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‘He ain’t gone walkabout! Ambo guys don’t go walkabout, they gotta be ready, you know, READY!’
‘Yeah, and we seen two ambulance in that big shed, means he in there, he in there for sure!’
Not wanting to get caught undressed, I crab-crawl my way back to the bedroom and throw on my uniform, complete with all its formal trimmings. Maybe if I wear the tie and jacket with gold buttons down the front and speak with a firm tone I can scare off my stalkers. By the time I psych myself up to step out and challenge the girls – a butter knife in my pocket for reassurance – the Datsun does a donut, whipping up a cloud of dirt and farts off towards the highway. The girls catcall before the car shudders over the cattle grate at the end of the track and disappears.
I phone Doug and explain the situation.
‘Yeah, I heard,’ he says.
‘Heard what?’
‘The blackfellas are a bit upset with you.’
‘Me? Why? I did fine with that kid last night.’
‘Sure you did but you also got yourself a big problem in the process, mate. Those Koori chicks are trouble and you’re the talk of the mission today. Heard they even got a special name for you, what is it again? Ah, Romeo! That’s it!’
‘Romeo?’
‘Romeo, as in Romeo and Juliet, you know, that movie that’s just come out?’
Baz Luhrmann’s sexy contemporary interpretation of the Shakespearean classic had recently done good business at the Australian box office. Even Aboriginal kids in Peak Hill, miles from any cinema screen, knew about it. Unfortunately I didn’t look anything like Leonardo DiCaprio. How could the girls have come to such a comparison based on the quality of my arse alone?
‘Take it from me mate, whatever you do, don’t be going down the mission on a job, understand? You’ll either be set upon by the women or a jealous bloke will glass your throat.’
He paused for a moment. ‘Actually, you got to get out of here.Those girls won’t let up until they pin you down. Literally.’
‘But Doug, you’re a cop for crying out loud!’
‘Come on. Cops can’t touch no blackfella these days, let alone a female of the species. You know that. Sorry to tell you this, mate, you’re on your own.’
Never have I covered the 20-metre distance between the nurses’ quarters and the ambulance station in less time. Whatever door I pass through, I make certain it’s bolted behind me. Despite Doug the policeman’s fear-mongering, if a call comes in for the mission I have every intention of making an official request for his assistance. This way he cannot, by law, refuse to help me. The idea of driving anywhere near the southern part of town has put me on a knife’s edge. What’s to say a bitter indigenous bloke down there doesn’t ring triple-0, fake some illness and jump up to strangle me with my own stethoscope?
My hopes of being nothing more than a passing interest are dashed the following day with the approach of the Datsun again at 10 am. It circles the ambulance station five or six times, coughing and backfiring. The car eventually skids to a stop and one of the girls gets out and peers through the window to see if I’m inside. Lying motionless behind the lounge, hiding for a good ten minutes, I wonder what my job has become. There is no question in my mind how different a situation like this would be if I were a female paramedic and my stalkers were male.
The Bogan Times comes out on Monday and ‘Peak Hill’s Romeo’ is front-page news: ‘Local Ambo Talk of the Town!’
Management in Dubbo are concerned. My wellbeing is under threat and the service has a responsibility for my safety next time there’s a call to the Peak Hill mission.
Within a week I get surprising news. Out of all the applications for Hamilton Station, mine has been selected and I’m offered the position. With little hesitation I accept. Although I’m told the merit of my application won me the position, I’m unconvinced. My transfer takes effect immediately, which rarely happens. It seems obvious to me that the Newcastle job offer and my report of sexual harassment are no coincidence at all.
On the afternoon I get my transfer letter the Koori girls arrive again for their daily patrol. This time I lounge on the verandah in my underwear and give them a wave. Having eluded them for a fortnight, the girls scream in delight. A moment later the Datsun stalls and skids into a ditch. As the girl driving curses and tries starting it again, her accomplices lean out of the windows, yelling at the top of their voices.
‘Hey, white boy!’
‘Love your arse, white boy!’
‘How about it, white boy!’
None of them actually leaves the car, and I sense for the first time they are too shy to come any closer.
‘Love you, white boy!’
‘Come and see us, white boy!’
Finally the engine splutters back to life. Before they pull onto the track again I make sure to blow them a kiss.
‘Thank you, girls! Thank you!’ I call after them.
The Datsun tumbles down and away in a flurry of hooting horns, wolf-whistles and flailing arms. When the dust settles and the road is quiet again, I’m overcome with shame for my unfounded anxieties. How harmless these girls were in reality, making the most of their life in this drab, nowhere town. A little innocent fun is all they ever wanted. Having finally lured the white boy medic from his house, I know in my heart they won’t be back.
But neither will I.
RUNNING WITH THE LEOPARD
South Africa
Sleep will never visit me, lying on a paramedic’s black leather lounge, imagining the lethal violence steaming across the city. Any moment now the phone will ring. My stomach is taut, turning with readiness, primed for action. Few men and women have slept, truly slept I mean, waiting for emergencies on a Jo’burg Friday night. Even Neil Rucker – The Leopard – is wide awake behind shut eyes.
A paramedic employed by Netcare 911, South Africa’s second biggest ambulance service, The Leopard drives a late-model Audi and is permitted to work from home. The Leopard’s modest red-brick house lies in a suburb close enough to the tough suburbs of Hillbrow and Berea for a quick response but far enough away to avoid bodies on his lawn in the morning.
‘Like to be around my cats,’ he says, pointing to a gallery of framed prints depicting handsome leopards crouching on the veld. Others recline on the boughs of trees yawning at sunset. The Leopard’s colleagues told me earlier in the day Rucker’s nickname was inspired not only by his passion for the big cat, but his own cunning intelligence and skill, in particular his masterful intubation of patients with severe oropharyngeal trauma. He’s got the veteran’s look too – shaved head, a few good scars, eyes narrow and a little icy.
The Leopard lights some lotus incense with his Zippo and puts on a CD of meditation music. Slow synthesizers complement the sound of trickling from a water feature standing among indoor ferns. Despite the atmosphere of an Asian spa I still can’t unwind. When the first call comes in I’m up like a jack-in-the-box.
Before we head off, The Leopard ducks into his bathroom and pulls the door shut. When he comes out he is wired-up, sniffing and rubbing his nose in the way a person would after snorting cocaine. I pretend not to notice. He may be suffering allergies, sinus problems.
‘Here, put this on,’ he says, passing me a bulletproof vest. It sits on my shoulders like a sack of rocks.
‘Wow, it’s heavy …’
‘Ja, it’s inlaid with ceramic. Don’t worry, we won’t be going swimming,’ he says dryly.
The Leopard pops some chewing gum in his mouth, punches the air with his fists and grabs the car keys off the table. Seconds later we are rocketing along roads drenched in the apocalyptic orange light of street lamps, the engine of the Audi revving wildly, my body pushed back in the seat as The Leopard clocks 200 kilometres per hour into town.
Held over a week in a classroom at Witwatersrand – the university attached to Johannesburg General Hospital – the globally recognised Advanced Trauma Life Support (ATLS) course is meant to be intense. Conceived by the American College of Surgeons, in South Africa it is taught by those with perhaps the most experience in trauma anywhere in the world. Even with levels of violence in slow decline since the end of apartheid, Johannesburg makes no attempt to shake off its image as one of the most dangerous cities on earth. In 2008, Time magazine published figures showing an average of fifty-two murders occur in Johannesburg every twenty-four hours. This round-the-clock blunt and penetrating trauma ensures Jo’burg is to medics what Milan is to fashion designers. From Europe, Asia and the Middle East they come – doctors, nurses and paramedics – to learn the craft of saving lives in the ‘golden hour’ after severe physical damage to a human body from external forces.
Endotracheal intubation, decompression of tension pneumothoraces and cricothyroidotomies were all on the menu. I couldn’t get enough of them. Many of the lectures and workshops practised skills beyond my previous level of training, skills I assumed to be out of my scope. Yet here I was, mixing it up with the best trauma surgeons in the world. I may have been transfixed by the experts, their stories and their tricks, yet had I known what the weekend would dish up on the streets of the capital, I would’ve been even more attentive.
After exiting The Leopard’s responder I can barely stand up. My eyes sting from the acrid stench of his smoking brakes.
In the middle of the road, on a hill out of Berea, a man lies on his back gazing up at the starless night. Superstitious Good Samaritans have removed the victim’s dirty takkies, placing the running shoes neatly beside his body, allowing a route of departure for his soul. Spreading from a single point on the man’s parietal skull, a stream of bright red blood shimmers in our headlights, still flowing freely, finding new tributaries in the bitumen, branching out and joining up, coursing to an open drain.
The Leopard lights a cigarette and leans against the car.
I glance at him, then down at the man, then back again. ‘Well?’
‘Well, what?’
‘He’s breathing.’
‘So? It’s agonal. You wanna tube him? Here,’ says The Leopard, casually opening the boot of the responder, retrieving his kit, passing it to me with his cigarette between his teeth, standing back again, entirely disinterested. Now that’s burnout, I think to myself. Typical burnout. Speeding to the scene, then doing nothing.
‘You won’t do it?’ I ask.
‘He’s chickenfeed, mate, all yours. Remember, don’t pivot on the teeth. If there’s blood in the airway, if you can’t see the cords, forget about it. We’re not going to stuff-up our suction this early in the shift.’
The vocal cords are Roman columns in the guy’s throat and I sink the tube easier than expected. Once connected to a bag, I breathe him up. The Leopard steps on his cigarette. He slinks over swinging his stethoscope casually, pops it in his ears and listens over each side of the chest and once over the stomach. Without saying a word he nods his approval. From the leather pouch at his waist he whips out a pen torch, flicks it over the wounded man’s eyes. The pupils are fixed on a middle distance, dilated to the edges, black as crude oil.
The Leopard chuckles.
‘Fok my, do all you people come here for learning miracles? Makes me lag, eh.’
He points to my knees either side of the patient’s head.
‘By the way, you’re kneeling in the brains.’
Early that morning I’d done a shift at Baragwaneth Hospital on the edge of Johannesburg’s sprawling Soweto townships. With three thousand beds it is one of the largest hospitals in the world and treats more than two thousand patients a day. Half of these are thought to be HIV positive. A constant stream of ambulances unloaded their sorry cargo onto rickety steel beds lined up side by side until, by mid-afternoon, there was barely room for any more. Teamed up with Simon, an Australian doctor with whom I’d participated in the ATLS, we cannulated, medicated and sutured non-stop.
While joining a doctor’s round in one of the wards, a boy of about sixteen was lying on a bed and as we passed by, he grabbed my wrist, pulling me close. His eyes pleaded as tears welled up and spilled onto his cheeks.
‘Please, friend, take it out, please take it out.’
On his right chest I could see a small bulge, the shape of a bullet sitting just beneath the epidermis. Exit wounds are not always a given, I’d learnt.
‘What’s your name?’
‘Treasure.’
‘What happened to you?’
‘Some men tried robbing me in Mofolo, I told them I had nothing to give but they klapped me hard and after I ran they shot.’
‘Bastards. Did it enter your back?’
‘Ja, bullet hit my spine, they told me it is shattered, they told me I am never walking again. When I fell down on the street I knew that. What will happen to me now? Last year my parents died in a minibus crash. There is no one to care for me.’
Already the doctors were three patients ahead – a ward round at Bara doesn’t wait. Treasure squeezed my arm tighter, sensing my urge to move on.
‘Please, brother, don’t go, please, take it out.’
‘Mate, I’m sorry for what happened to you, I really am. But the bullet is not interfering with any body function now, the damage is done. Maybe it will push out on its own one day.’
When I heard myself saying this to him – lying there unable to get up and walk to the open window, no father at the foot of his bed, no mother who named him her treasure holding his hand, no friends to help him pass the hours, the time he would forever spend turning over the memory of that one moment – I was filled with pity.
‘Just want this evil thing out,’ he said.
‘One minute,’ I told him. ‘I’ll bring a surgical kit.’
As I incised over the bullet, removing it with tweezers and dropping it into a steel kidney dish with a clink, I could feel Treasure’s muscles relaxing under the drape. A deep sigh passed his lips and his face smoothed out with relief.
‘God bless you, God bless you, God bless you,’ he whispered with his eyes closed, as if I had just exorcised an evil spirit. ‘God bless you forever.’
Among the pumps of a service station The Leopard unzips his bumbag. After looking around to make sure we are alone, he pulls out a 9mm semi-automatic handgun and slides out the magazine to show me its full load of rounds.
‘Got another one strapped to my ankle,’ he says.
With a sporadically effective police force, it is not unusual for paramedics to find themselves caught up in gunfights. Triage, the concept of sorting patients in multi-victim situations starting with the most critical, is superseded here by sheer self-preservation. If a member of one gang requests a paramedic to treat their own before those of an opposing group, it’s usually at gunpoint. The Leopard takes no chances.
‘Last year two of my colleagues were held up. Actually, it was an ambulance-jacking, they were left stranded in a bad place.’
As he drives me through Hillbrow, Johannesburg’s most densely populated urban slum of decrepit high-rise buildings, I see a neighbourhood I wouldn’t want to be stranded in either. Shopkeepers sit nervously behind thick iron bars and the blinking neon of pool halls and strip joints flickers on the figures of haggling prostitutes outside, their bodies shimmering with sweat.
‘Some of us call it Hellbrow. New Year’s Eve is the worst. People take pot shots with their guns from balconies, they let off fireworks horizontally, they throw furniture and other projectiles from windows, trying to hit people below. Few years back a fridge landed on a Metro ambulance. You never know what will come at you.’
Even ordinary party nights can be lethal in Jo’burg. Saturday evenings are difficult in most Western cities but here it’s a war-zone. Streets are jammed with people overflowing into the path of our car and the expectation of impending violence is palpable all around us. The Leopard locks the doors of the responder, says we’ll avoid the worst parts of the suburb, places even he won’t go unless accompanied by a police flying squad. He ignores red lights too, without being on a call. ‘You’ve got to keep moving. Robots will kill you in Johannesburg,’ he says, referring to the traffic signals. Rarely do I entertain irrational fears, but all heads seem turned on us tonight, eyes following the Audi as we pass, shady characters ready to pounce. In reality they could be just as well hoping we’ll stop and join them for a drink, take a break, have a laugh. But as we draw level with the next pub where words stencilled by the door read ‘No Guns Permitted’, I’m not so sure.
‘Zero Zero Three, come in.’
‘Three, go ahead.’
‘Man off a bridge, Yeoville.’
‘Rrrroger.’
Tossing individuals off bridges and towering apartment buildings is a preferred method of murder for some gangs in Jo’burg. Without witnesses and no weapon or identifying wounds, these deaths can be easily mistaken for suicide.
As The Leopard does a U-turn he points to the tallest building in Hillbrow, the notorious Ponte City Apartment block. This cylindrical skyscraper with a hollow core was built in 1975 as a luxury condo fifty-four storeys high. After the end of apartheid many gangs moved in and the penthouse suite on the top floor became the headquarters of a powerful Nigerian drug lord.
‘Once, we got half-a-dozen bodies in a week at the foot of that one,’ he says, flicking on the siren. But this was 2003 and things were changing. Using the South African Army as back-up, developers were evicting undesirables. Whether Ponte City’s former glory can be restored remains to be seen. Selling luxury apartments in the heart of a suburb where visiting the corner store for a carton of milk can get you killed will be tricky.
Half a minute down the road in Yeoville the traffic is backed up and we use the breakdown lane, our red and blue lights bouncing off the vehicles we pass. Under a freeway overpass we pull up behind a police van and see the officer in lane two standing over a young man lying face down, illuminated by the headlights of a late model Mercedes.
‘Lucky he missed the poor lady’s car, nice Merc that one,’ jokes the policeman. A woman in the front seat dabs her cheeks with a tissue.
I look up. The overpass is a good 20 or 25 metres high. No wonder the patient is groaning in agony. I’m surprised he’s even conscious.
Behind me The Leopard approaches with our gear. Seems the case has inspired him to show me what he’s made of. Or maybe the siren of our back-up ambulance wailing towards us has compelled him to act.
The policeman helps by manually stabilising the patient’s head. Calmly the Leopard scissors off the man’s shorts and T-shirt to expose him for a better examination. He slips a wide-bore IV into the cubital fossa without blinking and throws me a bag of Hartmann’s solution.
‘Five minutes on scene or we get docked,’ scoffs The Leopard. ‘Patient’s got an open-book pelvis with jelly legs, but it’s all about those five bloody minutes.’ He shakes his head and I know what he means. Time to hospital is the essence in trauma, but proper immobilisation, effective analgesia, cautious extrication and transport strategies will all, in the long run, reduce morbidity. Only by working the road can one truly appreciate ‘time’ as but one factor among many upon which an ambulance service should be judged.
Once the line is clear of air I connect and open it for a bolus. The Leopard double-checks the blood pressure, palpating seventy systolic. Falls from great heights often cause serious pelvic fractures like this, lacerating vessels internally and resulting in massive blood loss filling body cavities. This, in turn, can lead to absolute hypovolaemia – a condition of low blood volume – that could prove fatal.
‘Keep the fluids going wide open, we’ll shut it off at ninety systolic. Don’t go over ninety, got it?’
I nod.
