Paramédico. Benjamin Gilmour

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Paramédico - Benjamin  Gilmour

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one patient, there are so many, perhaps twenty, perhaps more. Where do we start? Triage, triage. My French comes back to me. We need to sort them, make sense of it, get perspective.

      The Leopard is so cool it shames me. He strides through the devastation like a war-hardened general, calmly slipping his hands into latex gloves. He takes no gear, no oxygen kit, no medicine, no bandages. Just the man and his portable radio. One at a time he stoops down to check the breathing and circulation of those lying motionless. Effortlessly he elicits responses from those who are conscious and checks the smashed vehicles and the truck for occupants. As I follow behind him, I finally hear him speak into his handset, his voice steady and commanding, his report plain and precise.

      ‘MVA, truck versus restaurant, no persons trapped, four dead, sixteen patients on the ground, unknown number of walking wounded, need fire brigade and as many ambulances you’ve got handy.’

      The Leopard grabs my shoulder and points to a man lying near a car that looks like it’s been through a wrecking yard. ‘Start with that guy, he’s not well. I’m going to delegate the back-up as it comes.’

      From the responder I get our gear and race back, stepping over the bodies of those beyond help.

      ‘He can’t feel his legs,’ cries the man’s wife, crouching beside him. ‘He can’t feel them!’

      I ask her name. It’s Melanie. She tells me the patient is Martin. Today is their wedding anniversary and he took her for dinner, alfresco, with candles.

      ‘Listen,’ I grab her attention. ‘Melanie, you’ve got to help me now. Here, take Martin’s head and don’t let it move. Keep talking to him. Stay calm because you need to keep him calm. We’ve got a job to do and we’ll do the job together.’

      After fitting the oxygen mask, I mould a hard collar round Martin’s neck and begin a head-to-toe examination. His breathing is rapid and shallow. I place my stethoscope in his armpits and listen. Limited air entry on the right, I’m certain of it. There is movement and crepitus, a popping sound and grating of crushed ribs when I palpate the chest wall. I suspect a collapsed lung. It may be tensioning, in which case an immediate procedure to release the pressure with a needle is required. As I break out in a sweat at the prospect of doing this, a Netcare ambulance team with a senior paramedic join me and begin cannulating and getting ready to board the patient. They will decompress the man’s chest once loaded up, the medic tells me. They work at lightning speed and I wonder if another supervisor is standing somewhere in the shadows holding a stopwatch.

      Medics are swarming all over the site now. Metro EMS, Netcare 911, even ER24, a company I’ve not yet come across. Suddenly The Leopard is behind me, leaning in.

      ‘Boet,’ he says in Afrikaans, meaning ‘brother’. ‘We got to go, we got a gunshot to the head just round the corner, they got no one for it.’

      I’m stunned. Broken glass crunches and mixes with blood underfoot as I carry the responder kit back to the car. It’s an awkward response in tragic times, but as I get into the front seat I begin to laugh. I laugh at the sheer absurdity of leaving the biggest accident of my career to attend a shooting. I laugh because it has taken me less than twenty-four hours to reach this point, this point where a paramedic’s work in Johannesburg is encapsulated entirely by a single, staggering moment of madness.

      And the night is but young.

      SHEIK, RATTLE AND ROLL

      England

      On the rain-drenched morning Henry takes the wheel I am secretly relieved the old man we are carting from one sad nursing home to another is afflicted by a state of dementia so advanced he is seemingly oblivious to our existence and stares silently ahead into a land beyond. Normally I wouldn’t wish the illness on my worst enemy. But as Henry pushes the siren and races down Herne Hill towards Brixton at the speed of a Grand Prix driver on amphetamines, it’s a good thing our patient – someone’s dear grandpa – is numb to it all. The old man bounces around like a leg of ham in a delivery van. In fact, groceries and daily mail probably get better rides than this in London.

      Approaching the intersection of Milkwood Road and Half Moon Lane is where we have the fourth near miss of the day. A car appears from nowhere, as Henry puts it afterwards, making it sound like a supernatural phenomenon beyond human comprehension. While hurtling through the red signal without slowing I assume this apparition has approached from the right, but I see nothing at all as I’m riding in the back clutching a crossbar with one hand and the patient’s shoulder with the other. When Henry plants his generous weight on the brakes I’m only half ready for it. Equipment flies into the front cabin, some of it catching me while passing. Airborne oxygen masks and kidney dishes are the least of my concerns. Our old man, drooling and wide-eyed, has long lost the instinct to hold onto the stretcher rails and our extreme deceleration threatens to catapult him through the windscreen. I have little choice but to throw myself on top of the patient, his brittle bones digging into me as I pin him to the mattress with my body. A sound of screeching tyres and angry horns is followed by the choking smoke of burning rubber pumping into the back of the wagon.

      ‘You all right, geezer?’ Henry asks once he has pulled over past the intersection, his face pale and puffing.

      ‘Think so,’ I say in a neutral tone, until it occurs to me how pissed-off I really am and I add, ‘Why the urgency anyway, mate? We’re going to a bloody nursing home.’

      ‘He should ’ave seen me comin’, tha bastard.’

      But Henry has only himself to blame and he knows it. Lights and sirens are merely a request for people to give way, not a demand.

      Henry’s hands are trembling as he collects the bits and pieces littering the front cabin. Though he seems shaken, I know he will do it again, maybe even today. Like a poker machine that eventually pays out, we’re long overdue for a prang. And if eventually he kills a man, or more than one, I want nothing to do with it.

      Got to quit, got to quit, got to quit.

      What am I still doing here?

      With its prestigious-sounding name no one would suspect a shoddy operation from this private Harley Street ambulance service. Ambulances plush as limousines, I thought. Only these would satisfy the British high society and foreign millionaires who visit the nation’s famous strip of specialist rooms and luxury clinics.

      Perhaps the greatest insult one can give a genuine paramedic is to call him or her an ambulance driver, yet this is what I was, my paramedic degree as useful as a sheet of toilet paper. The art of driving grannies to doctors’ appointments had, as I recall, never been covered. Why my skills were unattractive to the London Ambulance Service (LAS) when I applied for recognition of prior learning, I just don’t know. The LAS was naturally my first choice, but the process facing foreign paramedics hoping to get on London’s ambulances is known to be so long and painful that most don’t bother. Ironically, ambulance services in sunnier countries of the world like Australia and New Zealand have made quite a business of poaching British paramedics and have done this so aggressively over the past decade it has created a shortage of paramedics in England, and a minor political storm.

      Wasted skills aside, better money can be made working for private patient transport services anyway, even if it represents a significant drop in action. Nor is it wise to remain jobless while waiting for the bureaucratic process of the National Health Service. As Iraqi doctors and Iranian surgeons flipping burgers in London’s takeaway joints can attest, survival rules over pride in this cruellest of cities. Yes, we’d

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