Ghosts of the Navigator

It usually begins halfway through a night shift.

The calls have finally spaced themselves out. The coffee is cold. Someone has found a position in the bay that is almost comfortable, and everyone has begun relaxing without admitting that is what they are doing.

Then someone says it.

Usually a new hire, a visitor, or a supervisor who knows exactly what they are about to cause.

“It’s been quiet tonight.”

The room reacts immediately.

Someone groans. Someone knocks on wood. Someone reaches for their radio as though preparing to receive divine punishment. The person who said it is informed that whatever happens next will be entirely their fault.

Then everyone waits.

If the tones drop five minutes later, the case is closed. The shift has been cursed.

If nothing happens, nobody mentions it.

Most of us know that the word did not cause the call. Saying “quiet” does not alter dispatch volume, summon a cardiac arrest, or encourage someone to drive into a ditch. Researchers have gone far enough to test this in clinical settings, and the word has repeatedly failed to produce the chaos attributed to it.

That has not stopped anyone from flinching.

I used to think this was simply an inconsistency. Paramedics are trained to question assumptions, gather evidence, and avoid making causal claims we cannot support. We work in a profession built around observable findings.

We also knock on wood, blame the full moon, refuse to clean the truck too early, and become suspicious when a shift begins too smoothly.

After enough years in the job, that contradiction becomes less surprising.

Superstition is not always a literal belief. A medic can know perfectly well that the Q-word has no influence over the universe and still prefer that nobody says it. The ritual can be a joke, a habit, a way to avoid provoking coworkers, or simply part of the language of the station.

Sometimes we are not asserting that the curse is real.

We are participating.

The belief becomes convincing through repetition. Someone says the word, and twenty minutes later the tones drop for a terrible call. The sequence is memorable because it makes a good story. It will be repeated for years.

The quiet shift that remained quiet disappears from memory.

We notice the apparent hits and rarely keep track of the misses. Once the superstition is familiar, every coincidence strengthens it. The call after the Q-word becomes evidence. The uneventful hour after it becomes nothing worth remembering.

Emergency work makes that pattern especially easy to build.

The job trains us to notice relationships quickly. We enter a room and begin gathering information before anyone has finished speaking. We notice posture, skin colour, breathing, medication bottles, damaged furniture, and the expressions of the people standing nearby. Small details frequently do mean something.

Experience teaches us that the person who says they are fine may not be fine. A strangely quiet child may be more concerning than a loud one. The object placed beside the bed may explain the entire call.

Finding patterns is part of the work.

The difficulty is that the same mind looking for clinically meaningful relationships can also find relationships that are not there.

Two events occur close together. Someone says “quiet,” then a call arrives. The full moon rises, then the emergency department fills with unusual behaviour. A medic mentions a frequent patient, then that patient appears before the shift ends.

The timing feels meaningful even when there is no mechanism connecting the events.

Research has linked a reduced sense of control with a greater tendency to perceive patterns in unrelated information. That does not explain every superstition, but it fits the environment. Paramedics work inside systems where important events occur without our permission, preparation, or understanding.

We cannot decide who calls.

We cannot control what has already happened before we arrive.

We cannot guarantee that a reasonable assessment will lead to a good outcome.

Small rituals give some shape to that uncertainty.

We control the words used in the bay. We knock on wood. We avoid washing the truck before the end of shift. We accuse one particular coworker of being a black cloud. None of this changes the system, but it gives the crew something to do with the feeling that the next hour could contain almost anything.

There is also comfort in making randomness personal.

It can feel easier to say that the universe is punishing the new medic than to acknowledge that a child, a cardiac arrest, or a violent collision entered our night for no reason connected to us at all.

The joke gives chaos a temporary author.

That matters in a profession where events frequently resist explanation. We spend our shifts trying to establish causes. What happened first? What changed? What exposure, illness, injury, or decision led to the patient in front of us?

Then we return to the station knowing that some suffering will never offer a satisfying answer.

The Q-word is a small and mostly harmless response to that world.

It also belongs to the culture of the job.

Warning someone not to say “quiet” is a kind of initiation. Their reaction tells the crew something. Do they argue? Laugh? Apologize? Say it three more times to irritate everyone?

The ritual lets a new person participate in a shared joke before they understand all the history behind it. It says that the rest of us have seen calm shifts turn suddenly, have felt the atmosphere change when the tones dropped, and have learned not to trust peace too completely.

A supervisor of mine enjoys saying the word for exactly this reason. He grins before he does it. He knows the crew will complain, and the crew knows he is waiting for the complaint.

Nobody involved needs to believe in the curse.

The reaction is the point.

That is usually where superstition should remain: in the bay, in the joke, and in the stories we tell one another after difficult shifts.

The problem begins when it follows us to the patient.

A medic who expects the full moon to produce bizarre behaviour may begin interpreting the next patient through that expectation. The person becomes another “full-moon call” before the assessment is complete. Confusion, agitation, fear, intoxication, hypoxia, head injury, infection, or an unsafe environment can be flattened into the story the crew was already prepared to see.

The superstition has then stopped being harmless culture.

It has become a clinical frame.

The same can happen with ideas about black clouds, deaths arriving in threes, certain addresses always producing nonsense, or specific patients never having anything seriously wrong. Repetition creates familiarity. Familiarity creates expectation. Expectation begins deciding which details receive attention.

That is why skepticism matters most when we are convinced we are only joking.

Research has not found a consistent full-moon effect on the kinds of human behaviour and clinical activity commonly attributed to it. Trials examining the word “quiet” have not shown that saying it increases workload or patient volume.

The evidence is reassuring.

It is also unlikely to stop the groaning.

Facts do not instantly remove a ritual that has social and emotional functions. A person can know the word has no causal power and still feel uneasy after hearing it. The mind does not discard every learned association simply because the association has been disproved.

That is not unique to paramedics, and it is not evidence that clinicians are unintelligent.

It is evidence that clinical training does not make us less human.

The more important question is not whether I knock on wood. It is whether I know when to stop letting the ritual guide me.

I will probably always notice when someone says the word.

If the tones drop immediately afterward, I may blame them. If the full moon is hanging above the ambulance bay and the night becomes strange, I may acknowledge that it looks guilty.

For a moment, the joke can have its place.

Then the truck arrives.

The door opens.

There is a patient in front of me who has not been explained by the moon, the shift, my intuition, or the story the crew was telling before we arrived.

That person deserves an assessment based on what is actually there.

I can blame the universe later.

First, I have to go to work.

Notes and References

Brookfield, C. R., P. P. J. Phillips, and R. J. Shorten. “Q Fever: The Superstition of Avoiding the Word ‘Quiet’ as a Coping Mechanism: Randomised Controlled Non-Inferiority Trial.” BMJ 367 (2019): l6446.

Geller, Jennifer E., Pamela Ohman Strickland, and Joshua T. Bucher. “The Use of the Word ‘Quiet’ in the Emergency Department Is Not Associated with Patient Volume: A Randomized Controlled Trial.” American Journal of Emergency Medicine 56 (2022): 10–12.

Rotton, James, and Ivan W. Kelly. “Much Ado About the Full Moon: A Meta-Analysis of Lunar-Lunacy Research.” Psychological Bulletin 97, no. 2 (1985): 286–306.

Taher, Mohammad, Shahzad Pashaeypoor, Mohammad Ali Cheraghi, Mahmood Karimy, and Akram Sadat Sadat Hoseini. “Superstition in Health Beliefs: Concept Exploration and Development.” Journal of Family Medicine and Primary Care 9, no. 3 (2020): 1325–1330.

Whitson, Jennifer A., and Adam D. Galinsky. “Lacking Control Increases Illusory Pattern Perception.” Science 322, no. 5898 (2008): 115–117.

Further Reading

Sagan, Carl. The Demon-Haunted World: Science as a Candle in the Dark. New York: Ballantine Books, 1997.

Shermer, Michael. The Believing Brain: From Ghosts and Gods to Politics and Conspiracies: How We Construct Beliefs and Reinforce Them as Truths. New York: Times Books, 2011.