The Gap by Benjamin Gilmour

During a summer in Sydney, Australia, paramedics Ben and John face daily tragedy while both dealing with personal struggles. "The Gap" of the title of this book is both a scenic outlook in Sydney where suicides occur frequently and a metaphor for being on edge, the story much like a real-life version of Bringing Out the Dead but with a sense of humor. 

I enjoyed Paramédico by Gilmour and was excited when I heard the author had written another book about his experiences as an "ambo". It took me a long time to acquire a copy of The Gap but it was well worth the wait. Funny, moving, at times shocking and sad, the book is a testament to the courage, compassion, frustrations, danger, and other immense challenges paramedics face daily. 

Highly recommended - Stellar writing. I love medical memoirs (especially about emergency medicine, thanks to my early obsession with the TV show Emergency!) and books about such things as emerging diseases, so The Gap was right up my alley. I have, in fact, a collection of EMS books and I think Ben's writing is by far the best I've read. He takes you to the scene without going too far into detail about the gruesome and disgusting side of patient care, focusing instead on the emotion of patients and those that care for them. 

Trigger Warning for frequent descriptions of depression and suicide.

My review of Paramédico

Note: The Gap does not yet have a US publisher and I knew about its release because the author told me about it. It took a while to find it at a price I could afford but if you're interested and you're in the US, I got my copy from Book Depository. 

©2021 Nancy Horner. All rights reserved. If you are reading this post at a site other than Bookfoolery or its RSS feed, you are reading a stolen feed. Email bookfoolery@gmail.com for written permission to reproduce text or photos.

Bringing Out the Dead by Joe Connelly - book and movie

"Frank, she's got chest pain."
"She's got everything," I said. "Ma'am, what does the pain feel like?"
"I don't know."
"Is it like a pressure?" Larry said. "Is it like an elephant sitting on your chest?"
"Yes," she groaned.
"Is it a fluttering pain," I said, "like a bird flying in your chest?"
"Yes."
"Or a burning pain, like eating lit matches?"
"Yessss," she cried.
"She's got the yeses," I said. "Not much you can do for that."

~p. 59

At night the walls went up and the gates came down and the fear chased everyone inside, except for those who spread it, those it caught, and those, like me, brought in to witness.

~p. 134

Bringing Out the Dead by Joe Connelly is a backlist book, published by Vintage in 1998. I've had it on my shelf for so long I don't remember where or when I acquired it; but, my recent paramedic reading binge had me thinking I should give it a go. And, wow, am I glad I did. As in any book that describes emergency medicine, there are a few graphic scenes that may turn a stomach or two, but Bringing Out the Dead is just . . . it's deep, man.

Frank Pierce's first three years as a paramedic were oddly magical, but now he's burned out. He's been a paramedic working in New York's Hell's Kitchen for a private ambulance service long enough that the ghosts of those he couldn't save follow him everywhere. A young asthmatic teenager named Rose is particularly tormenting Frank, who was unable to intubate her before it was too late. He calls her, "The girl I helped kill". And, a man who should have died but whose heart Frank restarted because he had no choice but to keep doing CPR until the doctor gave approval to stop haunts him. Burke's body is shutting down; he will never return to consciousness and Frank knows it, the doctors know it. But, the family doesn't understand, so every time the man's heart stops the doctors and nurses must resuscitate a man who is never really coming back.

Frank's wife has left him, his boss keeps promising to fire him but won't because the service is short-handed, and Frank is oddly mesmerized by Burke's daughter, Mary, although he knows the good news she desires will never come. What will happen to Frank?

I read a few reviews when I finished reading Bringing Out the Dead and I have to agree with the people who said it's less a book with a definitive plot than a "slice of life". The reader accompanies Frank, feels his pain, watches him treat his patients and sees his ghosts, observes as he drinks himself into oblivion and then, when Frank takes a risk for a patient whom most might think undeserving of life, observes the moment when Frank thinks he is going to die on the job and . . . well, has an epiphany, I guess you could say.

I love the fact that as the book progresses you realize that Frank's not just losing his mind and addicted to alcohol for the sake of killing the pain, he's also addicted to his job.

What I loved most about Bringing Out the Dead:

The dark humor, the theme about learning to live with your ghosts, the peek into the emotional aspect of a job that is stressful, worked mostly by people who are both adrenaline seekers and deeply caring individuals. That second quote, above, is so profound. Sometimes all they really can do is bear witness.

Highly recommended - This book absolutely would not let go of me. I finished it and went straight into a whopper of a slump. Beautifully written, deeply affecting, sometimes graphic and more than a little scary, Bringing Out the Dead is about burnout, addiction and learning to live with the things that haunt you (equally applicable to paramedics and the rest of us, thematically). You will come out of the reading feeling a little nervous about whether or not the people charged with keeping you alive are okay because pretty much all of the characters in Bringing Out the Dead are a little crazy. But, it will also make you think about life and death and where the medical establishment should draw the line when it comes to resuscitation.

Of course, I had to see the movie version of Bringing Out the Dead. I like Nicolas Cage; he's one of those actors who does crazy and depressed, hysterical and suicidal equally well. He was, in fact, excellent as Frank Pierce and I liked the movie. Since I'd read the book not long before I watched the movie, I recognized lines that were taken directly from the pages of Connelly's book and knew when things were altered.

I was disappointed with the ending of the movie. In the book, the final scene is metaphorical. It explains -- through something that can't possibly really happen -- that Frank has decided that in order to go on he must live with his ghosts rather than fight them. It's a stunning scene and it's not in the movie. The ending of the movie is okay; it's just not as meaningful. Still, I liked the movie and I'm glad I watched it. But, it's the book I'll return to. Even as I was reading Bringing Out the Dead, I was thinking about how much I'd like to reread it in the future.

Interesting side note: Joe Connelly had only one other book published. Bringing Out the Dead was a bestseller; Connelly's second book was a flop. In fact, I can't find any information about Connelly at all, beyond a Wikipedia entry that tells absolutely nothing about what's become of the author since the publication of his second book. I hope he's alive and happy and writing poetry on a beach, somewhere.

©2014 Nancy Horner. All rights reserved. If you are reading this post at a site other than Bookfoolery  or its RSS feed, you are reading a stolen feed. Email bookfoolery@gmail.com for written permission to reproduce text or photos.

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.

©2014 Nancy Horner. All rights reserved. If you are reading this post at a site other than Bookfoolery  or its RSS feed, you are reading a stolen feed. Email bookfoolery@gmail.com for written permission to reproduce text or photos.

Minis - My Custom Van by Michael Ian Black, Atlas (poems) by Katrina Vandenberg, Rescue by Anita Shreve

This is quite a varied set of books. None of them were sent to me for review. One was a gift, one purchased and I won My Custom Van in a Twitter giveaway.

I had no idea who Michael Ian Black even was, when I won My Custom Van -- I just quickly looked him up and thought, "Yeah, I could stand a laugh," and signed up for the drawing. 

Five years passed before I got around to reading My Custom Van and I have mixed feelings about it, but I knew I was going to at least like it when I read the "Foreword by Abraham Lincoln." Essays include "One Day, I'm Going to Open a Scented Candle Shoppe,"which reads like a short story with a surprise twist ending and, "Hey, David Sedaris -- Why Don't You Just Go Ahead and Suck It?", an essay that is surprisingly complimentary to its subject. "Taco Party" reads like a story written by a high school kid trying to show off his coolness by peppering the description of his upcoming party with foul language. My favorite line: "You can't f***ing swim in guacamole!"  

Like a lot of comedians, he can end up in bad language, sex-laden, yucky territory and that makes it easier for me to foist upon the son who asked for it in 2009. It just feels like it's meant for the younger crowd. I did, however, accidentally laugh a few times, so . . . Recommended for those who don't mind off-color humor.

Atlas (Poems) by Katrina Vandenberg was a Christmas gift from my wonderful blog buddy Chris and reading about how to read poetry must have helped because the first time I picked it up, I couldn't get into it. The second time, I absolutely loved it. 

Vandenberg was in a long-term relationship with a man who contracted AIDS through a blood transfusion during the days before blood was screened for HIV. He was a hemophiliac. She was a Fulbright fellow in the Netherlands. These two major events -- the loss of a partner to AIDS and time spent in Netherlands -- informed her poetry with images of blood and tulips. 

There were a few poems that made little question marks hang over my head, but for the most part I found Vandenberg's poetry lucid and raw, about love, pain and beauty. I had to look up at least one Dutch painting she mentioned (always fun to have an excuse to go a-googling) and appreciated the learning experience. I will definitely be watching for more by Vandenberg. Recommended to poetry lovers. 

Rescue by Anita Shreve was, like the two books above, a book that I happened across while working on organizing my personal library. I had just finished reading The Paramedics within a week of finding Rescue and it seemed a fitting follow-up, a contemporary fiction read about a paramedic, the love of his life, and the daughter he fears he may lose to her mother's addiction.

When Peter pulled Sheila from the wreckage of a car, he could smell the alcohol, so he knew it was crazy (and, definitely unethical) to get involved with her. But, there was something about her that drew him back, again and again, till they ended up married with a baby. 

In the present day, his daughter Rowan is floundering. She's always been happy and well-adjusted but now she's acting out. The knowledge that her mother was an alcoholic leads her to numb her own fears by drinking heavily, herself. Can Peter reach Rowan before it's too late?

I read a few reviews of Rescue because I was curious what people thought about the paramedic action scenes. The book is Peter's story, about how he loved and lost his wife and has carefully raised his daughter but then realizes he is losing her, too. Because Peter is the hero, there are quite a few scenes from his working life. I loved that. Having just read a history of early EMS, I enjoyed reading updated scenes to see how things have changed. But, many readers had a problem with the abundant use of rescue scenes. They were in it for the usual Shreve fare and found his work uninteresting. My only problem with Rescue was the fact that I thought there were a few too many life-threatening accidents involving his family and Sheila was an unlikable character. Otherwise, I found the book entertaining.

Recommended if you like reading EMS action scenes with a touch of family angst. Atypical for Shreve but well-researched. I didn't like Sheila but I did admire Peter as a human, if not his choice in women, and I cared about Rowan. 

©2014 Nancy Horner. All rights reserved. If you are reading this post at a site other than Bookfoolery  or its RSS feed, you are reading a stolen feed. Email bookfoolery@gmail.com for written permission to reproduce text or photos.

The Paramedics by James O. Page

The Paramedics by James O. Page
Copyright 1979 
Backdraft Publications 
Source: Author

This is probably the weirdest way I've ever read a book and the story behind it is rather an interesting one. The short version: someone put me in touch with the author, who loaned me one of the 6 remaining copies of The Paramedics from his personal shelves and gave me permission to photocopy it for my own use. I returned the original to the author and put the copied pages in sheet protectors then snapped them into a three-ring binder. 

Jim Page died in 2004 so it's been quite some time since my first reading (and I'm pretty sure I didn't finish reading The Paramedics, the first time) but I was reminded of the book because my exercise time falls during reruns of Emergency! on MeTV and the author was a consultant for the TV show.

The Paramedics is a history of Emergency Medical Services in the U.S. The portions dedicated to the current state of emergency medicine in the field are well and truly outdated, of course, but the book is still of interest to anyone curious about how paramedics came into being. I first read The Paramedics in the late 90s and didn't remember a thing, so I found it surprising in many ways.

Emergency medicine in the field (meaning, emergency response for needs of regular citizens, as opposed to the field medicine of military practice during war) really began as a response to the need for quicker cardiac care when cardiologists discovered that minutes could mean the difference between life and death for heart attack victims. Treatment expanded from cardiac care to other emergency needs, like trauma, as it became apparent that trauma was another area in which time saved lives. But, EMS was very much a regional thing -- both in method and level of training -- that varied dramatically from one place to another; and, it took quite some time before the creation of national standards.

I found a few facts particularly fascinating. One is that most of the early paramedics were firefighters but in at least one case it was policemen who were the first EMS trainees and sometimes private ambulance attendants received training while cities or counties lagged behind. I also found it fascinating that some private ambulance services (previously burly men in white coats who merely loaded and carried patients to the hospital for a fee, like a cab service for the infirm) fought tooth and nail to prevent EMS becoming a branch of their local fire services because they feared a major loss of business. Eventually, it became apparent that private ambulance services could actually profit from switching to non-emergency transport, which was and still is needed.

It was also interesting to find that the same problems that plague paramedics today (burnout, back injuries, abuse of the system by citizens who hoped for a free bus ride, so to speak) were a problem nearly from the beginning of EMS.

There is a bit of background information about Emergency! in The Paramedics but the focus is on real-life events. I actually have a booklet that Jim Page wrote about the show, specifically, but I have no idea what's become of that.

Recommended but almost impossible to find - A fascinating look at how Emergency Medical Services originated. The Paramedics used to be in hot demand amongst EMS professionals (I don't know whether or not that's still the case) but it's long since gone out of print and it is nearly impossible to locate a copy.

I noticed there's one rating at Amazon. The reader says he bought his copy for $99 and sold it for $249. Whoa. And, his opinion was, "It was too much like it was screaming 'look at us'."  The Paramedics was written when the whole concept of EMS was still a very new and shiny thing so I didn't really have any problem with that undercurrent of pride, although I do agree that Page was not a brilliant writer. He was solid enough, in my opinion, and the fact that he was present at the beginning gives the book a nice, personal touch. Also, where else are you going to find photos of paramedics wearing bushy mustaches and plaid pants?

©2014 Nancy Horner. All rights reserved. If you are reading this post at a site other than Bookfoolery  or its RSS feed, you are reading a stolen feed. Email bookfoolery@gmail.com for written permission to reproduce text or photos.