taking notes on the drowning. This is the split consciousness that crisis demands. You cannot afford to be fully inside your own collapse because someone needs you to remain functional. But you also cannot fully escape it because you are collapsing, whether you acknowledge it or not.
And so you learn to inhabit both positions at once. The one who is managing and the one who is barely managing. The one who has it together and the one who is falling apart. The rescuer and the one who desperately needs rescuing. Like Nightingale in the contaminated wards, you become both the solution and part of the problem that needs solving.
There's a tenderness required here. A softness toward the self that the urgency of crisis often precludes. We're so busy assessing everyone else's needs that we forget to extend that same careful attention inward. We forget that we, too, are standing in the smoke. That we, too, are burning.
This is perhaps my most honest accounting of what it means to be human. That we are always both the observer and the observed. The one experiencing and the one noting the experience. The one inside the crisis and the one trying to make sense of it. We are frayed and nibbled. Aging and eaten. And still somehow taking notes. Still somehow bearing witness to our own consumption.
The question, then, is not whether we can escape this double consciousness. The question is what we do inside it. How we live in the gap between the one who suffers and the one who observes the suffering. How we tend to both without abandoning either.
Simone Weil spent her too-short life trying to understand what it means to truly pay attention. She wrote about attention as a spiritual practice, as the highest form of prayer, as the only real way to love another person. For Weil, attention wasn't passive observation. It was active, costly, transformative. It required the painful discipline of suspending one's own ego, one's own needs, one's own constant interior monologue, in order to truly see what, or who, is before us.
“Absolutely unmixed attention is prayer.”
She understood, more clearly than perhaps anyone, that attention is not free. That to truly see another's suffering is to be changed by it, marked by it, undone by it. That you cannot stand outside the burning house and witness it from a safe distance. You must stand inside. You must breathe the smoke. You must feel the heat on your own skin. And that this attention—this witness, this refusal to look away even as you are being consumed—this is the only love that matters.
Which means: to truly see is to be willing to be undone by what you see.
I think about this often now. About whether my Day 1, the one that was supposed to be about finally beginning my own work, was actually always meant to be this. A lesson in attention. In what it costs to truly see someone else's need. In what it means to stand in the burning house not because you're heroic or self-sacrificing, but because love has placed you there and you cannot imagine leaving. So I return, again, to the burning house. To Day 1 that became something else. To the notebooks still sitting on the desk, unopened.
Perhaps Day 1 was never meant to happen in clear conditions.
The poet Adrienne Rich knew this in her bones. In Of Woman Born, she wrote about the years of raising three sons while trying to write: "I was fighting for my life through, against, and with the lives of my children."
She was both the mother whose children needed her immediately, constantly, and the writer who needed solitude, continuity, uninterrupted time. The two identities did not peacefully coexist. They were at war. Rich didn't romanticise this split. She didn't call it "balance" or suggest it could be managed with better boundaries or clearer priorities. She called it what it was: a war. And she was losing. Or rather, both sides were losing.
“My children cause me the most exquisite suffering of which I have any experience. It is the suffering of ambivalence: the murderous alternation between bitter resentment and raw-edged nerves, and blissful gratification and tenderness.”
There's such honesty in that word: murderous. She doesn't soften it. She doesn't pretend that love makes the sacrifice easy, that maternal devotion erases the cost. She names the rage alongside the tenderness. The resentment alongside the gratification.
This is not Weil's self-emptying attention. This is not Levinas's ethical obligation joyfully embraced. This is the burning house when you have others inside it who depend on you, and you are also one of the people burning, and no one is coming to carry you out.
And yet—and here is where Rich's testimony becomes essential—she wrote. In stolen moments. In fragmented attention. In the very split consciousness that seemed to make writing impossible.
She wrote Snapshots of a Daughter-in-Law while her sons were young, and you can feel the fragmentation in every line. It's a poem of fury and interruption, of a mind constantly pulled between competing claims. It's not a polished meditation written from the calm retrospect of survival. It's a document created in the middle of the burning, by someone whose hands were literally full, whose attention was perpetually divided, whose Day 1 kept being interrupted by the immediate needs of small humans who could not wait.
What Rich discovered, and what connects her experience back to Nightingale's, to Weil's, to Didion's, is that the split consciousness isn't an obstacle to the work. The split consciousness is the work. The burning house isn't what happens before I can begin. The burning house is where I’ll begin.
The body knows this. It has always known. My hands this morning—I noticed them while making coffee, while my phone graciously sat silent, while I had a brief moment before the next call would come. The veins visible through thinning skin. Rivers of blue-green mapping a circulatory system that has kept me alive through every crisis, every breath, every moment of this emergency that has become my life.
The only question is whether I will spend my days—whether that is decades or months or just this one wild and precious morning—pretending I am not in the burning house, or whether I will have the courage to witness it.
To say: yes, I am burning. Yes, I am also trying to save what can be saved. Yes, both are true simultaneously and neither negates the other.
This is Day 1.
Not the one I planned. The one I'm living.
And the Witness? She's here. She's been here all along. Standing in the smoke with her notebook, her pen, her refusal to look away even as the flames rise higher.
