Paramédico. Benjamin Gilmour

      INTRODUCTION

      From the day of its invention the ambulance has attracted a magnetic curiosity from humans around the world. This vehicle racing to the scene of accidents and illness demands attention. When you hear one coming, you turn. When you watch it pass you wonder, if only for a moment, where it might be going, who is inside and what horrific mishap the patient has suffered. After fifteen years spent in the back of ambulances I’ve come to realise that medics and paramedics are endlessly fascinating to the public.

      But despite our appeal, the truth about us is largely hidden from view. It is hidden because, in the instant we drive past we have carried our secrets away, leaving nothing more than the wail of a siren. We are hidden because the usual depiction of paramedics on film and television is mostly a fantasy. The title of hero is forced upon us, and what is lost is who we really are.

      Right now, as you read this, more than a hundred thousand ambulance medics in all manner of unusual and remote locations across the planet are responding to emergencies. They are scrambling under crashed cars, carrying the sick down flights of stairs, scooping up body parts after bombings, comforting the depressed, resuscitating near-dead husbands at the feet of hysterical wives, and stemming the blood-flow of gunshot victims in seedy back alleys. A good number too are just as likely to be raising an eyebrow at some ridiculous, trivial complaint their patient has considered life-threatening. Each of these medics could fill a book just like this one, with adventures many more extreme, dangerous and shocking than those recounted here.

      My fascination with the lives of people from countries and cultures other than my own is driven by my ultimate desire to understand humanity. And so I travel at every opportunity to observe how people interact, and learn why they believe what they do, how they live and how they die and how they grieve. From the age of nineteen, during periods of leave each year, I have worked or volunteered with foreign ambulance services. Whether acting as a guest or consultant, I stayed sometimes for a month, other times more than a year. Every day it has been a privilege. There are few professions like that of an ambulance worker – we have a rare licence to enter the homes of complete strangers and bear witness to their most personal moments of crisis.

      Globally, the make-up of ambulance crews is varied, though it’s generally agreed there are two models of pre-hospital care delivery – the Anglo-American model based on one or two paramedics per ambulance, or the Franco-German model where the job is performed by doctors and nurses. Over recent years, a number of Anglo-American systems have also introduced paramedic practitioners with skills that, until now, have been the strict domain of emergency physicians. Pre-hospital worker profiles also include drivers and untrained attendants who can still be found responding in basic transport ambulances across many developing countries. Since cases demanding advanced medical intervention represent only a small percentage of emergency calls, it would be a mistake to judge ambulance workers as ‘good’ or ‘bad’ solely on clinical ability. Consequently, I have chosen to explore the world of many ambulance workers, no matter where they are from or what their qualifications. It is true that ambulance medics are united by the unique challenges of their job. They are members of a giant family and they understand one another instantly. While the work may differ in its frequency, level of drama and cultural peculiarities, there is no doubt that medics the world over experience similar thrills and nightmares.

      As a paramedic and traveller, I’ve enjoyed the company of my brothers and sisters in many exotic locations. I’ve lived with them, laughed with them and cried with them. And wherever it was I journeyed, my ambulance family not only showed me their way of life, they also unlocked for me the secret doors to their cities and the character of their people, convincing me that paramedics are the best travel guides one can hope to have.

      More than a story about the sick and injured, Paramédico is about the places where I have worked and the people I have worked there with. It’s about the men and women who have remained a mystery to the world for long enough.

      So, climb aboard, buckle up, and embark with me on these grand adventures by ambulance.