Paramédico. Benjamin Gilmour

simply ‘crash’. Adrenalin is, after all, a type of high. It creates euphoria and for this reason people engage in all manner of dangerous activities to pursue it. But like every other high, it is only high because it is preceded and followed by a low and ambulance workers are by no means immune. Indeed, some even orchestrate drama in their private lives to maintain their adrenalin levels artificially.

      It was about this time in the meeting that Boban Vivovski, the humpty-dumpty fleet manager, entered the room and said something to Poposka that didn’t please her at all. A shouting match ensued. She slammed down her diary with an almighty slap, pushed her swivel chair out and chased Vivovski into the corridor. The door slammed shut behind her. Outside the room the argument continued, punctuated every now and then by a loud thud, as if one or both of them were whacking the wall or throwing the other against it. All I could do was remain in the shade of her indoor tree, quietly embarrassed, listening to them blowing up outside. For the CEO and her fleet manager to behave this naturally in front of me was surely an honour, though I would have been less concerned were it not the day after a Macedonian doctor at one of Skopje’s main hospitals stabbed her fellow doctor seventeen times in a fit of rage. On the television they said she had a ‘brain snap’. As the scene of this stabbing played out in my mind while listening to the yelling in the corridor, I swallowed hard.

      When Dr Poposka came back into the room, unscathed, she sat down and let out a sigh, giving me a measured smile.

      ‘It’s not only the gypsies who are passionate peoples. Anyway, I would rather yell at my fleet manager than at my road staff. You will never hear me yell at ambulance teams. They work hard and don’t deserve it. They are my friends and I always take a cigarette with them. Without their respect I can achieve nothing.’

      One day, when Dr Poposka is tired of her position, she would consider working the road again and wants to be sure her legacy as director will not make her unwelcome there. As for the conflict among her management team, she insists it is ‘a type of love’. In my opinion she is suffering from plain and simple adrenalin withdrawal. For a former ambulance doctor there is a clear excitement deficit that comes with a management position and the office environment. Yelling matches and fist-fights are, one could say, the methadone of adrenalin withdrawal.

      Evidence of the Roma’s Indian origins can be seen on walls we pass in the ambulance, white painted designs identical to those I have come across in small desert villages of Rajasthan and Gujarat.

      We follow two boys running towards the Shutka bazaar clutching trumpets. Their eyes in our headlights are wide with excitement. The smell of barbecuing lamb wafts through the open windows of our ambulance and in the distance we can hear the sound of a brass band playing. When we reach the intersection of the bazaar a large crowd of gypsies surrounds a group of men on horns and drums. Slowly we edge the ambulance through a throng of scruffy kids with bleached spiky hair and gold chains dancing wildly. Their look is hip-hop but their moves are pure fireside Bollywood.

      ‘This will be us at 3 am,’ laughs Dr Aquarius. Snezhana Spazovska giggles and Sammy yelps the siren and waves at the mob. Some of the kids whistle in return and drum their hands on the ambulance as we go by.

      ‘We are now going to village in the hills,’ says Dr Aquarius. ‘The sun is down. You know what it means when sun is down on festival of Saint Nicholas?’