The Application of Pressure

by Rachael Mead

Genres: General Fiction

Synopsis

For paramedics Tash and Joel, a regular workday is like a supercut of the worst days of other people’s lives. They maintain their sanity through a friendship built on black humour, but as the constant exposure to trauma takes its toll, both, in different ways, must fight to preserve their mental health and relationships - even with one another. How much pressure can they handle, and what will happen when they finally crack? With each chapter revolving around an emergency - some frightening, some moving, some simply funny - Rachael Mead digs beneath the surface of gore and grit to lay bare the humanity of emergency services personnel and their patients. This breathtaking novel reveals not only the trauma of a life lived on the front line of medicine, but also the essential, binding friendships that make such a life possible.

Release date: May 26, 2020

Publisher: Affirm Press

Print pages: 253

Sample

PRAISE FOR THE APPLICATION OF PRESSURE

‘The Application of Pressure is the book we all want: a delicate story with blood and guts. Mead follows a pair of star-crossed ambos from training days across decades, living through their chaotic nights, listening in as they tell their stories to each other while they wait for the next call. Each section of the book works like a koan, reflecting on the siren-and-lights speed of life while slyly revealing the tender parts inside of the characters – and inside us.’

Steven Amsterdam, author of Things We Didn’t See Coming

‘On the surface, this is a darkly humorous novel about life in extremis on the emergency frontline; scratch a little deeper and this is a story about what it really means to take care of one another. There are scenes in this novel, by turns hilarious and chilling, I will never erase from my memory. It’s all there – blood, gore, sex, love, mental illness, and bodily fluids – but Rachael Mead doesn’t turn away and neither will her readers. With the lightest of touch and an unflinching insight into those that hold the fabric of our world together – our frontline health workers – Mead has written a book for our times.’

Molly Murn, author of Heart of the Grass Tree

‘An authentic, original tour of the mean streets of human suffering from the perspective of a pair of ambos, learning as they go, especially about themselves, all threaded on a kind of slow-burning 20-year-long half-conscious love story, written with a poet’s ear for language, and a novelist’s unsparing eye for both the dark and the darkly funny flip-sides of the human comedy.’

Peter Goldsworthy, author of Maestro

‘The Application of Pressure is genre defying, wildly entertaining and a beautifully rendered study of human beings under immense pressure. Rachael Mead takes us to the front line of human folly and misfortune with compassion, insight and an unflinching poetic eye. The wail of a distant ambulance siren is changed forever; few writers could manage a novel as original, tender, riveting and funny. The Application of Pressure is the work of a remarkable storyteller.’

Rebekah Clarkson, author of Barking Dogs

‘This is an extraordinary novel. It is unique in its subject matter but universal in its themes. It examines our relationship to bodies and minds – our own and those of others. It shows us what happens when the frailty of either is exposed, and it explores what it means to be a witness to that frailty. Mead’s writing is beautiful and precise, and there are layers of humanity in a single scene. I was frequently moved, and occasionally humbled into acknowledging my own prejudices and fears. Mead tells us how it is to be a paramedic – there is no euphemism, no sugar coating – but she does it with such compassion and humour that there is never a need to turn away. In fact, I couldn’t put it down.’

Pip Williams, author of The Dictionary of Lost Words

‘This novel is a brilliant-cut gem, shot through with luminous prose, bleak humour, pain, keen observation, dialogue so true you instantly know its people, and slow burning love. A masterpiece.’

Margaret Morgan, author of The Second Cure

Joel

1997

When his training officer asks if he’s seen a dead body before, Joel says no. The lie is such a reflex that it’s a long second before he registers that it’s not the truth. Joel shoves open the passenger door of the ambulance and climbs out before slamming it with equal vehemence, hoping Carl wasn’t watching his face.

The alley is crowded with crime-drama clichés: anxious neon graffiti, corroding dumpsters, and a cluster of police and paramedics whose reflective badges flash like predators’ eyes in torchlight. It’s only the heady stink of urine and rotting Thai food that makes the scene feel real.

The lights from the police patrol at the alley’s mouth splatter the dark walls with staccato bursts of red and blue. Tash is already at the far end of the alley, her tall, uniformed figure squeezed between her training officer, Giuseppe, and a fetid dumpster. Joel wonders how many of their classmates will be marched into this tiny backstreet for the same impromptu lesson before the coroner’s officer arrives. He threads his way towards Tash, the GORE-TEX of his brand-new paramedic jacket making a loud synthetic swoosh each time he brushes the arm of another officer. Tash tilts her chin in greeting, then turns back towards a doorway in what would usually be the gloomiest corner of the alley, now lit by the beams of several Maglites. It’s not until Joel peers over her shoulder that he sees the body.

It looks nothing like the other one. This is a young white guy, his skinny frame emphasised by his baggy black hoodie and loose jeans. One of his grimy sneakers, the colour of old chewing gum, is unlaced, the frayed end lying in a puddle that Joel hopes is rain but suspects is piss. He’s slumped on the step, his back against the door, one sleeve pushed up and his works in a tumbled mess by his hip. His hood is up so only his chin is visible, and Joel can’t tell if his eyes are open.

Joel senses the two training officers watching him so he tries for a poker face, hoping the effort isn’t obvious. Carl and Giuseppe have probably laid bets on how their students will react: who will freeze, who will cry, who will make a stupid joke or poke the corpse with a stick. Tash looks composed, but Joel notes that her quiet greeting was the only moment she took her eyes off the body. The safe money’s probably on her to take it in her stride. She’s been top of their class from the first week. Not as a kissarse teacher’s pet, but in that quiet, diligent way of clever women who think they need to be twice as good as the men to be considered equal. Joel doesn’t think this is the case, at least not anymore, but he’s smart enough never to say this aloud, especially in front of a woman he wants to ask out.

Carl turns to the two students, his torch beam sliding away from the dead guy’s hooded face to spotlight a smear of mud on the left knee of his jeans.

‘Hypothetical. You’re first on the scene, how do you run it?’

Joel sees Tash straighten her shoulders, and he jumps in before she can speak. ‘Check for consciousness, then whether the airway’s clear since ODs sometimes vomit, then see if he’s breathing.’ He’s about to continue when he feels Tash’s boot press into the side of his. She angles her head away, looking up, then into the shadows and corners at the back of the alley.

‘But of course, only after I check the scene for danger – hidden assailants, physical threats, that sort of thing,’ Joel says, pressing his foot back against Tash’s in what he hopes she takes as a thanks.

‘Nice save,’ says Carl.

Giuseppe huffs in a way that makes it clear Joel’s fooled no one. ‘Then what, genius?’

‘Circulation,’ says Joel. ‘Check for a pulse. If he had one, I’d draw up some Narcan to counteract the heroin that I’m assuming he shot up, from the look of his gear and the track marks on his arm.’

Tash crouches next to the dead man and looks at his face. She reaches towards his bare forearm, which is lying palm-up on his thigh. Just as she is about to touch his skin, she catches herself and looks up at Giuseppe. ‘Can I?’

He hesitates for a split second, then says, ‘Sure,’ but Joel thinks this is more because he wants to see what she’ll do than because it’s okay.

Tash runs her fingers across the skin of the forearm, then gently picks up his arm and pushes the sleeve of the hoodie further up, the black fleece bunching at his bicep. She brushes her fingers over the track marks as if reading a history of addiction in the braille of injection scars.

‘It’s not just the coolness or the lack of pulse … it’s weird; you can tell there’s no blood pumping under the skin. It’s inert. Like dough or something. Feel it.’

Joel is torn. It’s a dead junkie, for fuck’s sake. And he really doesn’t want Carl and Giuseppe to think he’s a psycho who gets off on touching dead bodies. He knows he only passed the psych test by some quick talking in the final interview. But he doesn’t want to leave Tash hanging either. She’s the person he likes the most in the class; she has a grin as open and wide as a farmer’s and a stride that says she never wears high heels. After a long second, he steps forward and crouches beside her.

She’s right. The guy’s flesh does feel like cool, doughy plastic. Now he’s level with the guy’s face, Joel can see the eyes. They’re open. His lashes are pale, and in the torchlight his irises are a cool, clear grey. It looks as if the junkie’s staring straight at Tash’s stomach, the light from the police cars flashing red and blue across the glossy sclera of his eyes.

‘Huh. They do look just like they’re sleeping. Well, he would if his eyes were closed.’ As soon as it slips out of his mouth, Joel realises he only wanted to say something, anything, to divert attention from the fact that he’s just voluntarily touched a dead junkie.

Tash looks at him. It’s that blank, even expression he recognises from the faces of girlfriends when he’s said something catastrophically stupid. He never fully grasps the issue with what he’s said, but he does know that it heralds a break-up, usually within the week.

Tash stands up, leaving him crouched there with the corpse.

‘Not all dead people,’ she says to Joel’s back.

Carl wedges himself into the ambulance driver’s seat, the steering wheel impinging on his gut’s personal space. He twists the ignition far enough to start the heater without the engine turning over.

‘So, grasshopper, what’s your takeaway from that experience?’

Joel clenches his fists on his thighs as potential answers crowd into his head. The effectiveness of Narcan is time-dependent? Shooting up alone in an isolated environment is inadvisable? That he’s inexplicably offended the girl he’s interested in?

‘Death is part of the job?’ It’s his best guess at what Carl wants him to say. He tries to deliver it as a statement but hears his voice rise on the final syllable.

‘That was a gentle introduction for a first DOA. No blood, no insides on the outside. No kids or animals.’ Carl checks to make sure Joel is listening. It’s started to drizzle, and the neon of Hindley Street bleeds down the windscreen. ‘People think this job’s all about saving lives and being the hero. Sure, that happens, and when it does you’re flying, so make the most of it. But really, everything we do, it’s all just delaying the inevitable. We all end up like that kid eventually. All we can hope for is that when it happens we’re in our own bed, preferably in a fug of post-coital bliss.’ Carl cranks the ignition, and Joel feels the ambulance’s rumble through his feet. ‘The most important things are pretty simple. Don’t kill anyone. If you don’t know what to do, always choose the least-worst thing. And don’t let the job kill you.’

Joel frowns. ‘You mean how I fucked up back there by forgetting to check the scene for danger?’ Maybe that’s why Tash blanked him; she didn’t recognise his attempt to acknowledge her help in the alley?

Carl sighs, checks the mirrors and pulls away from the curb, easing the ambulance into the fragile quiet of the 3am city. ‘No, numbnuts. I mean not letting the job get on top of you. Have someone to talk to. Friends, co-workers, counsellors. Find yourself a partner who’s not squeamish. There’s no shame in fishing off the company pier. I’m on wife number three, and if I knew at your age what I know now, I would’ve gone for an ambo straight off the bat and not ended up fat, depressed and crippled by alimony.’

Joel shifts in his seat. The thing he most wants Carl to teach him is how to deal with the ethics of desperately wanting to put his new skills to use, despite knowing this means actively hoping for a disaster to befall some random stranger. At this moment, though, all he wants is to be stretched out on one of the beds in the station’s sleep-on room and to not have to hear any more about Carl’s ex-wives.

Carl swings off West Terrace onto Wakefield, heading back to the station and the warm comfort of a Jason recliner. ‘Roll on seven o’clock. I’ll sleep like a dead junkie tomorrow.’

The face of Joel’s first dead person didn’t look like she was sleeping. Joel remembers repulsion slithering in his gut as he stared down at her. The lush jungle surrounding them was so unbearably close and humid that he felt cling-wrapped in sweat. His truck tour in central Ghana had stopped in the remote village for lunch, and some of his fellow travellers had wandered over to investigate the brightly dressed group of people clustered in the churchyard. Under an awning of woven palm fronds, a mature woman lay in a polished coffin, two women on either side fanning large leaves over her exquisitely dressed body. Crazy Susan had asked their guide how they could pay their respects, and the group of travellers had bowed their heads as one of the attendant women said a prayer. Joel had avoided Susan for most of the trip, assuming that a middle-aged woman travelling alone must be pathetic or weird, but at that moment he’d been grateful that she’d taken the lead. It shocked him, the dead woman’s face, and the fact that her body was just lying there in the open, with the heat and insects. Apparently, she was a queen. Joel wasn’t quite sure what that meant in West Africa, but the village had delayed holding her funeral until all her children could fly home from America and Europe. The villagers laid out her body each morning for people to pay their respects, her intricately embroidered dress and headwrap looking bright and freshly laundered despite the nightly storage of the coffin in the coolroom of a restaurant just down the road. The routine hadn’t done her face any favours. Joel clearly remembers the dead woman’s skin not fitting over the cheekbones like it should, and that one of the women repeatedly sprinkled the body with water out of a used plastic bottle of Revlon Lottabody, texta on a strip of masking tape rebranding the bottle ‘holy water’. He made a joke about it later. Crazy Susan looked at him with a flat stare before coolly stating that unlike other, more enlightened, societies, Western culture minimised exposure to death, shielding people from the unavoidable fact of their mortality. He’d turned his back on her, nastily mimicking her to his friends, but now he thinks that when he sees Tash next, perhaps he should try saying something along those lines. Maybe if he tells her about the queen, she’ll open up to him about what she meant by not all dead people.

The radio comes to life, frantic static underscoring the calm voice of the dispatcher. ‘City 171, cardiac arrest, Halifax Street.’

As Carl speaks into the mic, confirming they’re en route, Joel feels quietly rebuked by this paunchy middle-aged man’s energy. His own reaction on hearing the call had been dismay. Probably another dead body. Great. Joel lets his head sag back onto the headrest and closes his eyes as Carl flicks on the lights and sirens, filling the ambulance with the sound of urgency.

‘Here we go, grasshopper. Let’s raise the dead.’

Joel

2000

‘When I look at a pigeon, all I see is a failed owl,’ Joel says through a mouthful of Filet-o-Fish.

‘Not everyone needs to be an alpha.’ Tash shoots him a pointed grin and pulls the ambulance out of the drive-through. As they bump across the gutter and onto the road, Joel holds his Coke aloft like he’s making a toast. Tash is staging a one-woman boycott of McDonald’s, so finding something she’s willing to eat on night shift makes every crib break an exasperating expedition through the suburbs. It’s been a slow, wet shift; Joel’s looking forward to getting into the warm station-house and cranking back the recliner.

‘Did you see they’re opening applications for special ops? Are you going for it?’ Joel screws up his burger wrapper and reaches into the paper bag for his fries.

Tash laughs. ‘You’re kidding, right? A, I couldn’t do a chin-up to save my life and B, like I said, not everyone wants to be an alpha. A woman could choke on the fog of testosterone in the special ops crew room.’

‘I’m starting training for it on Monday.’

‘Great. Then you won’t be dragging me through every fast-food hellhole we pass each shift.’

They’re at a red light on Sudholz Road and Joel’s just shoved a handful of fries into his mouth when a woman pulls up beside them in a crappy, vomit-toned Corolla. She waves and makes frantic circles with her fist.

Joel swallows hard, the mass of fried potato lodging in his throat. He thumps his chest and coughs, trying to clear his airway. ‘I think we’ve got a live one.’ He hits the button to lower his window, and Tash cranes to look past him at the woman in the car.

‘My friend’s tried to kill herself. She just called me. I jumped straight in the car but now she’s not answering her phone. She’s just around the corner. Can you come?’

Joel glances at Tash. She shrugs and gives a small nod, so he signals at the woman to drive ahead. The Corolla tears away from the lights with a cough of exhaust. Tash pulls into the woman’s smoky wake while Joel picks up the radio.

‘Campbelltown 181,’ he says. ‘We’ve been stopped by someone who wants assistance. Will keep you informed.’

The Corolla winds through several side streets before pulling into the driveway of a house that looks like it’s constructed from Lego. It’s separated from the street by a postage stamp–sized lawn that screams rental property. The house is completely dark.

The woman runs to the front door while Tash calls in the address and Joel gathers the kits. The door must’ve been unlocked; the woman’s nowhere to be seen as they cross the dandelion-studded lawn. By the time they flick on torches and enter the doorway, she’s already running back towards them down the dark hall.

‘Quick – she’s in the bathroom – she’s slit her wrists.’

It’s Joel’s turn as attending officer, so he takes the lead and picks his way deeper inside, heading for the only light in the house, which is coming from a door midway down the hall.

It’s a bathroom, and splayed across the pale-blue tiles is a tiny, unconscious woman who is the spitting image of Lucy Liu. Despite it being winter, she’s lying on the cold tiles in a white bikini. There’s an empty bottle of shiraz lying near her outflung hand.

Not wanting Tash to catch him gawping, Joel puts down his kit, kneels beside the prone woman and turns her wrists to the light. She’s made a half-arsed attempt at slashing the insides of her forearms, the cuts superficial but plentiful, and there’s blood smeared the length of her arms and on the floor. To Joel’s eye, she either didn’t mean business or was too drunk to do the job properly. She doesn’t smell particularly drunk, though. Normally, the breath of patients who’ve drunk themselves into a stupor hangs in the air like petrol. Also, tiny as she is, it seems unlikely that she’d be unconscious from just one bottle of red. Now that he can see she’s in no danger of bleeding out, he starts his spiel, chatting to her in his non-threatening, talking-to-children-animals-and-unconscious-people tone.

Back in training, they learned a couple of ways to work out if someone is truly dead to the world or if they’re faking. One is to rub knuckles really hard against their sternum. It’s not pleasant. The other is to press a pen into the bed of a nail cuticle. This is equally unpopular. Both the sternum rub and nail-bed press will make anyone who’s conscious flinch, even if they’re determined – for whatever bizarre reason – to play possum. It’s a mark of extreme willpower to suppress that ‘what the fuck?’ wince.

As Joel reaches towards the woman’s sternum, he feels Tash’s presence in the doorway behind him and pauses awkwardly. He remembers that going for the cuticle is actually the protocol. If you try a sternum rub on someone who’s on the brink of consciousness, chances are they are going to lash out. They’ll clout you just as you’re leaning over them, possibly off-balance or, if the patient is in a white bikini, distracted. Joel feels a mix of relief and gratification that he’s both following the rules and avoiding one of Tash’s trademark eye-rolls.

Lucy Liu takes the cuticle press without a wince. Joel gets out saline solution and a large dressing, and begins wiping the blood from her arms so he can see which cuts need most attention. The bathroom is tiny, so Tash remains stuck in the doorway, unable to do more. . .