Wednesday, August 27, 2014

Paramédico by Benjamin Gilmour


Paramédico: Around the World by Ambulance by Benjamin Gilmour
Copyright 2012
The Friday Project (an imprint of HarperCollins)
Originally published 2011 in Australia by Pier 9 (an imprint of Murdoch Books Pty Ltd.)
Source: Purchased

Cynicism among paramedics in Australia is so entrenched that Pip James, a former lecturer at the ambulance education centre in Sydney, used to insist her students write themselves a letter immediately after employment. This letter would outline the students' motives for joining the job, the way they perceived the profession and a description of the paramedics they hoped to become. The letters were then sealed and only opened again once they had returned to the school after a year on the road. As expected, the students squirmed horribly when reading their earlier sentiments. But many also learnt how insidiously tainted they had become.

It's easier to avoid cynicism, however, when patients present with genuine and pressing needs, when the service is not abused. Ambulance workers in the West generally agree that the level of disgruntlement in their job is directly proportional to the number of time-wasters they attend. When customers call for a lift to the shops, for a drink of water, for a blanket when cold, it's no surprise. If customers reserved calling ambulances for serious injuries and acute illnesses only, frustration and cynicism among paramedics would probably decline accordingly. 

~p. 164

The purchase of Paramédico was one of those cases of "One book leads to another." First, I came across my old copy of The Paramedics and decided I wanted to read it, again, because I've been watching old reruns of the cult classic show Emergency!  Then, I happened across Rescue by Anita Shreve -- again, whilst unloading boxes of books and organizing my home library. I'm not even quite sure how I came across Paramédico, to be honest, but since I purchased it from an online bookstore I'm guessing that I just happened to be looking up something entirely different and thought, "Hmm, I wonder if there are any new titles about paramedics." It's an old obsession; I have quite a little collection of books about EMS and a handful of novels with paramedic heroes.

Paramédico is quite different from the other books I've read because it's not just about being a paramedic and what it's like; it's about the experiences of a paramedic who traveled around the world working with other paramedics, doctors, nurses and some lesser qualified medics while, at times, filming them. There's a film by the same name. I have yet to locate a DVD that will work in the U.S. but you can purchase Paramédico on demand at Vimeo, so I may give in and do that. I really would like to see the film.

The book is absolutely fascinating, as much (possibly more) from a cultural perspective as the stories of field medicine in action. After reading The Paramedics, I'd been wondering what emergency medical services are like in other countries and I could not have chosen a more fascinating peek into the differences in how ambulances are dispatched and staffed, what supplies are carried, what is expected of medics by patients in different countries. Expectation was something I had not thought about, actually, that in some places the expectation -- of pain relief or the lack of it, for example -- is completely different. Can you imagine an American accepting a vitamin shot or a valium injection for just about everything? Isn't it beyond fathoming that there's a country where the ambulances carry no drugs at all? Valium, vitamin shots, no medication, a ride on a floating ambulance that makes you queasy but lacks disposable vomit bags . . . those are options in other places.

One thing that seems to be a constant wherever you go is abuse of the system, something that baffles me because the last thing I can imagine anyone desiring is a ride in an ambulance or a visit to an emergency room, especially for no good reason. I'd have to be near death to end up in either (that's happened once -- I was in bad enough shape that I have almost no memory of it, which is fine by me).

Paramédico begins with an introduction and a chapter about the author's first posting in the Australian Outback. After you get to know the author's Australian background, he takes you on a journey around the world with stops in South Africa, England, the Philippines, Macedonia, Thailand, Pakistan, Iceland, Italy, the U.S. (Hawaii) and Mexico. His travels took place over quite a few years and it's been a few years since publication, so things may have changed in some of the countries he visited; Gilmour does make that perfectly clear. But, you still get a unique perspective on various cultures that likely have not altered much. I think that's what I loved most about the book. It had the feel of a travelogue but from a unique perspective, that of each country's emergency services.

The biggest problem most readers will probably have with Paramédico is that you need a strong stomach to read some of the medical scenes. I have no problem with that, possibly because of the stories my father used to tell about his time as a Navy Corpsman on a hospital ship. The reality is another thing entirely, I'm sure.

Highly recommended - A well-written peek into EMS in 11 different countries. Medical professionals of all kinds will appreciate the stories of situations and treatment but it's the cultural perspective that really makes Paramédico an excellent book; and, it's very well written. If you can read about messy medical situations without getting queasy, it's a book that I highly recommend.

One note: The author is not particularly complimentary to Americans. That didn't bother me. I think it's good to read about what people think of us in other countries and to get an outside viewpoint of where and how we (or the politicians who represent us) may be causing trouble for others.

Is this the last link in my latest round of chain-reading? Nope, I noticed a couple other books I'm pretty sure I haven't gotten around to reading during last week's work on the library (both novels with paramedic heroes, I think). So, I'll keep sliding in an EMS read, now and then. It will be hard to beat Paramédico. I hope Benjamin Gilmour will write more about his experiences, in the future.

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