Fiction

Paul’s first day

PAUL WAS ALWAYS the first person to be killed. I met him at his practical exam. The trainees were waiting for their names to be called.

Scenes of carnage outside – trainers lying around pretending to have broken legs, blocked airways, bleeding organs. Trucks parked at unusual angles, planks piled up like sculptures: the set of a theatrical catastrophe. Whenever I supervised the trainees I remembered my first exam. It was uncanny how real it felt. I could almost smell the burning rubber of braked tyres, the smoke from a chemical fire. As I knelt down to check an airway my hand would shake; I would convince myself a life was ebbing away in front of my eyes. Once I was about to simulate a glucagon injection. The trainer, who was supposed to be unconscious, coughed. I was so surprised I dropped the syringe. The trainer was kind. I went to pick up the syringe and she moved her shoulder slightly, to make it look as though I was checking her vein. I don't think I'm quite so merciful.

I looked out the window to see if they were ready for the next group. I sometimes felt as though I was releasing the trainees into Dante's Inferno. Walking into their own version of hell – an incorrect diagnosis and this one would be destined for the swamp water, that one for the flaming tomb. The way trainees behave in a simulation is very similar to the way they will behave on the job. The exam was not only a test of their practical skills. It was a chance to be shown their weaknesses, to have their fears dragged to the surface. The waiting room was quiet: the silence of young people about to confront themselves.

‘Bugger, my thumbs have gone numb.'

We all turned. Paul was looking at his hands as if he'd just discovered them. My first impression was that he was all arms – gangly things that made him look like a plasticine man. ‘My thumbs sometimes go numb when I'm nervous.' He looked around at the other trainees as if they were lifelong comrades. ‘Does that happen to anyone else? No? Just me, then.'

He clenched his hands a few times, then started wringing them, shaking tension out of the room. Some of the trainees smiled. I'm not known for my improvisational skills but for once I had an idea.

‘Here, give this a go.' I had a hand strengthener in my pocket, a device I often carry to improve my rock-climbing grip. I handed it over.

‘Cheers – you're a life-saver.'

Paul worked the strengthener furiously for a few minutes. His name was called. He stopped at the door, grinned and gave us all a double thumbs-up. I burst out laughing. It was the first time I'd let my guard down with the trainees. I felt as though I'd transgressed.

The next day Paul would make a special visit to the station to give it back to me.

‘So, how were the thumbs?'

He rolled his eyes. ‘Mate, the thumbs were fine. My brain was the problem.'

As Paul walked to this first exam it was the end of my shift and another supervisor came to take over. I stayed, curious to see how this young man would perform. Paul was waiting while another trainer explained the scenario, his body poised. The trainer told him to go. Paul instantly summed up the scene. He was able to take in the big picture, to make a lightning assessment with the information available, to develop a split-second action plan. Many trainees go straight to stemming blood – Paul was one of the few who didn't hesitate to check the airway. I watched him triaging. He might look goofy in everyday life; at work he was elegant, moving from one procedure to the next with the grace of a dancer. But he had one major flaw.

He forgot to check his own safety.

I watched all his exams; it was always the same. He would rush ahead with his brilliant instincts, hurdling fences to make a short cut, creatively digging a tunnel to get an oxygen mask to a trapped patient. In doing so he would forget the oncoming truck, the balancing pipe, the dangling wire. As I got to know him I realised it was due to his optimism, his belief in a benign universe. He just couldn't accept that the truck might not stop, the pipe might fall, the wire might not have switched itself off. After the first exam the trainer put his hand on Paul's shoulder.

‘Your skills are undeniable,' the trainer said. ‘But you've just died five times. You've been electrocuted, burnt, decapitated, gassed and probably run over.' He shook his head. ‘Pauly, that's got to be some sort of record.'

I watched Paul hang his head, and thought of my own mistakes. Mine would always come from caution. I would never be killed for a flash of contextual genius – I would never risk protocol and my own neck to make a rash decision. We envy people their talents; I think that was the first time I realised we can also envy their faults.

I often think back to the first time I met Paul. I'm not sentimental – at least I don't think I am – but once I left that bloody hand strengthener at a camping ground and drove three hours non-stop there and back to retrieve it. I'm not overly talented at getting to know people – most of the time I'm surprised when people want to spend time with me. For once I made the overture, stepping outside my awkwardness to make contact. I suppose the reason I've kept the strengthener is self-congratulation. A reminder that I had the sense to recognise a great friend.

 

‘THIS WOMAN IN the street told me I'm a problem-solver,' Paul said. It was Paul's first day as a probationer. He had worked as a trainee at another station for a year and had now moved to the next level. I swear he jinxed me that day. It is common for me to receive at least one job a month where I come out feeling like a bit of an idiot. This time we received three in a row. Afterwards Paul would joke that I'd set the jobs up, manipulated the system to make his first day more enjoyable. If only I had that power.

Paul closed the ambulance door and did up his seatbelt. I thought I'd give him some practice driving around, let him familiarise himself with the Blue Mountains before the first job came in. I learned quickly that Paul loved to give a running commentary of his life. Documentaries he'd watched, jokes he'd been told, books he'd read. On this first day I was treated to his summary of an Agatha Christie murder mystery. Paul's favourite detective was Miss Marple, the elderly spinster. She would solve mysteries by comparing the murders to little problems in her village – the arsenic murderer reminded her of the grocer who stole the pickles; the axe murderer, of the housekeeper who raided the vicar's petty cash. One day I found Paul in the kitchen trying to cheer up a tired colleague who had her head resting in her arms. She was a nice girl but I could see she had reached a level of exhaustion that transcended politeness. She turned her head.

‘Paul, no more Miss Marple. Please. I just don't have the energy.'

We drove leisurely down a hill, trees lining the street like spectators watching us in a parade. Paul moved from Miss Marple to a conversation he had that morning. ‘So yeah, this woman was selling books and she stopped me to chat. I think she belonged to one of those religious groups. Anyway, I asked her a few questions and she said she could tell I was a problem-solver. It's funny how people can tell things just by looking at you, isn't it?'

‘Did she also say you have an open face?'

‘She did, actually!'

‘Did you buy the book?'

‘I did.' He turned the ambulance slowly around a corner, an old beast making its way back home.

‘Paul, she says that to everyone. It's her spiel. She tells everyone they're a problem-solver as a selling technique.'

‘Maybe.' We stopped at the lights. Paul was so absorbed in the conversation that he didn't notice the light had turned green. A man from behind honked and Paul gave him a friendly wave. ‘Or maybe she only stops the people who really are problem-solvers.'

‘Possibly.'

The first job came through on the radio. I asked Paul if he was ready. He nodded solemnly, turning on the siren. This first job was a possible cardiac arrest. I radioed for a back-up team. As we drove, all the normal things were going through my mind – starting to plan, preparing myself for Paul's nervousness. There was another voice talking away beneath. I always wanted to see the trainees do well, but I hadn't realised how badly I wanted Paul to do well on his first job. It was as if a mantra was going through my mind. Not a death. Please don't let his first job be a death.

We arrived. The front door was locked. I yelled out, and there was no answer. With a cardiac arrest there is no time to waste – seconds can make a difference. I told Paul I was going around the back, to see if I could find an open door.

‘And if not, do we ...'

‘Yep – break it down.'

I went round the back, quickly scanning for open windows. The back door was locked as well. I took a step back, preparing to kick it in. I thought Paul would wait for my instructions, not realising he'd take my silence as a go-ahead. I took a run up. As I kicked I heard Paul crashing through the front door. We both barrelled into the room and I had to jump over a cat that appeared at my feet. It was a good thing it was a large room, otherwise we might have sailed right past each other and out the opposite doors. A perfectly healthy-looking woman of about seventy was sitting on her lounge suite in the middle of the room.

‘Lordy,' she said.

We assessed the scene. The woman had called the ambulance complaining of chest pains, which we always have to treat as a potential cardiac arrest. It was more likely angina. She was hard of hearing; she probably hadn't heard me yelling out. I was about to apologise. Paul picked himself off, brushing off his trousers. ‘And that's just our warm-up routine!' he said.

We sat down to examine her. She had felt chest pains. Her son had, very sensibly, told her to always call an ambulance immediately if she had even the slightest pain in that area. I explained it was probably angina, but that we wanted to make sure. I also said it was a good idea for her to come with us to hospital for a thorough check-up.

‘Oh no, I don't want to cause any bother,' she said.

I cancelled the back-up team and asked Paul to take her medical history. I wanted to give him a chance to do it without prompting. The doors were a good excuse, so I told him I was going to check the damage. I heard him as I was leaving the room.

‘What's your name?'

‘Ellie.'

‘That's a lovely name. And are you taking any medication at the moment, Ellie?'

When I went outside the back-up team was there. They had dropped past on their way to the station in case we still needed a hand. Our colleague Jerry looked at my handiwork as he was leaving. ‘You moonlighting as a renovator, Daniel?' I waited for a decent interval, then returned. Ellie was sitting forward in her seat with an expression of great interest. Paul was settled comfortably back into the lounge suite, waving around a biscuit as he talked. ‘Yeah, and then someone suggested paramedic training and it was weird, because my mum had always said I was quite good in an emergency, so I thought -'

‘Sorry, am I interrupting?'

‘Oh, right!' Paul snapped forward to take the rest of Ellie's history. He told her again it would be a good idea to come with us, just to make sure her condition wasn't more serious.

‘No, I really couldn't. You boys must be very busy.'

I felt a familiar frustration, the presence of an old foe. So much of the job involves fighting fear – it is always fear that hides behind politeness, behind the cheerful ‘she'll be right' attitude. We couldn't force Ellie to come to hospital; I knew it would take a great deal of cajoling to convince her to change her mind, if we even could. I was about to bring out all my stale arguments, the feeble weapons of logic and rationality, when I saw Paul staring at a painting on Ellie's wall.

‘Is that a Bruegel print?'

‘It is! The Tower of Babel.'

‘Thought so.'

I GAVE PAUL a questioning look behind Ellie's back. He ignored me. ‘You know, there's a print at the hospital and I've never been able to work out if it's a Bruegel. I keep meaning to check it out but I'm always too busy. Tell you what – if you come to the hospital, you can tell me if it's a Bruegel or not.'

Ellie paused. I could see Paul's smile was hard to resist. ‘All right. But I promise I won't take up too much of your time.'

We got our woman to the hospital and handed her over to the nurse. ‘This is Ellie,' Paul said, preparing to give her history.

Ellie smiled up at the nurse. ‘And this is Paul. He has such interesting stories.'

The nurse put Ellie in a wheelchair and we walked with her to the triage room, past the painting. Ellie asked the nurse to stop for a moment. She studied the painting. She turned to look at Paul over the top of her glasses. ‘Young man, that looks absolutely nothing like a Bruegel. It's not even the same century. It's a Vermeer.'

Paul grinned. ‘Well, I'm not much of an art critic then, am I?'

She laughed and the nurse took her away. We walked back down the corridor. I stopped for a look. ‘I didn't know you were into art.'

‘I'm not. There was a big book on her coffee table about Bruegel. Lucky guess.'

‘Bit unorthodox, wouldn't you say?'

‘We got her to the hospital, didn't we?'

‘Fair enough.'

The next job came in. This time it was to an infant who'd had a fall. It didn't sound serious but with children there is always a scary prospect. Not a kid with a spine injury. Don't let his first day have a kid with a spine injury.

We arrived and could instantly see the fall wasn't serious. The child was active and alert. We prepared to take the child to the hospital for a check-up. The mother insisted on a neck brace. I refused. The child definitely didn't need a neck brace and I was worried the act might cause more damage. I knew from experience that it was almost impossible to get a neck brace on a distraught two-year-old without first giving medication – we might as well try to lasso a wild horse. The mother was adamant. I prepared for a fight. As I started my spiel Paul went out to the ambulance; he came back with three adult neck braces, two children's neck braces and a teddy bear, which we use to comfort children during their journey.

‘Daniel, could I try something?' It was exactly the right thing to say, deferring to my authority so I wouldn't lose face in front of a patient.

‘Sure.'

He knelt in front of the girl, scratching his head. ‘I've got a little problem and I was wondering if you could help. Teddy's hurt his neck. We need to put a bracelet around his neck, but he's frightened. You can see that Teddy looks frightened, can't you?'

The girl nodded, her eyes wide, instantly forgetting her own fear. The mother moved forward, worried the girl might be hurting her neck by nodding. I held out my hand, signalling for her to wait.

‘I thought that if we all put on bracelets, then Teddy might not be scared anymore. Do you think that might help?'

The girl nodded again.

‘Would you like to hold Teddy while I put on your bracelet, to show him how to be brave?'

Paul handed the teddy over and the girl held it tenderly, unconsciously imitating her own mother. ‘Don't be scared, Teddy. You'll be fine.'

While the girl was comforting Teddy, Paul gently slipped on the child's brace. I could see a flicker of panic come into her eyes as she felt the material around her neck. Paul quickly picked up the next one. ‘Will you help me put this on Teddy?'

‘And Mummy and the nice men will put them on, too,' the girl's mother said. So we rigged up a bloody neck-brace production line until we were all secure. I wanted to take off the brace once the girl was in the ambulance, but the mother wouldn't hear of it. We arrived and started transporting the girl in a stretcher, still wearing the braces. Jerry passed on his way to another job, raising his eyebrows. ‘Must have been one hell of an accident, boys,' he said.

We got the girl safely inside. The nurse was one of my favourites, with a knack for calming down families. We left with the mother looking relieved. I gave Paul a light pat on the back. ‘Good work.' We walked back down the corridor. ‘Oh, and Paul?'

‘What?'

‘You can take off your brace now.'

The third job came in. By now I was starting to feel as though we'd stepped into some sort of folktale, that the next front door we walked through might transport us into another world altogether. From what I could make out from the radio message, someone had been injured at the local poetry reading. It was a notorious event – a monthly session at the pub that always seemed to involve more drinking than poetry. It sounded as though one of the poets had been hit on the head by a sharp object. I suppressed a sigh as I closed the passenger door. Not a poet with a head injury. Spare us both a poet with a head injury.

The reading was over by the time we arrived. A few people were still having heated discussions at the bar. The stage was empty save for the injured poet and his friend. They had reached the morose phase of drunkenness. The friend gave us a brief rundown. The poet had been reading on the stage, punctuating some of the lines with vigorous gestures. He jumped heavily on the stage, dislodging a print in a heavy frame. The print hit him on the head. His friend explained that it was a copy of an engraving by the mystic poet William Blake. ‘Who says art isn't dangerous?' he muttered to Paul.

We examined the poet. He was huge – over six feet, built like a wrestler. I felt as though I was in a recurring nightmare. Once again it didn't seem serious; once again we wanted to take him to hospital for observation. He refused to budge. ‘I'm walking forward into my own death,' he said.

I suspected he had a mild concussion and shock. When people are in that state they often fixate on one idea. I handballed to Paul.

‘Come on, mate – let's just get you down to the hospital.'

The poet shook his head. ‘I'm walking forward into my own death.'

‘Looks to me like you're just sitting in your own injury at the moment. Come on – let's get you down to the hospital and get you checked out.'

Again the poet shook his head. ‘I'm walking forward into my own death.'

The repeated phrase suggested he might have serious concussion. I was also worried that the combination of drunkenness and shock might make him turn nasty. I was fairly confident Paul and I could handle him, but I didn't want to find out. I kneeled beside the friend. His eyes were closed. I shook his shoulder and asked him if he knew what the poet was talking about.

‘He thinks he was cursed by William Blake when the painting fell on him. He thinks his immediate future has been foretold. He thinks that if he moves one inch he'll be...'

‘Dead. Right.' I looked across at Paul. ‘Any ideas?'

Paul thought for a minute. ‘I've got it!' He clicked his fingers, a strategy to get the poet's attention. ‘We'll reverse the curse. You can walk backwards.'

The poet looked at him with suspicion. ‘What?'

‘Well...if you walk forwards you'll be walking into your death. If you sit here you're in limbo. But if you walk backwards you'll be travelling into your past and you'll cancel everything out. You can walk backwards to the ambulance, sit backwards when we're driving and walk backwards to the hospital. You'll reverse the curse.'

‘Reverse the curse?'

Paul nodded. ‘Reverse the curse.'

Paul could see he found the little rhyme soothing. The poet thought for a minute, then shrugged his shoulders. ‘Sounds logical.'

Halle-bloody-lujah. We got on either side, helping him to his feet. The belligerence I'd worried about erupted. He pushed us away and started roaring. ‘Who are these people?'

His friend, still on the floor, opened one bleary eye. ‘They're physical manifestations of your psyche. The one on the left is your id and the one on your right is your superego. You just have to integrate them into your ego and you'll be fine.'

‘Oh, cool.' His relaxed, letting us take hold of his arms. Well done, friend.

Paul and and I looked at each other. We both appreciated the fragility of the poet's calmness. Without speaking the three of us walked backwards to the ambulance, Paul craning his neck to keep watch. Paul sat with him, the two of them facing backwards. This time when we passed Jerry on our way into the hospital, he just shook his head. ‘I'm not even going to ask this time.'

It was my favourite nurse again. Paul briefly explained the situation.

‘He thinks he's been cursed by who?'

‘William Blake.'

The nurse shook her head sympathetically at her patient. ‘Oh rose, thou art sick!'

The poet nodded vigorously. ‘That's it, that's it!'

The invisible worm / That flies in the night...Has found out thy bed / Of secret joy. Thanks, guys.' The nurse smiled at Paul and pushed the poet backwards down the corridor, quoting Blake all the way to the triage room.

I grabbed Paul, pushing him into the kitchen so he wouldn't hang around to ask the nurse out. I wasn't in the mood for romance.

The rest of the shift passed without incident, the two of us driving around the mountains with Paul happily musing on the day's events. Our shift ended and we took the ambulance back to the station.

‘So – how did you find your first day?'

Paul nodded. ‘Pretty good. And who knows – tomorrow I might actually get to treat an injury!'

‘You did well, though.' We checked the equipment in the ambulance, a simple housekeeping duty that aided the transition back to the everyday world. ‘Looks like you really are a problem-solver. Miss Marple would have been proud.'

For the next few months Paul slowly built his reputation as a skilled probationer. One day I had swapped a shift and Paul partnered up with Jerry. Paul had a death that day. A young girl who drowned in the family's swimming pool. I have never quite forgiven myself for not being with Paul at that job. Paul's work was exemplary and Jerry wasn't shy about telling everyone how well he had performed. Paul had seen death before in his role as a trainee but never a patient so young, never one he treated directly. I could imagine the horrible journey back to the hospital – Paul working furiously, even though they both knew the girl was gone.

My shift started soon before Paul's ended. I was at the hospital just as Paul came back from the job.

I saw him walking back from the triage room. I was going to ask if he wanted to come over to dinner. His head was down; he didn't see me. He suddenly stopped near the window, looking over his shoulder. I moved quickly into an alcove.

In that part of the corridor there is an optical illusion. You only notice it when your head is held a certain way, when your body has a certain posture. Light reflects off something outside – a tree perhaps, or part of the building – to make it look as though a form is behind your left shoulder.

When Paul turned I knew what he was thinking. It was something every paramedic in the station has thought, an unspoken initiation as inevitable as the first mistake, the first success. I knew Paul would probably take some time off, go bush for a few days. He would turn up on Monday, noticing a colleague's new haircut, teasing the cleaner about his defeated football team. For now, I knew why he couldn't look at anybody as he walked out.

He thought the girl had passed him.

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