Paramédico. Benjamin Gilmour

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 all like to work in our chosen careers, but decent heating and square meals are the only way to get through winter, and Kass, my then girlfriend now wife, needs a new woollen coat. Still, I wish we had chosen Barcelona over London when deciding on a city in which to base ourselves for a few years of European exploration.

      It’s colder than deep-sea diving off Alaska. Even with the windows up and my green fleece zipped tight I feel like an ice sculpture. We drop the patient off at his five-star nursing home – quite literally ‘drop’ as Henry claims he ‘wasn’t ready’ with the head end of the stretcher at the moment I called ‘one, two, three’. I’ve come to expect this kind of thing when Henry is way past his fried chicken and chips time. It will be his third lot in a single morning. Another of his shirt buttons is sure to pop before the day’s end.

      We park at a Harley Street corner so we can make a rapid response to the next boring transfer. As the rain thunders on the window, I watch Henry munching fried chicken, getting it tangled in his scraggly ginger beard and dropping it down the front of his uniform. In fact, his uniform is already stained from previous fried chickens. With a belly like that there’s only one place falling chicken tends to land.

      ‘So, you is telling me you once got a hundred quid tip off a Arab?’ he says as he eats, displaying the contents of his mouth.

      ‘Yeah, Kuwaiti royal family.’

      ‘Kuwai-i royal family?’ he licks his lips, looks annoyed. ‘I neva got nufink offa tha Kuwai-i royal family. Took one of ’em in too, I did. Had a hip done, he did. But tha Kuwai-i royal family never looked arfta Henry, did vey.’

      I sigh and glance at my watch, wondering what the Kuwaiti royal family would have thought about an ambulance stinking of fried chicken, driven by a maniac.

      ‘Mate, you know we got a Arab later on,’ says Henry, ‘four-firtey in from Heafrow …’

      ‘An Arab, Henry, it’s an Arab.’

      ‘Yeah, dats wot I said, a Arab.’

      Worst thing about having an ambulance with a broken stereo is that it forces one to listen to a partner chewing fried chicken and using bad English in England.

      ‘Well,’ I reply, ‘it’s nearly two o’clock, and you know the traffic.’

      Henry knows the traffic all right. This is part of the problem. He loves nothing more than to plan his day so that unless we use our lights and sirens we’ll be late to every appointment and pick-up. This is because, quite frankly, he loves to use the lights and sirens. When I first met Henry I spotted him right away as a wannabe paramedic who never made the grade. Being an ambulance driver is a little boy’s fantasy as much as being a train driver or bus driver. In most emergency medical systems, however, ambulance drivers must also use clinical skills normally reserved for doctors. This naturally excludes a good number of candidates, Henry included. Society is full of disappointed men and women who have longed to drive ambulances from the age of five when they spent each day constructing matchbox car crashes and sending matchbox ambulances to the scene. Recruitment departments of public emergency services are perpetually inundated by such applicants and spend half their time palming them off.

      The only other qualified paramedic working at the company was fired from the London Ambulance Service for visiting a Kensington barbershop while on duty. When I heard this I told him it sounded like unfair dismissal. Medics are normally permitted to visit coffee houses and corner stores in their catchments so long as they can quickly respond. Why not a barbershop? I mean, how long does it take to throw off an apron, brush down a uniform and go out with half a cut? Not long at all. If anything, the gentleman’s commitment to looking sharp and tidy in the workplace should have been commended. As much as I’d prefer it I’m never assigned to work with him. Our boss wants one qualified medic per wagon. And apart from the two of us, the rest are a bunch of fantasists who recently discovered a community college somewhere outside London conducting a five-day first-aid course they believe allows them to use the title ‘paramedic’. Never mind it took me four years of study to earn the same. While I don’t bother wearing anything at all to identify myself as one, these men could not be more decorated. From emergency service catalogues they have mail-ordered paramedic insignia of every description. Cloth patches, embroidered epaulettes, shiny badges, clip-on pins, reflective vests and so on, all emblazoned with the word ‘paramedic’; one ambulance driver is so covered in pins and badges he looks like a walking Christmas tree.

      Then there is the gear. While I have trouble locating my stethoscope most days, these men have got every imaginable utility dangling from their belts. There are Leatherman knives, wallets for gloves and scissors, phone holders, torches of various sizes, rolls of Leucoplast, radio holsters, mini disinfectant dispensers, rubber tourniquets and various other oddly-shaped black pouches containing everything but handcuffs. All these are attached for the prime purpose of looking as much like a paramedic as possible, or at least how they imagine a paramedic must look. This I find most entertaining and wonder how I’ve managed to do the same job for so long with nothing on my belt but a buckle.