There’s a psssssst sound above us and a wall-mounted air-freshener shoots a spray of lavender mist over our heads. As the synthetic fragrance enters my lungs I begin to feel giddy.
‘Let’s get out of here,’ I tell Tracy.
When we walk the guy out he says he hasn’t slept in a week, says he feels like ‘killing someone – anyone will do’. Tracy’s glad she’s not sitting in the back with him. I do my best to keep the guy calm with friendly smiles and conversation.
When I ask his date of birth for my paperwork, I see that today is his birthday.
‘Happy birthday!’ I say, then call out to Tracy, ‘It’s our patient’s birthday! Shall we find a cake shop on the way to hospital?’ We do these things from time to time, and we’re not the only ones. The other night we saw an ambulance outside Ben & Jerry’s, picking up ice cream for their patient with schizophrenia. Whatever it takes to keep our patients happy is a good thing in my books. It’s also a matter of safety. We’re confined in the back of an ambulance a foot away from people who are often agitated and unpredictable. It should be in our protocol to buy them cake and ice cream, if that is what’s required.
Before Tracy can answer me the patient grunts that he’s a diabetic and ‘can’t have fucken cake’. He drops his head and looks like he’s about to cry.
A lady in her eighties leads us down a concrete path lined with pruned rosebushes to a house that smells like gingerbread. ‘My son, he not wake up,’ she says in a southern European accent.
A man lies prone in a bathroom. He’s half-in, half-out of the shower recess, in his left hand a drained bottle of gin. Empty pill packets are scattered around. Tracy goes out to get the stretcher. Then I see that our patient is Hamish, a paramedic from a neighbouring station. Only a few months ago we worked a shift together and he seemed to be fine, if a little subdued. Lately I’ve heard he’s been having some issues: depression, delusions, addiction. The service had recently stood him down while deciding if he was fit for the job.
‘Hamish!’ I shout, shaking his shoulder. He’s wearing a polo shirt embroidered with our ambulance logo, and his feet are laced into rescue boots. A stethoscope and glove pouch lie in the sink and a fluorescent ambulance jacket hangs on a hook. I suspect the items have been placed there intentionally, symbols of his beloved profession now under threat, or to make sure we know that he’s one of us.
Hamish groans through the oxygen mask I’ve attached to his face. Tracy wheels our stretcher down the hall towards me.
‘It’s Hamish,’ I tell her.
Tracy turns pale.
I nod. ‘Polypharmacy, with alcohol, GCS twelve. Can you drop the bed to half-height? Reckon we can drag him onto it.’
As we head to Prince of Wales we phone our supervisor. We don’t have a choice. Tracy and I promise each other we’ll keep the matter quiet, but a semiconscious paramedic in the resuscitation bay at Emergency doesn’t stay secret for long. By midday there won’t be a medic in the city who won’t know about Hamish.
There’ve been many worse cases of paramedics called to their own. Hamish won’t die from his overdose today. But six paramedics I’ve worked with have ended their lives. Death is demystified to us; it’s the business we’re in. We know what works and what doesn’t. We understand anatomy, physiology, pharmacology. And those of us with their hearts set on suicide will rarely survive.
Tracy and I are both a little shaken after helping Hamish. The time is right for a treat to cheer us up. We see a Turkish takeaway joint and Tracy tells me how much she loves baklava. I pull over and reverse the ambulance back to the shop. We buy a few slices, but get a call before we can eat them. Not that it’s an obstacle to us; while I hurtle along with lights and sirens blaring, Tracy leans over and gives me a bite of baklava. This might appear intimate to others, but there’s nothing romantic about it. We’re just a brother and sister of the paramedic family, and I hate a sticky steering wheel.
Many husbands and wives of paramedics struggle to grasp this platonic relationship. Even Kaspia’s had her moments. But witnessing all manner of tragedies together inevitably builds a bond. Paramedics share pain and conflict, suffering and death. Like soldiers who’ve fought side by side, we’re united forever by what we have seen. In that sense we understand each other, at least a facet of each other, much better than our non-paramedic partners ever can.
High on sugary baklava, we arrive at a familiar housing block in Redfern. On level twelve our caller takes a good minute to unlock his door. There’s a CCTV camera on the opposite wall, red light flashing. A man in his thirties with wild eyes opens the door. He wants to know if we’re with the FBI. We shake our heads. CIA? No.
The man lets us in and tells us his place is bugged. Inside are a dozen cameras. He knows secrets – state secrets, explosive secrets – he says, and he’s being monitored. It looks more like he’s monitoring himself. We know he suffers schizophrenia and Tracy asks if he’s taking his medication. He says he ran out a few days ago. He agrees to come to hospital after we tell him he’ll be safe there. The man is paranoid and delusional; that’s our assumption. But I often have to wonder: what if some of these patients are telling the truth? What if they really are being watched, if they really do have state secrets? Nothing surprises me anymore.
An hour later we scream down Anzac Parade to a woman having a heart attack. We turn into a peaceful suburban backstreet, ditch our siren and skid into the gutter. On the verandah of a red-brick house we see a wizened man on a rocking chair who looks like he’s been sitting there for decades.
We exit the ambulance and go through the gate. I open the old man’s door thinking we’re here for his wife.
‘Is the patient inside?’ I enquire.
But he shakes his head.
‘No?’ I ask. ‘So where, then?’
He shakes his head again; he’s a man of few words. Then it dawns on me we’re at the wrong house.
‘Did you call for an ambulance?’
Again he shakes his head.
Before we can leave we hear a loud barking and a sausage dog charges right through the door and jumps on my leg. The old man ignores it. He doesn’t look over, doesn’t call the dog to heel. He just sits there indifferently and watches me curse and try to shake the thing off. Tracy picks up the kits and heads to the wagon. I finally manage to send the dog flying then leap down the stairs. But the dog’s on my tail, chasing me over the lawn, yapping like mad. With seconds to spare I exit the gate and slam it behind me.
When we reach the right address, a woman in her eighties with chest pain says her name is Nana Cat. It’s not hard to see why. There’s a cat on her shoulder and four in her lap. She tells us her chest pains came on after walking to the shops and back. Her complexion is grey and sweaty. If she wasn’t so sick I’d be patting her cats. Dogs might not like me, but cats I get on with.
Tracy readies the oxygen while I wheel in the stretcher as close as I can. I drop it to half-height a metre away. The patient will only need two little steps to be on it. Don’t walk a chest pain, I was told in my training, but it’s a couple of steps, hardly a strain.
We slowly help Nana Cat to her feet. Her fingers are cold and an icy chill passes from her hands to mine, then right up my arms and down through my spine. My whole body shivers and I get a bad feeling in the pit of my stomach. Never did I imagine two little steps could be so much effort. She can barely take one, let alone two. And as she tries for her second, she stops in her tracks. Her mouth gapes open and closed, like that of a fish out of water. All remaining colour drains from her face.
I scoop her legs from under her and lay her on the stretcher. She looks up at me and we lock eyes. Her look is screaming what her voice cannot. Her eyes are burning with fear, and the realisation that these are her final seconds on earth before a death she hasn’t prepared for.
Tracy calls for backup.
I pull out my scissors.
‘Set up the defib,’ I say, still holding Nana Cat’s gaze. A second lat
er her eyes lose their panic. She looks over my shoulder, to a place beyond the room, somewhere both close and far away. Her fingers relax in my grip and she submits to her fate. Before she dies she lifts her right hand in the air, as if reaching for something beautiful. The look on her face is now one of wonder, like she’s discovered how to fly. Then her pupils dilate and fog over.
Her pulse is gone before she loses consciousness.
‘CPR,’ I tell Tracy, and she starts compressions.
My trauma shears cut through Nana Cat’s blouse. I pull out the defib pads, peel them off and stick them on.
The monitor shows VF: ventricular fibrillation.
‘Charging up,’ I say. ‘Going for a shock. Stand clear!’
We defibrillate. Her body spasms but she doesn’t respond.
Another ambulance is coming. I cannulate and draw up adrenalin, then go for another shock. When the other crew arrives we continue our efforts. We get a heartbeat back and put Nana Cat in the ambulance, but she loses her pulse again soon after that.
When we reach the hospital the doctor seems annoyed. With a sigh he asks, ‘How long has she been down for? What’s the history?’ He’s looking for a reason to stop resuscitation, he thinks it’s no use.
As the doctor listens he gives a casual wave for a female medical student to ‘have a go at CPR’. I step back from Nana Cat’s chest. The medical student takes over but her compressions are weak. I want to push her aside and jump on again, do the job properly. But our role as paramedics ends right here.
A few minutes later the doctor looks around and asks, ‘Everybody happy?’
No one says a thing.
Then he glances at the wall clock and declares the time of death.
I bite my lip. I should have piped up, said no, I wasn’t happy. This shouldn’t be the way to end resuscitation. In the case of Nana Cat I know my objectivity is tainted by having seen her alive, by the fact we watched her breathe her last. Not to mention the guilt I now feel about walking her to the stretcher. Could those two little steps have sealed her demise?
‘Just bad luck,’ the doctor says as he leaves the resus bay, peeling off his gloves. ‘We spend a lifetime abusing our hearts. Eventually it catches up with us.’
Outside, Tracy is sitting on the back step of the ambulance with her head in her hands. I phone the control room and ask for time out. They give it reluctantly, and I understand why. They routinely have emergencies waiting. I say we won’t be long. We drive down to Coogee and order hot chocolates and sit by the beach. We watch as an afternoon storm rumbles in.
It’s easy to see that Tracy’s shaken up. I put my hand on her shoulder. When I started in the job a manager once told me, ‘If you can’t stand the heat, get out of the kitchen.’ Now we get offered professional help from a counselling service, but only when we want it, which isn’t very often. Most of us would rather hang out at the beach chatting informally with each other, drinking hot chocolate.
This is not the first time a patient has died on me, but Nana Cat is the first one to have looked in my eyes at the moment of death. What’s most disturbing is knowing that I was the final image she saw. When I come to breathe my last, I hope to be looking at the people I love or the wide, open sea or tall, snowy mountains. Not the sweaty face of a hapless paramedic.
CHAPTER 9
On my first day back for my regular shifts John turns up late and looks like a tramp, his uniform unironed. Once we’ve got the ambulance ready he goes straight to the lounge and lies down.
At 7.30 am he’s compelled to get up when we’re given a case. From his look and his smell, I suspect he’s at work to stop himself drinking. I ask him how he’s going, what’s new with Antonio. He just quietly shakes his head.
On the balcony of a unit block a shirtless man with a hairy chest is lifting dumbbells. Seeing us below, he stops and yells out, ‘Take that bastard away!’
We find our patient in the folds of a torn-up lounge chair. It seems he hasn’t showered in weeks. The room stinks of sweat, old beer and cigarette butts, with the whiff of charred meat. It’s a smell we all recognise, the odour of neglect. His body is little more than dry skin around a skeleton. Faded tattoos of swallows and daggers adorn both his arms. There’s a bottle of sherry on the table and a cigarette burning between his tar-stained fingers. His eyes stare vacantly at the television set until John switches it off. John hates it when people call us but keep watching TV while we’re standing there to help.
‘Merry Christmas,’ says John, in a monotone.
‘It’s Christmas?’ asks the man.
‘Any minute now, yes. I’m John. What’s your name?’
‘Bob.’
‘What can we do for you, Bob?’
‘Been depressed,’ he replies.
‘And you called yourself an ambulance?’
John’s not always like this. His sympathy for patients, and his tenderness, are well known. But these past few months he’s been different. The John I’m seeing is more often impatient, intolerant, jaded. His humour is shifting from cheeky to sardonic. His compassion is dwindling, a classic sign of burnout in the realm of first responders.
‘Yeah, I called you,’ says Bob, glaring at John. ‘Got a problem with that? You ever been depressed?’
‘Matter of fact, yes. But I never called an ambulance. Anyway, how long have you been feeling this way?’
‘Whole damn week. Come to think of it, the whole bloody year. Actually, I’ve been depressed from the day I was born. Even as a baby I tried killing myself.’
What an odd thing to say.
‘You live here alone?’ asks John.
‘Yeah.’
‘Ever been married?’
‘No.’ Bob pauses for a moment. ‘Had a girlfriend once, a long time ago.’
His sunken eyes search in the distance for memories. I wait for the glimmer of a smile, but there’s nothing. I’ve met old men like Bob a hundred times before. They live alone or out on the streets, their stories too familiar. A long-lost love, the one that got away, or walked away, or cheated on them and disappeared, or died an early death. The one they loved above all, who can never be replaced. Our city is full of lonely men who’ve locked themselves away or carry broken hearts from doorway to doorway.
Looking at John as he drives us back to hospital, I wonder if he’s thinking the same thoughts I am. His face is taut, a dam holding back an impossible pressure. I imagine he’s reflecting on the simple mistakes that spell the end for lovers, mistakes that can make them feel more dead than alive.
After dropping Bob off we’re dispatched to a woman hit by a car a block from St Vinnies. Her shopping is lying all over the road. She’s confused and combative and writhing around. We suspect she’s suffered a haemorrhage in her brain. Her life’s on the line, so we load her up quickly. It’s a race against time and John does what he can in the back of the ambulance as I floor it to hospital. The trip is all over in less than eight minutes. She goes into neurosurgery. Her chances are good.
It’s been a busy start to our shift. We drive to North Bondi and pull up in the car park to watch the swell come in. The ocean is a healer; its effect is calming and it helps us gain perspective. Shame John and I get so little time this morning. But even a glimpse of the water works wonders.
Bondi 402, you on the air? 402?
Affirmative. Go ahead.
Got one down in Bondi for you.
We start up the engine and proceed to a blond-brick unit block two streets from the beach. A woman yells, ‘Hang – I want to hang! Let me hang!’
A crowd of young backpackers and locals has gathered on a nature strip. They point to an apartment high up, where they reckon an old Chinese woman and her husband reside.
John and I make our way down a path to the entrance. We don’t get far. A glass bottle whistles past and clears John’s head by an inch, shattering on the concrete beside us. We both duck in time to avoid a vase, closely followed by a set of dinner plates, hurled from an open win
dow. Smashed porcelain lies everywhere. It’s not the first time this fortnight we’ve been attacked. But this time, thankfully, John retreats to the street. We wait for the police.
Things could be worse, I say to John. At least we’re not the target of a sniper. Getting shot at is a real danger for paramedics in other countries I’ve been to, like Mexico, South Africa and Pakistan. Jam jars and china we can handle.
A police cage truck pulls up at the very moment a wild-eyed woman begins crawling on all fours from the front of the building. She’s wearing a gingham apron and her hair sticks up like she’s been electrocuted. She’s not let up her desperate screaming for a second. ‘Hang! Hang! Let me hang!’ She spits and snarls, contorting her face, before plonking herself cross-legged on the roadside. We watch with the crowd as she takes a cigarette case from the pocket of her apron and lights up a smoke. With a cigarette clamped between her teeth she begins her crawl again, this time across the street, growling like a wildcat. Police direct traffic around her.
‘If we take her in the ambulance she’ll tear it apart,’ John says to the sergeant.
The conveyance of psychiatric patients is mostly done by ambulance because their problems are a health matter rather than a criminal one. Occasionally, though, when the patient’s so violent they’re a danger to us, we’ll opt for a police truck to take them instead.
The sergeant nods and orders his officers to don leather gloves. He tells the patient she’s under a schedule, a legal document that allows a mentally disturbed person to be apprehended against their will for transport to hospital. The police then pick up the woman, who’s kicking and screaming, and put her in their wagon, locking the door behind her.
The Gap Page 9