Paramédico. Benjamin Gilmour

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      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 СКАЧАТЬ