Skopje is littered with the evidence of better times. This city was a base for Alexander the Great, the birthplace of Mother Teresa, the place made beautiful in the Byzantine era and under the Ottomans. It was still beautiful on the day before the earthquake of 1963 when 90 per cent of the city was flattened. Rebuilt by Yugoslavs with a concrete obsession, Skopje became something else and then, when communist rule ended between 1990 and 1992 (and Yugoslavia broke up with Macedonia claiming independence in 1991), the money for public works dried up. Once grand fountains ceased their squirting but still remain as concrete eyesores in every empty plaza. City gardens are knee-high in grass and weeds, pavements are fractured or caved in completely and a whimsical Socialist-era fun park on the edge of town has not changed in forty years. As for the Macedonian dress sense, everyone appears to be clothed in drab and mismatched garments they have quite conceivably selected from suburban charity shops while blindfolded.
Three months earlier in Sydney, my paramedic partner and I were called to a woman originally from Macedonia now living in a small flat crammed with imposing floral lounges, a woman who felt the need to phone our emergency ambulance for what she described as a ‘burning tongue’. There is, of course, no documented protocol for such a complaint, but as far as we could gather her tongue was not alight, nor did it look particularly red or swollen or suffering the effects of hot curry or chilli pepper or any other such thing. What we did observe about her, however, was a level of nervous tension that commonly precedes inexplicable symptoms like this and is more often related to mental rather than physical origins.
As a lover of Balkan music I knew a little about the Roma gypsies residing in Eastern Europe, many in the small country of Macedonia, a country of just two million people, landlocked by Greece, Bulgaria, Serbia and Albania. What I didn’t know was that Macedonia is also host to the largest community of gypsies in the world, most of them living in a ghetto – or maalo – known as Shutka.
After the burning tongue I got to thinking about where on earth it might be appropriate to call ambulances for such a complaint. And although people call for some pretty interesting things just about everywhere, my mind persistently returned to Macedonia. Eager to explore not only the blood-and-guts of my industry but the varying cultural peculiarities that affect it, I booked a ticket.
There are two reasons why Macedonian ambulances are always snug in the front seat. Firstly, both doctor and nurse sit beside the driver. That’s three in a row. Secondly, most medics at Skopje 194 have a considerable girth, for which the Macedonian diet is clearly to blame. Here, a meal without yellow cheese is considered inedible, even fresh salad is topped with it. Nevertheless, winters in Skopje can be nasty and the cuddly warmth of a colleague is always welcome.
While all the drivers are male, most of the doctors and nurses are not. Unlike many ambulance services that struggle to attract female recruits, in Macedonia ladies run the entire show. Dr Maja Poposka, the surprisingly young and attractive director of the service is fond of black power suits and high heels, and is a stark contrast to the legion of women she commands who mostly have the attitude and build of lady prison guards. Even in their white scrubs, wooden clogs and dainty black doctor bags, these women could suffocate the toughest male paramedic in their fathomless bosoms. They bark at their patients in voices deepened by Marlboro Reds and give every physical indication that they mean business.
For the weekend of the 2010 Saint Nicholas holiday I have submitted to being the plaything of a lively lady doctor with a black beehive and cherry-red lipstick. She is known simply as Dr Aquarius and she calls me Benja. Dr Aquarius is assisted by a nurse named Snezhana Spazovska who has several sparkling diamantes set in her front teeth and painted fingernails so long she needs five precious minutes to get them into latex gloves. Sammy Rudovski is our driver, has been around a decade or two, and knows the drill. Generally he keeps quiet. Like all the ambulance drivers he is permitted to wear casual clothes, and on this festival night is decked out in a three-piece denim suit. None of them is happy about being on shift while the rest of the country is celebrating.
Like the sound of witches round a cauldron, regular cackles of laughter emanate from the front cabin. The witch analogy is not about evil spells, but rather the wicked sense of humour they share with ambulance workers worldwide.
Just over the river, in the shade of the ancient Kale Fort, we pull up and Dr Aquarius slides back the perspex peep window.
‘Benja, we have a heart problems!’ she shouts.
I appreciate her informing me, as the usual indication I get that we have been given a job is when the ambulance suddenly careens into oncoming traffic with the cry of a siren, throwing me off my seat. Riding in the back like a pet dog is not my idea of a good time. There are few windows and it’s hot, stuffy and claustrophobic.
After a few minutes we move back and forth between apartment buildings; down the driveway of one, reversing up again, going around in circles. Most blocks are identical to one another and confusion is common. When we finally find the address Sammy has picked it by little more than a tiny number scrawled on a wall in white chalk.
Dr Aquarius leads the ascent up a graffiti-sprayed stairwell to the eighth floor carrying her little black doctor’s bag containing a blood pressure cuff, stethoscope, her leopard-skin purse and cigarettes. When I see her do this I lament the many backbreaking years I have lugged every box and piece of equipment to top floor apartments without cause.
By the time we reach the fifth level with three to go, nurse Spazovska is gasping loudly behind me. Like a commando in the jungle, Dr Aquarius motions with her hand for us to stop. We pause a little for Spazovska to catch her breath, and she’s no picture of health. Her heart and lungs are shot by years of relentless fagging, her arteries clogged with Macedonian cheese. Needless to say, performing this job on a regular basis in a city of apartment blocks without elevators ought to keep her in better shape.
By the time we reach the patient’s door, Snezhana Spazovska seems close to respiratory arrest. Our patient, on the other hand, is calmly sipping a cup of tea. There must have been a mix-up, he says. He made it very clear to the call-taker that what he had done was slam his finger in a door. There’s no question that slamming a finger in a door is painful, but calling an emergency doctor and nurse to apply an ice pack hardly seems reasonable.
It surprises me this one has slipped past the control room at Budapest Hospital. When I sat with them a week ago I’d become convinced that only the meanest nurses were assigned to work there. Every second emergency call received would have them abusing the caller for not being sick or injured enough to warrant an ambulance. Phones were continuously slammed down in the ears of helpless victims as services were refused outright.
Nurse Spazovska is pale and sweaty and can barely speak. She leans over the patient’s glass coffee table while Dr Aquarius – who no doubt has seen this all before – rubs her back. Just for a moment I wonder whether I’m witnessing some drama created to give the man with his bruised finger a demonstration of what a real sick person looks like.
‘I … my … is … tachycardia,’ Spazovska splutters.
It’s bad news when someone with shortness of breath speaks like this, catching air between each word.
Her heart is doing double-time when I take her pulse, convincing me she’s genuine enough. Meanwhile the guy with the finger looks on with confusion. Despite our offers, Spazovska refuses medication and we patiently wait ten minutes for her to regain her composure. A recovery of sorts is made but it’s no way to be starting a night shift.
Macedonia is a guarded nation with a great suspicion of outsiders and not many places have had me feeling more like a foreign agent than Skopje. No one gives much away here.