Istanbul Graveyard Shift

Ambulance at Night

I’m uncertain when the jadedness began, or how it so fully engulfed me. It was surely a gradual process, spread over many years and countries.

When I first began traveling, nearly everything I experienced was revolutionary in some way. I clearly remember my first trip out of the US, to the Bahamas, when I was six. Until then my universe had been only Oklahoma and Texas.

But as time passed and borders added up, I somehow began to lose my original energy of discovery.

I remember finally reaching the pyramids when I was 25 and feeling tired, and hot, and not really all that excited. The pyramids of my imagination were far more interesting than those that stood before me. Reality seemed to diminish them somehow. The same thing occurred at Troy, and a few years later at the Taj Mahal.

It wasn’t that the historical significance and beauty of these sites was lost on me, but that the experience of them did not measure up to what the experience was supposed to be. Sightseeing bored me. Museums bored me. Comfort and luxury bored me. Backpackers bored me. It felt I was no longer gaining much from conventional travel. I needed something new. I needed a different way of experiencing a place. I wanted to begin getting under the surface of cultures by experiencing them at their most vulnerable.

It was for this reason that I found myself squished between three paramedics in the front seat of an Turkish ambulance at 1am en route to pick up an old man who’d tumbled down a flight of stairs somewhere in the outskirts of Istanbul.

We were stuck in an alleyway, trying to squeeze past a parked truck. The driver kept reversing, banging on the steering wheel, revving the engine, and trying to inch through again.

I had no business being there. I had no medial qualifications, and the only person I knew in the ambulance was Dr. Derya, whom I had met a few months ago in a bar and had talked into letting me accompany her on a few of her graveyard shifts.

The driver began to reverse again, but Dr. Derya stopped him and reached over and flipped on the siren, then laid into the horn, honking it over and over again until a man ran out of the building to move the truck.

“This driver is awful,” Dr. Derya said to me in English as we drove away. “We’re in the middle of an emergency and he can’t even realize to snap on the siren. He’s not even qualified to drive an ambulance. He used to drive a dolmus. That’s all. He’s too old for this work.  Sometimes he even falls asleep while he’s driving.”

Seated quietly between Dr. Derya and I was a nurse wearing a purple headscarf. It is forbidden in Turkey for employees of the secular state to wear headscarves, so her attire was technically illegal. But the rest of the staff weren’t exactly in uniform either: the driver was wearing slacks and a sweater vest and Dr. Derya was in a jogging suit.

My presence in the ambulance was also illegal. When asked, Dr. Derya would explain it away by saying that I was a medical student from the United States doing an internship.

We pulled out of the alley and merged onto the main avenue, the driver blinking, shaking his head to remain awake. The streets were almost completely docile — just a few old men standing around smoking under orange streetlamps and the occasional drunk. The only shops still open were the neighborhood bakal markets, who rarely shut business down for any reason, day or night, and the male barbershops.

Across town, we pulled up to an apartment building whose vertical column of five windows were all lit up internally. We rushed up the inner spiral of stairs with tackle boxes of medical gear, passing on each floor an open doorway of concerned faces, then through the fifth-floor door into a cramped little apartment filled with people.

A line of women all headscarved and wearing ash-colored trenchcoats were clasping their hands over their mouths and biting their fingers as the men beckoned us towards the back hallway, where an old man was slumped over on the ground, heaving, sweaty and delirious, only semi-conscious, with vomit down the collar of his undershirt.

It was my second night on the shift but I still wasn’t used to bursting so suddenly into people lives. I had unusual feelings about it from the beginning. I was intruding at the most intimate and vulnerable moments, seeing harried, emotionally distraught families, and, in this case, the patriarch of the household weakened to a feeble child by his illness. And yet there I was, a stranger, a foreigner, bursting into their homes in the middle of the night, and nobody even questioned me.

We dragged the old man into a room and splayed his body out. Dr. Derya lazered the beam of her mini torch into the pupil of his one open eye, then took his blood pressure. She told someone to get her some lotion and told the women and children to leave the room.

“Not you,” she said as I followed them. “You’re supposed to be a paramedic. Help me roll him onto his hip.”

The man groaned as we turned him. Dr. Derya unbuckled his belt, tugged down his pants and lubed up her rubber-gloved index finger. The men in the room looked away, ashamed, and the old man grunted and jerked as Dr. Derya slid her finger into his ass.

“Checking for blood,” she told me. “Old men with blood in their ass may mean they have cancer.”

She withdrew the finger to check the result, then shot something into his arm. He went limp and we lifted him onto a soft stretcher and began carrying him down the steep wooden stairwell, struggling and groaning under his weight. At one point we dropped his feet and he nearly fell out. When we finally got him into the ambulance, he began moaning again.

He stared up at me with one open eye the whole ride to the hospital.

Turkish Ambulance

Back at the ambulance station the subject of conversation was transvestitism.  Dr. Derya and I were lounging on sofas across the room from each other, the lights dimmed, the emergency radio turned to a low murmur. Beyond the window blinds I could see the outline of men smoking and pacing on the steps outside the emergency room.

Dr. Derya’s was lying on her back, talking towards the ceiling. She told me she spoke with a ladyboy for the first time a few nights back. She’d met her outside Burger King near Taksim Square. She had been out drinking with friends on Istiklal when they saw her strutting back and forth, soliciting customers.

“I was sitting on a curb, watching her,” she said. “Then for some reason I found myself waving her over. I was drunk.”

They talked for a while, then Dr. Derya began asking her personal questions, mostly medical-related stuff about her body, such as whether or not she could still have an orgasm.

“Could she?”

She could, somehow, Derya said. The ladyboy explained how surgeons had transformed her penis into a vagina, retaining all the most sensitive nerves.

“After that my friends wanted to leave, but I wanted to ask her more questions. I invited her to dinner at my apartment. I told her I would cook her manti. I don’t think she will come though.”

After that we were silent for a while, listening to the faint sound of sirens in the night. Derya turned the radio very low, so low I have no idea how she could hear it.

I fell asleep and began having strange, cinematic dreams of Dr. Derya, who assumed dark, cynical but heroic characteristics — a handsome, furiously intelligent woman in total disagreement with society, a mad doctor racing through the midnight streets of Istanbul witnessing the most horrible crimes.

Somebody touched my arm. I opened my eyes and Dr. Derya was standing above me.

“We have a heart attack,” she said.

She banged on the closet where the driver was sleeping and we climbed into the ambulance. Minutes later the old man sleepily crawled behind the wheel, and we took off.

Almost immediately he fell asleep, swerving into the next lane, almost into another car, and Dr. Derya had to shout to wake him up.

We pulled off the highway and ramped a speed bump, which tossed us and all the equipment in the back into the air, then crept down a dark alley to another five-floor apartment building, where two men with a third draped over their shoulders ambled toward us.

We put the wounded man on the stretcher and pushed him into the ambulance. Derya put gummy stickers all over his chest and belly, wired him to a monitor, pushed all sorts of buttons, slid an IV into his arm and we took off towards the hospital. There was no cardiac unit nearby, so we had to drive all the way back to the emergency room where we were based.

The patient was a middle-aged bald man, his large, bare belly shaking and jiggling as we drove. I had been riding around in that ambulance for two nights, wearing my rubber gloves and surgical mask, my face hovering over the patients, but only then was my presence finally questioned.

“What’s he doing here?” the man asked Dr. Derya in Turkish.

“Relax,” she said. “Try to rest.”

I can only imagine what he was thinking. If only he had known that I was there to watch him deal with death… Not that I wanted him to die. I don’t really want anyone to die. But I wanted to see how Istanbullus behaved in their final moments. I thought it would help me better understand them, and dying in general. I thought I would understand more about humanity by witnessing death. All that fear, so masterfully concealed, finally emerging, and sometimes true courage.

I wanted to know if different cultures die differently.

I’d seen Americans deal with death. Americans are delusional when they die, finding it hard to believe death actually happens to them. As a culture, they hide corpses immediately. Dead bodies are no longer a part of life. Corpses no longer lie for three days in the lounge room. Duels and public executions are things of the past. Americans scream and struggle against death, and attempt to conceal all its signs in the body.

In Turkey, death is everywhere. Death is in the streets and in the poems. Everywhere are the ruined cities of dead empires. You cannot avoid it.

Nonetheless, riding around in that ambulance with a dying man staring up at me made me feel uneasy, and I was glad to hand him over to the cardiac unit.

Back at the ambulance station I showed Dr. Derya and the nurse a preview of Martin Scorcese’s Bringing Out the Dead.

They didn’t enjoy it. Too morbid, Derya said.

The nurse, who was surprisingly cheerful despite the fact that it was Ramadan and she had been fasting for over a week, told me about a Turkish TV series about paramedics called “Night Angels.”

Our next call was from a man who’d supposedly been stabbed in the eye. We rushed across town to the hotel parking lot where he was sitting, drunk and alone in the dark.

There had been no stabbing. The drunken man’s eye was swollen and his shirt was ripped and he was barefoot and there was blood on his shirt, but he himself was not bleeding. He’d only been punched in the eye. Derya told him to put some ice on it and we left.

Dr. Derya and I sat in the back with the medical equipment as we drove. She told me Turkish ambulances are paid for by the state, so basically anyone can call them, at any time, for free. That’s why there are so many on the streets. Her ambulance received most of the major cases because she’s an actual doctor, whereas some of the others contain only nurses.

Sometimes, when they call for only minor injuries, like the man with a swollen eye, Derya scolds them for wasting her time.

When we finally got back to the hospital, the sun was beginning to come out, and the paramedics for the day shift were in there making coffee.

“Sorry,” Derya said as we left. “No serious cases last night. Maybe tonight. Will you be coming back tonight?”

“I’ll be back,” I said.

We shook hands and walked off in opposite directions into the awakening streets of Istanbul.

Read in Bootsnall

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